Spirituality and Religiosity during Suicide Bereavement: A Qualitative Systematic Review
Abstract
:1. Introduction
1.1. Bereavement after Suicide
1.2. Spirituality and Religiosity
1.3. S/R during Bereavement
1.4. Aims of the Current Study
2. Materials and Methods
3. Results
3.1. A General Overview
3.2. The Need to Be Helped by the Religious Community without Being Judged
“The answer is resoundingly yes. I mean, the minister and people coming over and asking what they could bring and some just showing up and saying, ‘‘I’m bringing a pot roast dinner’’ and just things like that all the time. And hugs always.”
“[t]ook care of everything… I stayed with [friends from the church]. The church had a restoration company in [town] who took all the furniture out of the room, cleaned the room, and replaced the carpet before I went back into the house. The room was repainted, recarpeted before I went back in. The church provided meals. So there was a lot of substantial, tangible support.”
“The priest that I dealt with… when we met with him, we said it’s important that it not be “I wonder what happened? Who knew this?” I wanted it to be acknowledged, recognised and talked about so that maybe it could help someone else. And he did. You know, he said it was an illness just like cancer or any other illness. So he did, he did a really good job with it.”
“Most of my church community responded supportively. A few misunderstood how suicide grief is different than other grief and their well-intentioned attempts at help simply made me feel worse.”
“I would say that [support came] mainly from friends and not so much from the church. It’s funny because, initially, I got cards and the minister came over, and all that. But I really think, as much as I adore all those people, I really think that they kind of like dropped the ball because, after that… it was done.”
“When you talk about support, I was astounded at the support. I mean the church was packed with high school kids too, but it was amazing. All the people that came really didn’t know us all that well. Her friends and our friends and just a huge support system… It was wonderful.”
“…we’re non-denominational. I didn’t know anything about what kind of arrangements to make and the funeral home had nothing for me.”
“He was not a believer, but I still wished to have a mass, I told myself that it wasn’t a profession of faith; a burial mass is a prayer, it’s those around him who are praying for him (…) the priest told me later that one or two people in the family had said to him: but, after all, he wasn’t a believer, why would you bury him with the church and the priest answered: that doesn’t stop his close relations from praying for him”.
“I felt let down by my church community, whose outlook seems to be that anyone who died by suicide or lost a son to suicide must be a sinner[,] have failed to pray enough[,] failed in some way to be a good parent… Not the same as the reaction to a cancer death…”
“I remember one day a woman came in and she told me that she’d heard from a friend about this and she said, ‘I will pray for her soul because she is probably not going to heaven.”
“I think I projected it [shunning] and perceived that people felt that way maybe more than they did. I remember somebody saying something like, ‘‘Do you know why he did it?’’ ‘‘Well no.’’ ‘‘Were you close?’’ ‘‘Well, I thought so.’’ I don’t think those were particular stigmas, but I just felt like people must think I’m the worst mother of the year because [name] killed himself.”
3.3. S/R-Related Experience of the Deceased as a Continuing to Exist Figure
“I still do not believe in God, but at the same time one day I began to say to myself: one day I will see him again.”
“I guess what I believe, and this is totally not in sync with the Orthodox Church… I don’t believe in hell and heaven. I believe there is an afterlife for everybody and it’s a good afterlife.”
“God saw he was hurting and took him to rest in his arms for eternity.”
“There’s a big tree in front of where his gravesite is and one bird showed up, and then another. And by the time I left there were like ten birds in this tree going: Yap, yap, yap, yap! So it was…little signs that…he’s OK. And he knows you came, and he’s happy you came.”
“I felt like he was writing through me, I wrote in tears and almost in a trance, it was very intense for the first few days, then it gradually faded out over the year.”
“My brother told me he was ok[ay], happy, free from torments of life and in heaven. It made me so happy.”
“Let me know everything would be [okay]… I would get the job… and I did.”
“In my dream he was telling me goodbye and telling me why he had to do it so I found some peace in that but at the same time it made me very sad because he was gone.”
“I think she may be stuck in limbo and unhappy.”
“I felt his soul rise when he died, like a part of me was going up… It was about (time of day) in the morning and I felt it go up. And I could tell it was death…”
“When I have those moments when I’m really missing them…I have a little ritual, which is…[to] light the little angel candle…you know, spiritually wishing them well by lighting the little angel candle. Hoping [my friend’s] way gets lit…because if he’s stuck in the darkness, then let the little angel light his way.”
