From pain to purpose: A psychodynamically and psychosocially informed narrative inquiry into suicide bereavement

A reported 5,691 people died by suicide in England and Wales in 2019 (Office for National Statistics, 2021), leaving behind an unclear number of suicide-loss survivors living with grief. The British Psychological Society’s (BPS) (BPS, 2016) position statement on understanding and preventing suicide acknowledged the need for further research into how suicide loss can impact others and how professionals can support them. Scholars have argued that when suicide-loss survivors attempt to access support and share their story, they can experience shame, stigma and feelings of responsibility for the discomfort of others (Peters et al., 2016). It is therefore likely that suicide-loss survivors may be affected by social discourses and personal constructs of suicide.The aim of this research was to explore a) the psychologically defensive deployment of narratives used by those affected by suicide loss and b) how dominant constructs of suicide may impact these narratives and the support suicide-loss survivors receive from health professionals. To conduct this qualitative study, I used an adapted Free Association Narrative Inquiry (FANI) to explore the defensive use of narrative and to identify key themes across the group. Four suicide-loss survivors from England and Wales each took part in two interviews, the first based on the life story method (Atkinson, 1998) and the second on the psychodynamic principle of free association (Freud, 1915). Additionally, I maintained a research journal, conducted a data panel and used psychodynamic theories and techniques, such as transference and containment, to interpret each case. The whole data set has been extrapolated to present a themed interpretative account.The suicide loss caused cognitive destabilisation (Clark & Goldney, 2000), rupturing the mental containment (Bion, 1962) needed to mourn and integrate the traumatic experience into the participant’s subjectivity of self. Different levels of formal (e.g. counselling and support groups) and informal (e.g. fundraising and being with other suicide-loss survivors) support was needed to process the heavy, complicated story of suicide. Surrounded by the suicide prevention construct, which led to a significant felt responsibility and identification with the suicide construct itself, participants invested in the heavy and complex internal narratives of purpose and healing to feel safe enough to integrate the experience into their life story. The themed interpretative account highlighted the narratives they used to protect themselves, and others, from the pain of their loss. The main overarching theme was transforming pain into purpose. The three subthemes were: (a) who am I? (b) the suicide construct: ours to own, and (c) the healer narrative, holding and containment. These findings offer great insight into the experience of suicide grief and how suicide-loss survivors are likely to be driven to find purpose in their loss. Health professionals need to provide multi-level support specifically for suicide loss, away from the rhetoric of suicide prevention. Additionally, they must be aware of the social and personal constructs contained within the psyche, which may impact the health professional and client within the therapeutic relationship and therefore efficacy of support, demanding specialist supervision and supervision training