The Continuum of “Survivorship”:
Definitional Issues in the Aftermath of Suicide
JULIE CEREL,PHD, JOHN L. MCINTOSH,PHD, ROBERT A. NEIMEYER,PHD,
MYFANWY MAPLE,PHD, AND DOREEN MARSHALL,PHD
In light of prevailing confusion over the meaning of the term “suicide
survivor,” we propose a more exact terminology for designating different levels
of impact on those left behind by suicide, ranging on a continuum from those
exposed to suicide through those who are affected by it and finally to those who
are bereaved by suicide in the short- or long-term, as a function of their loss of
a close emotional attachment through this tragic form of loss. We briefly note
the possible utility of this terminological specificity in promoting more clearly
targeted research and intervention efforts, and call for closer investigation of
various categories of “survivorship” in future studies.
Suicide is a complex issue. The complexity
of conditions that give rise to suicide are
matched by that of the terminology used to
describe those who cope with its aftermath.
Postvention, a term coined by Shneidman
(1969) at the very first American Associa-
tion of Suicidology meeting, refers to ser-
vices for individuals and communities after
a suicide occurs. In an attempt to move the
field of postvention forward, issues in lan-
guage and definition need to be addressed.
As participants in the Survivors of Suicide
Task Force of the National Action Alliance
for Suicide Prevention, as well as research-
ers, academics, and clinicians in the field,
we have found it crucial to better define
what is meant by “survivor of suicide,” a
term often used in a way that obscures the
considerable variation in the impact of the
event on those so labeled. Thus, in this arti-
cle we review the origins of existing termi-
nology and propose a more nuanced
nomenclature that captures the continuum
of suicide bereavement. We believe that
definitional clarity will promote greater rec-
ognition of the public health importance of
suicide exposure, help focus postvention
policies targeting vulnerable survivor
groups, and refine a research agenda that
extends beyond individuals with close kin-
ship to the decedent. At the same time, we
believe it is possible to respect the common
lay use of the term “survivors” in the con-
text of suicide to denote those who live
their lives following the suicide of a family
member or other close person. We recog-
nize that this term will continue to convey
a common identity as people bereaved by
this tragic form of loss, and might continue
to have utility in policy discussions of the
impact of suicide on others beyond the
deceased themselves.
JULIE CEREL, College of Social Work,
University of Kentucky, Lexington, KY, USA;
JOHN L. MCINTOSH, Office of Academic Affairs,
Indiana University South Bend, South Bend, IN,
USA; ROBERT A. NEIMEYER, Department of
Psychology, University of Memphis, Memphis,
TN, USA; MYFANWY MAPLE, School of Health,
University of New England, Armidale, NSW,
Australia; DOREEN MARSHALL, Department of
Counseling, Argosy University, Atlanta, GA,
USA.
Address correspondence to Julie Cerel,
College of Social Work, University of Kentucky,
627 Patterson Office Tower, Lexington, KY
40506; E-mail: julie.cerel@uky.edu
Suicide and Life-Threatening Behavior 1
© 2014 The American Association of Suicidology
DOI: 10.1111/sltb.12093