My heart is heavy after the recent suicides by Parkland teens, just one year after the school shooting that killed 17 of their classmates.  I am sure I am not alone in this.  Unfortunately, no community in the US is untouched by the loss of young lives.

We know that bereaved teens are at a three times higher risk for suicide, and this proves true clinically in my office each week.  We also know that this risk is much larger for those who have lost loved ones to death by suicide; I am unable to find any research on suicide risk after mass homicideAs a therapist who specializes in grief, loss and trauma, I am intimately aware of the nuances of suicidal ideation during the grief process which, as any bereaved person knows, lasts for several years at a minimum.  Most of my bereaved clients flirt with the possibility of ending their own lives at some time.  My job is to provide a safe place and trusted relationship to process these frightening aspects of both grief and trauma in addition to the sadness, anger, denial, and other more frequently talked about “grief emotions”. 

Yet this ideation reaches far beyond bereaved teens, and I also lay witness to this on a daily basis.  Today’s young people call themselves the “massacre generation”, the “mass shooting generation”, and the “Columbine generation”, and feel directly under threat either from others or themselves. 

The brave and thoughtful young people who seek therapy seem to bear the weight of a generation who live with the very real fear that their lives may be in danger or cut short.  For some, this sense of imminent threat and global grief creates a response in activism, but for many, particularly those without strong support systems, it creates a sense of nihilism.  As Dr. Hannah Schell states in her article for Vocation Matters (2019), “When the future looks bleak and your options seem severely curtailed, the view that nothing really matters can take hold.  Why bother planning for a future that may not come?”

This sense of hopelessness magnifies during times of grief, and often manifests in increased substance use, self-harm, and suicidal ideation.  Isolating forms of entertainment become appealing, such as obsessive gaming or binge-watching.  It also thwarts long-range planning, such as thinking of college, graduate school, or a long-term career or relationship. 

So here in Southwest Colorado and the Four Corners area, what can be done to help alleviate the suffering of these young people?  More importantly, what is being done?

After a dramatic rise in youth and teen deaths by suicide in both La Plata and Montezuma Counties, The Grief Center of Southwest Colorado has been expanding our services.  These include crisis response interventions after the death of students or school staff, grief groups at participating schools in Durango, Silverton and Cortez, and grief, trauma and resiliency sessions for teachers and school counselors in both La Plata and Montezuma Counties.  After the school shootings in Aztec, NM in December 2017, The Grief Center provided immediate support and aftercare through local youth service organizations including the Boys and Girls Clubs in both Aztec and Farmington.

 As valuable as the immediate interventions are, these services are generally requested for the first few days or weeks after a traumatic loss; we have a short but important climb in recognizing as a community that the needs of the bereaved go far beyond this timeline.  Often the reality of the loss and the impending hopelessness do not make themselves apparent until the survivor has been suffering with their great loss for more than a year or two. 

Of note, The Grief Center of Southwest Colorado is part of the ongoing effort to lower the occurrence of deaths to both suicide and substance use in our communities, speaking broadly to the fact that post-vention bereavement counseling is also prevention. 
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Sadly, these recent completed suicides by the two bereaved Parkland teens are not really a surprise.  We owe it to this generation, which I would like to see dubbed the “resilient generation”, to offer deeper and longer support after loss.

https://durangoherald.com/youth-suicide-in-la-plata-county…

Grief care a crucial support for the bereaved
Tye McClish used to spend a lot of time outside camping and hiking with his daughter, Lily, before she died by suicide when she was 13. He remembers her as a talented artist, who loved her horse.

"The hardest thing for me is there is not going to be any more pictures. There is not going to be any more memories,” McClish said.
The eighth-grader loved riding her horse, and she was a gifted artist who was always doodling.
“She had a huge smile and laughter. Even being depressed, she could light up a room with her laughter and smile,” her father said.
Lily had struggled with depression. She was bullied at school because she identified as a lesbian, McClish said.
However, the day she died, there was no indication that she planned to take her life, McClish said.
Shortly after Lily’s death, McClish started to attend counseling with Judy Austin, a grief specialist.
“I have never had this pain in my life before, and it’s not going anywhere. And for me, I’ve had to get comfortable with it in my space,” he said.
The regular counseling has allowed him to be more open with his emotions than he has ever been, he said.
For people who lose someone to suicide, grief counseling is important because they are far more likely to die by suicide themselves.
A study in the United Kingdom with 3,400 participants found that adults whose loved one died by suicide were 65 percent more likely to attempt suicide than those who lost friends or family members in other ways.
Youths exposed to the death of a classmate are also more likely to consider suicide and attempt it. About 14 percent of students exposed to suicide are likely to consider suicide themselves. While only 5 percent of those in the same age group reported considering suicide, a Canadian study found.
Grief can be isolating, and that is one way it can feed into a cycle of more suicides, Austin said.

