nobody talks about suicide, except if they're kidding

252 Pages·2012·2.08 MB·English

“NOBODY TALKS ABOUT SUICIDE, EXCEPT IF THEY’RE KIDDING”:
DISENFRANCHISED GRIEF, COPING STRATEGIES, AND SUICIDE
SURVIVOR IDENTITY IN PEER SUICIDE GRIEVERS

By
TANETTA E. ANDERSSON

Submitted in partial fulfillment of the requirements
For the degree of Doctor of Philosophy

Dissertation Advisor: Susan W. Hinze, Ph.D.

Department of Sociology
CASE WESTERN RESERVE UNIVERSITY
August, 2012
CASE WESTERN RESERVE UNIVERSITY

SCHOOL OF GRADUATE STUDIES

We hereby approve the thesis/dissertation of
Tanetta E. Andersson
candidate for the Doctor of Philosophy degree*.

Susan W. Hinze, PhD
Chair of Committee

Dale Dannefer, PhD
Brian Gran, PhD
Atwood Gaines, PhD

May 2nd, 2012

*We also certify that written approval has been obtained
for any proprietary material contained therein.

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ACKNOWLEDGEMENTS

I thank Professors’ Daniel Berardinelli, Ph.D and David Odell-Scott, Ph.D of Kent State
University for restoring my love of learning. At Case Western Reserve University, I am
especially grateful to the late Coach Bill Sudek whose assistance made it financially
possible to complete my undergraduate studies. I thank other track and cross country
coaches, Coach Jason Hudson and Coach Dennis Harris. I thank other members of my
CWRU family including Janice Eatman Williams; Curtis T. Jewell, my friend in arms,
and our mentee Frank “Nova” Polk. I am also very grateful to have received the Ruth
Barber Moon Scholarship and the Patricia B. Kilpatrick Case Service Award during my
studies. I am especially grateful to the Baton Rouge Crisis Center Foundation for
awarding this project a dissertation research grant.

The first sociology class I took as an undergraduate was taught by my dissertation
advisor, Susan W. Hinze, Ph.D. I am forever grateful to her for her intellectual guidance,
generosity, and belief in me. I am also deeply thankful to Dale Dannefer, Ph.D for his
insight and encouragement on this journey. Brian Gran, Ph.D and Atwood Gaines, Ph.D
also guided this project. I could not have completed this project without the help of Frank
Campbell, Ph.D. Over the course of my graduate studies, I am grateful for the influence
of Rachel Chapman, Ph.D, Angela Woollacott, Ph.D, Gunhild Hagestad, Ph.D, Rhonda
Williams, Ph.D, and Sarah Toman, Ph.D. Thank you, Bertice Berry, Ph.D for the Matrix-
style pearl of wisdom: “Stay in peace, on task, and immoveable. Free your mind.” Nadra
Williams, Donté Gibbs, Allison George, and Aaron Perine are students whom I treasure
for many reasons. I thank several graduate school peers including Dawn Aliberti, Casey
Schroeder, Joshua Terchek, Adam Perzynski, Ph.D., Lynn Gannon Falletta, Ph.D, and
Noah Webster, Ph.D.

I thank the members of my equestrian family—a wonderful cast of eclectic characters:
Kara Erdos Andrew and family; Bill and Carol Erdos; Jody Srsen, Jan Engle and I
remember Jane Core, my fellow Bob Dylan fan, “Let us not talk falsely, the hour is
getting late.” I acknowledge the equestrian teachers from whom I have borrowed in
becoming a teacher myself. I thank Joan Iversen Goswell for receiving the United States
Eventing Association’s Worth The Trust Scholarship during my doctoral studies. Most of
all, I am profoundly grateful to my parents, Judith and Ben Andersson, and my brother,
Mark Andersson. This work is dedicated to my study participants who courageously
shared their stories of loss and those advocates who work, volunteer, or walk in aid of
suicide prevention and suicide loss.

