Self destructive behaviors and survivors of suicide
Crisis and Trauma Intervention
Self- destructive behavior
Often synonymous with self-harm
May be used as a coping mechanism
May be used as an active attempt to drive people away.
Feelings of being incapable, undeserving, etc.
Self-destructive behavior is often a form of self-
punishment in response to a personal failure, which
may be real or perceived.
It is common misconception that self –destructive
behavior is inherently attention seeking, or at least
that attention is a primary motive. While this is
undoubtedly true is some cases, normally the
motivation runs much deeper that that.
Learned dysfunctional patterns of behavior early in
Types of self-destructive behaviors
Drug use and abuse
Risky types of behavior
Perspectives and Myths
Myth: people who commit suicide have a psychiatric illness
Fact: mental illness is not the dominant factor in most suicides
Myth: good circumstances prevent suicide
Fact: suicide cuts across race, age, job, etc.
Myth: most people who talk about it are not a serious risk
Fact: people usually talk about suicide or give clues and warnings of their intentions
Myth: people who threaten suicide, superficially cut their wrists, or do not succeed with
other attempts are not at risk for suicide
Fact: majority of people who succeed in killing themselves have a history of previous
Myth: talking about suicide to people who are upset will put the idea in their head
Fact: suicide is too complex a process to occur as a result of asking a question
Understanding Suicide – Common
The common purpose of suicide is to seek a solution
The common goal of suicide is cessation of consciousness
The common stimulus in suicide is intolerable psychological pain
The common stressor is frustrated psychological needs
The common emotion in suicide is hopelessness-helplessness
The common internal attitude in suicide is ambivalence
The common cognitive state in suicide is constriction
The common action in suicide is escape
Survivors of Suicide
Survivors of suicide represent the largest mental
health casualties related to suicide
There are currently over 32,000 suicides in the USA. It
is estimated that for every suicide there are at least 6
survivors. Some suicidologists believe this to be a very
Based on this estimate, approximately 5 million
Americans became survivors of suicide in the last 25
Grief does not follow a linear path. Furthermore, grief doesn’t always move in a
There is no time frame for grief.
Survivors should not expect that their lives will return to their prior state. Survivors
aim to adjust to life without their loved one.
Survivors often struggle with the reasons why suicide occurred and whether they
could of done something to prevent the suicide.
At times, especially if the loved one had a mental disorder, the survivor may
Shame or embarrassment might prevent the survivor from reaching out.
When the time is right, survivors will begin to enjoy life again. Healing does occur.
Suicide Bereavement 101
Survivors seem to struggle more with questions of meaning-making
around the death (“Why did they do it?”)... survivors often struggle to
make sense of the motives and frame of mind of the deceased.
Survivors show higher levels of feelings of guilt, blame, and
responsibility for the death than other mourners (“Why didn’t I prevent
it?”)...Occasionally, survivors feel that they directly caused the death
through mistreatment or abandonment of the deceased. More
frequently, they blame themselves for not anticipating and preventing
the actual act of suicide...
Survivors experience heightened feelings of rejection or abandonment
by the loved one, along with anger toward the deceased (“How could
they do this to me?”).”
What Do I Do Now?
Some survivors struggle with what to tell other people. Although you should
make whatever decision feels right to you, most survivors have found it best to
simply acknowledge that their loved one died by suicide.
You may find that it helps to reach out to family and friends. Because some
people may not know what to say, you may need to take the initiative to talk
about the suicide, share your feelings, and ask for their help.
Anniversaries, birthdays and holidays may be especially difficult, so you might
want to think about whether to continue old traditions or create some new
You may experience unexpected waves of sadness; these are a normal part of
the grieving process
Children as Survivors
It is a myth that children don’t grieve
Children are especially vulnerable to feelings of guilt and
abandonment. It is important for them to know that the
death was not their fault and that someone is there to take
care of them.
Secrecy about the suicide in the hopes of protecting
children may cause further complications. Explain the
situation and answer children’s questions honestly and
with age appropriate responses.
Helping a Survivor Heal
Accept The Intensity Of The Grief
Listen With Your Heart
Avoid Simplistic Explanations and Clichés
Understand The Uniqueness Of Suicide Grief
Be Aware Of Holidays And Anniversaries
Be Aware Of Support Groups
Consider your personal beliefs
What do you think, feel, or believe when considering
the concept of suicide? Your ethical, moral, and
philosophical conceptualization of suicide will have
direct and indirect inﬂuence on your clinical practice
It is fundamentally important to be aware of your
ethical and philosophical beliefs, conceptualizations,
and individual positions, as well as the direct and
indirect impact of these beliefs on your practice