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Perceived Experiences and Family Functioning of Suicide Survivors Philadelphia College of Osteopathic Medicine DigitalCommons@PCOM PCOM Psychology Dissertations Student Dissertations, Theses and Papers 2014 In Their Own Words: Perceived Experiences and Family Functioning of Suicide Survivors before and after Suicide Loss Wendy Shallcross Lam Philadelphia College of Osteopathic Medicine, [email protected] Follow this and additional works at: http://digitalcommons.pcom.edu/psychology_dissertations Part of the Clinical Psychology Commons Recommended Citation Lam, Wendy Shallcross, "In Their Own Words: Perceived Experiences and Family Functioning of Suicide Survivors before and after Suicide Loss" (2014). PCOM Psychology Dissertations. Paper 308. This Dissertation is brought to you for free and open access by the Student Dissertations, Theses and Papers at DigitalCommons@PCOM. It has been accepted for inclusion in PCOM Psychology Dissertations by an authorized administrator of DigitalCommons@PCOM. For more information, please contact [email protected]. Philadelphia College of Osteopathic Medicine Department of Psychology IN THEIR OWN WORDS: PERCEIVED EXPERIENCES AND FAMILY FUNCTIONING OF SUICIDE SURVIVORS BEFORE AND AFTER SUICIDE LOSS By Wendy Shallcross Lam Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Psychology May 2014 PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE DEP ARTlVtENt OF PSYCHOLOGY Dissertation Approval This is to certifY that the thesis presented to u.s by Wendy Shallc:~;oss La111 on the 29tJJ day of May 2014, in partial fulfillment of the requirements .for the deg!~e of Doctor of Psychology, has beeiJ. examined and is acceptaoie in both scholarship and lheraty quality, Committee Members' Signatures: Terri Erbacher, PhD, Chairperson Rosemary Mennuti, EdD Scott Poland, EdD Robert A DiTomasso, PhD, ABPP, Chair, Department of Psychology iii Acknowledgements I would like to take this opportunity to express my sincere gratitude to everyone who encouraged and supported me through the journey of graduate school, which has ultimately culminated in the completion of this dissertation. It has been a long, winding road that I would not have been able to traverse without the assistance of several key members of my support system. First and foremost, I am thankful for the suicide survivors of this study who chose to speak at length with me about some of the most painful days they have experienced in their lives. I was touched that they trusted me, a complete stranger, to bear witness to the depths of their sorrow and the beauty of the hope many of them have come to hold. This study would not have been possible without their brave commitment to share their family’s’ experiences. I am thankful for being entrusted with the deep honor of writing about their stories. I would also like to extend heartfelt gratitude to the members of my dissertation committee for their expertise, contagious curiosity, and wisdom. Dr. Erbacher-Duff’s mutual passion, dedication, and role as cheerleader were instrumental for me to keep pace and complete this project. Her willingness to speak anytime (no matter how early in the morning or on a weekend) about my progress and questions as the project unfolded are much appreciated and I believe essential for the quality of this dissertation. Dr. Mennuti’s knowledge of qualitative methods, willingness to “play with ideas,” and steadfast encouragement will be remembered for countless years to come. Dr. Poland’s consummate expertise and desire to enact change served as an inspiration throughout my excursion of collecting stories and tapping the voices of other suicide survivors. iv The ideas and participation of Dr. Emily Chernicoff, Dr. Erbacher-Duff, and doc- to-be Katherine Scipioni as members of my validation team were influential in forming a solid perspective of the story this work was meant to tell. I am extremely thankful for the time they have given me from their busy lives and I have enjoyed how our paths have crossed. I am also thankful for Nicole Carden’s willingness to assist but I am deeply saddened in light of the recent loss she sustained to suicide. Her role in this project is a profound reminder that research on this topic wasn’t all for naught; rather, it is a clear and present example of what work still needs to be done to help grieving families and future generations. Lastly, throughout the past years I have come to realize how fortunate I am to have the unwavering support of several members of my family. My husband, Reagan, has sacrificed much for me to continue my education and for that I am extremely grateful. Although a man of few words, his implicit, consistent presence has provided much comfort in rather dark hours. I am also appreciative for the support of my parents, as they have encouraged me to follow my passions and continually question. In particular, I am thankful that the topic of this dissertation has opened profound dialogue in my family, encouraging us to speak about what was formerly unspoken in our family. I hope that both through the thrust of this project and research pursuits of a similar nature that people like my great-grandfather, Edward Alexander Shallcross (1885-1950), will be known for the life they led rather than how they exited this world. In this regard, I am hopeful that as a scientific community, we can uncover effective ways for families to heal and potentially intervene to prevent future suicides. v Abstract This research explored the unique experiences of relatives of individuals who have died by suicide, termed suicide survivors, in an in-depth fashion using qualitative methods. Through a semi-structured interview, the present study explored how families dealt with general stress prior to the experience of suicide loss, how they handled the loss of a family member to suicide, and what has been used to cope in the aftermath. A major focus was to explore whether or not the event of suicide dramatically altered family dynamics or if families continued a pre-existing interaction pattern established prior to the loss. The results revealed that there was overall consistency in their patterns of interaction both prior to and following the experience of suicide loss. The support of friends was regarded as integral to the participants’ subjective well-being. Themes extracted from the interviews were compared with The Interpersonal Theory of Suicide (Van Orden et al., 2010) and the resulting theory (“the perfect storm model”) integrates the elements that unified the experiences of the group of suicide survivors as a whole. In terms of intervention, results revealed that seeking out the support of others who have a shared experience of suicide loss was helpful in regard to mutual support and to instilling hope for the future. Additional processes of healing are explored and promoted as authentic options for mental health providers to use in their work with the particularly vulnerable population of suicide survivors. Keywords: suicide, suicide loss, suicide survivors, bereavement, family functioning, coping, healing, grief vi "Each one of us here today will, at one time in our lives, look upon a loved one who is in need and ask the same question: We are willing to help, Lord, but what, if anything, is needed? For it is true we can seldom help those closest to us- either we do not know what part of ourselves to give, or, more often than not, the part we have to give is not wanted. And so it is those we live with and should know who elude us, but we can still love them. We can love completely, without complete understanding." - Extracted from the film A River Runs Through It “Suicide. A sideways word, a word that people whisper and mutter and cough: a word that must be squeezed out behind cupped palms or murmured behind closed doors. It was only in dreams that I heard the word shouted, screamed.” - Lauren Oliver, Delirium vii Table of Contents Acknowledgements ........................................................................................................ iii Abstract ........................................................................................................................... v Table of Contents .......................................................................................................... vii List of Figures .............................................................................................................. xiii List of Tables ............................................................................................................... xiv Chapter 1: Introduction ................................................................................................... 1 Introduction ................................................................................................................. 1 Statement of the Problem ............................................................................................ 6 Purpose of the Study ................................................................................................... 8 Chapter 2: Review of the Literature .............................................................................. 11 Introduction ............................................................................................................... 11 Common Experiences in Suicide Bereavement that are Distinct from Other Types of Loss……………………………………………………………...12 Individual Experiences…………………...……………...….……12 The Family Context in Suicide Loss …………………………….16 How Surviving Families Cope with Loss……………..…………17 Family Role-Related
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