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TABLE OF CONTENTS

LIST OF TABLES ........................................................................................................ 6
ABSTRACT .................................................................................................................. 7
CHAPTER ONE: REVIEW OF THE LITERATURE ................................................. 9
Specific aims ..................................................................................................... 9
Bereavement literature: origins and horizons. .................................... 14
Suicide and suicide bereavement. ....................................................... 22
Young adult and adult peer suicide bereavement ............................... 28
CHAPTER TWO: RESEARCH METHODS AND SAMPLE DESCRIPTION ....... 39
Procedure for collecting data. ............................................................. 45
Issues of data quality. .......................................................................... 47
Analysis............................................................................................... 52
Sample description .......................................................................................... 53
Demographic characteristics of participants ....................................... 54
Bereavement characteristics ................................................................ 54
CHAPTER THREE: ANALYSIS OF DISENFRANCHISED GRIEF IN PEERS
BEREAVED BY SUICIDE .............................................................................................. 57
Peer relationships as disenfranchised relationships ........................................ 58
Relational disenfranchisement: On the outside looking in? ............... 59
Relational disenfranchisement and social support contexts: “Should I
really be here?” ......................................................................................... 73
Relationships among co-survivors and social support. ....................... 79
Suicide and disenfranchising social forces ..................................................... 82

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Memorial services, religion, and disenfranchisement......................... 82
Media, disenfranchisement, and suicide grief. .................................... 92
Schools and disenfranchised suicide loss: “And let’s all pray for her
‘cause she had more problems than any of us could understand.” ........... 95
Disenfranchising language and silencing in suicide loss: “Nobody talks
about that [suicide], except if they’re kidding.” ..................................... 101
CHAPTER FOUR: COPING AND RE-ENFRANCHISING EXPERIENCES OF
PEER SUICIDE ‘SURVIVORSHIP’: INDIVIDUAL, INTERMEDIARY, AND
GROUP-BASED STRATEGIES.................................................................................... 108
Individualized Coping Strategies .................................................................. 110
Intermediary Coping Strategies .................................................................... 119
Psychological counseling and coping. .............................................. 119
Interpersonal advocators. .................................................................. 124
Group-Based Coping with Peer Suicide Loss ............................................... 136
Support group participation as externalized coping .......................... 137
Suicide prevention advocacy, activism, and re-enfranchised grief. .. 142
Suicide survivor identity: “I’m a survivor. This is what I went through.
I lost my best friend.”.............................................................................. 169
CHAPTER FIVE: ADVANCING THE DISENFRANCHISED GRIEF
FRAMEWORK, RE-ENFRANCHISEMENT IN THE CONTEXT OF SUICIDE LOSS,
AND SUICIDE SURVIVOR IDENTITY FINDINGS .................................................. 179
Expected study findings: Returning to study aims ....................................... 180
Study findings: Advancing and challenging the disenfranchised grief model in
peer suicide loss, re-enfranchisement contexts, and survivorship identity status 184
Advancing and challenging the disenfranchised grief framework by
analyzing peer suicide loss...................................................................... 184
Suicide loss disenfranchisement. ...................................................... 188
Re-enfranchising suicide loss: Group-based coping contexts and suicide
survivorship......................................................................................................... 189

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Understanding peer suicide griever re-enfranchisement at the macro-
level: Out of the Darkness fundraising walks. ........................................ 190
Understanding peer suicide griever re-enfranchisement at the meso-
level: Local Outreach to Survivors of Suicide (L.O.S.S.) Volunteer
Programs. ................................................................................................ 205
Micro-level understandings of re-enfranchisement and identity:
Suicide griever versus suicide survivor?................................................. 208
Implications of Suicide Loss Findings: Scrutinizing Commodification and
Medicalization of Grief ....................................................................................... 220
Commodifying grief by selling closure. ........................................... 220
Medicalizing suicide grief? ............................................................... 223
Conclusion and future directions. ..................................................... 226
Study limitations. .............................................................................. 229
REFERENCES ......................................................................................................... 235

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LIST OF TABLES
Figure 1: Summary of Study Sample Information .............................................................56