“The Buddhist survivor created a gathering that reflected her tradition and many of her loved one’s friends and neighbours attended: [Name] lived in a log house out of town and so we set up these tents and we had bales of straw and I hired a woman to come and play the fiddle, and we had a big chili supper, and [name] was a horseshoer… Eight horseshoeing friends of his came with their horseshoeing vehicles and… they all made him a shoe, a handmade shoe and… they put a bar at the open end so that luck wouldn’t run out, and gave it to me.”
3.4. S/R Experienced without a Conscious Choice
“I smelt the perfume of a rose and then I found a rose in the street. I took it as a gift, it’s not scientific evidence but a strange coincidence; maybe it’s an illusion, but what’s important it is that that helps you.”
“The family member bereaved by suicide noted that during a subsequent board game, randomly selected letters spelled out a name meaningful to both the bereaved and the deceased. She stated, “[A]nd to me, that was a sign that just could not be, there’s no way for that to be explained.” Many of these signs were blatant, which one participant noted, “…they smack you in the forehead signs that can’t be ‘whatever.”
“It was really a beautiful ceremony, of which I have a good memory, there was a lot of sadness in people, but not in what happened, in the songs, the sermon, it was all hope, many people contributed, we really felt carried”
“One person bereaved by suicide shared an emotional story of a police officer who prayed with her, stating, “That was so awesome. And I don’t even know, he knew right away. He just knew… He was like an angel that just came down at that minute and it was just strange.”
“These experiences facilitated a grace and peace that transcended the pain of loss.”
“In my dream he was telling me goodbye and telling me why he had to do it so I found some peace in that but at the same time it made me very sad because he was gone.”
“My religious background plays a big role in my continued grief and questioning, but no role in spiritual experiences as described in this study.”
“It kept me from dismissing the experiences & accepting them & learning from them.”
“Through all of the pain, it took quite a while for my spiritual life to grow stronger. My faith has helped me grow in many areas and to realise what is REALLY important. It has also helped me make meaning of the loss and honour [his] life and memory.”
“The experiences have helped me believe even more in a further experience after death.”
3.5. Conscious Reach towards S/R Themes
“For whatever reason, God chose… not to take [the suicide urge] away at this time. I’ll never know. But, I also believe He could have stopped the suicide. I believe that my daughter believed in the sovereignty of God and He allowed her to come home at that time. My spirituality is to totally rely on the sovereignty of God and not to question that.”
“Although rejecting their religion, two individuals continued to investigate different R/S traditions in a quest for understanding and meaning. One turned to Wicca/Paganism, embracing a ‘celebration in life instead of dwelling on death.”
“I needed to be pardoned through confession to be able to cope with this guilty feeling which fills me. The priest told me something very important: God can forgive you and your wife can forgive you through Christ. And that helped me a lot to receive that absolution, it was another way of re-establishing communication and the relationship, different from spiritualism or esotericism.”
“For me it was like a revelation, this death was part of his journey (…) I believe that we come into this world to learn things and have experiences, once we learn, we change and go off in other directions… I have the conviction that we are ourselves before being born and that we continue on afterwards and so, the importance of this life, which is only one bit, is relative, it is only one bit.”
“At the time I was an atheist like my brother, and then I told myself it wasn’t possible, it was unbearable, because he had got to that point; so, there had to be a God once I admitted that there was a presence, something, that lasted for some time. Now, I’m in doubt once again and the Catholic religion doesn’t suit me at all, so I’ve left religion.”
“I had a strong relationship with Jesus. The only thing I asked for was to help my father and mother to be happy. My father eventually [died by] suicide and my mother[’]s life worsened as a result. I discovered that religion was a waste of time.”
“I realised that if I wanted to continue to have a relationship with God, it was necessary for me to forgive him for what I believed he had done or not done.”
“There is something which escapes, which transcends, a higher force, a destiny, an individual, spiritual path that it is impossible for us to understand until the end.”
“I prayed to God…you take the person you’re concerned about, and you wrap them in something. And I chose a flannel blanket…this was before he [her son] died. And I wrapped him in the flannel blanket (crying) and I handed him to God…and…I said, “You guide.” So when [my son] died I think God said it was OK.”
