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OMEGA—Journal of Death and Dying

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The Detection of Resilience © The Author(s) 2023
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DOI: 10.1177/00302228231219047
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Suicide

Ana Gallardo-Flores1, José-Marı́a Morán-Carrillo1 , and

Maximiliano Garcı́a-Carmona1

Abstract
The study, conducted in 2021, describes the relationship between resilience de-
velopment factors and dimensions and the grief processes of persons affected by
the suicide of a family member. The objective was to analyze whether the loved
ones of suicide victims had developed resilient behaviors and how these were
manifested during the mourning process. To achieve this, two instruments were
used: the Brief Resilience Coping Scale (BRCS), and in-depth interviews, in both
cases applied to a sample of 21 individuals from whom narratives of their expe-
riences were obtained as elements for analysis. These narratives were oper-
ationalized, coded and analyzed according to the theoretical framework advanced
by the authors Edith Grotberg and Cecily Knight. The behaviors detected took the
form, among others, of artistic expression and/or the provisioning of support
services to people affected by suicide, generally through participation in associa-
tions and self-help groups dedicated to the care and facilitation of emotional ex-
pression resulting from the traumatic event.

Keywords
resilience, transformation, coping, suicide, grief

1
Department of Social Work and Social Services, Pablo de Olavide University, Seville, Spain

Corresponding Author:
José-Marı́a Morán-Carrillo, Department of Social Work and Social Services, Pablo de Olavide University,
Carretera de Utrera Km. 1, 41013 Seville, Spain.
Email: jmmorcar@upo.es
2 OMEGA—Journal of Death and Dying 0(0)

Introduction
According to the World Health Organization [WHO] (2021), in 2019 703,000 people
around the world died by suicide, accounting for one in every 100 deaths that occur on
the planet, or one person every 40 s. Globally, the data indicates that more men (12.6 per
100,000) than women (5.4 per 100,000) die by suicide, with male suicide rates being
higher in high-income countries (16.5 per 100,000), in contrast to higher female suicide
rates in lower-income countries (7.1 per 100,000). If we focus attention on the Eu-
ropean context, World Health Organization, 2018 states that the suicide rate is 13/
100,000, a considerably higher number when compared to Southeast Asia (10), the
Americas (10), the Western Pacific (9), Africa (7) and the Western Mediterranean
basin (6).
In Spain, the National Institute of Statistics INE, (2020) indicated that there were
3941 deaths by suicide that year, up 7.4% off the previous year. These figures are
alarming for the country, where every day 11 people take their own lives, or one every
2 hours. The above data justify suicide’s definition as a “silent pandemic” (Prats, 2021).
Apart from suicide attempts and suicidal ideation, the figures reflect a suicide success
rate of 7.7 per 100,000 inhabitants, making it the leading cause of unnatural death.
These figures are three times higher than those for traffic accidents and homicides, and
85 times higher than those produced by gender violence. Finally, the Spanish
Foundation for Suicide Prevention (FEPS, 2020), through the Spanish Suicide Ob-
servatory, states that the highest number of suicide victims were 40–59 years of age
(1,608, 41%), and more than 1000 were over 70 (26%).
The magnitude of the above figures allows us to appreciate the pain, frustration and
subjective anguish that must be endured by those who have been affected by the
suicidal behavior of a family member. These people, as we will demonstrate in the
study, must grapple with a major emotional, affective, and psychosocial impact as a
consequence of the suicide incident. The news of a loved one’s suicide activates
mechanisms of resilience and individual survival as a way to adapt to a new life
situation. This syndrome is defined in the specialized literature as that suffered by a
Suicide Loss Survivor. Feigelman et al. (2009) argue that one’s condition as a survivor
should include the affected person’s self-perception, and is associated with negative
symptoms beyond grief and/or psychiatric signs, as it also usually includes changes in
one’s self-perception and long-term life narrative. Meanwhile, Jordan and McIntosh
(2011) argue that survivor status entails high levels of self-perceived distress (psy-
chological, physical and/or social) for considerable periods of time after the suicide of
the related person. Seeking to define it further, and in connection with the profiles of the
participants in this study, it emerges that the subjective impact of the survivor ex-
perience is shaped by one or more of the following factors: (a) proximity or kinship
(relative) with the deceased (Cleiren et al., 1994); (b) kinship linked to some kind of
psychological connection to or attachment with the deceased; and (c) those affected by
a high level of distress after the suicide of the deceased, regardless of kinship or
psychological attachment (Brent et al., 1993).
Gallardo-Flores et al. 3