The need for grief care is also a bit at odds with American culture, which tends to put the focus on getting back to normal and going back to work, she said. But sometimes, the bereaved don’t understand how big an impact a loss can have on them.
There is also a tendency to want to escape, cover up or fix difficult emotions across our culture, she said. But part of grieving requires acknowledging difficult feelings.
“We only gain resilience by knowing we can hold the depths of sorrow, despair, depression. ... It’s not permanent, we will always come out of it. But unless we have that lived experience and people around us have that lived experience, we don’t always know that,” she said.
Austin opened The Grief Center of the Southwest Colorado in 2007, and it became a formal nonprofit in 2015. The nonprofit provides grief counseling to anyone who has lost a loved one regardless of the manner of death or how much time has passed since the death occurred. Services are offered on a sliding fee scale.
Counselors from the center also visit schools, businesses and organizations when a death has occurred. This includes going to Durango School District 9-R schools to support staff and students after a death by suicide, Austin said
Initially, counselors comfort the bereaved, listening without judgment, and offer them a list of possible options for grief support they can seek later, such as support groups and therapy.

Tye McClish sought out grief therapy shortly after his 13-year-old daughter Lily died by suicide in 2017. Working with grief specialist Judy Austin has helped him to be more open about his emotions.

The Grief Center has had an exponential increase in the demand for its services over the last three years likely because of an increase in traumatic losses, such as suicides, substance-related deaths, homicides and car crashes, Austin said.
To react, the Grief Center plans to expand its services with a new satellite office that will open this fall in Bayfield Town Hall, she said.

LOSS Teams In many communities across the United States, volunteers who have first-hand experience losing a loved one to suicide are among the first to respond to a death by suicide, and they can immediately recommend locally available grief care to the bereaved.
This response model was started by Frank Campbell, the executive director emeritus of the Baton Rouge Crisis Intervention Center. He founded the first Local Outreach to Suicide Survivors Team, or LOSS Team, in 1998.
Before founding the team, residents took an average of 4.5 years to seek care at his center. With the new team, the average time to seek care decreased to less than 60 days, he said.
The trained LOSS Team volunteer is one of the most valuable people to respond to a suicide because their presence can help bring hope to someone who has just discovered or witnessed a suicide, he said.
“(The bereaved) look up at the person with the LOSS Team and they lock eyes with that person and, I mean, it is just that dramatic. And they routinely say, ‘Oh my God. You know what I’m going through,’” Campbell said. “What happens in that moment I describe as the installation of hope.”
He was initially unable to start the program in Baton Rouge because the coroner was concerned about the potential contamination of the scene while a death was under investigation.
However, Campbell said he built a friendship with the deputy coroner who was eventually elected coroner and who was willing to work with the new team. His LOSS Team has never caused a problem at a scene, he said.
Reducing the amount of time it takes for a person to seek help can prevent additional mental health problems that people who experience such a loss can develop, such as anxiety, post-traumatic stress disorder and substance abuse, Campbell said.
When La Plata County Sheriff’s deputies respond to a death by suicide, generally two members of the victim resources team responds, said Kathy Brush, victim resource coordinator.
The team will provide emotional first aid because the bereaved are not ready for counseling right after a death, she said. Most people are in shock and can’t retain much information.
“We are present with them. That is our main focus,” Brush wrote in an email to The Durango Herald.
In the days after the death, staff members with victim resources will call the family and recommend therapists, clergy or Heartbeat, a support group for those who have lost loved ones to suicide, Brush said.

