
Surviving Suicide

A mother's story

##

## Heather Hapeta

First published 2012 paperback

This e-edition published 2012

The author has asserted her moral rights in the work

Self-help, memoir.

Paperback

Publication Date: 2012

ISBN 978-0-473-20510-2

epub

Publication Date: 2012

ISBN 978-0-473-20511-9

This book is copyright. Except for the purposes of fair reviewing, no part of this publication (whether it be in any e-Book, digital, electronic or traditionally printed format or otherwise) may be reproduced or transmitted in any form or by any means, electronic, digital or mechanical including CD, DVD, eBook, PDF format, photocopying, recording or any information storage and retrieval system, including by any means via the internet, or world wide web, or by any means yet undiscovered, without the permission in writing from the publisher. Infringers of copyright render themselves liable to prosecution.

Published by Passionate Nomad Publishing.

Wellington, New Zealand

kiwitravelwriter.com

TABLE OF CONTENTS

Foreword

Introduction

A critical time

And time continues

More Survival Tips

Theories of Grief

Society's attitudes and responses

How different groups respond

Seeking help from a counsellor

Viewing the body

Suicide and the press

Funerals

More useful information

Books recommended

Note from the author:

This small book addresses my son's motorbike accident, his suicide, and my responses to it all.

It also has advice and examples about surviving the death of someone by suicide gleaned from my counselling experiences.

Although an alcohol and drug counsellor, I was ignorant about suicide until my son hung himself. After a year of working through the most painful time I could imagine, I studied bereavement counselling, then worked for the newly established, Canterbury Bereaved by Suicide Society 1992/95

I believe there is a need for this book: New Zealand has about 450 suicides annually, each affecting 6 to 10 people. This means there are over four-thousand kiwis who need this information - and that's just in the first year – these numbers are cumulative and some people may first seek help many years later.

When someone has a friend or family member die by suicide they are more likely to suicide than they were previously. I believe this book will help reduce the chances of family or friends suiciding by addressing their grief: it's accepted that un-addressed grief is often the root cause of some subsequent deaths.

So, I've written this for survivors of someone's suicide, and in the hope that their friends will also read it so they can be of help. Counsellors and social workers will benefit from this small work too.

I've talked of writing this piece since the mid-nineties: it's finally done!

In memory of a son and brother: Gregory Booth 1970 -1990

About the author:

Heather Hapeta, previously an alcohol and drug therapist, studied bereavement counselling under Mel McKissock at the Bereavement CARE Centre in Sydney Australia. She then worked for the Canterbury Bereaved by Suicide Society (New Zealand) for four years, had a private grief practise in Napier and was a founder member of NALAG NZ (National Association of Loss and Grief). She has facilitated survivor groups in many parts of NZ; presented grief and suicide workshops and training sessions to suicide victim-survivors, counsellors, social workers, mental health workers, NZ Police, Youthline, Victim Support, and Samaritans, and others.

Since 1997 she has been writing travel tales as the KiwiTravelWriter - fulltime since 2002.

Her travel book is **Naked in Budapest: travels with a passionate nomad** (pub 2007)
Foreword

When asked by Heather if I was available to read drafts of _Surviving Suicide: a mother's story_ , I leapt at the chance. When asked to write the foreword, I again leapt. Having worked as a colleague of Heather for 16 months in Christchurch, (Canterbury, New Zealand) in the early 1990s, I knew her wit, passion, dedication and part of her story.

I knew enough about her story to know it was one that needed to be told. What I didn't know until I read this book was how much her story needed to be told and read by everyone – mothers, others bereaved by a suicide, those who are friends of those bereaved by suicide, mental health professionals, physical rehabilitation professionals, nurses, academics, policy makers: Everyone.

This book provides us all with many favours. The chapters in the second section gives practical information on how to help, how to help yourself, what not to do, and what to do, as well as survival tips for getting through the hard bits. There is information on legalities, social work and counselling theories, and even refers us to books we can read that can help.

However, the biggest favour is this book itself. In here you will find a story that is moving, even heart breaking in parts. A mother's story of loving an injured young man who lost hope: it is both Greg's story as told by Heather, and Heather's story in the immediate aftermath and days, weeks, months, years after both Greg's accident, and then his suicide.

The writing is exquisite in its language, the story telling is delicate as well as raw, the pain tangible, and the personal changes are immense. In the trauma and the emotional physical wrenches of grief, the story holds hope. Hope for life.

For those who want to know more about hope, I recommend this book as both a professional and fellow traveller in having being bereaved by those who have suicided.

As Heather says "Slowly I realised I had the strength to do what I wished, what I needed, that grief had somehow given me permission to be myself".

Suicide Bereavement is not a journey anyone chooses. However, becoming whole and who we want to be is one we do choose. While we don't choose the circumstances that determine that journey, Heather shows that living through hard circumstances can lead us to who we become.

Ann-Marie Stapp

MA Applied Social Work

PG Cert Health Sciences (Alcohol and Drug Endorsed)   
ANZASW, SWRB 2263

March 2012
A Critical Time

'... _The critical nature of this boy's condition does not appear to have impinged on everyone's mind'_ he says. He writes the same words in the medical records. Chilling words, and to have my concerns confirmed is frightening. Once again I've increased Greg's chances of living by insisting specific daily blood tests had continued. My mind races on and on.

How much longer do I have to watch their every move? How can I cope when this doctor goes away for the weekend? At least I now know I'm not being paranoid about Greg's care - or rather his frequent lack of care. My super-vigilance will continue: I don't care if they think I'm an over-protective mum. I wish we were still back at Christchurch Hospital's intensive care unit where they knew exactly what's been happening over the past month. Not like these people, my head tells me, it hasn't become clear to them that he could die at any time with clostridium, gas gangrene: most of the staff has never even heard of it - a disease rarely seen since the 1940s and the 2nd World War. I'm glad I'm a Leo. Bossy; determined; pushy, protective: all the negative things I've been called at different times over my life are now assets - a mother lion protecting her cub against anything. So many thoughts rush through my mind as I walk beside Greg's bed, holding his hand.

Down the lift we travel, past the photo of their stern-looking first medical superintendent, down to what feels like the dungeon of the hospital. I hate leaving the security of our room in the ward. There, surrounded by familiar things I feel safer; the chair I sleep in, Greg's photos, music, get well cards; message book; and the Garfield toy his sister, Renée, gave him for his sixteenth birthday only days after the accident. How dare they call it an accident - a turning vehicle hit him. It's a miracle he's survived this long. He should have died then many of the staff has said. Thank god for Dr Mercer's skills that first night. On and on and around and around my mind travels and talks to me as we take our daily trip to the pokey room in the basement.

I'm amazed this unpretentious looking piece of equipment – the hyperbaric unit - is so important, so vital in our lives. It's a recompression chamber and I never thought of what it would look like when I'd heard it mentioned before. I thought it was only for divers with the bends after diving - a pretend submarine - a ship that goes diving without being in the water. Some humour hangs on the wall - a bicycle pump - the sign beside it says, _In case of pressure failure break glass and pump like_ _mad._ The emotional pressure increases as everyone takes their place. My mind stops abruptly when Greg's distressed, weak voice fills my ears.

'I don't want to go in there. I hate it. I don't care if I need it. It's awful! I'd like to see you all go in there. It's awful. I hate it! You're trying to kill me. I'm not going in; take me back to my room.' I'm full of fear as I listen to his outburst. It's essential treatment. He doesn't know how close to death he is, how vital it is for his body to be saturated with oxygen while he's under the atmospheric pressure in the chamber. That, coupled with mega doses of penicillin, is the only treatment that can save him from the certain death that gas gangrene brings.

Yesterday he was so febrile he was unaware of them slicing large pieces of necrotic flesh from his pelvic area as he lay in bed – saving time while the theatre was prepared for another operation. Even then the staff tried to chase me from his side; 'You will have bad dreams from seeing this' I'm told. No way was I moving, he wanted me and that's where I was staying. He doesn't know that twenty-four hours ago he went to theatre yet again – the 20th time in four weeks - and his femur was dislocated and removed: the last of a leg they'd fought so hard to save. Once again it was his life they were fighting for, and for his life, the last of his leg had to go.

Now, in this tiny room, I again try to save my son. I can hear my voice begging him to co-operate with the staff. He refuses to listen. 'Greg you could die if you don't have this treatment.' I implore 'please go in,' but his mind is elsewhere, decision made, and nothing changes it. I plead with him to allow the stretcher to be taken into the unit to no avail and grasping at straws; I try and convince him to comply with the treatment.

'Greg, I'll come in there with you.' Relief and consent flood his eyes. I am the only person he trusts right now. Pain has rolled back the years and before me is a scared five, or six or seven-year old boy in a previously strong, healthy, rugby playing, sixteen-year-olds body.

'That's not possible' the doctor says.

'Why not?' I'm belligerent and suspect a fight is looming; 'I've been scuba diving. I know how to clear my ears and stuff!' I'm lying to a doctor I trust – despite having siblings who scuba-dived I've only snorkelled. I don't care. It's my son and I'll do anything for him. Greg's co-operation is imperative and the doctor eventually agrees to this stroppy woman breaking the rules. He gives up his space in the chamber, and I prepare to enter the small space with a nurse and my son: the only non-medical, non-staff, non-patient, ever to do so.

Removing my jewellery, metal, and shoes, I put on the soft theatre booties then climb through the round opening into the lock – the space where air is equalised with the pressurised air inside or the normal air outside. We haven't 'dived' so go directly into the second and larger part of this lifesaving piece of metal. Previously I've only seen small portions of the interior as I peered through the portholes at Greg lying inside. There's not enough room to stand up and I understand his claustrophobic feelings. Equipment is checked, and I do little tasks as requested; hold this, pass that and soon the nurse calls for Greg.

His stretcher is slid in, and five minutes later we're ready to dive. Now I am feeling scared: Greg eardrums had been pierced to stop them bursting and fear also reminds me of the oxygen convulsion he had on his first dive. My mind races and I'm anxious that I too will have problems – jeopardising Greg's treatment if the 'dive' is aborted because of my adverse reaction. On a different level, another voice in my head reassures me that all will be OK, to just swallow like on the plane, you'll be fine; nothing can go wrong when you're doing the right thing. Being with Greg is the right thing, and I breathe to calm myself – just as I coached his breathing in ICU.

Greg lies silently. His now skinny hand clenches mine, and my mental debating team quietens. He needs me, wants me and I can, and will, do anything he wants from me. Both doors close tightly and the hyperbaric unit is airtight. Air starts pumping in and as it makes a strange hissing noise I start swallowing, clearing my ears long before I need to. Soon, an old, heavy, world war two type of pilot's mask is placed over Greg's nose and mouth. This is the part he hates. Bravely he breathes the pure oxygen normally, evenly; the only change is a slight squeezing of my hand, confirming I'm doing the right thing despite the lie about scuba-diving. I'm glad to be in here with him holding those thin little hands.

The dive continues. We pause periodically, 3 fathoms, 5 fathoms, 9 fathoms. My ears feel the increasing pressure and I swallow at regular intervals - more often than necessary – and soon we're at 12 fathoms: our destination. Because of Greg's earlier convulsion we can go no deeper. The nurse and I indulge in meaningless chit-chat although I want to save my energy for Greg: holding his hand, my thumb caressing his skin and sending him positive thoughts and occasionally talking quietly to him. He keeps his eyes closed and can only talk when the mask is removed briefly to let him breathe normal air. I don't recall our conversation, only that his voice is strange with the effect of the oxygen - Donald Duck like. The respite is quickly over: tears pool in his eyes as the mask covers his lower face again. My heart hurts. I never wanted to see my child, any of my children, like this. It seems only yesterday I was collecting field mushrooms, trying to encourage labour on the day he was born, nearly three weeks late: my third, unplanned, child. Such dreams I had for them all. Top of the list was health and happiness, never something like this. Never this. This is an unimaginable nightmare and I want to wake-up.