Although there is no standard behavior with which those affected respond to a

suicidal act, Albert Cain’s classic text Survivors of Suicide (1972) describes the ways in
which some survivors react to it. These phenomena include a distorted sense of reality,
troubled personal relationships, guilt, disturbed self-concepts, rage due to impotence, a
search for meaning in the event, identification with the suicide victim, self-
destructiveness, and/or incomplete mourning. Sometimes the post-impact experi-
ence may develop into Complicated Grief (Complicated Grief, CG) (Lichtenthal et al.,
2004), which may, in turn, develop into Prolonged Grief Disorder (PGD) and pathology
related to the time that symptoms last, and not only to symptoms. In the case of CG, its
fundamental characteristic is the appearance of complications (mental disorders) that
call for clinical attention (Maciejewski et al., 2016).
Coinciding with some of our findings, firstly, the studies concur that suicide be-
reavement is different from that over other types of loss (Bailley et al., 1999); and,
secondly, the diversity of grief management is linked to kinship and emotional
proximity to the deceased (husbands, wives, children, partners, boyfriend/girlfriends,
etc.) (Jordan & McIntosh, 2011). In this regard, the diversity in the experience of grief
varies when facing the loss of a child (Maple et al., 2010), the loss of a parent (Cerel
et al., 2008) or, as the case may be, the loss of a spouse (Levinson & Prigerson, 2000).
This aspect is especially relevant to our study given that, of the total of 21 cases studied,
these were individually represented by the suicide of five husbands/wives/partners, five
sons/daughters, seven siblings and five fathers/mothers. We should clarify that, al-
though our sample is composed of 21 survivors, one of these persons had lost two
family members.
As for the subjective experience, suicidal loss forces one to deal with a set of
symptoms centered on three basic emotions: guilt, shame and social stigma (Goulah-
Pabst, 2021; Jordan & McIntosh, 2011). The interventions by those responsible for their
health should be oriented at coping with the impact of the experience through adequate
postvention work (Shneidman & Mandelkorn, 1967; Chávez-Hernández & Leenaars,
2010), understood as the work of facilitating the therapeutic process to manage grief in
connection with the context in which the bereavement will take place; this postvention
work should incorporate specific coping and support mechanisms, including medical
and clinical care if needed.
From the perspective of postvention, one of the most psychologically impactful
responses is to achieve Posttraumatic Growth for people affected by this adversity
(Tedeschi & Calhoun, 2004). This concept denotes a positive change resulting from
handling very challenging life situations, coupled with behaviors and emotions that
produce greater appreciation for life, intense interpersonal relationships, higher self-
esteem, and a richer spiritual life.
The set of reactions associated with Posttraumatic Growth is relevant to our study, as
it defines transformational (resilient and/or coping) behaviors, understood as cognitive-
behavioral efforts aimed at combating post-impact stress (Levi-Belz, 2015, 2016). As
noted above, these behaviors have been analyzed in accordance with Grotberg’s (1995)
Resilience Factors theory and Knight’s (2007) Three-Dimensional Resilience
4 OMEGA—Journal of Death and Dying 0(0)

Construct. Based on the work of both authors, the analysis of narratives detected
processes of post-traumatic transformation and growth. The behaviors observed were,
among others, participation in events aimed at promoting awareness of, prevention, and
postvention related to the suicidal act; and activism in associations and groups to assist
family members affected by suicide. Complementarily, the transformation also
manifests through artistic expression (writing, painting). This is what Thompson and
Neimeyer (2014) call “grief therapy,” understood as a creative way to help people cope
with heartbreaking (difficult and transformative) experiences. The results suggest that
emotional expression through participation in self-help, prevention, postvention and
artistic expression groups alleviates the feeling of alienation caused by shame and the
stigma of loss, with these negative feelings being ameliorated by attachment to a group
and the facilitation of emotional expression through active listening, acceptance, and
shared experiences.

Research Question and Objectives

The question that our study aims to answer is: Do the suicide survivors in the sample
possess indicators demonstrating the possession and development of resilience in their
respective grief processes.? Reviewing the literature, we found that resilience helps to
restore balance in people who have suffered an adverse or stressful situation at some
point in their lives. The objectives of the work, thus, are the following:
General objective: To identify and describe resilient behaviors in the grief processes
of people affected by the suicide of a family member.
Specific objectives: (1) To describe, with reference to Grotberg’s model, the
manifestations of resilient behaviors in the people comprising the sample and; (2) To
describe, with reference to Knight’s model, the manifestations of resilient behaviors by
the people in the sample.

