Jennifer Levin
Hi everyone and welcome to Untethered: Healing the pain from a sudden death. I am Dr. Jennifer Levin, and I specialize in traumatic death and helping individuals through the struggles, pain, trauma, and chaos of an unexpected death. Today’s podcast features an interview with a dear friend, colleague, and fierce advocate for survivors of suicide, Dr. Nina Gutin. I first learned about Nina when I was getting ready to lead my first grief group from a colleague almost 10 years ago. When I reached out, her she asked me to call her back after the summer because she was booked and let me tell you she was worth the wait. Dr. Gutin is a psychologist who works in the field of suicidology. She works with clients who have experienced the death of a loved one by suicide, trains clinicians on how work with survivors of suicide loss, facilitates suicide loss support groups and is extremely active in advocacy and prevention of Suicide. She has written countless journal articles; book chapters & speaks throughout the US and internationally on the topic of suicide. I am so honored that she is sharing her wisdom and experiences with us in this podcast.
Okay, so, Nina, I'm so glad you're here today. Let's go get started. So would you mind telling us just a little bit about yourself?
Nina Gutin
Well, you've already mentioned a lot in my bio. So just to reiterate, I'm in Pasadena. People often say, Nina from Pasadena. And I'm just really happy to be here with my long term friend with a shared passion in helping people deal with the vicissitudes of traumatic grief.
Jennifer Levin
What got you interested in this specialization of working with individuals who've lost a loved one to suicide?
Nina Gutin
Well, I was in graduate school training to become a clinical psychologist in the 90s, and I lost my brother to suicide, Jeff, in 1995. And so I know firsthand what a difficult, life shattering and traumatic loss it is. But I also know now what, at least from, in my own story, what some of the elements were in being able to integrate the loss and to heal. And so it made complete sense, moving forward professionally, to be able to make use of what I learned from my own experience, and to use that in ways that could help other people. And in doing so it felt like I'd be honoring my brother, as well as continuing to make meaning of my own loss. And so, since, well, since I've been doing this, I feel like every time I either run a group or work with survivors, there's additional growth that occurs as a consequence of developing relationships and feeling like I've got something to offer.
Jennifer Levin
You mentioned your brother Jeff, are you comfortable sharing your story or Jeff's story with us?
Nina Gutin
Yeah, I lost him in 1995. I don't want to go into too many details. But in our shared history as siblings, there was a lot of trauma in our family. My mother was pretty abusive. She was addicted to multiple drugs and was very volatile and erratic. And he, even though social workers removed him from our home when he was 12, he went to live with our father and seemed to be doing much better. In his mid 30s, he started to talk about, to me anyway, what I knew to be flashbacks of some of the abuse. And I basically begged him to go into therapy and told him that therapy had saved my life. And he refused. He said, I don't want to know what they are. I just want them to go away. And shortly after that he took his life.
Jennifer Levin
I'm so sorry. How did Jeff's suicide, how did that impact your work as a clinician?
Nina Gutin
So eventually, though, when I was more healed and felt like and for me, that meant that I could bear other people's pain without it activating my own, I actually found that it was really helpful to work with other survivors, because in that way, I could sort of use my own experience as something that would be even if I whether or not I disclosed it in a way to understand and relate to clients, and to run groups. And, and again, it was a way of feeling like I was continuing and have been currently I'm continuing to make something meaningful out of the loss. And then, in addition, I've been doing trainings for clinicians to ensure that they are competent to work with survivors, because it's a very unique type of loss, and also very passionate about making some changes in the larger field of Suicidology. And, and in the way of, in our ways of understanding and treating people with suicide experiences.
Jennifer Levin
Yeah. You mentioned it is a unique loss. And absolutely, I have so many clients that I've worked with, who just struggle with issues that are so different from any other type of sudden death. And I'm wondering if you can talk to us, from your perspective of what do you think some of those biggest struggles are that individuals face right after they've experienced a death of a loved one, by suicide?