Twice a day, for an hour each time, for ten days, this treatment had continued. No wonder he didn't want to do this last dive. 'I'm trapped' he tells me, 'what are they putting in the mask? They're trying to kill me. It's got poison gas'. Fever and drug-induced paranoia returns to this scared little boy and I'm grateful to be in here to reassure, and support him.

At last the dive is over and again I've been able to keep my promise to always tell him the truth about what is happening, whether he understood or not. Please let it remain the truth that he'll never have to do this again I pray to a god I'm not sure exists, and yet again I tell Greg how proud I am of him, how brave he is to face his fears and move one step closer to life. He's exhausted and sleeps for much of the afternoon. I sit beside him and look back over the past few weeks.

It's been over a month since his accident and while some events are etched clearly on my mind other parts are hazy, dreamlike. I recall driving into our garage muttering angrily about the front door being left open. Where were the dogs? Our Irish setter and Afghan hound explored the city together whenever mood combined with opportunity. Was this to be another of their nocturnal wandering nights I'd wondered? Surprisingly the dogs were home, but no children.

Moments later the phone rang. A young friend of Greg's had said 'We're at the hospital. Greg's had an accident!' She passed the phone to Richard, my elder son, who said we needed to come quickly; Greg needed an operation; he had signed the consent form. It was really serious he'd told me and he was scared Greg might not live. 'Please hurry.' All I remember of the drive was that it took forever, that every traffic light was red and my partner was quiet and supportive as he drove, trying to reassure me all would be OK.

That evening, April 4th 1986, had started like many other evenings: my father's birthday, me at a meeting, my three children doing their own thing – Renée on a date, the two boys hanging out with friends at home. None of us has a premonition that a life-changing event was about to happen. That an accident was about to occur.

Arriving at Christchurch Hospital we're directed to the Intensive Care Unit but Greg is already in the operating theatre. Richard pieced the evening together for me.

He said Andrew, Greg's friend and whom he had taught to ride, had arrived at our place to show off a new motorbike. The boys at our place were all admiring of the shiny bike and each went for a ride. Six times Andrew rode up Marshlands Rd to the roundabout and back, each teenage boy enjoying the thrill of being the pillion passenger on the new machine. Greg was the last to climb on the back.

Heading home, speeding, they pass a fire engine and, on this long straight road, were hit by a vehicle that turned in front of them - crossing their path to drive into a bottle store. Greg's knee ripped backwards, resulting in an almost complete amputation of his right leg at the groin, while Andrew continued on for another hundred yards before crashing in the driveway of a cattery: Greg left on the road at the site of impact.

Witnessed by the fire crew, they radioed for an ambulance and one of those miracle-making events happened: an ambulance was around the corner, in it were two men who, I later heard, had just returned from an advanced trauma-training course. Their skill, inserting two lures, giving Greg two and a half litres of saline during the drive to the hospital, combined with amazing pants (called inflatable mast appliances) which were blown up to keep pressure on the gaping wound helping reduce the flow of blood, all came together to stop him dying.

The night passed in a blur. Friends came to sit with us; I must have rung someone although I don't recall it. Staff came out from theatre to give me progress reports and in my head and heart I chanted the only prayer I knew, over and over and over again - _God grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference._ A non-believer, I'm too scared not to believe in a God right now – frightened that if there really is a god, my disbelief will result in me being punished by Greg's death.

It was hours before I met Mr John Mercer, the surgeon whose skills in arterial reconstruction saved his life. 'He should never have reached the hospital alive' he told me at dawn. Greg is alive but critical. As I listen, I feel optimistically confident in the skills of this quietly spoken man and trust him. Just then my son is wheeled past, wrapped in foil, a jumble of life-supporting tubes helping him breathe, a plastic-bag of blood hanging above him and blood-stained fluids draining below him. My heart sinks at the physical reality I'm told of his condition and the nature of his injuries.

He has multiple fractures of his right leg; multiple fractures of his pelvis; 30-cm laceration of anus / rectum; and a 5-cm gap in his femoral vein. Many staff has been involved in the fight to save his life from his arrival at 2130 until the operation finished at 0530: and now he is in ICU.

' _Parents appear to understand the potential gravity and complications of Greg's condition_ ' Mr Mercer records on Greg's chart. He has 6 pins, 4 rods and 8 adjustable clamps inserted into his leg, a colostomy bag for his bowel, and a vein has been taken from one leg and been painstakingly sewn into the other. The surgeon tells me this next 24-hours is crucial to his recovery, and then, 'if he survives', because of faecal contamination, the risk of something dangerous - called clostridium – 'will be of real concern for the next two weeks'.

That morning I began what was to become a daily ritual which continued for several months. After being with Greg in ICU, holding a hand, or massaging his uninjured foot (frequently the only places I was able to touch him as staff worked around his bed) I would go home at 8 am, shower, change my clothes, and then be back by the time ward rounds were finished at 9 am and visitor restrictions in ICU lifted. I then remained at his side – except for half-cigarette breaks when nicotine-withdrawal became too strong to ignore – until eight the next morning when I repeated the home, shower, clean clothes routine. Many years later, rereading his hospital records, I find ' _relatives,_ or _family present_ 'written in each shift report.

I continue reading and give silent thanks to the twenty-six people who donated the units of blood he needed during that first night: fifteen units pre-theatre; 2 units of haemacel, six litres of normal saline and 11 more units of blood in the operating theatre. I read five-thousand cc's of blood are estimated to have been lost in theatre, and many, many, more on the side of the road, in the ambulance, and in the Accident and Emergency Department. Following my fire-fighter father's example I'd been a donor since I was sixteen: now Greg's receiving the gift of blood just as others had received donations from us.

Each day is painful – emotionally for me, physically for Greg – his thankfully is reduced by drugs. Every two hours nurses take measurements of his hugely swollen, and still swelling, thigh. They regularly listen for a pulse in his lower leg to ensure the blood flow is being maintained after the transplant to repair the ripped vein. ' _Renal failure. Deteriorate. Unstable. No spontaneous_ _respiratory effort',_ the __ staff note the hours and days on his records. They tell me again and again his vital signs, pulse, and heart rate 'are slower and more even when you are here,' and that, and love, ensures I stay with him 23 hours daily.

Three days later, the day before his sixteenth birthday, Greg goes into renal failure. Kidney dialysis is started forty-eight hours later when a portable dialyses machine wheeled into ICU. That evening we celebrate - Greg may now suck ice. What huge progress that seems and we all feel elated. Our world has shrunk to the space around Greg's bed and the dingy waiting room. I doze lightly and sporadically on a reclining chair beside his bed and during the night Greg is once again taken off the machine that has been breathing for him. This time he keeps breathing by himself.

'Thank you' he says to the nurse who removes the tube from his throat - his first words in a week. The next day he is restless and aggressive, pulling at tubes and his colostomy bag, disorientated, and refusing oxygen. He is convinced they are trying to kill him with gas. As well as metal sides on the bed, his thin wrists are tied to the bedrails creating even more agitation.

'Breathe me' he pleads as he loses the rhythm and memory of how to breath. I hate the panic and fear I see in his eyes. I'm so grateful I'm now fifteen months sober, have had treatment for my alcoholism, and can be with him physically and emotionally – something my children missed as they grew up – I was often an emotionally absent mother despite having dreamt of being the best mother children could have. Unfortunately we are judged by our actions, not our intentions

'In and out' I say in time with my breath, 'in and out, in and out.' Slowly he relaxes and eventually breathes calmly, evenly – until the next time he forgets how to breathe and again begs me to help him with that most basic essential of life sustaining actions.

His condition improves from critical to serious and Greg is transferred to a ward directly above ICU to continue dialysis. That night he believes Danny (his 35-year old step father who had died of cancer 3 years earlier) wanted him.

'I want to die. Please kill me. Mum please cut my throat' I am so scared. Nothing had prepared me for hearing words like this. I feel cold, icy cold, my heats beating faster and I don't know what to say. 'Danny wants me to come' he'd said minutes earlier. That had been scary but being asked to cut my sons throat was beyond anything I could ever imagine. I even wrote cmt in journal, too scared to write the words in full.

'He doesn't need you. I need you. I want you here,' I'd told him, begged him to stay. But now I'm struck dumb, speechless, inadequate. How does a mother respond to such a ghastly request?

Greg had just found out his left leg had been amputated below his knee, the result of no circulation to his lower leg. So as well as the amputation, another reconstruction of his vein and artery was required.

Two days later, still febrile, he asks for a mirror and reluctantly, one is finally bought in for him. He cannot believe his leg is no longer there – he can feel the pain in it. Already agitated this increases his restlessness and despite sedatives nothing calms him and he's soon back on the critical list, and back in the intensive care unit.

He trusts no-one except me and yet another specialist is bought to his bedside: a psychologist who writes fear, denial, psychotic, anxiety ++ on his chart. Sandy McCloud tells the staff to remove the restraints: he suspects the valium Greg is being given is a major cause of his agitation. It's discontinued and within hours Greg is co-operative. Soon a red sticker appears on cover of his ever-increasing notes - ALLGERIC TO BENZODIAZAPINES. (Valium).

One step forward and another back and the next day his leg has more amputation, this time above the knee and his surgeon asks that he not be told. Over the next 24 hours he has three profuse arterial bleeds from the graft site in his groin, and eventually the femoral artery has to be tied off. Mr Mercer later said to me 'it always seems that every life-saving procedure we performed on Gregory created another life-threatening problem later on.' Tying off the artery is going to cause more complications too.

Once again his condition is described as 'poor' and he is 'not to be turned over night' 'as bleeding from the original groin injury is a real risk.' The site of the arterial and femoral vein grafts is becoming necrotic (dead or dying) and I have lost count of the times he has returned to theatre; the units of blood he's received.

Greg has not eaten but over the past 2 days has requested bottles of milk which both the kitchen and I supply – despite nurses giving it to him, he tells me not to let the staff to know as believes he's not allowed milk, and tonight he asks for his beloved deep-fried fish and chips! Not the ideal food to start with but at least it is food and when I bring them in he eats a couple of chips and a wee piece of the battered fish.

Again this seemed a major step forward and 48-hours later he's being transferred from the inner-city hospital to Princess Margaret Hospital where Mr Mercer is based, and where Greg is scheduled to have yet another operation. It's the 22nd April and I sleep at home for the first time since the accident. It was good to have an uninterrupted sleep, as despite Greg having graduated up to the 'seriously ill' list, things were about to change again and the next day I was back sleeping in a chair beside him.

Bizarrely, in this hospital nestling under the hills, Greg was put in the very room his great-grandmother had died a few years ago, and where Danny, his step-father was treated for cancer before coming home to die in 1983 – a then 12-year old Greg holding his hands during the moments of death.

Within four days of the transfer Greg is back on the 'critically ill' list and is 'specialled' rather than transferring him back to ICU. I am again warned of his very possible death, and before he goes to theatre I watch slices of dead flesh being cut from my son, refusing to leave the room as Greg wants me there. It obvious his leg will be removed completely, dislocation of his femur, a hind-quarter amputation. Over the next days we took the emotionally long walk to and from his room and the hyperbaric unit and I don't recall the number of trips to theatre he and the surgeon have taken. Despite having a nurse who only cared for him each shift, I put in a complaint about the lack of care – blood tests not taken regularly, antibiotics not given on time without me reminding the staff. Amazingly, despite the red allergy sticker on his notes, he's given valium when he has an oxygen convulsion in the hyperbaric unit, resulting in a 'severe dysphoric reaction.'

'Continuity and liaison of cares at night MUST BE IMPROVED' is written on his notes, and finally the hyperbaric specialist, declares the 18th dive is the last. Greg's eardrums are healing well he records and also writes, 'we have a long way to go but we seem to have won this potentially fatal round.'