Methodology and Study Design

A non-experimental, mixed-method, exploratory analysis was employed using the In-
Depth Interview and the Brief Resilience Coping Scale (BRCS) to measure the ex-
istence of resilience, and levels of it. For the analysis of the interviews, the theoretical
concepts were previously operationalized and codified, and subsequently searched for
in the narratives in order to analyze the discourse of the individuals, using the Atlas Ti
software.

Sample
We worked with a sample of 21 people who had lost a family member to suicide. To
access the sample (Table 1), we contacted state-level NGOs and self-help associations
specializing in support for surviving family members. The organizations gave their
authorization to contact their members. These groups were:
Gallardo-Flores et al. 5

- Suicide Prevention and Postvention. Papageno (Seville)

- Ubuntu (Cadiz)
- Survivors of the Suicide of a Loved One (Cádiz)
- Prevention and Support for Those Affected by Suicide. (APSU, Alicante)
- Angels of Blue and Green (Málaga)
- Green Hugs (Asturias)
- Mutual Help Group, Psicólogos Princesa 81 (Madrid).

The Quality and Ethics instructions of the Helsinki Declaration on Ethical Principles
for Research Involving Human Subjects (World Medical, 2008) were incorporated, as
well as the legal aspects of (Spanish) Organic Law 3/2018 on Personal Data Protection
and Guarantees of Digital Rights.

Table 1. Profiles of the Study Sample.

Marital Lives Relationship Year of

Subject Age Sex status Children alone Studies Works to deceased loss

01 43 F Single 1 No University Yes Child 2018

02 57 F Widow 1 No University Yes Spouse 2015
03 59 F Widow 2 Yes University Yes Sister and 1997
husband and
2010
04 37 F Married 1 No VT Yes Child 2020
05 40 F Divorced 1 Yes University Yes Sibling 2003
06 26 F Single 0 No University Yes Sibling 2010
07 45 F Divorced 3 No FP Yes Partner 2020
08 60 F Divorced 2 Yes FP Yes Mother 2017
09 38 F Married 1 No University Yes Sibling 2020
10 31 M Single 0 No University Yes Sibling 2019
11 33 F Single 0 No FP Yes Child 2020
12 54 M Married 2 No University Yes Sibling 2017
13 43 F Single 1 No Secondary** Yes Child 2018
14 43 F Married 3 No Secondary** Yes Child 2018
15 69 F Widow 2 Yes University Pension Mother 2016
16 38 F Widow 1 No University Yes Wife 2020
17 28 F Single 0 No University Yes Sibling 2017
18 39 F Single 0 Yes University Yes Partner 2019
19 61 M Married 0 No Secondary** Yes Child 2015
20 49 F Married 0 No VT Pension Sibling 2020
21 58 F Divorced 3 No VT Pension Mother 2019

Notes: * VT, Vocational Training, ** Secondary includes Primary and Secondary Source: authors’ own.
6 OMEGA—Journal of Death and Dying 0(0)

Table 1 defines a sample of 18 women and three men ranging age from 26 to 68, with
educational levels spanning from elementary to higher education. Most were single,
and the time elapsed since their loss until the time of the study ranged from 8 months to
23 years.

Instruments
The data collection instruments used were the In-Depth Interview (qualitative) and the
Brief Resilient Coping Scale (quantitative). This mixed methodology furnishes the
results with theoretical coherence and internal and external validity by allowing for the
observation and analysis of the sample in an integral manner. The BRCS (Sinclair &
Wallston, 2004) has been validated in Spanish by Limonero et al. (2010) as a self-
administered questionnaire (Likert), with scores ranging from 4 to 20 points, with
14 expressing low resilience, and scores equal to or higher than 17, high resilience.
The in-depth interview allows for the collection of content through personal nar-
ratives, which facilitate the identification of discursive elements and significant data on
the suicidal experience, grief management and resilient behavior. According to Cadena
et al. (2017): “The in-depth interview is developed by asking questions, listening to and
recording the answers, and then asking other questions that expand on a particular
topic” (p. 1613). In this type of interview the questions are open-ended and the in-
terviewees express their perceptions in their own language. Through it we obtained
testimonies from family members who have gone through a suicide-related be-
reavement, allowing for a reconstruction of the past, a description of the present, and a
projection towards the future, including goals. The in-depth interview reveals the
interviewees’ norms and values, their perceptions of what they are going to narrate,
their beliefs and behaviors, etc. The questions used in the study were the following:

1) In relation to the loss event, how would you define yourself as a person at the time
of the suicidal act?
2) In relation to the loss event, how would you define yourself as a person at this time?
3) In relation to the loss event, how do you envision yourself as a person in the future?

