The story of a suicide and thereafter What is the motive of writing “Left Behind”?   

Nandini: April 27, 2017, For most people, this date may not mean anything other than just another date in the calendar. However, that day, my life changed forever. On that day, I lost my husband, Dr. TR Murali, a well-known urologist, to suicide. April 27 was the day one suicide killed two. That was the day I lost my precious partner and the sun plunged into darkness.  In the wake of that devastation, my life changed forever.

For a few minutes, for just a few minutes, there were only two of us in the house—me and the lifeless body of Murali. In those moments, before the world descended on us, I decided to speak the truth. I am a communications professional, and a gender and diversity researcher and practitioner who works with LGBTQIA+ issues; I am no stranger to stigma. I realised that choosing not to talk about it would be contributing to the stigma, shame, secrecy, and silence around suicide.

A death by suicide is a mysterious, confusing, perplexing way to die.  Across the world, suicide is not easily spoken about because of the taboo associated with it.  There is a wall of stigma, secrecy, shame, and silence—the 4S—that makes free, frank, and informed conversations impossible.   We either demonise, condemn the act and the victim, or glorify them as heroes.

As I struggled to find my feet and begin to live again, I discovered that survivors of suicide loss are unheard and unseen, their needs and concerns unrecognised.  I therefore write of the angst of the survivor, and of the overwhelming feelings of confusion, anger, shame, loneliness, and guilt that survivors of suicide loss face.  I wanted to address the shame, secrecy, silence and stigma of suicide loss, and a step towards bringing it out of the closet. As a creative person, I’ve dealt with life’s multiple challenges through my writing; transmuting pain into purpose, healing and transforming through loss, building resilience and discovering newer meanings in life.

With Murali’s death by suicide, I acquired a freshly minted status as a survivor of suicide loss. I had gained membership into an exclusive club, where membership is by chance and never by choice. People like me are individuals with a lived experience of suicide loss. This simply means that we’ve had a direct, first-hand experience of having lost a loved one to suicide. We are experts by experience— and that is just as valuable as the kind of academic credentials people earn. We, along with other stakeholders, can work together as partners in fostering change, and creating safe supportive spaces for informed conversations on suicide.

To make sense of the ensuing range of emotions and the vortex of memories, I began to explore the literature on loss and grief associated with suicide and found surprisingly little.  Therefore, I decided to write about my experience.  Besides there was no book by a survivor of suicide loss in the Indian context. What message does the book “Left Behind” give?  

Nandini: We need to create safe supportive spaces for informed conversations on suicide. It talks about the need to tell our stories authentically; to reclaim our power; to move from victimhood to living a life of purpose and meaning. It’s about redefining resilience in the face of a tragic loss.  It advocates for sensitive and informed public and professional engagement with survivors of suicide loss. It advocates for a convergence of multiple stakeholders to prevent suicide because preventing suicide is everybody’s business. What are your thoughts on suicide being considered a consequence of weak mind?    

Nandini: Dominant narratives of suicide locate it in the context of crime and sin. It is viewed through the lens of morality and perceived as a character flaw: religion conflates it with sin, while the law equates it with crime. The media sensationalises it and either glorifies or demonises the victim. This is exemplified in the language that dominates suicide narratives. We say that people who have died by suicide have ‘committed’ suicide, which implies that suicide is a crime and equates it with self-murder. Such insensitive and non-critical language reinforces the mainstream view of suicide as a crime.

A stigma is a mark of disgrace. It is something to be ashamed of and is located within a larger social context that tends to view a particular issue, and the people impacted by it, in a negative light. It is often fuelled by ignorance, prejudice, rigidity, and judgement. Mental illness, suicide and HIV/AIDS are highly stigmatised, for example. While the first two are perceived as character flaws or moral failings, HIV/AIDS is additionally associated with taboos around sex and sexuality, in a clear case of social stigma.

Suicide is mired in stigma, myths, and misconceptions despite the fact that it is a great leveller, and nobody is immune to it. Sociologists agree that every human being has two strong impulses embedded within themselves: Eros, the life-affirming impulse, and Thanatos, the life-denying impulse. For many, Eros dominates, and as a result, they embrace life. On the other hand, when Thanatos dominates, people are driven to kill themselves. Of course, these impulses need to be viewed in a larger framework of risk factors that increase the likelihood of suicide and protective factors that prevent it.

‘Suicide breaks all the rules. People we know and hold dear have defied the course of nature and determined when and how they died. Our loved one’s act throws our own perceptions to the winds, our way of looking at life and death is sundered. The question, “Why do we die?” has always been an unanswerable mystery; with suicide, the question reshapes into, “Why did my loved one choose to die?”’ writes Carla Fine in No time to say goodbye. 

Hence, we need to shift perspectives that locate suicide in the context of crime and sin to that public health perspective that views suicide as a preventable public health issue.