Such were the days of our hospital-centred lives and one day, returning from my daily trip home for a shower and change of clothes I was furious. The minister from my mother's church, the church of my youth and where I married Greg's father was praying over my son in what sounded like the last rites. I was livid! Although I had some spiritual beliefs they were not associated with any religion and this sounded like all hope was gone for Greg. Since the accident I had not allowed any negative thoughts near him but here was this large Pacific Island man wishing him a safe trip to the other side. Well that's what it sounded like to me and I reacted like a banshee warning this intruder of his own death by my hands if he ever came back. Yelling, I pushed him from the room, backed him down the corridor, through the foyer to the stairs – telling him he was never to return to Greg's room. Never! Never ever!

The poor man: in his Samoan culture, a man of the cloth is given respect and here I was, a woman, a palangi, half his size, treating him in what he'd believe was a highly disrespectful manner. He later told my mother she had not brought me up very well.

Greg's multi-fractured pelvis is healed enough for him to be helped to stand beside his bed, a physiotherapist on each side. My little boy now towered above me: two months in bed had hidden a growth spurt and now we are being shifted to yet another hospital. Mr Mercer tells me he has been dreaming of Greg and with that, and the need for huge skin grafts, it is time for another specialist and another ward. Neither Greg nor I are happy.

The transfer admission records note: ' _Adolescent regression and fear – obviously depressed and withdrawn boy – little spontaneous conversation.'_ From July to December 1984 Greg remains in Burwood Hospital: the staff would have been more circumspect and less judgemental or subjective in their notes had they thought I would be reading them some years later. Ten days from admission his weight is recorded – 40kg – and 2 days later he is allowed out for 2 hours with his brother and sister, another 2 days and his temperature is again elevated. His moods fluctuate wildly and it's recorded that 'mother is angry Greg not receiving psychological support' for this major trauma. I bring protein-enriched milkshakes for him, give backrubs and note he has a tiny bedsore - ' _pressure sore noticed by mother'_ was written in his ever-growing medical records. It seems unless I am constantly at his side his treatment would be even worse. I also feel fragile and for a week attend an alcohol support group daily – not fragile that I will drink, just emotionally drained, and needing sustenance of my own.

Greg's weight continues heading downwards despite both my and the hospital dieticians efforts to tempt his taste buds. He has also found out he is likely to be sterile and now says he should have died in the accident. A waterbed is bought in for him and with its warmth, and the reduced pressure on his still huge, gaping groin wound, his mood rises and he sleeps more. By the end of July his temperature is normal and I bring a dozen eggs for him to eat when he wants them: his weight is only 36kg and he's still vomiting frequently. Despite this he starts mobilising – standing with a frame – and he is sure he'll be home in 3 or 4 weeks. I take him home for a couple of hours and he learns to transfer himself from the bed to a wheelchair. He's pleased with his progress but breaks hospital rules by smoking in bed. Staff record they have 'spoken to mother about her attitude to disciplining him and her need to adhere to visiting hours' and they start 'behaviour modification' plans with him.

Despite his low weight they also record that he can only have food from the kitchen at mealtimes. Despite their rules I continue to go to the hospital whenever he rings me and deliver any food he wants - even if he only eats a mouthful when it arrives. Potato and gravy from a multi-national fast food outlet is one of his common requests. Severe phantom pains continue. Mr Mercer had explained this was largely because of the traumatic initial injury and the overwhelming nerve damage done by the tearing of his flesh in the accident. Another little step forward is when he tries crutches for the first time, he's very weak and the physio says they'll try again a few days. While all this happens he returns twice more to theatre for further debridement of dead flesh and grafts: the skin taken from his thigh. He is also referred to the pain clinic and eventually tries acupuncture. He's so sensitised to pain after the months of high-level pain, it means that even the tiny needles cause him distress.

The following months, with further surgery and blood transfusions and Greg being isolated dues to fears of him being exposed to the highly infectious, antibiotic resistant MSRA bug (Methicillin-Resistant Staphylococcus Aureus **)** that has closed wards, and **** which could be fatal to him in his weakened immune system; **** and despite often having to be nursed on his abdomen and wheel himself around the hospital on a trolley, Greg's weight slowly improves and on the 8th December 1986, the plastic surgeon (Mr Sinclair) sends a letter to Mr Mercer saying ' _Greg is healed'_ and, he comes home for Christmas.

And time continues

Five-years later, breaking glass disturbs my reading. It's early evening and I'm in bed hoping for a couple of hours sleep before my relieving job at an old folk's home. Real estate is slow over the holidays and I'm pleased to get some casual night shifts.

Christmas, only two days ago, had been good. Greg, despite being twenty, loved his traditional stocking full of goodies, despite being twenty years old, and phone calls had connected us with his sister Renée in England, and his brother Richard, who was enjoying the sun and beaches of Northland.

'NO. NO. NO. It can't be true,' I feel sick and scared.

'Greg's killed himself' my mind tells me. 'Don't be dramatic,' says another part of my brain 'of course he hasn't.' How did I know he was dead? The sound of broken glass had never before seemed to signal death.

'I know he's dead I know he's dead' screamed something, or someone, inside my head. Only twenty minutes ago he'd sat on my bed.

'I can't stand only having one leg'

He'd told me that a thousand times, a million times. No doubt many more times in his heart and soul since his motor-bike accident nearly five years ago. Was there something different in how he said it this last time? I run from my bedroom in my underwear.

'Oh no, oh no Greg no. Where's a knife? How can I get him down? Help me. Someone please. A knife. Dial 111. Run back out. This knife is blunt. He's cold. No, he's warm. Oh no Greg. No. No, no, no. Resuscitate him. Heart massage. Five quick pressures. Tilt his head back. Breathe. Breathe. Breathe. Heart massage. Help me. Someone please help me. More breaths. More heart massage. Back to the phone. Where is the ambulance? Hurry please hurry. Massage. Breathe. Breathe. Breathe. Oh my god he's alive! I heard him breathe! I'm sorry Greg. I don't want you dead. Breathe again! Massage. Breathe. Am I doing it right? Why can't anyone hear me? What's happened to my voice? In my head it's a scream. It comes out weak and raspy 'His dog whimpers, nudges at me kneeling beside Greg, then cowers as he goes inside the house. He's teasing me, it's not true.

'Don't be so bloody melodramatic' says a critical person sitting up in the garage rafters. 'You know he's dead, you're only putting on a show'

How strange to be up here I think as I look down at the desperate mother trying to breathe life into her son. How can I be in both places at once?

'Stop doing that' says critical self still sitting up there. Watching. Being no help at all! 'You know he's dead. Why keep on trying? That gurgle was not him breathing. It's your own breath coming out. You're doing it wrong! Stop it. You're just putting on a show –just being a drama queen.'

I tilt his head back again, block his nose. Breathe. Repeatedly: again and again and again.

At last, the ambulance arrives. They carry my boy's limp body out of the garage. Put on an oxygen mask and listen for a heartbeat. There is no heartbeat. The help that finally arrived cannot help. It's too late. It was too late from the sound of the broken glass.

My intuition knew that when I heard the sound of a jar breaking on the concrete floor. My intelligent self knew that when I ran in to the garage. My nursing skills knew that. His mother didn't. His mother could not, would not, believe her son was dead. His mother tried to reverse the truth.

The police and undertaker arrive. I ring my mother, I ring a friend in Auckland, I ring my sister, then awfully, terribly, unbelievably, my daughter and my other son: calls so bad I can't remember them.

What sort of funeral do you want the undertaker asks? I DON'T WANT ANY YOU STUPID MAN! I don't want to put my son in the ground. I don't want him to burn. I want him alive! What do you mean what do I WANT? I want a cigarette that's what I want! Despite the craving for a cigarette or something else to numb the pain, I don't use anything. At some deep level, I know I can survive this without resorting to an illusionary crutch like booze, pills or nicotine. But a decision has to be made. I feel pressured into making decisions right now.

Memories of the nightmares I'd had of my husband's decomposing body return from seven years ago. I can't go through that again – but I don't want Greg to be burnt either. Can I keep him here? Crazy thoughts rush through my mind. Walking with James in this suburb with its many cemeteries, I always feel sad at all the unkempt graves. Sure I'd look after his grave but what about when I die? Who then: his brother and sister when they come to Christchurch but then? Even Greg has commented negatively on the houses that overlook the cemetery. I have no problem as what to do with my body – cremate it, but for my son, somehow that is hugely different. Finally a decision for the crematorium is made: now the undertaker makes me write a funeral notice: I hate what was in the paper. Why couldn't he have suggested just a simple death notice and details later notice? I now think he was just trying to get his company being sealed in as the provider of the funeral services.

Reluctantly I stay overnight at my mother's house – I later learn we regress in grief, and true to this, I am compliant and just do as I'm told and go to the old family home. At four in the morning, after a sleepless few hours, I walk back home, to my place. The house is empty but I feel better to be at the site of Greg's death, preparing our home for his return after the autopsy.

My head is foggy. It's full of cottonwool and busy in conversation with itself at the same time: 'Where is Greg now' it asks. Is there life after death or are you just dead? I wish I knew. I want Greg to be alive somewhere, somehow, but I don't believe in the god of religions and heaven up in the skies. I wonder if it's like the Buddhists said and that this life's behaviour determines the next life, and if so, where does suicide fit in with that? Will he be floating forever as a soul with no resting-place? Or will he have to go back and do all this again?' It is all so confusing and scary and my head won't shut-up.

Some forty hours after his death, and the autopsy, he is returned to me. Friends are there to welcome him home. Our little lounge is now a marae, and a tent is in our tiny backyard for the overflow. I lie beside his coffin; my head feels like a washing machine, thoughts racing through it, jumbled up, all knotted together, and spinning too fast for me to examine any of them. All I know is that right now it's right to have him here at home – home where I can try to come to terms with his death, well not his death, but his suicide.

Even sitting by the coffin with his body right beside me, it's hard to believe that he is dead, it doesn't seem possible, and right now I'm angry and in my head I tell him I'm angry that we all put so much energy into keeping you alive and now you just go and kill yourself. I feel just like your auntie when she said that if you weren't dead she'd kill you. And yet I understand too, I know your physical and emotional pain was tremendous, that life was hard, but damn-it-all, it's like that for lots of others too. Why couldn't you have waited until you had been to Queen Mary Hospital? I know they could have helped you. And you often did well with self-hypnosis for your pain. Why couldn't you have done that on Saturday night too? I pick up his sister from the airport.

The next day I remember a video tape I'd seen. ' _Play if I'm dead_ ' was written on it. When I'd first seen it, some six months previously, lying casually on the TV unit, along with others, I'd looked at Greg with raised eyebrows: an unspoken question.

I'd always said I would never communicate in that way with my kids. I hated the non-verbal comments, commands and questions my mother had given and I'd sworn to myself 'never' yet once again I was breaking my own rule. Not only breaking it but also not watching the tape or asking him about it. Did I know what it was to say? Too scared to confront the issues it could raise? I don't know.

And now, after his death, I've remembered the tape and I'm too scared to watch it. Petrified! Did it say it's my fault he's killed himself? And yet I couldn't ignore it. Deep down I knew it had to be seen before the funeral. Maybe it said how or where he wanted to be buried. How could I live with myself if he has requested something that I don't provide? Still too fearful to watch it, I asked Renée and a friend to view it for me. What a childlike coward I was. Renée, who has just flown in from London, is again being asked to take on a parenting role for me. I have regressed in age – evident the night Greg died when I'd obediently gone to my mother's house: not wanting to be a bother. Not able to insist 'I'll stay here'. No-one asking what I wanted; making decisions on my behalf, thinking they were helping and child-like. I obey. Now I want my daughter to look after me – just as she had in my drinking days.