Procedures
Through telephone contact with the respondents, the objectives of the study, its
characteristics, and its data protection guarantees, were explained, as well as the date,
time and place of the interview. Due to the geographic dispersion of the respondents, the
interviews were conducted via videoconference, which guaranteed visual contact and a
sense of personal engagement befitting the subject matter in question. The interviews
were recorded, and the recordings were used to produce the transcriptions.
The interviews consisted of three phases: (1) Introduction and a reading of the
informed consent and data protection information (2) An in-depth interview featuring
Gallardo-Flores et al. 7

three open questions, according to the guidelines (3) Completion of the BRCS Test
through the Web platform.
The interviews then underwent discourse analysis after the operationalization and
pre-coding of concepts to detect narratives, using the Atlas Ti (Version 8) computer
program.

Analytical Framework
The Brief Resilient Coping Scale (BRCS) (Sinclair & Wallston, 2004) is an instrument
that identifies the possession of resilience, and its levels, dividing them into High, Low,
or Neither High Nor Low, through Likert scale responses. The statements were:

1) I look for creative ways to deal with difficult situations.

2) I believe I can learn positive things when I deal with difficult situations.
3) I actively seek ways to make up for the losses I experience in life.
4) No matter what happens to me, I am confident that I can control my reaction.

For the analysis of the qualitative data obtained, two theoretical models were used;
Grotberg’s (1995) resilience factors and Knight’s (2007) three-dimensional construct
for resilience. According to Grotberg (1995), “the sources of resilience are organized
into three factors and require the concurrence of at least two of them” (p. 7). The factors
she outlines are:

a) “I Have”. Support provided by society to the individual through emotional ties:

parents, siblings, friends, neighbors.
b) “I Am”. The development of intrapsychic strength, self-esteem, self-perception
and will.
c) “I Can”. The acquisition of interpersonal skills and conflict resolution; the indi-
vidual’s creativity and humor to deal with difficult situations.

These factors are expressed through (Grotberg, 1996):

“I Have.”

· People I trust and love who set limits for me so that I learn to avoid dangers.
· People who show me, through their behavior, the way to proceed so that I can learn
to manage on my own.
· People who help me when I am sick or in danger.
8 OMEGA—Journal of Death and Dying 0(0)

“I Am”

· Defines socially accepted values for which to act or mobilize (will to meaning).
· A person that others appreciate, and who is happy when I do something good for
others, showing my fondness for them.
· Respectful of myself and others, and willing to take responsibility for my actions.

“I Can”

· Talk about what scares or worries me, and look for ways to solve my problems.
· Control myself when I feel like doing something dangerous or that is not right.
· Find the time to talk to someone and have them help me when I need it.

The above dimensions are manifested in personal characteristics expressed through

behaviors, acts, language, speech, narratives, expressions and actions, which this study
seeks to identify as part of its results.
Knight’s (2007) model proposes a construct that defines resilience as:

1- A state (What it is and how to identify it). This, in turn, is expressed by:
a) Emotional competence, consisting of a positive self-concept and an internal locus
of control (self-control and emotion regulation), personal autonomy, and a sense of
humor.
b) Social competence defined by the ability to generate stable social relationships:
communication, a sense of belonging and empathy are relevant to resilience.
c) An orientation to the future, representing a marked experiential intentionality and a
clear idea of the meaning of life, with an optimistic approach and a sense of
commitment, flexibility and adaptation to situations.
2- A condition, what can be done with it?
3- A practice, how can it be cultivated?

The analytical framework for the analysis of results can be summarized in the
following diagram:

Results and Analysis

Brief Resilient Coping Scale (BRCS)
It was possible to identify the level of resilience of the people in the sample using the
data obtained. As can be seen (Table 2), out of 21 subjects, seven exhibited High
Resilience (33%); eight, Low Resilience (38%); and six individuals showed Neither
High nor Low resilience (29%).
Gallardo-Flores et al. 9

Diagram 1. Analytical framework for the study.

Once the sample was categorized into these three groups, we proceeded to study the
presence of Grotberg’s resilience factors and Knight’s dimensions through analysis of
the in-depth interviews, using Atlas Ti.