Heartbeat The day Michelle and Tony Gelles’ only daughter, Savannah, died by suicide, one of the many people they talked to that day recommended Heartbeat.
The two started to attend the group a week later. The La Plata County chapter of the group was started in 2013 for people who have lost loved ones to suicide. It is now overseen by the The Grief Center.
“Everyone is experiencing the same thing, so we don’t feel alone,” Michelle said.
Savannah was spontaneous and spunky, and an adventurer who enjoyed boating, camping and riding horses.
“She was the rock in our little family of three, always wanting to keep us all positive,” she said.
Savannah started to struggle with the symptoms of borderline personality disorder, a condition that can magnify a person’s emotions, when she was 13 or 14.
The Gelles family immediately sought treatment and feel they did as much as they could for Savannah, Michelle said.
She describes her grief at the loss of her 22-year-old daughter as complicated.
“It’s a roller coaster of unpredictable emotions and reactions,” she said.

Ginger Domingos also started to attend Heartbeat meetings after her daughter, Rachel, died by suicide in 2015.
“It was really good to share how you’re feeling and confirm that you are not going crazy. I literally hurt so bad that I swear it cracked my heart,” she said.
Heartbeat was founded in 1980 by LaRita Archibald in Colorado Springs, and she has observed the difference the groups can make, although they are not a replacement for therapy.
“Many survivors tell me ... being in this group saved my life,” she said in an email.
In addition to attending the support group, Domingos found support through an online email group called Parents of Suicide. The international group allows her to read the stories of others who have experienced a similar loss and keeps her from feeling alone in her grief, she said.
“I think that’s been lifesaver,” she said.


mshinn@durangoherald.com

Grief on Mother’s Day
 
While Mother’s Day is intended to be a day of celebration, for some it is a day of reminded loss.  This may be true for those who have lost their mothers or mothers who have lost a child.  The images of the perfect day, in addition to school and church activities dedicated to celebrating mother’s day, can trigger a cascade of pain and emotional distress. 
 
The death of a parent is the most common form of bereavement in the United States. Almost 12 million Americans lose a parent every year, but our society tends to believe that because it is expected that our parents will die, bereaved adult children need to “get over it quickly and move on.”  Many bereaved adult children feel they have lost a friend and advisor. They lament that there is no longer anyone who can truly relate to their childhood memories, nor anyone with whom they can openly share their or their children’s awards, achievements, or everyday lives.
 
“When a mother dies, a [child’s] mourning never completely ends,” says Hope Edleman, author of the 1994 book Motherless Daughters, one of the first books to examine the emotional journey a woman takes when she loses her mother. When a child dies, a mother’s mourning never completely ends, and she will grieve each milestone her child will not reach.
 
If Mother’s Day is painful for you, you’re not alone—and you have the right to spend it however you want, and to take care of yourself in the process. Here are a few strategies to find strength this Mother’s Day — consider sharing them with loved ones so they can help support you.
 
1.    You have the right to choose how you want to spend the day
Even the most understanding friends and family may expect you to be cheerful on Mother’s Day. Talk to them ahead of time so they know how you’re feeling and what you’re up for this year. Let them know that you may change your mind about participating in festivities, even at the last minute. Tell them if you’d prefer to play it by ear, and release the guilt and shame that may come with bowing out of social pressure to celebrate. Research shows that we’re not actually very good at predicting how we’ll feel in the future, so leave yourself room for flexibility.
2.    You have the right to be acknowledged as a daughter and/or a mother
3.    You have the right to feel however you feel
Mother’s Day can be filled with memories and traditions that cause unexpected and shifting emotions. There’s no one right way to be. People who tell you how you “should” feel or act may mean well, but they may not know what’s best for you.  Notice when you tell yourself how you “should” feel. Try to replace those thoughts with acceptance of your feelings as they come.
4.    You have the right to talk about it—or don’t
There is a misconception that talking about a loved one who has died “will make people sad.”  By contrast, bereaved individuals report that hearing others say the name of their loved ones makes them feel both seen and understood. 
5.    You have the right to take care of yourself
Be gentle with yourself.  Research shows that self-care can make it easier to cope with stress, especially during challenging times.  Eat well, stay active, try to sleep, and give yourself the opportunity to relax when you need it.  In short, practice parenting yourself.
6.    You have the right to hold on to hope that you will not feel this bad forever
This particular day may not be the same as it was before.  It may never be quite that way again.  But it won't necessarily always be this hard.  You don't know what next year has in store for you, and you won't always feels how you do right now.  Watch for signs of the mental trap of permanence -- believing that things will never get better.  If you find yourself falling into it, try replacing words like "always" with "sometimes" to remind yourself that the future is not fixed.