A friend watches the video with her, filtering it for me. I'm terrified it's going to reveal to one and all what a terrible mother I am: so terrible my son has killed himself. I sit by his coffin, cold, shaking with fear, waiting for the verdict, judging myself: the verdict – GUILTY.

At last they emerge, Renée is crying. He didn't blame me, in fact he praised me, said I was the only reason that he hadn't killed himself - yet. It was about his pain, physical and emotional. He'd made no requests about a funeral. He left his meagre belongings to me.

The night before the dreaded cremation, four nights after I'd found his body hanging, swinging in the garage that had dislodged the glass jar I heard smash, Sam, a Maori friend who had put up the tent, used Greg's watch as an orators stick (tokotoko) and as each held it, his friends address Greg – they talk of memories, love, anger and pain. His coffin is full of notes, gifts, and the four day collection of my tear-laden tissues – sending my tears with him. This is his last night at home, tomorrow we are going to Rehua Marae for a service before the final act, the dreaded, unwanted, cremation.

Greg's funeral was a blend of two cultures. Having been brought up by a Maori dad since he was six, our family lived a comfortable mix of Pakeha and Maori ways. I'm sure Greg would have assumed that on his death, if he'd thought about it, that he too would go to Rehua, just as his dad had only six years earlier.

Strangely, I had attended the opening of Rehua marae in the late fifties with no idea of the major role it would play in my life. It was my first time on a marae in my mono-cultural city and I recall being called on from the entrance and sitting on chairs set in front of the building built by the young men at the hostel. It's a wharenui, a carved meeting house in which all major Maori tribes were represented and the first urban marae in Christchurch. It also was the site for my husband's funeral before we flew to Northland, and now being used for my son.

The simple ceremony over, his coffin is closed then carried to the hearse. A journal entry reminds me of that day:

'Can I come with him?' I ask the undertaker. I walk around the hearse in a daze and attempt to get in the driver's door- wrong side, back I go and into the passenger seat. I sit there hand pressed against my mouth. What is it I'm scared of saying. Screaming inside, keeping it stuffed down. We start the journey. The final journey. I know I have to let go. I don't want my boy burnt!

Greg's not a body he just lived in a body He's not a body he just lived in a body. Over and over this thought goes through my head.

Bealey Ave; the street I was born in. Look at everyone driving around; walking normally; don't they know I'm in pain? How can they be doing normal things? How dare they, my son is dead.

Here we are, turning into Linwood Ave. Greg used to fish here when he was only five or six. Greg I love you. I wish I'd shown you more He's not a body he only lived in a body.

Linwood Ave School, so many memories around here, 'I'm a honey child' he tells his new teacher yes you are a honey child Greg and I love you. I can't stand this. He's not a body he only lived in a body.

Hell we're nearly there, here's our street, slow down! I can't stand this. He's not a body he only lived in a body he's not a body he only lived in a body. Over and over it goes through my head. What does it mean? It's only his body that going away. He doesn't need his broken body any more- please god let him be running again.

Oh my god we're here. I'm going to be sick; I need to go to the toilet. Greg I'm so glad we travelled this last trip together; we've been through a lot just you and I.

_Greg you're not a body you only lived in a body and I'm saying goodbye to that body. YOU will never die; your spirit will live with me forever. This is our goodbye Greg, this trip together- we've done a lot together, alone, just you and me and this is our final trip. Let's go inside and say our public goodbyes. I'm so pleased you're not a body you only lived in a body_.

I had no idea how painful grief was. I had not realised it was as physical as it was emotional: it felt as though someone, or fate, or Greg, or a vengeful god, had put its hand into my chest, grabbed my heart, clutched it, squeezed it, twisted it, then ripped it out. I just knew I had a huge aching, bleeding hole, a wound that would never heal.

Already I knew I wasn't working through the 'grief process' in the neat and tidy way of the five distinct 'stages' I'd read about in the [1969] book by Elizabeth Kubler-Ross. (Denial, anger bargaining, depression, acceptance) My grief was not tidy. It was a messy, confusing and strange time which started every morning.

Each morning, as I woke, someone in my head said 'I've been waiting for you to wake up. Your son is dead.' For less than a second I don't believe it, and then try to crawl back into that nano-second between sleep and that cruel, daily, announcement. A month after Greg's death my journal records: _I feel dead, only 1/2 alive, going through the motions, can't be bothered, what's the use, it doesn't bloody matter. I'm making lists of things that need to be done but can't be bothered carrying them out._

For much of my life I'd visualised myself as a kid's toy – the one with fat round base that can't be pushed over – that no matter how bad things were I would always bounce back up eventually. This time it felt as though someone had a heavy boot on that toy. That this time, that fat-bottomed baby's toy couldn't get upright no matter what I did.

However, despite feeling as though I'd never survive, that I would die from grief, I continued reading, journaling, and talking to a counsellor who I'd been attending for untreated childhood sexual abuse. My conversation with her now is all about my current pain. I later read that suicide is the only death in which the person who suicided, puts their psychological skeleton in someone else's wardrobe. I'm grateful to that therapist who gave me the space to explore that wardrobe, one whose contents, dirty, torn and crumpled, were overflowing.

I also devour books about grief – biblio-therapy I've come to call it, therapy through books – and they help me see my reactions are 'normal' even though none of this time feels anything like normality.

The Courage to Grieve **** by Judy Tatelbaum arrives from a friend from New Mexico - she inscribes it ' _To Heather – my most courageous friend, Ilse'_. I don't feel courageous but her faith in my survival allows me to move a little step further along this rocky road. Another book arrives, from Alaska. ' _Especially for Heather, A survivor, a winner, and a special friend, love from Ingrid_ it says: How to Survive the Loss of a Love **** by Colgrove, Bloomfield & Williams is simple to read and offers me hope.

Memories and dreams take me back through Greg's life – almost as if I'm looking for a point at which I could change history. I even go back a generation: 'if my father had not been a motorcyclist, maybe I wouldn't have liked bikes and so Greg wouldn't, so then the accident wouldn't happen and then the suicide would not have happened either' my head tells me. My dreams are the same – he is always young, happy, cheeky, and handsome, so it's always a terrible shock to get the daily proclamation about his death.

Daily I also absorb love from his dog. A couple of years ago he'd appeared without warning: 'Gregory! Get rid of that dog.'

'I'm looking after him for a mate' he says

'I don't care' I replied 'Get rid of him, he's ugly'

Secretly, I was scared of him. White, a few black spots, six stone of solid muscle, bandy front legs, squinty little eyes and a large head. Not a sight that endeared itself to me. It was not only his physical appearance that was threatening. Bad publicity had fed my prejudices. 'KILLER DOG. SAVAGE ATTACK' Headlines such as these had taught me about English Bull Terriers. Not the type of dog I wanted.

Worn down by Greg's' nagging I gave in on the condition that 'it' remained locked in the back yard and never came inside! Days later, standing at the window, phone in hand, it was impossible not to have that darn dog catch my eye and it seemed to smile at me.

A few more days and he didn't seem so scary. I even caught myself feeding him the occasional treat out the window, and watching Greg having fun with him and an old football. I even found myself laughing at his antics and clown like behaviour.

After a month it dawned, I'd been conned! There was no friend who owned 'James'. He was an orphan. The result of a broken home and my son had adopted him. Despite my initial fears, I reluctantly agreed to his staying as it was good to see Greg having fun with this strange scary dog. Ever since his accident he found it hard to trust people. But here was a creature that just loved him, didn't notice he had a leg missing. And, because of that, James stayed and little by little he wriggled into, not only the house, but also my heart.

James slept on Greg's waterbed and watched TV from the couch, enriching Greg's life. He fed him, loved him, and at times ignored him and still James remained a loyal and devoted friend. They had many adventures together, some recorded on video. James loved to watch himself on TV. Barking, whimpering and much tail wagging at the screen showed he knew who the star was. Sometimes they went away in the big Chevy van that Greg had customised, James shedding his short white hair all over the plush purple fittings.

A few years later it was James who was with me when Greg died: James who whimpered as the ambulance staff attempted to resuscitate him; James who sat by his coffin as it lay in our lounge and James who comforted me as I worked through my grief. How glad I was that I had grown to love him. Now it was my bed he slept in, my car he shed his hair in, and my grieving heart he poured his love into: a loyal and trusting friend. Tears come to my eyes as I remember with love that bandy, ugly, slit eyed, big headed ball of muscle that had brought unconditional love to our home. (And whose cremated remains are now on Conical Hill, Hamner Springs, beside Greg's)

I hated Saturday nights as they clicked over yet another week since Greg's death. I found myself watching America's Funniest Home Videos and Billy T James shows so I could laugh.

The police return Greg's clothes. I love the smell of them, sad at the solitary boot and hate the rope they also return and want to chop it into tiny pieces. I'm super sensitive to sirens, ambulances in particular, and cry wherever I hear them.

In April we survive his 21st birthday, acknowledging it with a couple of his best friends with a dinner of Greg's favourite foods, but Christmas loomed over me like an approaching storm. Dark clouds of impending doom hung around any thoughts of the summer holiday season and I had no idea how to handle it. I'd never been a grieving mother before and didn't know if I'd ever learn to live around the huge hole in my life. Rainbows in my mind now range from black to pitch – with just occasional glimpses of brighter colours. I write in my occasional journal:

July 1991. Dear Greg, I'm angry at you killing yourself, I'm angry that you wouldn't wait a few more days, I'm angry that you didn't tell me, I'm angry that you didn't give me a chance to help you then. Well I'm saying I'm angry but right now I'm not - I feel detached from this - it's not real

31st Oct 1991. You have to let go they tell me. Let go what and how. What will be left if I let go Greg? I feel that I will have nothing left of him; nothing left inside me. No emotions. There will be an even bigger hole to fill if I let him go. Actually nothing inside me almost seems a good idea. That's often how I feel; lonely but safe and secure in its familiarity. Right now my feelings seem dead. Am I abnormal? Where are my feelings? I feel stuck. In the beginning I had lots of feelings, now only in little patches and then I shut them off. Do I think I should be finished with all the pain by now? That people are sick of hearing my pain. Well I'm not finished! Will I ever be?

As Greg died in December, anniversary feelings were mixed up with the approaching holiday. Previously we celebrated this time with a traditional family day: kids delving into stockings at an unbelievably early hour, presents from under the tree were opened after a special breakfast; bacon and eggs, fresh orange juice, waffles topped with raspberry jam, banana and whipped cream, percolated coffee. How was I ever going to enjoy those things again? How could I go to the old family home for the usual dinner and celebrations when Greg wouldn't be there?

Journal entry: December 1991

It's been a year since he died

Or so the calendar says

My hearts confused,

It seems unreal, can it really be?

Are you sure it's not a day ago,

A month ago

Or perhaps it didn't happen at all.

Am I dreaming?

A terrible nightmare?

Please let me wake.

My spirit says it was 500 years ago

And the calendar lies.

Shops, full of invitations to buy, had gifts exactly right for Greg. Shirts, sweaters and CDs, all seemed to have his name on them while nothing appeared to be appropriate for his brother or sister. Memories of his pleasure at simple things, such as peanuts in the shell in the toe of his stocking, made even the fruit and vegetable section of the supermarket painful.

Assumptions by others that Christmas would follow previous patterns made me mad. Don't they know that nothing will ever be the same? My head came up with solutions that ranged from ignoring the season completely through to just joining in with the usual plans. Nothing fitted and the old rules that had taught me I should try to make everyone happy and not to express strong feelings, no longer applied. After other family deaths Christmas day had been very much business as usual and I felt that was expected of me too. Greg's death however, had changed me.

Slowly I realised I had the strength to do what I wished, what I needed, that grief had somehow given me permission to be myself. Greg's death had exposed the part of me that no longer cared what others thought about my actions. Before, a don't-care attitude had been a part of my rebel, drinking, dope-smoking days, now it was a part of maturing, of me not needing others approval. Approval now came from within, from knowing how to be true to myself, and ideas began to emerge: ideas and activities that would soothe rather than irritate.

