Suicide Bereavement and Complicated Grief

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National Center for Biotechnology Information

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Hiking in Suicidal Patients: Neutral Effects on Markers of Suicidality


This prospective, randomized, crossover study evaluated the effects of hiking in high-risk suicidal patients (n = 20) who performed 9 weeks of hiking (2-3 hikes/week, 2-2.5 hours each) and a 9-week control period.


Hiking is an effective and safe form of exercise training even in high-risk suicidal patients. It leads to a significant improvement in maximal exercise capacity and aerobic capability without concomitant deterioration of markers of suicidality. Offering this popular mode of exercise to these patients might help them to adopt a physically more active lifestyle.

The American Journal of Medicine

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Letter from Marty Berglund, Senior Pastor


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What Is Complicated Grief?

Complicated grief is an intense and long-lasting form of grief that takes over a person’s life. It is natural to experience acute grief after someone close dies, but complicated grief is different. Complicated grief is a form of grief that takes hold of a person’s mind and won’t let go. People with complicated grief often say that they feel “stuck.”

For most people, grief never completely goes away but recedes into the background. Over time, healing diminishes the pain of a loss. Thoughts and memories of loved ones are deeply interwoven in a person’s mind, defining their history and coloring their view of the world. Missing deceased loved ones may be an ongoing part of the lives of bereaved people, but it does not interrupt life unless a person is suffering from complicated grief. For people with complicated grief, grief dominates their life rather than receding into the background.

The term “complicated” refers to factors that interfere with the natural healing process. These factors might be related to characteristics of the bereaved person, to the nature of the relationship with the deceased person, the circumstances of the death, or to things that occurred after the death. People with complicated grief know their loved one is gone, but they still can’t believe it. They say that time is moving on but they are not. They often have strong feelings of yearning or longing for the person who died that don’t seem to lessen as time goes on. Thoughts, memories, or images of the deceased person frequently fill their mind, capturing their attention. They might have strong feelings of bitterness or anger related to the death. They find it hard to imagine that life without the deceased person has purpose or meaning. It can seem like joy and satisfaction are gone forever.

The Center for Complicated Grief

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New Targeted Therapy Helps Overcome Disabling Grief

Complicated Grief  (see NIHM – 13)

Recent research has identified the public health significance of a previously overlooked syndrome in adults who have lost a loved one. Complicated grief, a seriously debilitating condition with symptoms similar to both depression and post-traumatic stress disorder (PTSD), affects about 10% to 20%7,8 of people suffering the loss of a loved one, or about one million people a year. While grief and depression are generally normal and adaptive responses to loss, in complicated grief the feelings of loss and disbelief do not go away after several months and become disabling, often for years. A targeted treatment developed specifically for complicated grief showed a better response in bereaved individuals when compared with interpersonal psychotherapy (IPT), a proven treatment for grief-related depression. The targeted grief treatment employs techniques used to treat depression but which are modified to include PTSD therapies that address issues of trauma and loss-specific distress. In a randomized controlled trial of 95 individuals with complicated grief, 51% of those treated with the targeted therapy showed improved scores on various measures of depression, compared with only 28% showing improvement from IPT. Thus, by using a targeted treatment specific to the features of complicated grief, many with this debilitating condition can once again become productive and lead pleasurable lives.

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Where is God When It Hurts? by Albert Y. Hsu

Family and Community Ministries, 25(1), 19-­‐29

Helen Harris

Albert Hsu begins most of the chapters in Grieving a Suicide with a question. That is appropriate given the thundering pain and questions when survivors deal with the aftermath of the suicide of someone they love. In Chapter 8, the author takes on a question commonly found both in grief literature and in the literature of major religions. Where is God when it hurts? Where is God when I hurt? If God is God and if God cares for me, how could a powerful and caring God allow this to happen?

Hsu begins answering this question with the story of two soldiers during World War II: one a Jewish resistance fighter who survived Auschwitz to later kill himself; the other a German Nazi who became a Christian theologian. One saw the horrors of the world and despaired. One saw the possibilities of God in the world and found hope. Hsu explains the difference by discussing the importance of our awareness of the suffering of God, i.e. the capacity of God to feel completely with us and for us.

God is then, says Hsu, not a removed God who lets bad things happen to us, but a loving God who allows free will to play out and then walks with us through the pain. “The only possible solution to the suffering of humanity is that God exists and has taken suffering upon himself” )Hsu, 2002, p. 120). How then do we understand our sense of abandonment in such circumstances? Hsu turns to the writing of CS Lewis and notes “God’s seeming absence during grief is simply because of the traumatic nature of grief”
(p. 121).

The author relates two apparently paradoxical biblical stories from the Gospel of Luke. The first is the story of Jesus not returning with his parents at the end of the Passover in Jerusalem. In this instance, they thought he was with them; he was not. The second is the story of the pilgrims on the road to Emmaus. They thought Jesus, who had been crucified was not with them; he in fact was. Hsu concludes that God is with us when our pain is deepest, even when we do not know it. “In our grief and loss, Jesus comes alongside us. He is not intrusive, but he is available to break bread with us and rekindle our hope”
(Hsu, 2002, p. 122).

Hsu, A. Y. (2002). Grieving a suicide: A loved one’s search for comfort, answer & hope.
Downers Grove, IL: InterVarsity Press Books.

Dr. Helen Harris is a Senior Lecturer in the Baylor School of Social Work where she teaches Advanced Practice and Loss and Mourning. Dr. Harris’ professional experience includes 8 years in residential child care and 13 years in hospice work.

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How to Respond to Bereavement or Grief at Work

Human Resources

Sorrowful things happen to your employees and coworkers. These are the people with whom you spend the most time nearly every day of the week. When bad things happen to your coworkers, you can be profoundly affected, too – and you also want to know what to do.

What is appropriate when a coworker loses a parent or a child? How do you express sympathy when a coworker announces a terminal illness or a family member injured seriously in an accident? There is no formula and dealing with tragedy and sorrow is never easy.

But, these ideas should help you know what to do about employee bereavement and grief when, inevitably, tragedy strikes an employee or coworker in your workplace.

Whatever else you decide to do in response to your coworker’s bereavement and grief, a sympathy letter is always appropriate. Here’s my new sympathy letter template with a sample sympathy letter to help you get started:

Write a Sympathy Letter

Start your sympathy letter on your normal stationery with your name and address and date. Or, if you have chosen to hand write a note on a card or piece of stationery, start with the date.

Dear (Employee Name),”

Start your letter with a description of the event and your sympathy. Depending on your relationship with the employee, you need to write a company note, but you might also want to write a second, personal note. The focus here is the company sympathy letter.

Example: “We want to express our sympathy for the recent loss of your mother. Losing a close family member is always sad and we want you to know that we are very sorry for your loss.

Offer to assist the employee during the grief period without obligating company resources or setting a precedent that you will be unable to offer to all employees.

Example: “Please let us know if there is anything that we can do to assist you as you deal with the loss of your mother.

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