The personal narratives of many suicide survivors testify to the reality that the death of a loved one to suicide can be an enormously difﬁ cult experience, one that may have life-transforming effects on the mourner (Alexander, 1991; Jackson, 2004; Stimming & Stimming, 1999; Wrobleski, 2002). Empirical and clinical study of survivors also offers considerable support for this intuitive understanding that the loss of a loved one to suicide may be a particularly difﬁ cult form of bereavement (de Groot, De Keijser, & Neeleman, 2006; Jordan, 2001, 2008, 2009; Knieper, 1999). Nonetheless, the question of whether mourning after suicide is different-and, if so, whether the differences are quantitative or qualitative in nature (or both)—remains a challenge to be resolved (McIntosh, 2003). The answers to these questions have important implications for how we think about the impact of suicide on survivors and how we develop support services that might ameliorate some of the suffering of those left behind (Jordan, 2001; McIntosh, 2003). Beyond that, there are important deﬁ nitional issues about survivorship that suicidology and
thanatology have yet to address satisfactorily. These issues include determining (a) who is considered a survivor, (b) how many survivors there are, and (c) what the relationship is between exposure to suicide and the experience of becoming a survivor. Our goals for this opening chapter are twofold: to offer a framework for addressing questions (a) and (b) and to make the case for why specialized study of suicide bereavement is needed. In Chapter 2, we address the debate within the literature about whether bereavement after suicide may differ from bereavement after other modes of death-and, if so, in what ways. We also offer a conceptual framework for thinking about the differences and commonalities in bereavement after suicide and after other types of losses. In Chapters 3 through 5, we provide comprehensive reviews of the literature that address the actual impact of suicide on adults, children, and families, and on clinicians who work with suicidal patients.