Labelling suicide as “weak” leads to demonising and condemning the act and the victim. This only creates a cycle of fear and lack of trust that dissuades those struggling with suicide to seek professional intervention and for survivors of suicide loss to rebuild their lives after the tragedy. Why did you feel the need to narrate your own experience in the book?    

Nandini: Our stories make us who we are. Our biographies; our destiny. In the deafening silence around suicide, I decided to tell my story. Left behind as a survivor of suicide loss, I nevertheless rose resilient. Although much has been lost; much still remains.

People like me are individuals with a lived experience of suicide loss. This simply means that we have had a direct experience of losing a loved one to suicide. However, individuals with direct experience of suicide are not restricted to just loss survivors.  It also includes suicide attempters, those with suicide ideation, and attempt survivors.

Until recently, the voices of people with lived experience of suicide loss or suicide attempt have largely been marginalized in suicide prevention discourse and interventions. The enormous personal and collective shame and the culture of stigma, shame, secrecy, and silence around suicide silences voices of dissent.

Yet people with lived experience of suicide, and particularly those impacted by suicide loss, are powerful change agents in suicide prevention. As a result of our direct first-hand experience of the tangible and intangible aspects of a suicide death, we can be catalysts in addressing the stigma, shame, secrecy, and silence around this serious global public health issue.

I firmly believe that formidable challenges require authentic responses. As part of my initiatives associated with SPEAK, whenever I create awareness about suicide prevention, I always reference it to my own lived experience as a loss survivor.  I’ve noticed that this has an instant connect with the audience. The most hardened cynic sits up in anticipation. Those impacted a similar loss glimpse hope, however nebulous. A lived experience perspective preserves the dignity of the deceased and those impacted by the loss. It fosters trust. The openness counters built in resistance and opens doorways. It fosters a willingness to engage with the toxic silence with the antidote of compassion.

When people with lived experience speak up, we directly counter stigma, shame, secrecy and silence with raw authenticity and honesty. This is important because talking about suicide is not an easy conversation.  Most people tend to avoid the “messy” space or react negatively because historically, suicide has been framed in a moral perspective with connotations of sin and crime.

There is no substitute for being authentic and owning your story. People who die of suicide are not mere statistics or numbers. When loss survivors speak to be heard, people realize that here is someone for whom suicide is not a mere cognitive construct but based on direct first-hand experience. When I reveal my vulnerability, it evokes compassion and connection in the audience. It also enables them to get in touch with the courage within themselves to engage in a ‘difficult’ conversation. A suicide is the death of the two” is said on what basis?

Nandini: The suicide of a loved one “kills” the person left behind. WE metaphorically die with the deceased; especially if we happen to discover the suicide. Suicide is killing of the pain rather than the body”, how is it justified?

Nandini: Suicide has been described as “psyche ache” or intolerable psychological pain. For the suicidal person, death by suicide is preferable to the agony of living in pain. The American Association of Suicidology says, “The primary goal of suicide is not to end life; but end pain.” After researching on suicide, what have you concluded on the same?  

Nandini: According to the World Health Organization (WHO), globally, 800,000 people die by suicide every year. Every 40 seconds, someone in the world dies by suicide. Every 41 seconds, a family is left to make sense of it. Like me. Millions like me. However, people who die by suicide are not mere faceless nameless statistics.

Suicide has been aptly described as a “death like no other.’ A suicide is sudden, violent, shocking, traumatic, and unanticipated. A self-inflicted death, suicide violates fundamental norms of self-preservation in all living beings. Why do some of our loved ones choose to kill themselves? This eternal puzzle wrapped in mystery and enigma, unfortunately, shapes the trajectory of suicide grief.

Jeffery Jackson, who had lost his wife to suicide, writes in A Handbook for Survivors of Suicide, ‘For the person you lost, the pain is over. Now it’s time to start healing yours. You are a “survivor of suicide”, and as that unwelcome designation implies, your survival—your emotional survival—will depend on how well you learn to cope with your tragedy. The bad news: surviving this will be the second worst experience.’

The grief following a death by suicide is traumatic.  It has been aptly described as ‘grief with its volume turned on.’

A suicide is the only death in which those who survive the loss are compelled to deny, hide, or invent a socially acceptable reason for the cause of death. Because suicide is a social, cultural, and religious taboo, we are overcome by overwhelming shame and embarrassment.  We therefore seek to ‘reinvent’ the mode of death in a desperate attempt to reclaim a sense of honour, both for deceased, our family and ourselves.