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“Nobody Talks About Suicide, Except If They’re Kidding”: Disenfranchised Grief,
Coping Strategies, and Suicide Survivor Identity in Peer Suicide Grievers.
ABSTRACT
by
TANETTA E. ANDERSSON
Since Durkheim’s (1897/1979) classic study, sociologists have understood that while
suicide appears to be a highly personal and private act, it is also a social act. In 2009,
nearly 37,000 Americans died by suicide (American Association of Suicidology, 2012).
Experts estimate that every suicide intimately affects at least six individuals, both family
members and friends, connected to the suicide decedent (Shneidman, 1969). A central
question in the field of suicide bereavement is how suicide grief differs from other types
of loss (Jordan, 2001). However, such a focus has restricted suicide grievers studied to
next-of-kin relationships, despite emphasis that suicide grievers constitute several
populations (SAMSHA, 2010). By investigating suicide loss in peer relationships through
a qualitative study, this dissertation serves to diversify scholarly inquiry of suicide grief.
Moreover, employing the disenfranchised grief framework (Doka, 1989; 2002) as a
theoretical lens emphasizes the sociality of suicide loss, especially in terms of relational
status and stigmatized dimensions of death by suicide (Charmaz & Milligan, 2006).
Twenty-six peers were identified through chain referral sampling strategies (Berg, 2007)
and in-depth, semi-structured, face-to-face and telephone interviews were conducted.
Results identify several new variants of disenfranchised grief in terms of stigmatized loss
and relational status. A continuum of intrapersonal, intermediary, and group-based or
extrinsic coping behaviors was developed to conceptualize and understand participants’

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varied re-enfranchisement experiences. In particular, participants’ involvement in suicide
prevention advocacy such as fundraising walks and programs contributes insights into the
process and meanings of re-enfranchisement among peer suicide grievers. At the macro-
level, this impetus towards advocacy for suicide prevention among participants is
considered through the lens of the health social movement literature within medical
sociology (Brown et al., 2004). Alternatively, at the micro-level, findings suggest that a
suicide survivor identity is a collaboratively-based identity whereby group contexts
influence how this status is defined, signified, affirmed, and even policed (Schwalbe &
Mason-Schrock, 1996). Moreover, the existence of these group-based remedies for
suicide grief raise the question of whether recently proposed changes to the upcoming
DSM-V medicalizing (Kleinman, 2012) and privatizing grief under a depression
diagnosis will indirectly foreclose suicide grievers accessing these resources.

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Chapter One: Review of the Literature
Specific aims
Sociologists are very familiar with thinking about suicide in the vein of
Durkheim’s (1897/1979) classic work. By using macro-level data, his approach
underscored that suicide is a social act, even though it appears to be a highly personal and
private act. Sociologist Monte Bute points out that Durkheim’s classic study, somewhat
paradoxically, created a disciplinary blind spot in studying death and dying within
sociology. “Because Durkheim emphasized macro-level data to create an invariant model
of research; he wasn’t interested in individual cases or motive or intention,” explains
Bute (as cited in Smajda, 2011). He continues that this has to some extent thrown the
baby out with the bath water in terms of sociologists studying meaning and process
related to death, dying, and loss. Yet, suicide does not occur in a vacuum and the effects
of suicide continue after the act.
In 2009, nearly 37,000 Americans die by suicide. It ranks as the tenth leading
cause of death in the United States. By contrast, in the same year, over 16,799 Americans
died as a result of homicide. This comparison is not made to diminish the loss of lives to
homicide, but to foreground the scale of suicide as a public health problem on a societal
level (United States Public Health Service, 1999). Further, it is estimated that at least six
individuals are intimately affected every time such a loss occurs (American Association
of Suicidology, 2004; Colt, 1991; Shniedman, 1968). For example, from 1984-2008, that
equates to 4.5 million or one in every sixty-five Americans. In contrast to Durkheim’s
work, my research seeks to identify social patterns in suicide’s aftermath.

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