In-Depth Interviews
For the analysis in Atlas Ti codes were produced based on the analytical framework
established to operationalize the authors’ factors and dimensions. These codes were
identified in the narratives of the sample’s subjects, and are expressed in phrases or
sentences used as elements of discursive analysis for each of the author’s categories.
Description of the resilient group whose discourse reflected the resilience factors
identified by E. Grotberg (1995).
It was possible to identify the presence of 136 elements of discursive analysis in the
group’s members. Subsequently, they were organized according to said author’s three
factors, the most prevalent being “I Am,” appearing 68 times in the interviews (50%).
The second factor, “I Can,” appeared 50 times (37%); and the third factor, “I Have,”
appeared in the narratives on 18 occasions (13%).
The results obtained, according to the above categories, show the most significant
types of narrative discourse, organized by factor, dimension and subdimension, as
follows:
“I Have.” This factor was identified through the expression of organized and
coherent phrases or sentences (four dimensions) alluding to temporally related and
evidence-oriented events.
10 OMEGA—Journal of Death and Dying 0(0)

Table 2. Persons in the Sample Showing Resilience, According to the Scale.

I believe I can
I look for No matter what learn positive
creative ways happens to me, I things when I actively seek
to deal with am confident dealing with ways to make
difficult that I can control difficult fore the losses I Degree of
Subject situations my reaction situations experience in life Tot resilience

03 5 4 5 5 19 High
05 4 5 5 3 17 High
07 4 3 5 5 17 High
10 4 4 5 4 17 High
12 5 4 5 5 19 High
15 4 4 5 4 17 High
20 4 4 4 5 17 High
06 4 3 5 4 16 Neither
low nor
high
08 4 3 4 3 14 Neither
low nor
high
09 4 3 5 3 15 Neither
low nor
high
11 4 4 4 4 16 Neither
low nor
high
16 4 3 3 4 14 Neither
low nor
high
19 4 4 4 4 16 Neither
low nor
high
01 3 2 4 4 13 Low
02 2 2 2 3 9 Low
04 2 4 4 1 11 Low
13 1 2 3 5 11 Low
14 3 1 1 1 6 Low
17 1 3 4 5 13 Low
18 1 3 1 1 6 Low
21 4 2 3 3 12 Low

Source: Authors’ own. BRCS by Sinclair and Wallston (2004), organized by resilience level.
Gallardo-Flores et al. 11

The first dimension refers to the possession of spaces and people generating enough
confidence for one to share their emotions, experiences and moods, because they feel an
acceptance of them and their situation, as reflected in the following narratives:

“I couldn’t share with other people, but in the support groups there is a space of trust, in
which, within the confines of the tragedy suffered, at least you can share.” (Woman)
“Personally, the association helped me a lot, as I was able to talk naturally. Sitting down
with other people who had gone through this and expressing my feelings was very
important.” (Man)

The second dimension of this factor is evidenced through the “the interviewees’
identification of people who taught them to recognize risks or to set limits to avoid
dangers,” as in statements like this:

“You’ll think I’m stupid, but I think he left giving this to me as a gift. Making me be
careful, keeping me from hurting myself. So that I don’t cling to them (referring to other
people), you know? Both Daniel (therapist) and Nuria (from the self-help group), and my
partner (current partner).” (Woman)

The third dimension reflects identification with “people who resolve to act freely,
analyzing and choosing alternatives and then doing things by themselves, without
depending on others,” for example:

“... and I suffered greatly with my current partner. I suffered again because I didn’t expect
it, but now I have the tools to overcome it, which I didn’t have before. The Papageno
association has helped me a lot to find those tools.” (Woman)

Finally, the fourth dimension of this factor is evidenced when respondents refer to
“identifying people who offer them help in case of illness and danger,” as reflected
below:

“It’s all good. We call each other, we are in a WhatsApp group, all of us women, together,
but we often call each other privately if we see that something is up, because we know each
other so well that, from the way we write, we already know how other people are doing.”
(Woman)

“I Am.” This factor identifies six dimensions. In the first one, the interviewees refer
to themselves as “people who acted driven by society’s values, which generated
synergies and characteristics that helped them to face stressful situations. This allows
them to muster wills and become examples for others.” This is evident in the following
narratives:
12 OMEGA—Journal of Death and Dying 0(0)

“I want to express that I feel empowered now. I feel empowered to fight for this issue, you
know. And that’s why I’ve taken on the Presidency of Ubuntu, because I’d like to be able to
help other people.” (Female)