Memories of a four-day hike on New Zealand's famous Milford Track, only two months after his death, reminded me of the peace nature provided. Over the years we, Richard, Renée and Gregory, had spent many days and weeks living under canvas by the sea, rivers, farms, and native bush. Exploring New Zealand had been a big part of our life and packing up the car for a weekend out of the city a regular joy. Slowly a plan evolved that suited us - tramping the Abel Tasman National Park at the top of the South Island.

As painful as both the anniversary and Christmas were, the trip was healing. Memories of other holidays gave us opportunities to talk about Greg, and that, along with the beauty of the area helped us cope with what had appeared to be impossible. In one simple move we had removed ourselves from the sights and sounds of others enjoying Christmas. While walking in the peace of the native bush, beside white sand, blue sea and green bush helped us realise that life could be lived again. That maybe we could even enjoy Christmas, one day.

Two or three years later tinsel and trees once again became part of Christmas. Over the years I have often included Greg in my activities – a toy put under the city mission's tree for a needy family; a donation to a hospice, a special ribbon on the Tree of Remembrance, while in another year, money (donated in his name) for planks to help build a wheelchair walkway in a Banks Peninsula native bird sanctuary.

Slowly I learned to live with Greg's death. And, as I slowly learned to live with his life, not his suicide, it seemed that 'letting him go' gave him back.

More survival tips for friends and family after a suicide

Christmas and anniversaries

Each year we hear of the pressures families feel during December - stress from overspending, unrealistic expectations, violence due to alcohol and other drugs. Pressures like these are multiplied when we're grieving.

Decisions about a Christmas tree or it to send cards need to be made. Yes? No? Maybe? Will the children want to hang stockings as usual? Will we continue with family traditions or make new ones? Talking about these issues helps not only our decisions, but also helps both our grief and our mourning.

Just to be clearer, as I see it, grief is about our feelings, while mourning is about the actions and rituals we do around a death. Both need our attention.

I have found no one right or wrong way of working through grief: just ways that helped me and knowing that the anticipation was always worse than the occasion was one thing that helped. So, as Christmas, or another anniversary approaches, do what feels right for you - gut instinct worked well for me.

Strange as it may seem, while being necessary grief is also a privilege: it stems from giving and receiving love. Just as love doesn't end with death, neither does grief end with the funeral. Sometimes our grief is more painful as the weeks and months pass.

It can be more intense on birthdays; on the birthday of the person who died as well as our own, and, especially for children of the deceased, reaching the age of the loved one who suicided can be critical. Holidays, special family dates and anniversaries all alter the intensity of our grief. These dates may not adversely affect all the family, although the first experience of each event is usually traumatic. The first anniversary of the death can be especially painful as we relive the events of a year ago

So, how will you cope? Will you make a plan or take it as it comes? Most people find simple advance planning helpful; just remember that plans are not carved in stone and they can be changed even at the last minute. For instance, you decide to be on your own then find you want company. If this happens don't berate yourself for the change, after all it's impossible to plan how we will feel in the future so live in the present time, in the 'now'. I hope these tips will help you, and help your friends, understand grief.

Be as gentle, compassionate, and loving to yourself as you would to a grieving friend. Memories are yours to keep so talking, laughing, and crying over them means you are growing through your grief. By the time the first anniversary arrives most of us have realised that ignoring grief does not make it go away. Conversely, talking about our pain does not make grief worse, although sometimes, or often, it may feel that way.

Often friends stop talking about the deceased person as they assume that when you cry 'they have made you feel bad' - as if their talk could increase our pain – we know how painful it is and know their talk cannot intensify it. I believe it's because they feel uncomfortable with our tears rather than their concern for us that stops them talking about the person. It's difficult to explain to them that our crying is beneficial. No-one ever says they had a bad cry, it's always 'I had a good cry.'

The first anniversary is also an important time for some religions and cultures: it's then that memorial headstones or plaques are either erected or unveiled. These events can range from a small private ceremony to large gatherings of friends and family. Many Pakeha New Zealanders have adopted this practice from Maori and tell of the tremendous benefit they felt. One woman told me, after the unveiling of her daughter's headstone, 'It was like the funeral without her body. We could grieve for her in different way to that raw, raw grief of the actual funeral.'

Others of us choose to change our routine and be away from their usual surroundings at anniversary time. The choice is yours. Don't do what you think you 'should' do - those 'shoulds' are rarely helpful.

Friends and family may encourage you to 'keep active', 'get on with life', 'you have to let her go' and other non-helpful advice such as 'he wouldn't want to you keep crying'. I am sure you have heard all these and other such homilies. One I hated was 'you're lucky to have other children', as if our children were interchangeable.

Keeping busy will not heal grief either. Experience shows it increases stress and merely postpones or denies the need to talk, feel, and cry. 'Time heals' the vague 'they' also say. Not true. It's what we do with the time that does the healing: ask anyone who used medication to dull the pain - when the pills stopped the pain was still there, just waiting to be dealt with. As a past colleague said, 'time doesn't heal; it doesn't get better, what happens is things get different.'

Bodily distress is common at anniversary time and all those aches and pains that may have occurred when the person died can return. These range from vomiting to chest pains, from backache to infections, or even being accident-prone therefore, if you feel stressed or have low energy levels, listen to your body and treat all symptoms with appropriate care.

Eat healthy, natural foods or have vitamin supplements if your health practitioner recommends them. Rest is important and exercise, such as walking, can be of immense value. Walking is good at any time but especially now if you are feeling tired or not sleeping well: others prefer a good workout at the gym, run, or cycle. I don't.

Special dates often, in fact usually, have no significance to anyone else, so be prepared to take what you need. Your grief is your right and I encourage you to claim it. Don't allow others to damage it because of their ignorance.

If you haven't tried journal writing now is a good time to see if it helps you – many love their notebook that listens to everything and makes no judgment. (More of journaling further on)

The Canterbury Bereaved by Suicide Society wrote the following for one of their pamphlets or newsletter.

  * Remember you are not alone. Find someone to talk to.
  * Use your loved ones name. Talk about them, good times, bad times, and other holiday memories.
  * Eliminate as much stress as possible. Plan ahead, keep it simple. Ignore others expectations.
  * Involve your children in your discussions and planning...it will help their grief too.
  * Do what is right for you and your family, don't be pressured into doing things that aren't OK
  * Use whatever form of spirituality is meaningful to you.
  * Pace yourself physically and emotionally, be tolerant of your limitations...grief is tiring!
  * Christmas will come no matter how much you may not want it. You will survive.
  * Remember the worst has already happened!
  * Take one day at a time, one hour at a time. 
  * Anticipation of the event is always worse than the actual day.
  * Buy a special gift and donate it to a charity in your loved ones name
  * Burn a candle over Xmas to symbolise their presence in your thoughts. 
  * Write a letter to them in your journal. Describe how Xmas is without them.
  * Change holiday habits. A Xmas breakfast instead of dinner. A restaurant instead of at home.
  * Keep all your holiday habits. For some, the familiar is reassuring.
  * Expressing your feelings honestly always helps.
  * Volunteer to work at the local mission, old folks home, answer Lifeline calls (if trained) 
  * Have a special toast to absent loved ones before the main meal.
  * Tie a yellow remembrance ribbon on the Xmas tree - your own tree, or the town one.
  * Set aside an evening to look at photos and talk about him or her.
  * Make a memory book. Children find this really helpful too.
  * Make a list of things you found helpful, share it with others. Keep for next year.

For more about the BBS group see _Who Cares? A social history of the Canterbury Bereaved by Suicide Society 1988-1994 ISBN 0-473-03155-8_

Journal writing

Suffering in silence can make you sick. The old adage that confession is good for the soul appears to be correct – not only for the soul but other factors too. Studies have found that it's physically and emotionally beneficial to express emotions. (Dr James W Pennebaker. _Opening Up. The healing power of confiding in others)_ Blood tests showed improved levels of immune activity in people who had expressed deep emotions on paper than those who had not.

When we cry, chemicals which release tension are in our tears, so physically and emotionally, we gain when we cry. It seemed to matter little if they wrote, or talked about their feelings.

Tears produced by onions are very different to the ones created by an emotional moment. I read somewhere that we have 1 million, 850 thousand drops of tears to cry (65 litres). Now, I have no idea how accurate that is or how it could be measured, all I know is that figure helped me – every time I cried I knew I was reducing that number, which meant it was good that I was crying!

Journal writing is an effective way to talk about feelings. Grieving people often find they are able to express on paper feelings they have felt unable to verbalise. This is particularly so for those who have been conditioned not to expose their thoughts or are afraid of their strong emotions and other people's reactions to them. Writing can also allow us to see the progress we've made, or recurring patterns.

Feelings and thoughts can be so confused when in our minds. Grieving people have described their head as a washing machine, or that there's an egg-beater whizzing around in their mind. So many thoughts that are so jumbled up that it becomes impossible to remove any one idea for examination.

Grieving people are also frequently expected to, or need to, return to their employment at an early stage of their mourning. Mothers of young children invariably usually need to continue with child care. For these folk, writing has another benefit, as when our heads are full we can't remember tasks.

Keep paper or notebook handy. Use it to make lists of what needs to be done as ideas come to the surface. This means you don't need to remember them and now it's been recorded you know the task will be done at some time. List writing lets paper remember so you can forget. Once on the list the task can be forgotten until it's time to attend to that chore. When you have the energy to attend to a task, look at the list and decide which one to do.

A friend told me 'I used post-it notes. I wrote one task on each. Stuck them on my spare bedroom wardrobe door. As I finished them I took them off and put them in my journal. It meant that I could also reconfigure them just as I wished.

Extremely painful memories or flashbacks can also be addressed by journal writing. The more we attempt to suppress thoughts the more we have them. Studies with Vietnam vets have shown that one of the most successful treatments for flashbacks of the horrors of war has been to have them talk and re-live the experience. ( _Dan Weg, White Bears and Other Unwanted Thoughts: suppression, Obsession, and the Psychology of Mental Control.)1989 ISBN 0-89862-223-9_

Talking about experiences we've been trying to suppress does is painful: however, the short term pain seems preferable to the long-term mental and physical consequences of attempting to keep the unpleasant experiences and memories pushed down.

When people are grieving it's virtually impossible to maintain the extreme high levels of grief that is often felt. Luckily nature appears to drip feed it at a level that person can tolerate, cope, and handle it – not that it felt that way to me. I thought I would die from the pain at times.

I also thought about suiciding. This was confusing as I knew the pain it caused yet I considered it. Thoughts of suicide and my fear of others killing themselves, as well as thinking of my own death consumed me at times. I was bewildered by this but now know how common it is –that this was just another part of grieving a suicide death. A part that needs to be talked about with someone who knows this is a frequent reaction, a feeling more than an intention. I have heard a saying ' _we are as sick as our secrets'_ and when these thoughts are exposed, have had sunlight, flashlight, or torch on them; they lose much of their power over us. Knowing this was really helpful to me.

Grieving people use many ways to not have to think or feel for short time. Some ways I used were sleeping, cleaning, eating, or watching TV. Others jog or clean excessively. Cleaning the walls or vacuuming doesn't tax the mind but can often save us from unwanted thoughts – temporarily. I've been told juggling is another way of finding short-term reprieve from emotional pain: all these are helpful so long as they are not continued for a long, indefinite periods.

Just know this – the grieving person, especially in those early hours and days, is doing exactly what they need for this moment.

Remember, no one way is right for every person. I offer the following mix of ideas for you to choose from and modify for your own use when or if you write a journal.