And remember, death ends a life, but does not end a relationship.

 
Links to information presented here: https://optionb.org/advice/how-to-spend-mothers-day-on-your-own-terms

https://www.vitas.com/resources/grief-and-bereavement/mourning-the-death-of-a-parent

It can be very challenging for adults to know what to say to children following a death by suicide. Adults may find it difficult to tell children what has happened, however, communicating clearly with children is helpful to them in dealing with their grief and in feeling safe and secure.

At a Glance:
·         Suicide bereaved children may experience anxiety, anger and shame.  Allow for a range of feelings.
·         For children to adjust to a death of any sort they need a realistic and coherent understanding of what has happened.  Secrecy can undermine the basic trust you want to establish with your child.
·    Effective communication that is clear, age-appropriate, and honest serves to reassure children that someone will take care of their physical and emotional needs.
·         Children will continue to grieve as they encounter new stages of their development.
·         Children grieve differently than adults, often in "doses."
·         Be alert to children blaming themselves for the loss: “Nothing you said or did caused this.”
·         Do not hesitate to reach out to a grief counselor for help for either you or your child.

Particularly following a suicide there can be a desire by adults to protect children from the truth and hide from them what has happened. However, for children to adjust to the death of a parent they need a realistic and coherent understanding of what has happened. If they do not have this they will tend to fill in the gaps with their imagination which can be unsettling and create anxiety.

Children will tend to be aware that something is happening that they don't know about; they may hear half-truths or exaggerated details from other children. For these reasons it is advisable that children are given information from a trusted adult who cares for them.

Effective communication that is clear and honest helps to reassure children that someone will take care of them physically and emotionally. It also helps to create a renewed sense of safety, security and trust. It is preferable to use language that is familiar to the child, that they will understand and that is comfortable for you.

Children tend to grieve differently than adults. Their grief will be intermittent, they will move in and out of the experience, and at times, may appear unaffected by what has happened. This may simply indicate that they are processing the event in their own way.  It is also important to remember that children will continue to grieve as they encounter new stages of their development. This means that as their emotional and cognitive abilities develop they will express their grief in new ways and they will have different questions which may require different or more complex answers.  You will have this conversation many times over the initial weeks and months, as well as throughout the child’s life.

Children generally learn to grieve by watching and learning from a significant adult. If you are having difficulties because of your own experience of grief and trauma it is important to seek some support from family, friends or available support services.

The sense of being out of control emotionally is often a part of grief that may overwhelm or frighten some kids. Grieving is normal and healthy, therefore assisting your child to accept this and find constructive ways to express and experience grief is important, particularly through talking, movement and exercise, and creative outlets.

Things for Parents to Know from Grief Experts:

• It is rare that experts see mentally-stable children fanaticize about death or suicide after talking about it or learning of a loved one’s passing, nor do they try to hurt themselves. Talking about suicide doesn’t implant ideas. By talking about it with children proactively, they know they can trust you and come to you with their concerns. It might remain mysterious if they are left to wonder or look into it on their own.
• In today's world of rapid communication and social media, it is highly unlikely that you will be able to "shield" your child from the reality of the manner of death.  Children as young as four have reported knowing about deaths by suicide that their parents did not know they knew about. It is important this information come from a parent, trusted adult or counselor in an individual or small group situation. 
• Unlike adults and older children, young kids don’t have the stigma associated with suicide, so it usually doesn’t feel as shocking to them. At age 5, 6 or 7, they seem less concerned about the method of death and more interested in knowing if the loved one is ever going to come back, or where they might be now. 
• With really young kids, experts tend to frame the death as dying from a sickness in the brain, in the same way you might explain a sudden heart attack – although this sickness was there, it may have been unseen by others and then struck suddenly without warning. This sickness is not contagious – you can’t catch it from someone.  With older kids, explain that their loved one died on purpose. By around 8 or 9-years old, kids can begin to understand suicide.
• You may begin the conversation by asking your child: “What do you know about suicide?;” “Do you understand the long-term ramifications of suicide?” (such as that it is forever and that family and friends suffer);  “What can you do if you or a friend are sad?”
• Kids do Google novel things, so if the suicide story is a public one, showing them the search results could be a part of your discussion, if that feels appropriate.
• Not everything has to come out at once, but can begin whenever the child asks deeper questions about the death. This conversation will become part of the everyday fabric of your child’s experience.
• You may want to inform relatives and friends of your discussions with your child – children will often turn to other adults to verify what you have told them or what they have heard in the community.
• Maintaining this open line of communication and being clued in to the child’s life is important. Letting children know they can talk to you about anything and ask questions and explore options for help with you might help to bring them more comfort.
• It’s always an option to enlist the help of a third party expert to help with this discussion and navigate the child’s questions and concerns.
• Children may exhibit regressive behavior after a death, including clinginess, wanting to sleep with parents, etc.  Experts advise parenting to the child's need for security during this time.  