Nina Gutin
Well, for one thing, this is a traumatic loss. And so one of the things that's not uncommon is people to have what are commonly understood as PTSD symptoms, and to feel like in addition to the loss, other types of functioning are impaired. And you know, and most people don't know that this is fairly normal so they start to wonder, Oh my God, am I going crazy, I used to be able to do all the all of these other things, and now I can't do them anymore. So to know that it's a tramatic loss and to also understand that in contrast to other types of losses, both the intensity and the longevity of the losses is greater. And so, you know, those are just some of the general things. There are also specific issues that are very consistent with suicide loss, which often don't occur and other types of losses, the need to try to, you know, understand why, we sometimes deal with guilt, whether or not it's warranted, and to try to give yourself a fair trial if these questions about, you know, the fact that our loved ones made what most people would conceive of as a choice, but some people can see it as not necessarily a choice. But you know, all of those issues that come from this sense of our loved ones having made this choice, and what does that mean, in terms of our relationship? Some of the things that can be difficult is there's a lot of stuff going on now about, you know, all suicide is preventable, which is simply not true. But when that seems to be the prevailing message, there's this sense that, well, if I didn't prevent it, then I must have done something wrong, whether or not that is true at all. But I think that sort of drives the, the guilt and the self blame in a very unfair and difficult way. And then there's the significant stigma. The research is really clear that survivors of suicide loss are seen as more blameworthy and less deserving of support than survivors of other types of loss. And I learned along with most other survivors have experienced people who they thought were friends just sort of disappear, disappear. You know, they might be there after the first couple of weeks, but and then if we do run into them, the subject seems to be taboo. So it can feel really isolating. And that there are very few places where we can even say our loved ones names, much less talk about not only the impact of the loss, but the circumstances of the loss, or even aspects of the relationship and our loved ones lives before then because people are so kind of freaked out about it. So those are just a few of the things that make this a particularly difficult loss.
Jennifer Levin
You mentioned the concept of a trial. And I'm thinking of a couple of people that I've worked with, who just constantly constantly judge themselves, blame themselves over and over again. And I'm wondering if you'd be willing to just expand on that concept, because they just blame and judge themselves as guilty. And so can you talk more about that?
Nina Gutin
Yeah. And I'm gonna quote, a dear friend and colleague of mine, Jack Jordan, because he's come up with some sort of great ways of conceptualizing this, but what he talks about is that, and I know this personally, as well as professionally, that when, after suicide, when we look back at what happened before then, it's through a frame of what he calls the "tyranny of hindsight." So in other words, we assume that we should have known then, what we know now, that we should have known that a suicide was going to happen, when in reality, there was, in many cases, if not most cases, there was really no way we could have known that. And so in some ways, we presuppose that we should have known it, it carries, like we're implicitly guilty, right? Because we should have known what to do, and we should have done this, or we shouldn't have done that. And so often, that's what fuels the should have, would have, you know, and the sense of, of guilt. And so, the concept of a fair trial, sometimes, you know, when I'm working with survivors in my practice, and, and it's not uncommon, and again, because I've experienced this myself, I use what I sort of developed to challenge myself and to say to them, you know, as you're talking about this, I'm only hearing a prosecutor. If there were a defense attorney, what do you think they might say? And so in some ways, if survivors can almost play devil's advocate with their own guilt by thinking about, if someone who was their defense attorney were to say, well your Honor, I, you know, my client was really doing the best that she could, at the time, there was no way she could have known that doing this or not doing this would have had a negative consequence. And so, you know, so in some ways, if they can move out of the sort of rigidity of the grief to sort of entertain another perspective, that can lead to a more integrated and balanced way of thinking about this, and people have described when they've been able to do this, or something similar, that their guilt transforms into remorse, I wish I'd known more then, and, you know, might have been able to try to do this or regret that, you know, I didn't know back then what I know now. And you know, and that sort of, is easier to sit with, in some ways than the self flagellation of guilt.