“It deepened my understanding of God and the way He works in our lives and how He uses everything in our life to develop us. I knew that because the Bible tells us that, but I didn’t know it experientially… Now I get it. And that’s how I felt. I felt like I finally really got it. And in spite of how awful this has been, God has been faithful to me and, like I say, …it just deepened my faith in God.”
3.6. Not Relating to S/R Themes during Suicide Bereavement
4. Discussion
4.1. The Need to Be Helped by the Religious Community without Being Judged
4.2. S/R-Related Experience of the Deceased as a Continuing to Exist Figure
4.3. S/R Experienced without a Conscious Choice
4.4. Conscious Reach towards S/R Themes
4.5. Limitations and Further Research
4.6. Guidelines for Spiritual/Religious Leaders and Mental Health Professionals
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Database | Number of Citations Found | Number of Citations after Removal of Duplicates | Number of Citations after Reviewing Titles and Abstracts | Number of Articles after Full-Text Reading |
---|---|---|---|---|
PsychInfo | 224 | 223 | 6 | 4 |
Medline | 112 | 48 | 0 | 0 |
Web of science | 148 | 75 | 3 | 3 |
Total: | 484 | 346 | 9 | 7 |
Authors, Year of Publication, Title and Journal | Country | Methods | Sample Characteristics | Recruitment Method | Analysis | Main Findings Related to Suicide Bereavement and S/R | Quality and Limitations |
---|---|---|---|---|---|---|---|
Jahn and Spencer-Thomas (2018). A Qualitative Examination of Continuing Bonds through Spiritual Experiences in Individuals Bereaved by Suicide. Religions. | USA | Demographic and history questions; Spiritual Experiences of Survivors of Suicide Questionnaire (part of it, four open-ended questions) | 1301 individuals bereaved by suicide (1155 female), aged 40–64. A total of 57.9% of participants were affiliated with an organised religion; a majority (37.4%) 482) Protestant Christian, while 27.2% were spiritual but not associated with an organised religion. | Recruited online (emails, social media) | Inductive thematic approach; thematic analysis according to Braun and Clarke | Nine themes about spiritual experiences: a helpful sense of comfort; a helpful sense of connection with the deceased; intense sadness evoked by spiritual experiences; confusion regarding spiritual experiences; negative reminders of the deceased or negative meanings of spiritual experiences; evidence of an afterlife; general importance of the spiritual experiences’ meaning; impact of and on religious beliefs; and others’ responses to disclosure of suicide or spiritual experiences. | Generalisation limited by recruitment methods and sample characteristics; method not conducive of follow-up questions; failure to include some S/R related data in the analysis. |
Castelli Dransart (2018). Spiritual and religious issues in the aftermath of suicide. Religions. | Switzerland | Face-to-face in-depth interviews | Data from three studies involving 50 suicide survivors (39 female), 18 survivors younger than 30, four older than 40. A total of 46 participants of Christian origin by birth (36 Catholics, 8 Protestants, and 2 Evangelists), while 22 were “truly Christian”, 17 spiritual, 10 agnostic or atheist, and 1 Buddhist. | Recruitment through social agencies, self-help groups, media advertisements and snowball sampling | Grounded theory | Four themes/categories: S/R rites as a resource for saying farewell and honouring the deceased’s memory; suicide and existence after death; suicide as a test of spiritual or religious beliefs as well as of the relationship with transcendence; suicide, S/R and responsibility. | Studies not focused on S/R; sample characteristics not allowing generalisation and possibly resulting in biased findings; religiosity of most participants possibly hindering generalisability of findings to more secular populations. |
Lynn Gall et al. (2015). Spiritual beliefs and meaning-making within the context of suicide bereavement. Journal for the Study of Spirituality | Canada | Semi-structured interviews | A total of 11 bereaved individuals (mean age 49) and four mental health workers (mean age 53). Three Catholics, two Protestants, two Jews and four of no affiliation. | Recruitment through support groups | Phenomenological approach, method not specified | Seven themes/categories developed from data gathered from individuals bereaved after suicide: impact on spirituality; religious stigmatisation; religious support; relationship with God; rituals; afterlife; continued bond. Four themes/categories developed from data gathered from mental health workers: involvement of spirituality, afterlife, rituals, and continued bond. | Sample characteristics not clearly specified and limiting generalisation of findings; limited information concerning reflexivity. |
