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Teen Suicide: Helping Survivors Make Sense of Sudden Loss
Teen Suicide continuing education counselor CEUs

Section 4
Adolescent Suicide: Coping with Trauma

CEU Question 4 | CEU Test | Table of Contents | Grief
Social Worker CEUs, Counselor CEUs, Psychologist CEs, MFT CEUs

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On the last track, we discussed five concepts regarding denial following a teenager’s suicide.  These five concepts are, the initial reaction, layers of insulation, benign denial, blame as denial, and conscious denial.  We also discussed the identifying strengths technique.

On this track, we will discuss three types of bargaining survivors of a teenager’s suicide may use to cope with the trauma.  These three types of bargaining are the long goodbye, scapegoating, and cutting off.  At the end of this track, we will discuss the Rescripting technique.

As you are well aware, survivors of a teeanger’s suicide may use bargaining in order to become more comfortable with their survivorship.  In return for a more comfortable emotional position in the wake of the traumatic loss, the survivor  pays a price in terms of behavior or lifestyle. 

Clearly, bargains are not necessarily permanent, and some play an active role in helping survivors perform the tasks of daily life.  Some survivors, however, may get stuck in bargains that are hard to change, leaving them with coping mechanisms that are harmful to themselves, their family, and other supportive family members.

3 Types of Bargaining

1. The Long Goodbye -
A first type of bargain survivors of a teenager’s suicide may use to cope with the trauma is the long goodbye.  Brandon’s daughter, Debbie, committed suicide at the age of 14. 

Brandon stated, "It was so sudden!  I never got a chance to say goodbye.  I feel like I have to keep her with me, just for a while, until I feel like I’ve had the chance to really say goodbye.  I moved my home office to Debbie’s bedroom so that I’d be close to her throughout the day.  The room is just the way she left it.  That room holds her memories, and I feel very comfortable in there." 

Brandon’s bargain kept him tethered to Debbie, and since Debbie was never ‘quite gone’, Brandon did not have to experience the loss fully.  The cost, of course, was that Brandon could not progress in the tasks of mourning. 

I also found that Brandon experienced a sense of isolation.  Brandon stated, "A part of me has been ripped out!  If I could just go back to how we were and say goodbye properly, then I could be a whole person again!"

2. Scapegoating - A second type of bargain survivors of a teenager’s suicide may use to cope with the trauma is scapegoating.  When I first met Carl, 49, he was in the middle of a lawsuit directed at the doctor he felt had failed to diagnose his son Gary, 17, with depression. 

Carl stated, "After my son Gary committed suicide, I just wanted to die.  I feel very guilty about Gary dying.  And I feel that doctor actually murdered him!"  Carl’s intense anger at himself and the doctor kept him from acknowledging and processing his intense rage at his son.  Carl stated, "I never hated my son!  I loved him!  I’m not angry at Gary.  I’m angry at myself and that damn doctor!"

3. Cutting Off - In addition to the long goodbye and scapegoating, a third type of bargain survivors of a teenager’s suicide may use to cope with the trauma is cutting off.  As you have seen, a cutting off bargain may involve conscious cutting off of either behaviors, such as talking about the event, or feelings, such as guilt.

Marta, 42, stated, "Since my oldest daughter Laura committed suicide, I just don’t have time to think about it.  I have three other kids that I have to care for. I don’t have the luxury of letting myself fall apart!"

Rescripting Technique - Helping 'Supermom'
Instead of confronting her reactions to Laura’s suicide, Marta, and single mother, channeled her energy into becoming a ‘supermom’ to her three younger children.  Marta was referred to therapy after her efforts to be the ‘perfect’ mother resulted in her collapsing from exhaustion and being brought to the emergency room. 

I stated to Marta, "almost everyone has a fantasy image of being a superperson with a constant smile and loving heart, who is all things to all people at all times with no wear and tear on the self.  Sometimes, people who have survived a loved one’s suicide try to become superpersons by overdoing or overgiving in all of their relationships and roles.  However, trying to be a superperson can be very costly.  Being a superperson means you have no time to take care of your own needs.  If you neglect your own needs, eventually this will decrease your ability to care for the other people in your life." 

Rescripting Technique - 3 Steps
I encouraged Marta to participate in the Rescripting technique.
-- 1. What is a Perfect Mother?
First, I asked Marta to brainstorm a list of adjectives describing the cultural ideal or stereotype of the perfect mother.  Marta stated, "Well, a perfect mom always has plenty of energy.  She’s always there for her children.  She never has to say no."

-- 2. Price of the Ideal Mother
Next, I asked Marta to brainstorm a list of personal costs and costs to others that were the price of her image of the ideal mother.  Marta’s list included no longer having time for her favorite hobby, painting, and no longer having time to spend with her friends from work.

-- 3. Write a New Script
Finally, I asked Marta to write a new script for herself.  This new script would include room for caring for herself as well as providing for her children’s needs. 

Marta’s new script stated, "I have expected myself to be all giving all of the time, but that isn’t realistic or healthy for me or the children.  In order to be a giving mother, I need to be able to give to myself.  I’ll spend half of my free time on myself, and the other half on the children.  If I spend all day Saturday with the children, I’ll spend Sunday caring for myself.  Of course, if one of the children has a special need, I will revise my 50-50 plan and give more time to the child in need.  If I have a special need, I may not be able to give what I want for the kids, but by caring for myself when I am in need, I will be better able to care for them later.  I will make a commitment to my therapy sessions, even if that means I need to spend a little less time with the children, or make other arrangements for them if they need transportation to an extracurricular activity."

Think of your Marta.  Would the rescripting technique help him or her make a commitment to stop cutting of his or her feelings and to practicing better self care?

On this track, we have discussed three types of bargaining survivors of a teenager’s suicide may use to cope with the trauma.  These three types of bargaining are the long goodbye, scapegoating, and cutting off.  We also discussed the Rescripting technique.

Peer-Reviewed Journal Article References:
Green, E. J., & Myrick, A. C. (2014). Treating complex trauma in adolescents: A phase-based, integrative approach for play therapists. International Journal of Play Therapy, 23(3), 131–145. 

Howard Sharp, K. M., Russell, C., Keim, M., Barrera, M., Gilmer, M. J., Foster Akard, T., Compas, B. E., Fairclough, D. L., Davies, B., Hogan, N., Young-Saleme, T., Vannatta, K., & Gerhardt, C. A. (2018). Grief and growth in bereaved siblings: Interactions between different sources of social support. School Psychology Quarterly, 33(3), 363–371.

Lewis, K. C. (2019). Review of Teenage suicide notes: An ethnography of self-harm [Review of the book Teenage suicide notes: An ethnography of self-Harm, by T. Williams]. Psychoanalytic Psychology, 36(1), 108–111.

Love, H. A., & Durtschi, J. A. (2020). Suicidal ideation and behaviors in young adults: A latent profile analysis. Journal of Family Psychology. Advance online publication. 

Schapir, L., Zalsman, G., Hasson-Ohayon, I., Gaziel, M., Morag-Yaffe, M., Sever, J., Weizman, A., & Shoval, G. (2016). Suicide, satisfaction with life, and insight capacity among adolescents with mental disorders: A preliminary study. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 37(5), 347–352. 

Shirk, S. R., DePrince, A. P., Crisostomo, P. S., & Labus, J. (2014). Cognitive behavioral therapy for depressed adolescents exposed to interpersonal trauma: An initial effectiveness trial. Psychotherapy, 51(1), 167–179. 

Online Continuing Education QUESTION 4
What are three types of bargaining survivors of a teenager’s suicide may use to cope with the trauma? To select and enter your answer go to CEU Test.

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