In the second dimension, the subject feels that he/she is a person “for whom others
feel appreciation and affection, which makes him/her feel appreciated, respected as he/
she is,” as in the following statement:

“Because I have to live with myself for many years. If we are all alright, I am the first one
who is alright. Many things have always happened to me, and there were times when I felt
very lonely, without any support. I forged on and today I realize I that haven’t felt alone at
any time. Since this happened to me, I haven’t felt alone.” (Woman)

The third dimension is that which is identified with “happiness from doing
something good for others, showing affection, feeling the need to transcend and do
things for others,” as reflected below:

“Well, I’d like to help. Help with suicide prevention. After what happened with my
brother, whenever I see any news or any article related to the topic of suicide, I try to give
my opinion and experience. That is, I try to help spread the word about suicide through
talks or meetings, or direct help to people, or at grade schools, or high schools.” (Male)

“I am happy, as long as my... my people are happy, I.... I want my people to be happy.
(Woman).

The fourth dimension is that which expresses “respect for others and for oneself, for
their moods and emotions.” This is evidenced in the following narratives:

“Yes, I used to be a hothead, because I’ve always had a quick temper. It’s been a process of
years. After the suicide, which affected me a lot, I suffered a lot. Then you start to realize
(that) there are certain attitudes that are not helpful, and that are good for nothing.”
(Woman)

Dimension five refers to the attitude that expresses “willingness to take responsi-
bility for their actions, with confidence and conviction, consistent with their emotions,”
as seen in the following excerpts:

“...now this one... (referring to herself) a lot of people don’t like her because I tell the truth,
I say that, and I don’t want to change it. I want to keep being like that because I think that’s
how I should be, I don’t have to be pleasing everybody.” (Woman)
“Now it’s my turn to pull the cart, which I can do because I am alright. I have to be alright,
for me, and for them. And I do this with pleasure, because I have to help them.” (Male)
Gallardo-Flores et al. 13

The sixth dimension has to do with a feeling of “certainty that there will be a solution
and everything will be solved, optimism about the future, translating into projects or
plans,” as seen here:

“... with this COVID thing, when everything was so unsafe, I work at a sporting events
company, so you can imagine. Everything was up in the air, and I was worried, but I’m not
worried anymore. If something happens, well, ..... we’ll look for a solution to the problem.
Solution, problem, solution. (Woman)

“I Can”. Grotberg’s third factor features five dimensions, together having to do with
the “acquisition of interpersonal and interactional skills that enable conflict resolution.”
The first of these refers to the fact that the subjects “can develop skills to interact and
interrelate in order to manifest or express emotions.” This can be seen in the following
excerpts:

“I try not to think about it, to live with it, but you can be a little afraid that at some point
things will go wrong, because there are many things that can get mixed together, and my
mind doesn’t see another way out, I’m also afraid of that...” (Woman)
“Personally, I’m not afraid of something like that happening to me. I think I have my head
screwed on right. I have been through quite difficult situations, and it has not led me to that,
but I do understand that a person who does it, in this case my brother, I think about how bad
it must have been for him to resort to taking his own life, which is the most precious gift.”
(Man)

The second dimension of this factor refers to the “ability to solve problems, identify
appropriate times and places to deal with them, drawing on alternatives such as humor
and creativity,” as below:

“A lot of people get very upset and I ask them ‘What do you care if she comes, if she wears
those clothes, if she comes at this time...’ As I have dealt with big problems, it seems to me
that they’re wasting their time and energy on such nonsense.” (Woman)

The third dimension has to do with the “capacity for self-control in the face of
situations and memories of adversity, pain and stress.” This is reflected in the following
narratives.

“At this time, I have my lows. I try to think that, given what this experience is, in the end
you learn to live with the pain. You get over it. You live with that loss, and you try to focus
on the good times.” (Woman).

“I felt powerless, guilty and angry, disconnected from the world...My feeling at that
moment was ‘I can’t believe it!’ Well, I’m going to see how I deal with it, with my family.
I’m going to focus, personally manage my emotions, to try not to go any further.” (Man)
14 OMEGA—Journal of Death and Dying 0(0)

The fourth dimension refers to people’s “ability to identify the right time and place to
spontaneously express their feelings.” This is defined in the following narratives.

“The mistake I’m making - I know it, I don’t need to be told - is that I completely distance
myself from everyone. I withdraw. I don’t want to talk to friends, or to relatives. I don’t
want to talk to anyone, and now I’m very afraid of detachment.” (Woman)

The last dimension of this factor involves “capacities that resilient people can
develop to identify the characteristics of people who can help them in their grieving
process.” Below are narratives that reflect this.