Krysinska et al. (2014). Religion and spirituality in online suicide bereavement. Crisis | USA, UK, other countries | Randomly selected 250 memorials in two online cemeteries for the bereaved by suicide | Thirty-five memorials from 250 randomly selected memorials written mostly by family members on average three years after the death. | Memorials found in two online cemeteries | Interpretative and deductive thematic analysis | References to religion/spirituality found in 14% of memorials. Ten themes: God’s will, gratitude for peace for the deceased, peace wish, continuation of the spirit/afterlife, reunion, grief of the survivors, other religious/spiritual, gratitude, description of the deceased, and general religious/spiritual. | Methodology not allowing generalisation or deeper understanding of S/R during suicide bereavement. |
Vandecreek and Mottram (2009). The religious life during suicide bereavement: A description. Death Studies | USA | Face-to-face semi-structured interviews, a demographic form | Ten women bereaved by suicide, age from 48 to 64 (M = 57.5). Nine Protestants and one Buddhist. | Recruitment through suicide support groups | Qualitative descriptive analysis | Ten themes: afterlife destiny of the loved one, a more spiritual perspective, the impact on religious beliefs, support from family and friends, survivors’ contribution to emotionally distant relationships, long-term and in-depth spiritual support, religious support from congregants, the ministry of clergy, the funeral service, and the return to public worship services. | Sample characteristics and recruitment strategy possibly determining biased results and preventing generalisation. |
Vandecreek and Mottram (2011). The perceived roles of God during suicide bereavement. Journal of Psychology and Theology | USA | Face-to-face semi-structured interviews, a demographic form | 10 women bereaved by suicide, age from 48 to 64 (M = 57.5), 9 Protestants, 1 Buddhist. | Recruitment through suicide support groups | Descriptive methodology (classifying attributions to God into themes and describing them) | Four themes: contrary to ancient Christian teaching, God as judge did not deny heaven to their loved one; God was in control but was not responsible for the suicide; God provided individualised spiritual care; God brought good out of the tragedy. | Sample characteristics and recruitment strategy possibly determining biased results and preventing generalisation, highly religious participants whose results may not represent more secular survivors. |
Mastrocinque et al. (2018). Spirituality and Religion After Homicide and Suicide: Families and Friends Tell Their Stories. Homicide studies. | USA | Community-based participatory research; focus groups with people bereaved by homicide and bereaved by suicide (separately) | Seven focus groups with 27 participants (three groups of people bereaved by suicide). Three men and 24 women; mean age 50 years (SD = 14.5); 15 respondents bereaved by suicide: (all women, all white), average age 51.4. | Mailed letters advertising the study; announcing the study in support group meetings; emails advertising the study to bereaved people and service-providing agencies; ad in the local newspaper; $20 gift cards for parking, refreshments, etc. | Framework analysis for identifying themes; biopsychosocial model as framework | Four themes: parental and spiritual intuition; finding comfort; internal challenges with spirituality and religion; connection with spiritual and religious communities. | Self-selecting recruitment strategy possibly biasing the sample toward those psychologically ready to participate; limited information concerning reflexivity; comparison of bereavement after two different types of death, possibly preventing a deeper view into those bereaved by suicide; insufficient information about participant’s religious affiliations. |
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Čepulienė, A.A.; Pučinskaitė, B.; Spangelytė, K.; Skruibis, P.; Gailienė, D. Spirituality and Religiosity during Suicide Bereavement: A Qualitative Systematic Review. Religions 2021, 12, 766. https://doi.org/10.3390/rel12090766
Čepulienė AA, Pučinskaitė B, Spangelytė K, Skruibis P, Gailienė D. Spirituality and Religiosity during Suicide Bereavement: A Qualitative Systematic Review. Religions. 2021; 12(9):766. https://doi.org/10.3390/rel12090766
Chicago/Turabian StyleČepulienė, Austėja Agnietė, Beata Pučinskaitė, Katryna Spangelytė, Paulius Skruibis, and Danutė Gailienė. 2021. "Spirituality and Religiosity during Suicide Bereavement: A Qualitative Systematic Review" Religions 12, no. 9: 766. https://doi.org/10.3390/rel12090766