Jennifer Levin
That's such a great perspective. Thank you so much for sharing that. Now, I know, in addition to your clinical work, or your client work, that you are so active in providing training to other therapists, and in your advocacy work for suicide prevention. Can you talk a little bit about some of the things that you do in this area?
Nina Gutin
Yeah, so there are a number of things that I do, I mean, I do, I had done, I've done training in prevention, because I and I will say there are many of us within the field who are trying to change the pretty entrenched ways in which suicide is understood, and the way that people with suicidal experiences are treated. And just to give you a little bit of an overview, traditionally, it's been framed up in terms of a very rigid medical model, that it's all within the individual, it's got to do with the neurotransmitters, and the best type of treatment is with medication. But we now have the research and a lot of us have known for a very long time that there are so many other factors, besides one's own biological makeup that contribute to suicidal experiences. And that we have to look outside of the physiology of the individual to look at these outside factors, and including things like cultural factors, relational factors, even political factors can factor in, like there, I don't want to spend more time on some of the research, but it's pretty clear when there are changes in the social structure, that the rates go up all sorts of discrimination and abuse will, you know, will affect people's suicide. So we're really trying to sort of move the needle to become more expansive in our ways of understanding suicide, and certainly in our ways of treating this, which is basically, well, first of all assessment is basically liability based. And by that, I mean it's based on the clinicians liability, and uses symptom checklists rather than sitting with the person and hearing their stories and finding a way to say yes, that makes sense from your perspective. Because more than anything, not people who are in distress need to feel heard and validated, not just to be checked off but the checklist and to do so while you know, trying very, very hard to do everything to preserve that person's autonomy, because the research is really clear that involuntary hospitalization even though it, and I have to say it may be necessary in rare circumstances, but it's overused. And the research is clear that it's, I'm going to use a fancy term just because it's a fun term to say, iatrogeni. And basically, what does that mean is it actually makes things worse, rather than better. Not always, it depends on the type of hospital and the type of care that went gets within the hospital. But very often, these days, it actually can, can make people feel worse. Yeah. So that's one of the areas of training that I am an advocacy and that I've become involved with, then there, the other two are within the sphere, of suicide bereavement. I'm trying to work with clinicians to help them understand what's unique about suicide loss, what makes it different from other types of losses. And in doing so, what are the clinical mistakes to avoid in understanding and supporting survivors. And so I've been doing trainings with clinicians, because I just, there's also some research that shows that clinicians who are not trained in at the very least in the nature of traumatic loss are not only less helpful, but sometimes more hurtful. And so there's that. And then the other area where I do trainings is one of the one of the other things that I hadn't mentioned before in terms of what I do is, I'm the co chair, along with my very dear colleague, Vanessa McGann, of what's called the Coalition of Clinician Survivors, because one of the things that I recognized early on, was that the impact was both personal and professional. And we also recognize that for clinicians who lose clients, or patients within a clinical context, that carries all sorts of extra issues, like the confidentiality, and sometimes other clinicians blaming them, even when again, they did everything they possibly could have. And so for close to 20 years, we've had this coalition to support clinicians who have lost either a loved one or a client in these contexts. And so as part of that, we do trainings with organizations to not only help them prepare for losses, if and when God forbid, they do occur, but also to have protocols in place so that they know how to best support both the surviving families of the one with loss, but also the clinicians who were involved in the treatment.
Jennifer Levin
Such wonderful work and so, so needed. We've had a long history together, as you mentioned, you and I, as colleagues and friends, I know how important self care is for you. Do you mind sharing some of your self care practices with our audience and what fills you up?