“After these first times, I think and tell myself that I have to do something to motivate them
(parents) and that’s when I try to guide them towards help. ...I got into the world of victims
through the Asociación Ángeles de Azul y Verde (Blue and Green Angels Association)
and Debes Alcalá, groups for grief management in the police” (Male).

Description of the group of people affected by the consummated suicide of a family

member who, according to the BRCS test, have a high level of resilience and, in turn,
reflect Knight’s (2007) three-dimensional elements in their discourse.
As discussed in the analytical framework, the areas of the Three-Dimensional
Construct of Resilience focus the analysis model on Emotional Competence, Social
Competence and Future Orientation.

Emotional Competence. The narratives manifest a desire to help people who are cur-
rently suffering a situation similar to the one they experienced. Their narratives address
what worries them, and/or ways to solve their problems in an autonomous way, in
which creativity is put into practice to express, confront and transcend their pain.

“I work with my own students. As I said, I’m a high school teacher and I started to work on
grief with my students. When I told them what had happened to me, it connected with their
pain as well. When I joined the class the children gave me so much life! My students gave
me so much strength. I worked with them on the pain they had inside, and that helped me to
create what I call the ‘Scar Club’ in my free time.” (Woman)
“Any action that can prevent suicide is good. I’m willing to talk about the experience, the
feelings that those of us who have lost a family member to suicide have experienced.
(Man)

Social Competence. This results from a commitment to actions undertaken to help other
people adapt to the adverse situation. The process of resilient grief leads them to a
personal transformation arising from the adversity experienced, and heals the pain by
helping people who share the same situation.
Gallardo-Flores et al. 15

“First we began to address the grief; at first only over the death, but then I realized that
there were many other forms of grief: over abuse, family abandonment; in short, a lot of
things. Then we worked on suffering. It was beautiful for me... My hope is to be able to do
things along that line, but things that really provide the survivors with tools. When you
understand the pain of others, and you really go all in for them, and step out of yourself,
that’s when I think you really start to heal.” (Woman)

Orientation Towards the Future. This dimension makes it possible to find meaning in the
adversity experienced and to foster forward-looking thinking in which they see
themselves overcoming challenges. Many of these projections, as we saw above,
involve helping other people in the same state, as helping generates motivation in their
lives, bolstering their potential for personal change.

“What is my future path? Well, I’d like to help. To help with suicide prevention.” (Male)

“Now I feel I have the tools. I feel more confident, but we’re still making little progress,
and that worries me. That’s why I get involved to leave a better future for other people who
are going to go through the same thing. I am immersed in many activities to work on
suicide postvention.” (Male)

Discussion
In response to the research question “Do survivors possess or develop resilience in
their grief processes?” the results of the study show that they do possess resilience
and have the capacity to develop it. Using the Brief Resilient Coping Scale
(Table 2), 33% of the sample exhibited high levels of resilience, the rest having
medium or low ones.
Of Grotberg’s three factors, the one with the highest prevalence was the “I Am”
group, corresponding to 50% of the total elements identified. This is significant, as the
“I Have” factor, identifying people and spaces that provide affection, security, trust and
love, was the least prevalent in the group, corresponding to 13%. This accords with the
studies of Grotberg, who focuses her work on the identification of the factors that
develop and enhance resilience in children and adolescents, drawing on Erickson’s
early stages of development in her analyses.
In the case of our study, we worked with a sample belonging to older age groups,
which entails different tasks and objectives, as affective bonds and experiences are
handled with different cognitive and vital resources. This explains why the rest of
the factors, in a stage of development adjusted to the sample, are more predominant.
The ages of those involved means that they possess tools and learning obtained from
other social agents. As a consequence, grief allows them to develop coping
strategies by taking responsibility for their actions; that is, by identifying with the “I
Am” factor.
16 OMEGA—Journal of Death and Dying 0(0)