At Home  The following suggestions may assist you at home.

Communication
·         be open and honest; use the words 'dead' or 'death'
·         keep a calm and cool demeanor, but don’t be afraid to tell your child that this is difficult for you or that you do not know all the answers, especially to the “whys?”
·        be aware of what emotions are arising in you as you discuss the death, particularly if you are experiencing anger.  Children may interpret an angry voice as meaning you are angry at them, which can lead them to wonder if they may have caused this or done something wrong.
·         be honest and open with children about the suicide. Use language the child understands and that you are comfortable with.
·         Be aware of the possibility of instilling fear with phrases such as “God wanted him/her with Him,” They are in a better place,” or of romanticizing death or heaven as a place to be free of pain and difficulties.
·          to avoid stigma use the word 'died by suicide' or took their life rather than committed suicide. This avoids reference to a crime
·         answer facts in short simple sentences without unnecessary detail
·         be available to listen and assist with any concerns your child may have
·         respect their views with non-judgemental responses

Emotions and Actions
·         give comfort, hugs, and reassurance as needed by your child
·         stick to day to day routine and schedules as much as possible
·         reduce change to a minimum
·         take time to prepare them for any further change that may be approaching
·        allow your child to express all emotions in a safe way, e.g. find healthy ways to vent anger, it is okay to cry; emotional storms only last a short time.
·         you can comfort your child with the concept that a person continues to live on in the hearts and minds of others and that they will never forget them
·         be assured that your child does not have to talk about it in order to heal; art, movement, activities that involve the hands such as clay, knitting, baking, building, and imaginative play are ways to integrate and express the confusing thoughts and feelings
            reduce electronic use during this time.  It does not provide the integration of the limbic brain and pre-frontal cortex needed to process big events, and also teaches children to deal with their pain through escape.
·         make time for just being together, take time out, re-establish recreational activities and outings when you can.

Grief Education  These points may help you to support your child:
·         take time to talk with your child about the person's life, not only their death
·         teach your child the importance of making time to eat properly, exercise and rest
·         it is okay to have fun, encourage them to be kids, play, explore and laugh
·         re-involve the child in chores and responsibilities when they are ready to cope with them again
·         reassure them about their short-term goals, let them know you are there to help them find ways to adjust to life without their loved one.
           be aware of other triggers for your child, such as anniversaries of previous losses, holidays, etc.
            
 Signs to watch for and enlisting professional help for your child:
• Talking about wanting to die or kill oneself
• Looking for ways to kill oneself, such as searching online, looking in medicine cabinets, knife drawers, etc.
• Talking about feeling hopeless or having no reason to live
• Talking about feeling trapped or in unbearable pain
• Talking about being a burden to others
• Increasing the use of alcohol or drugs
• Acting anxious or agitated, or behaving recklessly
• Sleeping too little or too much
• Withdrawing or feeling isolated
• Showing rage or talking about seeking revenge
• Displaying extreme mood swings
**As a precaution, remove all medicines and guns from areas where children may access them

Change is in the air.  One can sense it – in the changing weather and in the restlessness in our homes, classrooms and workplaces. 