Serendipitously, I stumbled upon the Bill of Rights for survivors of suicide loss:

Suicide Loss Survivors’ Bill of Rights

  • I have the right to be free of guilt.
  • I have the right not to feel responsible for the suicide death.
  • I have the right to express my feelings and emotions, even if they do not seem acceptable, as long as they do not interfere with the rights of others.
  • I have the right to have my questions answered honestly by authorities and family members.
  • I have the right not to be deceived because others feel they can spare me further grief.
  • I have the right to maintain a sense of hopefulness.
  • I have a right to peace and dignity.
  • I have the right to positive feelings about the one I lost through suicide, regardless of the events prior to or at the time of the death.
  • I have the right to retain my individuality and not be judged because of the suicide death.
  • I have the right to seek counselling and a support group to enable me to honestly explore my feelings to further the acceptance process.
  • I have the right to reach acceptance.
  • I have the right to a new beginning.
  • I have the right to be.

Shame is a universal emotion. All of us experience shame at some point in our lives. However, in the context of suicide loss, shame acquires unexplored dimensions and implications. A person experiencing shame will downsize and altogether deny the reality of their experience by disowning their stories, for shame makes one feel small, flawed, and unworthy.

Brene Brown, one of my favourite authors said, ‘You have to be brave with your life so that others can be brave with theirs.’

And perhaps that’s how we drive change; that’s how we make ourselves seen and heard…   that monumental sorrows can be left behind… one story at a time… Why according to you suicide victim’s family is forced to face shame and stigma?

Nandini: Until my husband died of suicide, I believed it was something that happened to others. I naively presumed that it could not happen to me, in my family. My only brush with suicide was news reports in the media and a dear friend in school whose parent had died of suicide. Even then as a young girl, it struck me that my friend’s family refused to discuss it. It was cloaked in an iron curtain. I sensed there was something shameful about suicide.

Ironically, when faced with the suicide of my spouse, I too was overcome by the same sense of shame. What would I tell the family? What would I tell my friends? Would they judge my husband as a criminal? Would they judge me as having failed in my wifely duties to prevent this? I began to evolve a strategy of the official version of his death (prolonged illness, sudden death, whatever is acceptable) and the real version (death by suicide). I decided to use either of the two versions, depending on who I was talking to.

Today, when I look back, I realize that like most survivors of suicide loss and survivors of suicide attempts, I too was experiencing the stigma associated with suicide. How did I ‘catch’ this? Dominant narratives of suicide locate it in a context of crime and sin. In Medieval Europe, for instance, people who died of suicide were denied burial and their families were excommunicated, and their property confiscated. While societal attitudes towards suicide, and survivors of suicide loss are no longer so blatant, the tradition of stigmatization nevertheless persists in several subtle and not-so-subtle forms. There is no social acceptability associated with suicide, which is viewed as a character or moral flaw.

A stigma is a mark of disgrace. It is something to be ashamed about or feel shameful about. Stigma is located within a larger social context that tends to view a particular issue, for example, suicide, mental illness, and people impacted by it in negative ways. This is known as social stigma. And simultaneously, people impacted by suicide tend to internalize the feelings of shame, blame and judgment, known as self-stigma.

Social stigma perpetuates negative attitudes and stereotypes about suicide that are internalized by all people as a default setting. Hence for all survivors of suicide loss, the knee jerk response is shame and self-blame. It is common for people to blame the victim or the family, not realizing that the causes that drive a person to suicide are multiple and “lie with the forces of suicide itself in the same way that people of die of other illnesses.” We wouldn’t blame a person or the family when the cause of death is non-suicidal, why then do we indulge in blame games and accusations when it comes to suicide: “Didn’t you see it coming?” “Were there any clues?”

Negative attitudes can be conveyed through a combination of several pathways: Gossip, relentless speculation, intrusive probing, negative media portrayals, insensitivity, social isolation, naming and blaming of suicide victims and their families. Or worse, there is the “wall of silence” around suicide that makes it clear that it is a social and cultural taboo and therefore not to be talked about openly; but stashed away as a “secret.”

Such speculations adversely impact and exacerbate the trauma of survivors of suicide loss. They compound our primary loss and makes the grief complex and complicated. The social stigma of suicide leads to self-stigma that is associated with low self-worth, guilt, shame, and self-blame, which influence our grief trajectories and well-being.

Like a mould festering in darkness, the stigma, shame, secrecy, and silence around suicide proliferate in the darkness of ignorance, fear, and negative stereotypes. Writer Maggie White perceptively sums up the symbiosis between shame and stigma thus: “Self-stigma is the birthplace of shame. And shame and stigma have been doing a destructive, cyclical dance for long.” The relationship between stigma and shame of suicide is the classic chicken and egg conundrum. Which came first? However, that’s beside the point.

Suicide is a preventable public health problem. It cuts across demographic barriers and no one is immune to it. We need to mainstream empowering conversations on suicide anchored in compassion, concern, and care. It takes a convergence of diverse stakeholders to break the barriers and collective wall of silence around suicide and build bridges of support and connection. Preventing suicide is everybody’s business. Every voice matters.

Find the pre-order link to the book “Left Behind” here—

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