Stigma, shame, secrecy and silence

Until my husband died of suicide, I believed it was something that happened to others. I naively presumed that it could not happen to me; in my family. My only brush with suicide was news reports in the media and a dear friend in school whose parent had died of suicide. Even then as a young girl, it struck me that my friend’s family refused to discuss it. It was cloaked in an iron curtain. I sensed there was something shameful about suicide.

Ironically, when faced with the suicide of my spouse, I too was overcome by the same sense of shame. What would I tell the family? What would I tell my friends? Would they judge my husband as a criminal? Would they judge me as having failed in my wifely duties to prevent this? I began to evolve a strategy of the official version of his death (prolonged illness, sudden death, whatever is acceptable) and the real version (death by suicide). I decided to use either of the two versions, depending on who I was talking to.

Today, when I look back, I realize that like most survivors of suicide loss and survivors of suicide attempts, I too was experiencing the stigma associated with suicide. How did I ‘catch’ this? Dominant narratives of suicide locate it in a context of crime and sin. In Medieval Europe, for instance, people who died of suicide were denied burial and their families were excommunicated and their property confiscated. While societal attitudes towards suicide, and survivors of suicide loss are no longer so blatant, the tradition of stigmatization nevertheless persists in several subtle and not-so-subtle forms. There is no social acceptability associated with suicide, which is viewed as a character or moral flaw.

A stigma is a mark of disgrace. It is something to be ashamed about or feel shameful about. Stigma is located within a larger social context that tends to view a particular issue, for example, suicide, mental illness and people impacted by it in negative ways. This is known as social stigma. And simultaneously, people impacted by suicide tend to internalize the feelings of shame, blame and judgment, known as self-stigma.

Social stigma perpetuates negative attitudes and stereotypes about suicide that are internalized by all people as a default setting. Hence for all survivors of suicide loss, the knee jerk response is shame and self-blame. It is common for people to blame the victim or the family, not realizing that the causes that drive a person to suicide are multiple and “lie with the forces of suicide itself in the same way that people of die of other illnesses.” We wouldn’t blame a person or the family when the cause of death is non-suicidal, why then do we indulge in blame games and accusations when it comes to suicide: “Didn’t you see it coming?” “Were there any clues?”

Negative attitudes can be conveyed through a combination of several pathways: Gossip, relentless speculation, intrusive probing, negative media portrayals, insensitivity, social isolation, naming and blaming of suicide victims and their families. Or worse, there is the “wall of silence” around suicide that makes it clear that it is a social and cultural taboo and therefore not to be talked about openly; but stashed away as a “secret.”

Such speculations adversely impact and exacerbate the trauma of survivors of suicide loss. They compound our primary loss and makes the grief complex and complicated. The social stigma of suicide leads to self-stigma that is associated with low self-worth, guilt, shame and self-blame, which influence our grief trajectories and well-being.

Like a mold festering in darkness, the stigma, shame, secrecy and silence around suicide proliferate in the darkness of ignorance, fear and negative stereotypes. Writer Maggie White perceptively sums up the symbiosis between shame and stigma thus: “Self-stigma is the birthplace of shame. And shame and stigma have been doing a destructive, cyclical dance for long.” The relationship between stigma and shame of suicide is the classic chicken and egg conundrum. Which came first? However, that’s beside the point.

Suicide is a preventable public health problem. It cuts across demographic barriers and no one is immune to it. We need to mainstream empowering conversations on suicide anchored in compassion, concern and care. It takes a convergence of diverse stakeholders to break the barriers and collective wall of silence around suicide and build bridges of support and connection. Preventing suicide is everybody’s business. Every voice matters.

Dr Nandini Murali is a communications and gender and diversity professional. A recent survivor of suicide loss, she established SPEAK, an initiative of MS Chellamuthu Trust and Research Foundation, Madurai, to change conversations on suicide and promote mental health.