From practical observation of my clients, and my own experience, I believe it matters little when we start, or at what part of the grieving journey, just that we start. Some people start immediately, others do not begin to address some of their grief issues until much later. The one important factor is that you do start and that each entry is dated. Journals, unlike diaries are not always written on a daily basis and by dating the entry you can see the movement and chart your progress. For me, progress sometimes meant I felt like I was going backwards at times – looking back I can see it was all part of the process for me.

Journal writing allows the safe expression of our anger, blame, or guilt without hurting others. Anger and blame often pass and by expressing it in your journal means we don't irreparably damage relationships by inappropriate blame or guilt producing words. Those painful and blaming emotions are better written in a private journal than expressed in a conversation or in a letter.

Of course should these words need to be expressed verbally at some stage, journal writing is also a good way of sorting the wheat from the chaff, to clarify what we really need to say and what can be left behind. Confronting people with our pain or accusations is made easier when we know exactly what we want, or need, to say and we can ignore the many side issues which easily camouflages or confuses the real issue we're talking about.

Unsent letters in a journal means one can speak directly to the person addressed. This can be anyone: the person who died; the hospital staff; funeral director; through to the person who caused the death or injury through drunken driving to name a few. It is extremely effective to write as though you are speaking directly to that person – knowing that it will not be seen by anyone. If you decide at a later date that you do wish to say it directly to them, the unsent letters in your journal will have cleared the air so to speak and you can then write a clear letter. Such letter writing, just like me writing this book, means it's really helpful to put the writing aside for a while (days or weeks) and then edit or rewrite parts.

Writing to the person who has died enables you to express thoughts and feelings that you may not have said in life. After a death we all have regrets and will often say: 'if only I had told her' 'if only I'd said xyz to him' these regrets happen whether the death was sudden or anticipated. Letter writing in your journal enables you to say those words. Sceptics of this method have been pleasantly surprised at the results when they attempted writing a letter to their loved one, or even to a dead person you have resentments or anger towards.

These letters can release feelings of sorrow and anger, regret or guilt. Our expressions of grief are unique and personal and by writing them you don't have to meet the expectations of others. Spelling and grammar are unimportant. Nevertheless I suggest your journal always be kept in a place where your privacy will be respected.

Finishing unfinished business with a person who has died can transform pain into growth and helps finish a jigsaw that appears to have missing pieces. It allows us to complete our emotional relationship with the person.

A woman to whom I had suggested letter writing writes of her experience: _'my father's death was not sudden yet it was in the fact that years later I realized I had not said so many things which still held importance in my healing. Those 'things' were imminent in my mind for a long time and then I wrote Dad a letter . . . fourteen years after his death. I found a quiet special place, and once my pen contacted the paper I felt a bonding, and the words came freely. Within weeks after the letters completion I was able to visit his grave and I read him my letter. I knew within me he heard every word. I then destroyed to the letter. That was an action of closure but the result_ _has been an opening to loving memories of his spirit.'_

These letters can express love, longing, and gratitude as well as releasing feelings of sadness, anger, regret, or guilt. Each letter needs to be written in one session so we can complete one part of the mourning process. A letter on the same topic can be written again and again and even again if necessary the next week, the next day, or the even the next year. Don't reread the previous letters, just write another one each time.

Naturally we become angry, sad or hurt while writing these letters, but continue writing even if your words have disappeared behind a wall of tears and you can hardly see the paper. This is extremely beneficial both physically and emotionally. Clarissa Start ( _Being a Widow_ ) talked of her journal been her 'paper psychiatrist' in which she confided all the thoughts and feelings she had tried to squash down and of the enormous benefits that followed.

Some ways the journal entries can be started are:

  * I really miss the way you
  * I'm so sorry that
  * I wish I had told you
  * What I'd like to ask you is 
  * I'm really angry
  * When you
  * One of my very special memories is . . .

Be creative and most of all listen to that wise person who lives within, that inner voice that knows what needs to be said. Often I didn't know my real feelings about something until the letter was finished. I just needed to get started and allow my energy to flow and I was soon in touch with my inner truth and so will you.

Some other ways of using a journal are in a book, _The New Diary by Tristine Rainer_. She talks of making lists of feelings; impressions; or thoughts. She says is this is a time-saving method of journal work. Word portraits of the person are also helpful. I found this a great way to help grieving children – they all loved creating a book about their mother, sibling, friend or grandparent.

Many people have dreams after the death of someone close to them. Recording these in a journal often provides a visual journey through grief, with our subconscious a helpful partner as we work our way through unfamiliar territory. I wrote about a couple of my dreams, but the one thing I really remember was my son grew up again in my dreams. As the months went by, he got older and older in each dream and I found it helpful having him alive and happy in those dreams – although I hated the shock each morning to find he was not eight and alive, but twenty and dead!

There's usually no need to decipher these dreams just accept them as you experienced them. In my work people usually had their own ideas about 'what the dream meant' and I believed they do not require my, or anyone else's, interpretation of them. When they asked, would turn the question around: 'What do you think it means?' Once they answered I would agree that their explanation sounded right as usually it did – just as other family member's dreams may have been quite different with very different understandings.

Finally, remember your journal is not for other people's eyes. It is easier to be totally honest with ourselves if we know that no one else will read what we've written, it's a combination of both insight and catharsis.

While we're discussing writing, now seems a good place to mention suicide notes. These notes are not as common as people believe - my memory of them is that it would be under a third, possibly even less than quarter, of people left a note. In our support groups, when notes where discussed, most people wished they had been left a note, while those who had been left one often found them confusing and felt it didn't explain anything – in fact it left even more questions.

Just as we did with people's dreams, we did not try to interpret the notes. Once again this is an area where different family members saw diverse 'messages' in the notes: there was no right or wrong way of reading them, and everyone's understanding of them usually changed over time.

Theories of grief

One of the ways I learned to live around the huge hole in my life was to study bereavement counseling and social work. There were no programs to study bereavement counselling in New Zealand and just a year after Greg's death I attended a summer school at the Bereavement CARE Centre in Sydney Australia to enhance my counselling skills.

There, with Mel McKissock as tutor, we were reminded that Elizabeth Kubler Ross did not suggest her template for grief - denial, anger, bargaining, depression, and acceptance - was for anyone but people with a terminal disease, people grieving for themselves. Unfortunately even today the media, and untrained or badly trained counsellors, perpetuate the myth that this is how we grieve the death of someone. Her model is great for other losses (divorce, employment, infertility as examples) just not for a loss by death. Bereavement is a loss that can never be reversed – most other losses can even if it's in a different form – adoption, remarriage, new job.

My grief was not orderly. It seemed others were not either from what I witnessed when I worked as a bereavement counselor for BBS (Canterbury Bereaved by Suicide Society 1991-1995) or in my private practice, or during my times as an alcohol and drug therapist.

There are various theories of the grief process which you can find and read yourself, but I found grief itself comes in many shapes and sizes. My theory to add to the mix is the 'Heather Hapeta Can-of-Worms Grief Theory'.

Imagine a can of worms you have collected to take fishing. Picture each with a word etched on them. Words like; anger, love, distress, denial, numbness, bargaining, blame, disbelief, fury, rage, terror, fault, horror, dread, depression, shock, pain, panic, guilt, and yes, even acceptance or relief. Those are just to start with: grieving people can and will add many more.

Now look at that can of worms again. Look again in one more minute, then in five: look again days, weeks, and months later. Each time you look, the worms and their words will be in different places. That's what grief was like for me. Nothing neat and tidy; no logical progression of feelings leading to the 'closure', 'letting go', or 'acceptance' that friends, family, colleagues and the media want us to do - perhaps so they can feel better. We need to do it our own time and mostly the grieving person does it well - and exactly as they need to, despite the worries of friends. Of course, occasionally people do get stuck and need help, but more of that later.

How would you draw your model? Doing just that is another helpful exercise either alone or within a grief group. Another model we used in BBS suicide support groups was to look at a gemstone, a multifaceted diamond. When you hold such a stone to the light it looks different depending on where you are when it's held up to any light – that people on one side see different colours reflecting from the same stone, and every time we move the gem, or the light changes we all see different things. This model is particularly good for families to consider: we are grieving the same person but we all see something different reflected back.

In the beginning there are many common reactions, usually starting with shock, disbelief, anger, fear and numbness. People often call many of these 'denial' whereas I see them as a protective barrier, a cloak, a way of coping with that which seems 'uncopable'; a word that doesn't exist but one all grieving people know. Luckily it is 'just' a feeling and we do cope despite all the seeming evidence to prove we cannot live through this death, and a suicide grief is unlike any other.

For much of this early grief time we have limited concentration, can appear and feel robot or zombie-like; find it difficult to make decisions; or we have strong emotional outbursts – all are normal.

Disorientation, searching and yearning, anger and guilt were daily companions and I often thought I saw my son, could smell him, or hear him talking to me. I also became super sensitive to sirens, ambulances, and funeral cars. Weirdly I even started eating the cereal my son loved and which I'd hated. Many other grieving people told me they too have done or thought things others thought strange or even bizarre. Others become accident-prone or have physical symptoms that mirror the person's death, and studies show grieving people attend their health centre more often than usual.

I initially lost weight I then began to put it on as the truth of Greg's death became more real and painful, as I realised he would not return and even my thoughts of suicide were a common reaction I later find.

Once again I need to say, all these symptoms and behaviors are normal! They're not signs you need to get tablets from your Dr; see a counsellor; or self-medicate with alcohol or other drugs, all of which you may consider, or friends suggest.

Sadly, because we regress (emotionally go back to a younger age) during grief, husbands and wives, parents and children, brothers and sisters usually cannot support each other. This often leads to the breakup of relationships because of this perceived lack of support. If grief is badly affecting your relationship, I believe this is the time to seek bereavement counseling or a support group for people going through the same type of bereavement grief.

For the person who finds the body after a suicide (often even if it was a stranger) grief is, or can be, complicated. It can include Post Traumatic Stress Disorder (PTSD) and this usually needs professional support – not something I can discuss here, albeit to say, many people have had great relief by talking about or emotionally and physically walking through the 'scene' again. If you found the dead person and images of that continue to play in your mind – please see your health professional or a suicide bereavement (postvention) counsellor.

During the second year of grieving, after the summer school, and not wanting to return to my successful career selling real estate, I attended university. Slowly I gained energy, was able to make decisions, and good sleeping patterns started to return. I was no longer obsessed by 'The Loss' or 'The Suicide' but was able to grieve for my son, the loss of his leg, and for me.

Mal McKissock describes 'the tasks of grief' as:

  * to accept the reality of the loss
  * to experience the pain of grief 
  * to adjust to an environment in which the deceased as missing
  * to withdraw emotional energy from the deceased and reinvest it in other relationships

As well as from my own experience, I've observed it takes two to five years to work through that list - especially in the case of suicide bereavement. And, I can report, writing this over twenty years later, I have had tears well up in my eyes – none of the devastating weeping of those early years, but tears none the less.

Society's attitudes and responses to grief

We often have difficulty with our grief because of the expectations of those around us. We've all been shaped by our family, by society and we westerners are mostly a death-denying group. One of the ways we deny deaths existence is through language. We use euphemisms such as kicked the bucket, passed over, lost, gone away just to name a few: no doubt you could add more that your family use. And, check out the language on sympathy cards, many try to pretend the death hasn't happened, or that at least you should not be sad!

Our rituals often also help us deny death – or at least attempt to avoid it. We still often cover the dead person's face, part of our old primitive fears that death may be catching or that the deceased's spirit could affect us. Today we do it differently – crossing the road to avoid the grieving person, 'I wouldn't know what to say' we proclaim, in reality we're scared death is contagious. Notice at funerals how we remove ourselves from being the next death, the next funeral we will meet at. We talk about the way the person died and how we are not like that. We are not over-weight; we are not diabetic; we don't drink and drive; we are not that old: all very subtle, but at the next funeral of someone you didn't know, or were not close to and listen to the conversations.

Listen too to how we teach people how to do grief - how we reward them for not grieving. 'She's bearing up well. She didn't cry' 'He's being so brave.' 'What a good wee man he is, really supporting his mother'. Everyone who hears comments like these tucks them aside until they too are grieving – then they pull them from the recesses of their mind and put them into action by not crying, being brave and putting their grief aside so they can 'support' others.

Even our intuitional practices encourage and validate our avoidances of death. Screens or curtains are put around a person who has died in hospital; no mention is made of them to other patients unless someone asks. And, we keep finding ways to keep people alive, from the very premature babies to the very old and I wonder at what cost and for the benefit of whom? Often, it seems, not for the person themselves.

And finally, we frequently deny the significance of death by belief systems that attempt to make us feel better. Some of these ways include religions which tell us to be happy, there is life after death, or it's a transition. While many people have these beliefs, when we say these things to friends what they often hear is 'don't grieve'. This denies the fact that death is painful and needs to be acknowledged, even when we have those religious or cultural beliefs.

Whether we are a friend, family member, or counsellor it's really important not to impose our beliefs on the grieving person. We tell people things to try and help, but often it's us we are helping with the old trap of wanting to fix things, fill in the silence, and therefore confirming our position and not listening to their thoughts, feelings and beliefs: and that's what grieving people need someone to listen to them – or sit with them in silence.

Natural and normal grief responses

  * Tightness in your throat or chest 
  * Crying unexpectedly
  * Mood swings 
  * An empty feeling in the your stomach; loss of appetite; over eat
  * Feelings of guilt or anger at yourself, the dead person, others, or institutions 
  * Feel restless and seek activity but find it difficult to concentrate.
  * Feel as though the loss isn't real, that it didn't actually happen. 
  * Sense the person's presence; expect them to walk in the door, hearing their voice, 'seeing them'
  * Wander aimlessly; forgetful; don't finish things you start
  * Have sleep problems; sleep too little or too long, dream of the deceased 
  * Grieve for future plans that can no longer happen
  * Have trouble thinking, planning, making decisions
  * Aching arms
  * And with suicide, we often feel rejected, abandoned or betrayed.

You will have some, or all, of the above, and your grief will last longer than you or your friends expect. It will exhaust you, it will change, and it will change you. It will also affect all of you; physiologically, physically and socially.

How different groups respond to death

We don't 'get over' grief. While our loss usually becomes part of the fabric of our life and we are not aware of it, generally it never goes away completely, it get 'different'.

We all grieve differently, generally according to what we learnt about grief as we grew up and the amount of grief we have encountered. We seem to carry a grief basket somewhere deep inside us and when we judge someone for over or under reacting to something, we have no idea how full their grief basket is, or how strongly constructed. This is hard when within a family we all respond in different ways and often expect others to feel the same as we do. They don't and can't.

Sibling loss, while changing the position in the family, it can also include being angry at your parents for not preventing the death, guilt at being alive and becoming aware of your own mortality. Interestingly a comparative study at Canterbury University (Bereavement by Suicide and Natural Death: a comparison study by Renée Booth 1994 New Zealand) says in the abstract ' _Relationship to the deceased was examined in a qualitative way. The responses led to some interesting findings. Spouses were found to have a slightly higher level of grief than parents or adult children. Siblings responded with the highest level of grief but this may have been influenced by the number of suicide bereaved siblings in the study.'_

Young men often react by withdrawing and stifling their emotions or substituting grief with aggression. Some parts of society, or other countries, still have unwritten 'rules' about gender roles and within grief it's no different. For example many men think they have been taught they 'should' be in control, support others, and be confident, courageous, think not feel. It must be hard, if not impossible to grieve if you have these messages in your head. After all, grief is all about lack of control

.

So men may be silent, keep their grief secret, or become really active (jogging or working long hours for example) or suppress feelings with alcohol or other drugs. Just because you can't see their grief, it doesn't mean it's not happening.

Do children grieve I've been asked? Most emphatically yes they do. Nonetheless the way in which they respond can be or seem different to ours and this has led to us making assumptions that children don't grieve, that they are resilient and get over death quickly and easily. However I have been constantly amazed at their understanding of death and the depth of their grief, which they often feel constrained to hide from adults as it 'upsets mum' or 'makes dad cry'.

Children can have physical symptoms such as head or stomach aches. They can be anxious, angry or guilty, just like us. Make sure you use exact terms around death. Youngsters who are told 'dad's sleeping' can be fearful of bed times. 'Lost' is another unhelpful and confusing metaphor for children to hear. Depending on their age they will expect you to go and find the person who is 'lost' and if you don't 'go and find them' children will be concerned that Mum won't find them if they are lost.

Most importantly allow them to see you crying. It's no use saying it's normal or OK for them to cry if they never see adults grieving too. We're their role models and what you teach them now, is what they will carry into their future grief – if they don't see you cry, no matter what you tell them, the lesson they're learning is, 'don't cry.'

Remember the forgotten mourners: the ex-partners, wives, husbands, lovers, friends and colleagues, we all grieve over a death no matter our current position in the person's life.

Suicide survivors, that is, the friends and family of a person who dies by suicide, usually need more support than mourners of other deaths. Unfortunately they often don't receive the care and can feel isolated because of a perceived or real stigma. It has been estimated that for every suicide death, there will be six survivors (Shniedan. E): a survivor-victim role that remains with them for life. These figures cumulate and annually they rise. John L McIntosh Ph.D. says this group has been considered 'the largest mental health casualty area related to suicide.'

It is accepted practice in mental health assessments that merely knowing someone who has suicided is a risk factor. Therefore, given survivors are at higher risk of suiciding themselves, it's vital they're helped, appropriately, with their grief, especially in those first few days, weeks, and months.

Consider this: it seems once a person has had a suicide death close to them, they are immediately eight times more at risk of suiciding than they had been the day before the death. So, by supporting people grieving a suicide death, you will help reduce the numbers of deaths. Feeling suicidal is a common reaction to suicide, help for your grief helps with these thoughts.

Seeking help from a counsellor

Asking for help from a skilled bereavement counsellor simply means you want support for a problem you may (or may not) have. Talking to someone who is not emotionally involved, getting help for the bewildering feelings we have, and most importantly, learning how to express them without hurting ourselves or others is invaluable.

Friends or family who have used a counsellor are often the best people to ask who they would recommend. Bereavement counselling is time-limited and ideally should be no longer than six sessions, spread over 3 to 6 months. Many also people return to counselling for one or two sessions at anniversary times. We (BBS) also held a candlelight ceremony at Christmas time which most found therapeutic even though they may not have attended either support groups nor had individual counselling.

Remember, if you feel uncomfortable with the therapist, trust your intuition and seek another opinion or consider an alternative counsellor.

Viewing the body

This is an important part of the grieving process for most people: but people must be supported to do this. Police and other officials often say you, or they, shouldn't see the person; 'the body is too damaged' or 'it will be too distressing to see'. Internationally, studies suggest that is not so. No matter how bad things are, it's usually not as bad as the picture our imagination has painted.

So, how can you support someone as they identify, or view the body? This is how I took families through the process when I was at the suicide postvention organisation, and how I taught other professionals to follow this process. Firstly, my recommendation to all medical personal who deal with dead people – if a bandage would have been used when the person was alive please put a bandage on the deceased person too.

I would arrive at the hospital morgue 30 minutes before the agreed meeting time and see the person myself. (Note: I usually had met the next-of-kin or family a few hours or a day earlier.)

The waiting room was joined to another smallish room into which staff wheels the deceased person before the family or friends enter. Once in I noted the obvious, the position of the deceased and any noticeable injuries, I also took in all the other elements in the room. Returning to the family room, I waited for the family, then told them something like this.

'When you go in the first thing you will notice is the trolley that Jane/ Joe is on. It is facing head-first. She/he has a bandage over the right side of her/his face and a white sheet covers his body. In the left corner of the room is a little table that has flowers on it and an easy chair beside it. The opposite wall has a landscape picture with two more chairs under it.'

If there are any sounds or smells I would mention them too. By describing the scene it meant they were free to concentrate on the reason they are there: to see something they don't want to see. To see someone they know dead. Their imagination has usually painted a much worse picture of how this will be, often based on TV crime programmes, and knowing what's behind the door helps reduce anxiety.

Occasionally they wanted me to go in with them, but I always let them make those decisions. I would wait for them and talk about the experience if they wanted to. I would often end up either counseling, or being the facilitator of a peer support group they would attend, so this time was helpful in creating rapport if they decided on such support for the next day, next month, or the even the next year.

Suicide and the press

Every now and then in New Zealand there is a call for reporting more about suicides in newspapers. And every now and then, the papers manage to get a grieving parent to tell the story of their child's recent suicide, and which they do describe in the hope of preventing more suicides.

Unfortunately, there is no evidence that there will be fewer deaths will happen because of their story: in fact empirical evidence says the reverse happens. That, when vulnerable people see such information, especially if it describes the manner of death, they are reminded of a way they too could be 'successful' or achieve headlines too - a sad 15-minutes of fame.

The reason for my son's death, and the manner in which it happened, was of no public interest, nor of any help to anyone but friends and family – and they didn't need to read it in the press. New Year celebrations continued everywhere except in our lounge. We sat beside his coffin, crying, laughing, and talking about how and why: also expressing love, laughter, pain, anger and blame - none of which would be of help to anyone except us.

Nothing of what we could have said to the papers, especially in the regressed stage we were at then, would have stopped another suicide or prevented another family from spending days, weeks, months and years examining every conversation they had had with the person that would have reversed the result.

Life, unlike the1998 Gwyneth Paltrow movie _Sliding Doors_ , does not allow us to try different actions that would, could, should, maybe, result in different outcomes. Grieving a suicide means we go through all those possibilities in the search for an answer, and depending on the time we were interviewed for such a story, the story of the 'why' of the suicide would change. What journalists can't tell, and don't know, is that many in the family have very different reasons for the 'why' of the suicide, and the 'how' it could have been prevented or that these 'reasons' change over time – often dramatically.

What is the agenda of those who believe that publicising the method of death is of interest or benefit to others? One article I read said, _'some health and social workers say the copycat syndrome is real and must not be risked at any cost.'_

People working or studying suicide or post-vention doesn't say _'the risk is real'_ – they know it, and observed data confirms it. Not just in New Zealand, but throughout the world. I suggest those who doubt this, research World Health Organisation data.

So, sadly, friends and family, who want to discuss, in the press, events leading up to and around a suicide, do so from an uninformed basis. When we grieve a death we regress tremendously and the emotional decisions made during that time are often regretted, and what we believe today will change many times as we work through our grief.

Suicide was removed from the New Zealand Crimes Act in the early nineteen-sixties but the stigma around the method of death remains. We continue using the language of crime: 'he committed suicide', instead of 'she or he suicided'. Arguments about people being 'committed to' the act of suicide are spurious. When we use the word 'committed' it's followed immediately by an action – mostly a crime. They, he or she committed rape, incest, murder, theft, and some fifty years later, still to suicide. So, a suicide survivor is contending with not only the complexity of grief, PTSD (if they found body), but this societal stigma too.

When we're grieving the death of a loved one by suicide and are faced with such unspoken judgement (albeit unknowingly) of our child, husband, wife, lover, friend or parent, our circle of support is reduced just when we need it the most. For those who find the unfamiliar word (suicided) too harsh, there are many euphemisms they can use – he took his own life or, by her own hand, are just two.

I would have had no real problems with my son's death being reported, but why? When my husband died at 35 years old no one thought that newsworthy, it wasn't announced as yet another cancer death. I rarely see front-page space, or other column inches, devoted to individual cancer deaths, strokes, or heart attacks: so why is it wanted for suicide?

