Supporting Partners After a Suicide Attempt

When a person attempts to take their own life, this is without doubt a crisis of immeasurable proportion. It is right that priority is given to their immediate safety and longer-term recovery.  

However, if they are in a relationship, it tends to be the partner that the ‘baton’ is quickly passed to – by both medical and mental health practitioners – in order that they carry out the caretaker/guardian role. My research suggests partners are expected to silently endure the aftermath of a suicide attempt despite invariably being traumatised themselves. We usually try to avoid the source of our trauma but in this scenario, partners are more often than not unable to do this. 

The uncomfortable truth is that partners experience a maelstrom of thoughts and feelings that they feel obliged to keep hidden from others. It can manifest as concomitant primary and secondary traumatic stress, ambiguous loss, relationship injury and reactivation of childhood trauma. This is what I term the shadow side of partners’ lived experience, and can include:  

• Never being fully able to relax (“You’re actually frightened to get comfortable again in case there’s another big upheaval”) 
• Feeling exasperated in the aftermath of the attempt (wanting to “scream from the mountain tops”) 
• Implications from in-laws that they hadn’t shown their partner enough ‘tender-loving-care’  
• Diminished trust in the other person, including feeling less inclined to share with them  
• Intrusive thoughts and images about the suicide attempt (“It will never fully go away. He has the ability to bury it so deeply that he doesn’t think of it whereas it pings in my head when I hear any missing person, suicide, anything like that…”) 
• Ambiguity about the family ‘system’ – feeling the partner ‘checked out’ of the family when they attempted suicide, and perhaps no longer wanting to remain in the system themselves 
• Feelings of grief for their loved one who, though physically present, is now very much psychologically absent  
• Feeling no longer the person they once were (“Our relationship was never the same again. Never. And I really don’t think it ever will be because I know I’m not the same person I was, definitely I’m not the same person I was”) 

Of the above experiences, we should not underestimate the impact on partners of relationship injury following a suicide attempt. The feelings of betrayal and hurt can be immense. In a single moment, their whole view of the relationship, past, present and future, can be transformed. Some partners I spoke with felt they would experience emotional death if they remained in the relationship, which in these instances led to the relationship ending or a long-standing impasse.  

Such feelings might help us to understand why some partners go on to experience suicidal ideation themselves. A recent Danish study (2020), for instance, found that those who were exposed to a relative’s suicide attempt were more likely to experience suicidal ideation themselves, particularly if the attempt was made by a close relative.  

So what can we, as mental health professionals, do to support partners? We must be careful not to unconsciously collude in a reductionist view of partners as solely caregivers. When partners present for therapy, we have an opportunity to guide them beyond over-identifying with this role and to provide a space for their personal experiences.  

We can help partners: 

• Acknowledge potential shadow feelings, such as anger, hurt, betrayal, disappointment, rejection and resentment 
• Reconfigure burden of care as trauma – this experience goes way beyond the realm of normal human experience and functioning 
• Watch out for old traumas that may be triggered by the suicide attempt 
• Build resilience in the midst of ambiguous loss and boundary ambiguity – partners can create ways to help navigate the psychological absence of their loved one as well as their absence from previously established roles and tasks within the family system 
• Explore attachment injury as an opportunity for relationship transformation 

In this way, over time, we may be able to support partners to experience post-traumatic growth, with some noticing improvement in quality of relationships, inner strength, optimisim about the future, and gratitude for the simpler things in life. 

Life After a Partner’s Suicide Attempt, by Dr Francis McGivern, is available from Karnac Books