The transition from spring to summer is one of paradox – as most of us were products of a three-season school year, we are conditioned to anticipate the endings and the beginnings inherent in this seasonal juncture.  For most of us, emotions are mixed as we feel sadness at certain endings, and excitement at possible new beginnings.  Summer can bring with it both a feeling of freedom, and a fear around the lack of structure planned days and nights bring.

For bereaved individuals and families, this transitional time can be felt in fits and starts.  While it is often a relief to put the academic calendar year behind us, the uncertainty of the future looms large on our horizon.  More freedom may bring with it the fear of more time to miss our loved one, longer days may mean more time to feel bereft of their presence.  And the sadness which accompanies the good-byes may seem incongruent with the sunshine, new growth, and smiling faces beaming at us from television, online and print ads.

For those of us who are grieving the loss of a loved one, as well as those who have not experienced this great loss, this transition offers an opportunity to become aware of the smaller losses in our lives, such as departing classmates and work colleagues, and to practice saying good-bye.

Ira Byock, MD, author of The Four Things That Matter Most: A Book About Living, tells us that there are four simple phrases: “Please forgive me,” “I forgive you,” “Thank you,” and “I love you,” which can carry enormous power to mend and nurture our relationships and inner lives, thereby facilitating the grief process, regardless of the reason for the loss of a relationship.  I often add a fifth when working with bereaved clients, the simple act of saying “good-bye.”

Perhaps we can practice, and help our children to practice, this mindful leave-taking at this time of year, adjusting the five phrases to fit the situation.  For example, one might say to a teacher or professor, “I’m sorry I was not always attentive in class,” “I forgive you for reprimanding me,” “Thank you for teaching me so much,” “I love/appreciate you,” and “Good-bye.  I wish you well.”

And then, perhaps we can allow ourselves to experience the myriad of emotions that arise.  To truly grieve whatever loss we may feel as we begin to incline ourselves towards the next part of our journey, and to hold each of them with kindness. 

In this way, we can practice experiencing loss and accepting the feelings that accompany it.  After all, change is in the air – and it is inevitable. 

During the lead up to the holiday season, a lot of focus is often put on family-oriented days such as Thanksgiving, Chanukah and Christmas, and often we who are bereaved have been advised to make a plan for those days.  By December 31, we have actually lived through them, and breathed a sigh of relief as we discovered we could.  With so much energy put towards those holidays, however, New Years can sneak up on us.  There is an unavoidable impact marked by the calendar turning, and the societal expectations to celebrate and start over with a clean slate by making a list of resolutions can be difficult, if not plain absurd, for those of us who have lost a loved one.

When we are grieving, we know there is no such thing as a clean slate.  Our grief does not end with the calendar year, and it may be daunting to face a whole new year stretching out in front of us. We may be afraid of what the new year might bring; we may worry whether or not we can handle any more challenges. Our tendency is to stand at the threshold of a new year looking back rather than forward.  To move on may feel like leaving our loved one behind -- an act of betrayal or abandonment of the one we love. 

Our current experience of emptiness and loneliness may make us reluctant to face this new year, and its approach may mean different things for different mourners. Whether we welcome, dread or ignore a new year may depend on where we are in our grief process.

If our loss was recent, sudden or unexpected, we may still be in shock or the wound may be extremely raw.  We get up in the morning, put one foot in front of the other, breathe, and tell our story of what happened to ourselves and others.  The calandar page turning matters little.  It is important to remember with gentleness that feeling a little numb or detached keeps us safe while we wake gradually to the reality that life and our world is not how we knew it or thought it would be. 

If we have courageously held our grief over time, the swelling around the injury of our loss may have gone down some.  We may not know details or have a clear vision of a future, but we may feel the stirrings of hope.  We are learning that the passage of time will always bring about a new day, month, and year.  And though we do face these without our loved one, we will take the gifts they gave us with us into this uncertain terrain. 

January 1st is just another day, with no power or meaning except the meaning we choose to give to it.  Acknowledging our special needs as grieving persons, we can choose to make softer resolutions for the new year – perhaps framed as gentler hopes: for a peaceful year which includes becoming at peace with our loss, learning to understand better our own grief process and ourselves through it, and the possibility of enjoying life even though we grieve. 

We would love to hear from you and have you share with others about what is helpful to you at this time of year while grieving.  Please share them below.

May you find moments of peace.