Nina Gutin
But unfortunately, there's like, and you know this too that part of the one of the self care things which I probably shouldn't be doing more of this, saying no to things. But when I'm asked to do things that are related to this field, things that do fill me up and that I'm passionate about, sometimes it's hard to say no. But I keep learning the lesson over and over that if I don't start saying no to things, I'm just going to get, you know, supersaturated and burnt out. So I've actually just started being able to say, I need to back out of this at least for a while as one way to care for myself. And the other thing is just to have as much as contact with friends who get it, who I don't have to worry about judging me. Or you know, who you know, they get me I get them and we sustain each other. And then like, well, you know, just sort of doing things that I enjoy going to movies when don't want to get started, but are unfortunately our beloved movie theater where I live closed down. But you know, going for a run, you know having great conversations with my yet now young adult daughter and playing board games on my phone, that's like a way to de stress and just get my mind off, you know, some of the head stuff, and of course exercising.
Jennifer Levin
So all those things that we recommend to our clients, we do as well or we try to do, saying no, setting boundaries, social support, time with people who are meaningful.
Nina Gutin
Yeah, and I want to say actually, very early on, you know, it was so overwhelming in those early stages that, self care was not a concept. But the only thing that I did that I know, realized was self care, I, I sort of developed my one and only addiction ever to jigsaw puzzles. And so, right after Jeff died, I was working on my dissertation. And I had to make a bargain with myself that if I spent X number of hours working on my dissertation, then the rest of the day I could spend doing jigsaw puzzles, and I didn't leave the apartment except to go get more jigsaw puzzles. And I realize now that the jigsaw puzzles were a metaphor, you had this big box full of fragments, you have this need to put them back into a picture that's coherent and cohesive. And to repeat that over and over again. And I think that was a good metaphor for what I needed to do for healing is to, you know, because in some ways, this loss is about reassembling the fragments that are left in the wake of a loss into a new picture.
Jennifer Levin
Makes me think that I've always been very attracted to jigsaw puzzles is because everything fits together so nicely at the end. And, yeah. So in closing, and this is the same question I asked everybody in closing, but what advice do you have for individuals who are struggling with the grief and the pain and just the, the intensity and the darkness, right after the pain of a suicide loss?
I happen to know Marilyn, what a wonderful, wonderful way she has of looking at that. Yeah. Wow. Such great wisdom, such great advice. Thank you for sharing everything you did about what you've experienced your clinical knowledge, your expertise and what a pleasure has been speaking with you today. So I appreciate it.
Nina Gutin
Well, thank thank you so much. And thank you for the offer to be able to share my experience.
Jennifer Levin
Thanks all around. So Nina Gutin everyone. Take care.
As Nina stated she has been able to use her work in the field of suicidology as a way to find meaning in her own loss and I have never met someone as dedicated to improving the lives of individuals impacted by suicide loss as Nina. There is nothing she will not do for her clients. She has a wicked sense of humor, has a brilliant mind and is beyond compassionate. She is incredibly philanthropic, goes out of her way to be creative and thinks out of the box to make sure the needs of her clients and those she cares about are met. In our interview, although Nina was talking about suicide loss, there are so many commonalities that apply to unexpected death in general. I am sure many of you who have experienced an unexpected loss from other causes can still relate to feelings of going crazy, trauma responses and dealing with friends and family who do not know how to respond to your needs or how to interact with you. There are also things Nina discussed that are unique to suicide. The stigma related to a suicide death is so real and prevents so many people from getting the help they need. I am also so glad she shared Jack Jordan’s concept of a “trial” because I see so many suicide survivors presume themselves to be guilty in the cause of their loved ones suicide as a way to find answers to a situation that does not make sense. If you are coping with loss of suicide and find yourself in need of support, I recommend you seek a mental health professional like Nina, someone who specializes suicide or unexpected loss is knowable about the needs of suicide survivors. Thank you so much for joining today’s episode of Untethered Healing the Pain After a Sudden Death. For help with a sudden and unexpected loss, sign up for my free mini course, where I will teach you about the 3 Truths About Living With A Sudden and Unexpected Loss. Please visit www.fromgrieftogrowth.com to sign up.
