The Tripartite Model of Suicide Bereavement
By Diana Sands, Ph.D., Director, Centre for Intense Grief; author of the book and DVD Red Chocolate Elephants: For Children Bereaved by Suicide (2010), Sydney, Australia, Karridale
How we talk to ourselves and others about the loss of our loved one can ease our grief or make it more difficult. To better understand this issue, research was undertaken that studied the stories of those bereaved by suicide, and from this research the “Tripartite Model of Suicide Bereavement” was developed (Sands, 2008; 2009; Sands, Jordan & Neimeyer, 2010). The model is often referred to as the “Walking in the shoes model”, because it uses the metaphors “Trying on the shoes,” “Walking in the shoes,” and “Taking off the shoes” to describe how those bereaved metaphorically try on and walk in their loved one’s shoes. Although the model is set out in three phases it is understood that grief is not linear. The model is a simplified version of complex suicide grief processes that aims to increase understanding of this experience to provide appropriate services and support. It is not suggested that the model is representative of all people bereaved by suicide, but many of those people have found comfort and guidance in recognising aspects of their own grief experience in the model. Clinicians and counsellors have also reported that the model is useful for understanding and supporting those bereaved by suicide.
The model is not just focused on the way the bereaved story their grief, but also importantly on the effect of suicide bereavement on the griever’s relationships. The model identifies opportunities for relational repair for the grieving person’s sense of self, relationships with others and with the deceased. A central theme of the model is the challenge for those bereaved to create an adaptive and nurturing ongoing relationship with the deceased, given the intimate nature of suicide in the lives of those who love them. The model describes how, while the bereaved ”Walk in the shoes” of their loved one, the ongoing relationship with the deceased tends to be developed through thoughts about the pain their loved one suffered. For example, a parent said, “I think about the pain he suffered at the time of death …the pain of dying and the pain before he died…it’s with me all the time…”. Importantly, the model explores the function of these efforts, identifying opportunities to support and assist integration of grief.
Hold fast to dreams
For if dreams die
Life is a broken-winged birdThat cannot fly.
Hold fast to dreams
For when dreams go
Life is a barren field
Frozen with snow. (Langston Hughes)
The first phase “Trying on the shoes” is concerned with the struggle to understand the self-inflicted actions of the loved one in ending their life. For many there will be questions about whether the death was accidental, or whether the loved one hoped to be saved and did not intend to die. These issues are commonly explored through “Why?” questions. The second phase “Walking in the shoes” is concerned with the imagined or known pain and trauma of the loved one’s life and death. Thinking about this pain is extremely distressing, and often those bereaved feel angry, and betrayed by themselves or their loved one, for not knowing or understanding how intense the pain was. Commonly those bereaved try to understand the loved one’s actions by symbolically placing themselves in their loved one’s shoes. For some this takes the form of physically visiting and retracing step-by-step their loved one’s last days, or hours. Finally, the third phase “Taking off the shoes” occurs when those bereaved are able to set aside the manner of the death. The suffering the loved one experienced is sadly accepted, while reinforcing that suicide is not a way to deal with pain and difficulties. This phase is often marked by growth and a commitment to living, talked about with family and friends as it slowly becomes possible to remember good and comforting memories about the loved one.