Postvention in Action - The International Handbook of Suicide Bereavement Support

Chapter 9 History of Survivor Support (p. 101-102)

John L. McIntosh1, Iris Bolton2, Karl Andriessen3, and Frank Campbell4
1Academic Affairs, Indiana University South Bend, IN, USA
2Link Counseling Center, Atlanta, GA, USA
3School of Psychiatry, University of New South Wales, Sydney, Australia
4Campbell and Associates Consulting, LLC, Baton Rouge, LA, USA

Abstract: The resources and assistance available to significant others in the aftermath of suicide emerged initially in localized and individually developed approaches of support. Certainly, traditional therapeutic resources for the bereaved have been available. However, many of these support resources were often conceptually outside the traditional, professionally provided therapeutic approaches. The history of the survivor pioneers in North America and across the world is chronicled, along with the developments that have followed – resource development and dissemination, funding, research, advocacy, lessened stigmatization, professional organizations – and their impact on support for survivors. Crucial among these developments has been the substantial efforts of survivors themselves in raising awareness and bringing vital attention to the needs and issue of survivors but also to the support services for those bereaved by suicide.

Introduction

Writing a historical account of the experiences of suicide loss survivors over the centuries to contemporary times, Colt (1987, 1991/2006) related a long history for survivors – from concern based on economic and property reasons, followed by stigma and shame that led survivors to go “underground” (1987, p. 14). As he relates this defensive isolation response and the hiding of feelings such as grief and guilt, he suggests that the first recognition of the needs of survivors emerged at the birth of suicidology in North America in the late 1950s and 1960s, with research of suicides in Los Angeles, California, by Shneidman, Farberow, Litman, and others at the Los Angeles Suicide Prevention Center. This suicide prevention center was among the first to realize that survivors needed to talk about their loss. From this need sprung early survivors support groups. Additional resources and services that provide support in various other ways have also been developed. Organizations and individuals who were not themselves suicide survivors became supporters, advocates, and partners. However, the early work for recognition and support resulted primarily directly from the tremendous efforts of individuals bereaved by suicide.

Survivors and Postvention

Edwin Shneidman (1968), a psychologist and pioneer in the field of suicidology, coined the term postvention as early as 1967 (see Chapter 1 in this volume). Shneidman defined his terms saying, I would like to use the Latin root “vention,” using three prefixes to portray the full range of activity [action before, during, and after]. I would like to suggest prevention, intervention, and postvention… In postvention, one deals with people after suicide attempts and with the survivorvictims of committed suicide. (Shneidman, 1968, p. 88)

Writing later, Shneidman (1975/1981) seems to focus primarily on the more traditional psychotherapy-based services approach to help the suicide bereaved, not mentioning or anticipating the grief or support group approaches that would soon proliferate. In recognition of the importance of postvention, he states that “a comprehensive suicide-prevention program should attend to the psychological needs of the stigmatized survivors” (Shneidman, 1967/1995, p. 6) and that a “benign community ought routinely to provide immediate postventive mental health care for the survivor-victims of suicidal deaths” (Shneidman, 1969, p. 22). In his foreword to Albert Cain’s landmark book, Survivors of Suicide, Shneidman goes on to state that “of the three possible (temporal) approaches to mental health crises – prevention, intervention, and postvention – in the case of suicide at least, postvention probably represents the largest problem and thus presents the greatest area for potential aid” (Shneidman, 1972, p. x).

Postvention was established as a part of suicidology, and the provision of postventive care was on the verge of major strides toward addressing the needs of survivors. While this care would include traditional therapy approaches (see e.g., Jordan, 2015), postvention in the form of groups focusing on support in particular would emerge as a significant avenue for healing and help to the suicide bereaved.

Support Groups

While there were general grief support groups (and grief therapy) in existence, it was the efforts of individuals and small numbers of survivors that led to the development of the first mutual help and other support groups in the United States and Canada (Chapter 10 presents a review of the effectiveness of suicide survivor support groups). In the late 1970s and early 1980s, several groups were founded that led the way and often served as models for groups in other locations. Although documentation on groups or resources is minimal, one of the earliest of the programs specifically for suicide survivors was the one-on-one grief counseling offered through the Contra Costa Crisis Center in Contra Costa County, California, in 1972 (e.g., cited by E. Betsy Ross in her 1997 book describing planning efforts to begin her own support group for survivors in 1977; Ross, 1997). Working with the coroner’s office, survivors were identified, contacted by letter and phone, and asked if they needed services. Appointments were made and a grief counselor visited them in their home for sessions (Doyle, 1980). In addition, the renowned suicidologist Norman Farberow (2008) relates that the then–Los Angeles Suicide Prevention Center in the “early 1970s” started a survivors program that provided a therapy (i.e., not support) approach. However, “after two or three meetings and many absences by the participants, the program was terminated” (Farberow, 2008, p. 5). Other unsuccessful starts followed, and Farberow speculated that the reason the counseling and group process approach that had been attempted did not succeed was that the approach was incorrect: