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Join certified trauma professional Dr. Amy Hoyt and licensed therapist Leina Hoyt, MFT at https://www.mendingtrauma.com as they teach you how to recover from trauma and cPTSD. Trauma shows up in our everyday reactions and sensations and recovering requires a multi-prong approach that considers the mind, body and spirit. Dr. Amy and Leina will teach you the most emerging research and skills to empower you to overcome your past traumas. They address nervous system health, somatic therapy, trauma, cPTSD, EMDR, Neurofeedback, IFS (Internal Family Systems therapy), and many other modes of recovering from trauma. As mental health experts, sisters and trauma survivors, they teach you the tools that actually helped them recover, are backed by research and have helped thousands of their clients. Each episode is packed with clinically effective methods as well as scientific findings to guide you through your own trauma healing journey. Whether discussing cPTSD, PTSD, medical trauma, somatic therapy, nervous system regulation, EMDR or neurofeedback, Amy and Leina will help you recover from trauma so that you can reconnect to yourself and others.
Dr. Amy Hoyt (02:10)
Hi, welcome back. This week's episode is a continuation of last week where we talked about suicide. This week we're going to focus on how suicide affects family members that have basically surviving family members. And before we do that, we want to make a really important clarification about the way we talk about suicide. And it's something Leina and I
want to adjust as well because I don't believe last episode we did this, but we want to start thinking about death by suicide or they died, someone died by suicide instead of speaking about suicide. And the reason is, is because when we talk about suicide, sometimes there can be blame and shame.
Whereas if you lost a family member to cancer, that would be different. And so by switching our language to say they died by suicide or there was a death by suicide, what it acknowledges is that the death is just as impactful
Leina (03:10)
Right.
Dr. Amy Hoyt (03:28)
as someone who died of something else and that we know that suicide comes from mental illness and that is just as valid as a physical illness such as cancer.
Leina (03:38)
Absolutely. I think that's a really important clarification. And I like that you acknowledge that we didn't do that in the last episode, but we're going to be more mindful of that in this episode. I think there's such a stigma for death by suicide. And being able to talk about a death happening a certain way removes some of the stigma and the shame, I think.
Dr. Amy Hoyt (04:06)
Absolutely. There is a death by suicide in the United States every 11 minutes. And death by suicide is actually one of the leading causes of death in the United States. Globally, this is a 2018 statistic, so it's, I'm sure, much higher now, but...
800 ,000 people died by suicide in 2018 globally. So it is a very important illness and that illness affects everyone just like cancer would.
Leina (04:49)
Exactly, yeah. Yep, and the more we can do to destigmatize things for the family members as well.
Dr. Amy Hoyt (04:59)
Yeah, because there is still quite a bit of shame and
embarrassment. What are, I don't know. There's, there's still that stigma, as you said.
Leina (05:13)
Absolutely. It's almost seen as like a weakness. Well, if the person had been stronger, they wouldn't have done this. And we know that, I think in England, they have a designation that something like death by suicide, while the balance of the mind was impacted or something like that, which is a really non -judgmental, non -shameful way to identify it.
Dr. Amy Hoyt (05:20)
Yeah.
Mmm.
That's a great, that's a great tidbit. Okay, so if you have had a family member who has died by suicide, and by the way, one in five people globally has been affected by a death by suicide, whether it's a family member, a friend, an acquaintance. But if you are a family member who has had someone die by suicide, you,
have your own, of course, grieving process, and we'll talk about that in a little bit, but there are also increased challenges physically and psychologically.
Leina (06:24)
They're pretty profound. It's really fascinating. And I think the more we understand about how death by suicide affects us, the more we can cope with some of those things that happen.
Dr. Amy Hoyt (06:41)
Absolutely. I know psychosomatic challenges are prevalent with surviving family members. So let's talk a little bit about what psychosomatic challenges look like. And I know sometimes people think, they're just pretend like, yeah. So can you, can you work through that for our listeners, Leina?
Leina (06:56)
No.
Absolutely. So psychosomatic is when whatever's happening to you in your brain or in your mental health affects your body. And unfortunately, in Western medicine for decades, centuries, maybe even, there's been this divide between what happens in your mind or your brain from what happens in your body. And that's
the more you study about this kind of thing, that's just ludicrous. So psychosomatic symptoms are real symptoms that are impacting your health because of distress in your mind or because of an imbalance in your brain, sometimes due to grief and loss.
Dr. Amy Hoyt (07:50)
Absolutely. And what are some of the more common psychosomatic symptoms that you see?
Leina (07:55)
I see commonly a lot of gut stuff. So a lot of irritable bowel, a lot of issues with needing to use the restroom frequently. And the other thing that I see a lot of is like headaches and stomach aches. And another thing that's really common is kind of
this slowness that happens for people when they're in the midst of grief and despair. And sometimes people will describe it as like they're walking through water or they're walking through some kind of thick liquid that they they can't make themselves move faster. And for true. Yeah.
Dr. Amy Hoyt (08:47)
Yeah. So it's like a fatigue coming out of grief. Yeah.
Leina (08:55)
Right. And we've talked before in other episodes about capacity. And when you have a tremendous amount of energy going towards helping you survive a terrible loss, then you are going to have diminished capacity and more fatigue.
Dr. Amy Hoyt (09:10)
Sure. Yeah. Well, we also know one of the risk factors of surviving family members is what could be called contagion, really, that death by suicide can be contagious. And what we mean by that is there is a higher chance of a family member also dying by suicide if they've lost a family member to suicide. So do you want to talk about the study in Korea?
Leina (09:36)
Yes.
Sure. As we were researching for this episode, we found a really interesting study on the CDC website. And it talked about how in Korea, they did this study and it was primarily focused on familial impact of suicide. The
data that came out of this was that women in Korea who had lost their husbands were three times, three and a half times more likely to die by suicide and that it usually would happen within about 24 months, 25 months. And
that was really fascinating to us and that the impact of a death by suicide is so much different psychologically and emotionally than a death by natural causes. It's more difficult to get over. It's more difficult to process. I think part of that is because culturally, at least in America, we think about it as a choice.
I mean, I don't know how accurate that is.
Dr. Amy Hoyt (10:52)
Yeah, no, I mean, if, anyone listened to last week's episode, it's, it's not an active choice. It is, it's more like I need to get out of this pain and how can I get out of this right now? That's part of it. I mean, not every death by suicide is the same, just like cancer. There's many, many different types of cancers. So, but yeah, I, I agree that this, this illusion of choice
Leina (11:02)
Yeah.
Right.
Dr. Amy Hoyt (11:22)
that suicide is like some sort of logical choice. We know that people are not connected to their prefrontal cortex when they're making plans to die by suicide. We know that they are in their limbic brain. We know that in your limbic brain, you are actually disconnected from your wise mind and your ability to use your executive functions, which are your choices. So agencies diminished when you're in your limbic brain. So
Leina (11:46)
Absolutely. Absolutely. Yeah. And you also don't have accurate perception or
your reasoning or logic flee when you're not in your prefrontal cortex. So all of those contribute. if we can, first of all, start understanding that suicide is not about choice, it's about desperation and that people in our families who die by suicide are not making a choice to leave us necessarily, but they're trying to leave their pain.
Dr. Amy Hoyt (11:59)
That's right.
Yes. And that brings us to another point we really wanted to talk about. One of the other effects on family members besides this increased risk of dying by suicide is the overwhelming feelings that are very conflicting that come along when we lose a family member to suicide. So you can feel super angry towards your family member that died by suicide.
At the same time, you can really miss them. And this causes a lot of internal distress.
Leina (12:56)
Absolutely. And a lot of it's because there's something that can happen in our culture, in Western culture at least as far as I'm familiar with, that says that you can't be angry with somebody that you love. And we've talked before about how anger is an emotion and there's no inherent moral value to any certain emotion. There is to behavior, but there isn't to emotion.
Dr. Amy Hoyt (13:21)
Mm
Leina (13:25)
And so if we understand that we can love people and still feel irritated or angry or mad at them, pissed at them, if we understand that those two conflicting things can exist at the same time, that can lower our sense of distress.
Dr. Amy Hoyt (13:44)
Yeah, absolutely. The other emotion that's pretty prevalent is feelings of guilt. I should have known, I should have done more, I should have intervened when, you know, during this conversation, almost re, yeah, I should have noticed more replaying so much, which I think is really normal.
Leina (13:59)
I should have noticed this.
It is really normal.
Dr. Amy Hoyt (14:12)
And so what we want to encourage is just to notice those thoughts. Notice that you might be thinking about how you could have done things differently and at the same time, notice that or allow yourself to...
Leina (14:20)
Mm -hmm
Dr. Amy Hoyt (14:36)
I guess let go of some of that guilt, which is really, really difficult.
Leina (14:42)
Yes. Yeah. Well, and it's part of the trauma reaction in our brains is this attempt to never let it happen again. So now we're going to go over every single thing and using hindsight, we're going to say to ourselves, I should have noticed this or I should have done this or should have said this. And those
That way of thinking is very understandable post -trauma and it's, it'll kill us. Like it's terrible.
Dr. Amy Hoyt (15:23)
Yeah.
What sort of relief can we offer family members? What sort of skills, tools can we offer family members who are struggling with surviving a death by suicide?
Leina (15:39)
Sure. I think one of the biggest ones is to seek help or support from people who will listen and not judge.
There's not a lot of not judging around these days. And even people who love you and are well intentioned will judge the amount of time it's taking you or how intense your feelings are or your fear that somehow you miss something. And in an effort to make you feel better, they will say things like, they're with God or,
it's not your fault. telling somebody it's not their fault actually does not make them believe it. So what does help is to be able to say you're really worried you missed something and you just reflect back.
Dr. Amy Hoyt (16:23)
So what helps.
Let's talk a little bit more about that skill because I think that's the secret sauce and it's difficult. So what do you mean by reflecting back?
Leina (16:38)
Yeah.
So if I lost somebody to death by suicide and they say to you, this is terrible, I should have done something, instead of you saying, well, you didn't know, which is well -intentioned and true, what would be helpful for me is if you said, you're really aware of maybe things that you think you missed.
You're really worried that somehow you could have stopped this.
Dr. Amy Hoyt (17:20)
That is such a ninja skill man.
Leina (17:22)
I know it's really hard and and like I said there's no shortage of judgment in the world today and so it's even harder these days than maybe it would have been 30 or 40 years ago. The other thing that will crop up a lot with any kind of death and grief will be like why aren't you over this yet? I think there's something wrong that you aren't you know back to normal. And
the other thing that I think is really important to notice and recognize is that things will never be the same again. They can't be. We're not trying to make them the same again. And pretending like they are only does more damage to the person who's trying to recover from a loss of this magnitude. And so we just reflect back what they're experiencing.
Dr. Amy Hoyt (17:55)
Right.
Mm-hmm.
And, and there is a chance that you may never be quote unquote over it. In fact, that's more likely. And instead of the goal being to get over it, I think the goal is accepting what has happened and noticing our grief. And there's a lot of research about
Leina (18:20)
Correct. Right.
Dr. Amy Hoyt (18:40)
eventually using our grief to reach back and help other people who are experiencing grief. And that's a big...
Leina (18:46)
Right, the concept of post -traumatic growth is really powerful. But it's post -traumatic, so if you're still hit by the trauma and you're still grieving, then you're not in post -traumatic. Anything.
Dr. Amy Hoyt (18:51)
Yes.
Grieving.
Yes, yes, exactly, exactly. There's no shortcutting grief. Yeah. I think the other thing is there is an increase in suicide ideation with family members and so recognizing that as we talked about in last week's episode, recognizing that thinking about suicide does happen, but it doesn't mean you will act on it.
Leina (19:07)
Mm -mm.
That's a really important distinction.
Dr. Amy Hoyt (19:31)
And so go back to the questions in last episode where do you have a plan? Do you have access to the tools to carry out your plan? Those are going to be some of the questions that you want to ask yourself or another family member who's confiding in you that they too have suicidal ideation in order to determine next steps. And of course,
Leina (19:42)
Mm -hmm.
Right.
Dr. Amy Hoyt (20:00)
we always, always, always recommend calling 988 if you are in an active, if you have suicidal thoughts, a plan, and you have access to the tools in your plan. Call 988. There are counselors that are, specialize, I mean, there's bilingual counselors, there's LGBTQ plus counselors, there's...
Leina (20:26)
Counselors for military.
Dr. Amy Hoyt (20:28)
Yeah, yeah, exactly. Military. Again, you will be on a brief hold as they locate the best person for you. So just know that they will not leave you on hold forever. But there is a lot of support. And if it's a true emergency, that's your first call. If it is not an active emergency, we really encourage people to seek professional help through
Leina (20:55)
Absolutely.
Dr. Amy Hoyt (20:56)
therapy through group programs, yes, exactly, support groups. They're incredibly beneficial. In fact, the research shows that with trauma, group work is more effective than individual talk therapy.
Leina (20:59)
Support groups.
Yep. Yep, because there's a sense that you're not alone.
Dr. Amy Hoyt (21:19)
Mm -hmm. Yep. So we are grateful to be able to talk about this subject even though it's really difficult. We have experienced a family member dying by suicide and we are keenly aware of the cost of this type of loss. And so as this is Suicide Awareness Month, we just want to
be a resource for anyone who is struggling or a loved one who has survived.
Leina (21:53)
Absolutely, yes. And thank you for joining us for this really important topic.
Dr. Amy Hoyt (22:00)
We will see you next week.
Leina (22:02)
Take care everybody, bye bye.