The coroner's act, which is designed to look after the deceased's interests, is of course interpreted differently given the different backgrounds of coroners. In Christchurch we had one with a legal background, in many other places the coroner may have no legal experience and often merely reflects societal attitudes, although this is hopefully changing. I recall one death (not in Christchurch) that was attributed to an accident despite not only a note but also a previous attempt in the same manner, because the coroner was reported to have said 'a young person wouldn't do this.' Sadly the parents immediately stopped counselling for what they had acknowledged as a suicide.

Arguments about the reporting of suicides are unhelpful. What is needed is more support for those who are left behind to struggle through their pain and the suicidal thoughts that we are often left with.

Remember, despite the headlines, suicide deaths are numerically small and the grief from this form of death is different, however, I know, and so do many, many others, it is possible to survive the pain.

Here are a few suggestions I learnt from my own pain and others experience when I was involved with the Canterbury Bereaved by Suicide Society:

* Do let us talk – mostly we don't want your advice, just your ears – we need to voice what's going on in our head

* Do respond honestly to our questions about the death

* Don't remove tasks, responsibilities, or other actions, unless we ask you to. Tidying our daughter's room; sorting our husband's clothes, or a father's office, although painful, these actions are often needed, and valued tasks that help us work through the pain. Just because it hurts doesn't mean we don't want to do these jobs. We may just want to do it later. When we are ready.

* Don't tell us it's not our fault; that it's XYZ's fault; that its Gods will; and that we'll find a meaning to this in time, or any other conclusion you may have: ours may be different. Your deductions may be true but we have to work through a process to arrive at our own answers. Each of us will grieve in our own way and come to our own solutions.

* Don't tell us that you know how we feel – you don't, even if you had some-one die by suicide.

* Try not to let your own sense of helplessness stop you reaching out to us. Some of the most helpful support I got was from people who said; 'I don't know what to say'. I knew they were speaking from the heart.

* Do allow us our own feelings: we will be working through anger, disbelief, hate, love, blame and every other human emotion there is. We won't be doing it in a nice neat list like many grief books suggest. It will be more like a can of emotional worms – each one wriggling, and working their way from the top to the bottom then back up to the top, again, and again.

* Don't tell us what you would do, or how you would feel if you were us – you aren't us.

* Remember our grief will not be over in 6 weeks or six months. We have at least a year of working through the first pain, the funeral, the inquest, then the first Christmas, the first birthday, and the first anniversary of the death, the funeral and every other important time that we shared with our loved one.

Funerals

Funerals are for the living: they're a vital part of our grieving and mourning processes and being involved in the planning is healthy. It also gives us the chance to express the love we have for that person. Or conversely, it allows us to work through feelings that are not so love-based. After all, not all the funerals we will be involved with will be for people we love, and working through the so-called negative feelings is important too.

Relief, guilt, anger, are just a few of the feelings that we may have. For example, what of the daughter who was sexually abused by the father she is now burying, or the estranged wife of an abusive man. I recall a woman whose husband was identified as a paedophile (immediately after his death) and she felt hurt, that her whole life with him had been exposed as a lie. She wanted to dance on his grave, but thought she had to continue with the grieving-widow role and didn't (then) tell her family information the police had just disclosed to her.

Children too benefit from being involved in the planning of a funeral. I have been told of occasions when one of the younger members of a family came up with a suggestion that really struck a chord with them and was grasped with appreciation. Children are helped in the same ways as adults, so reading a poem about grandma, or dad, at the service not only involves the child but also allows a healthy expression of their grief.

I recall being horrified at the sight of my daughter walking into Rehua Marae with her beautiful long, blonde hair gone. Her gift to her stepfather was to put her hair in his coffin. Where, at twelve, she had found that idea I have no idea and to this day she remains happy with her action.

Also, the amount of money spent on a funeral does not equate with the love you have for that person: this is demonstrated by the appropriateness of the funeral rites. They can show we have thought about the person and your grief, not what society thinks a funeral should be like. It is possible to have an economical memorial that is sensitive to all our needs and I advise you to get quotes for all or parts of the funeral. The price for services offered by the various firms can differ considerably.

**Legal requirements** (in New Zealand)

Despite being simple, the legal requirements after a death, when we are grieving they can appear overwhelming, especially when we add to them our perceptions of what is needed. Only three things are needed – and these tasks are where a trusted friend is invaluable.

  * The death certificate, issued by a Doctor, showing the cause of death, OR a coroners burial certificate
  * The body must be contained in a coffin or other suitable container. (In New Zealand this just means solid enough to be handled by the pall bearers)
  * The burial must be in an area permitted by law (usually a cemetery) or cremated in an approved facility

**And, within three days of the burial or cremation** _,_ the following forms must be lodged with the Register of Births and Deaths.

  * Death registration form (from the registry office or on-line)
  * The death certificate; the medical certificate as to the cause of death; and if cremated, the coroner's burial order.

And that's all!

A good friend can be delegated to get these certificates from the Register of Births Deaths and Marriages, and return them within the appropriate time. When I returned the forms relating to my husband's death, after a week instead of three days, I was chastised by an officious young person at the desk.

More useful information

The funeral service or ceremony can be undertaken by anybody. A funeral director, undertaker or minister of religion is NOT required at any stage.

As an example, at my son's funeral the undertaker was used to embalm him and for transportation: he also put the death notice in the paper. I was not aware of the legal requirements then and so allowed myself to be directed into actions that on hindsight I would not have chosen had I been aware I had a choice. A woman with a religious affiliation conducted the final ceremony. A good friend ensured my wishes were carried out and acted as my information gatherer – a vital role as I had many questions but didn't want to leave my sons body – nor did I have the energy to look up phone numbers and ask questions, others reading this will have valued having 'something to do'. Isn't it good there is no 'right way' to do grief!

Some other things you may not know about funerals in New Zealand.

  * You can make the coffin
  * Sometimes you can dig, or fill the grave
  * Bodies do not need to be embalmed except in special circumstances (For example, my husband's body was required to be embalmed as we flew him to his family urapa ( Maori cemetery) in Northland)
  * In some cemeteries you can build the memorial stone or cross
  * And, you can use your own vehicle to transport the deceased

Arranging your own funeral?

I sometimes wonder if people who do this are control freaks or perhaps they're just susceptible to the marketing practices of some funeral directors.

A few generations ago grandma lay in the front room, someone washed the body, friends and neighbours paid their respects and supported the grieving. There was little planning as funerals were similar, the minister knew the deceased and cemeteries were often beside the church.

Over the years, funeral directors, like all commercial enterprises, began to look for new ways to increase their profit and many years ago they convinced us, for ease and hygiene, to take grandma out of the family parlour. Be modern they told us, bring her to our parlour, save all the worry and show your friends and neighbours how sophisticated you are, how up-to-the-minute.

Well, maybe not those exact words, but the result was the same and grandma was taken off our hands and another layer separated us from death: they are doing it again.

As a result of their suggestions, adverts and free booklets for funeral planning, it seems already some 5% of Kiwis are arranging their own funerals. The adverts tell us how helpful it will be for our grieving and stressed family.

Nonsense. Funeral rituals are for the living, a vital part of our grieving process. 'They' say time heals. Not true: it's what we do with the time that does the healing, and working through the funeral planning is just part of the 'doing'.

So if you think you will help your family by planning your funeral, please think again – you may be delaying their grief process just as pills, or alcohol, do.

To help: leave money to pay for the rituals if you can, and talk about death and organ donation - then leave it up to them. In New Zealand our bodies belong to our next of kin when we're dead, so don't try to control your family as they don't have to do what you planned!

**The New Zealand legal processes** (Coroner and Inquest)

Why are the police involved in a death? They must attend any sudden or unexpected death (no matter where it occurs) and notify the coroner. The coroner then decides whether an autopsy or inquest needs to be carried out or not. (An inquest is a legal or judicial inquiry into a matter of fact).

The role of coroner predates the Magna Carta. Originally he was the monarch's representative to ensure the crown received its legal share of the dead person's assets, the death duties or other taxes. Today the coroner's role is as an independent judicial officer to protect the dead person's interests and ensure the cause and circumstances of the death are known.

Although a coroners court has powers to make recommendations or comments which may reduce the chances of a similar death, it is not a fault-finding court. On occasion fault may become apparent from the enquiry, and this is when recommendations may be made.

While the coroner can interview people, call for reports, phone interested parties and visit the scene, in fact a large percentage of the enquiry work is carried out by his officers, namely designated NZ Police Officers.

The inquest is usually set in the Corners Court. Each court can be different and despite operating under the same laws the proceedings can be handled differently. The court is open to the public.

I encourage people to find out what the police will be saying **before** the court hearing. The better prepared we are the better it is to hear – just like viewing the body at the morgue, we can cope with anything given the right support. This can include being told the information that will be presented at the inquest by the pathologist or any other person who will be there.

Counsellors also need to know what the process is in their area, how the room is set up and where everyone will be seated. (Using the same process I described earlier for when viewing the body)

In my experience of the Christchurch (then monthly) coroner's court, rarely did families hear new information about the person or circumstances. If they were concerned beforehand, we would encourage them to call the pathologist or coroner. Nevertheless, although nothing new was being presented, being there was usually a really helpful part of their grieving. Although it's painful, it can also be a closing, or ending, of one more part of their grief journey.

I remember, at Greg's inquest, correcting a sentence in a record that will be buried in a vault somewhere. While that correction may not seem important to anyone but the family, it may also be vital when someone is searching records for family tree information or other such research. Now, I can't recall what it was about, but at the time I was adamant that it be changed.

I include the following for your information:

Protocols for the Reporting of Suicide in New Zealand (2007)

Preamble

Reporting suicide requires journalists to exercise fine editorial judgement within the framework of statutory constraints imposed by the Coroners Act 2006.

The media have a recognised duty to inform the public on matters of public interest. Suicide is an issue of legitimate concern to the public and the media can perform an important role in informing and educating the public about this complex issue. Stories can address likely causes; warning signs; trends in suicide rates; recent advances in treatment; and suicide prevention strategies.

Individual suicides may be inherently newsworthy and need to be reported. In such cases, a responsible approach will consider the potential for news coverage to both contribute to cause further harm and to communicate positive messages that may save lives.

Editors, editors-in-chief and editorial leaders of Fairfax Media publications, who are aware of the ongoing debate about, and research into, links between media reporting and suicide rates, accept the need to:

• Report suicide in a straightforward manner by providing concise and factual information that increases public awareness of risk factors, warning signs and possible actions to help a suicidal person.

• Avoid simplistic explanations for suicide which usually results from a complex set of circumstances and is seldom the result of a single event. When appropriate, risk factors associated with suicide such as mental illness, alcohol and drug abuse or others should be explored by journalists.

• Avoid presenting suicide as a method of coping with personal problems.

• Avoid focusing only on the deceased person's positive characteristics.

• Avoid language, images or presentation that glorifies, trivialises or romanticises suicide or persons who commit suicide particularly in media which target or are likely to be available to young people.

• Avoid unnecessary reference to details of method or place of suicide.

• Avoid speculation especially surrounding celebrities.

• Take into account the impact of suicide on families and other survivors and follow media codes of practice on privacy, grief and trauma.

• Where appropriate, include community resources available for those at-risk such as help-lines and counselling services.

• Consult reputable sources when seeking comment on suicide.

Books I read (early 1990s) and recommend

The Courage to Grieve. By Judy Tatelbaum. Harper and Row 1980 ISBN 0-06-091185-9

Survive the Loss of a Love. Colgrove Bloomfield & Williams Bantam Books 1976 ISBN 0-553-01481-1

Good Grief: rituals for dealing with grief. Elaine Childs-Gowell. Gowell Publications 1989 ISBN 09622817-0-0

My Son My son: a guide to healing after death, loss or suicide by Iris Bolton 1983 Bolton Press

Silent Grief: Living in the wake of suicide by Christopher Lukas & Henry M Sieden 1987 Papermac ISBN 0-333-51019-4 