It was also observed that the number of items that relate to the factors that concur for
the high-resilience group coincides with the score obtained on the Brief Resilient
Coping Scale. Thus, we conclude that those subjects in the group who scored higher on
that test possess a greater number of items related to Grotberg’s factors.
If we incorporate the gender variable, the factor most present in men is “I Am,”
which expresses the development of intrapsychic strength, self-esteem and will with
respect to socially accepted values. In the case of women, “I Can” refers to interpersonal
and conflict resolution skills. It is deduced, then, that men developed more internal
strengths and tools, while women developed more interpersonal and coping skills.
In line with the research by Ross et al. (2021), the presence of the stigma surrounding
suicide in society is evident in the absence of individual and social support for the
management of grief, making it difficult for families to adapt to the loss. It is, therefore,
very significant to observe how the resilient group expresses in its narratives the
importance of helping other people to overcome their adversity, and how this help
becomes a tool that empowers and strengthens them, making grief management
healthier.
The results of the study evidence post-traumatic growth in resilient survivors
through transformation and growth behaviors incorporating more positive grief
management strategies. These people generate strategies to cope with trauma, over-
coming their adversity through participation in support groups, involvement in ac-
tivities that raise awareness of suicide, and the exteriorization of their experience
through artistic tools such as writing or painting. This statement coincides with the
findings of Thompson and Neimeyer (2014), who share that people who perform
creative actions resignify the traumatic event, with this activity enabling them to tackle
life more optimistically and make sense of the adversity they have experienced.
Grotberg (1995) and Knight (2007) state that the possession of resilience allows for a
transition from pain to personal growth, making possible a transformation revealed in
the discourse analyzed.
Taken as a whole, we clearly observe in the narratives that these people exhibit a
greater appreciation for life and a certain way of acting, one reflecting a personal
commitment towards the rest of society, especially towards people who have gone
through the same adversity, such that they undergo a process transforming their adverse
experience.
The motive behind the action is to generate adequate knowledge of the phenomenon
of suicide, and to raise awareness of it, as their testimony generates positive social
changes that favor the adoption of suicide prevention and postvention measures. Their
narratives highlight the physical, psychological, emotional and social repercussions of
survivors at both the citizen and institutional levels.
In conclusion, and in line with the objective of this study, the results indicate that the
resilient group demonstrated behaviors reflecting the potential to construct new be-
havioral and cognitive subdimensions, especially in relation to Grotberg’s factors of
resilience, a finding that paves the way for future research to delve deeper into the
acquisition and detection of resilience, promoting effective adversity management.
Gallardo-Flores et al. 17

Limitations and Future Lines of Action

The limitations of this work spring from the small number of people comprising the
sample, which was due to the difficulty of finding participants for a study that, in-
evitably, forces them to (re)connect with pain and traumatic experience. Nevertheless,
the effort made afforded us a more thorough understanding of the object of study, that
is, the way in which those affected by a suicide experience the concepts of pain and
stigma, as well as the various ways of coping with grief through disparate resilient
skills.
The study aims to help shine a light on a topic that, although dramatic, given the
distressing and sobering data, is all too often overlooked and stigmatized by public
opinion. We proceed based on our conviction that exposure to the suffering of the
relatives of a suicide victim can generate awareness and commitments by public Health
and Social Services institutions, ultimately responsible for the generation of post-
vention programs and the empowerment of the survivors of a suicidal act.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship,
and/or publication of this article.

Funding
The author(s) received no financial support for the research, authorship, and/or publication of this
article.

ORCID iD
José-Marı́a Morán-Carrillo  https://orcid.org/0000-0001-6946-7897

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Author Biographies
Ana Gallardo-Flores is Diploma in Social Work and Social Education Official
Master’s Degree in Gender and Equality. PhD Cum Laude with specialization in care
and resilience, within the specialty in Social Sciences. Researcher Indis group with
participations and communications in various international conferences and contri-
butions in book chapters, University Pablo de Olvide Seville, Spain. Mónica Renedo
Award for her contribution to research and promotion of Resilience, University Jaime I,
Castellón de la Plana, Spain. Coordinator of the Program for training for employment
and autonomous living of people with intellectual disabilities. Member of the Tech-
nological Commission of the Department of Social Sciences at the University Pablo de
Olavide. Currently teaching at the University Pablo de Olavide since 2012.
José-Marı́a Morán-Carrillo is Professor at the Universidad Pablo de Olavide (UPO),
Seville, Spain. PhD in Social Work and Degree in Sociology from the Universidad
Pontificia de Salamanca, Madrid. Teaching and research lines: Psychosocial Crisis
20 OMEGA—Journal of Death and Dying 0(0)

Intervention, Epistemology of Social Work and Social Work with Individuals and
Families. Coordinator of the Emergency Commission of the Andalusian Council of
Professional Associations of Social Work since 2021. He has been representative of the
European Platform for World Wide Social Work at the U.P.O. (2004-2009) and Fellow
at the Real Colegio Complutense (Harvard University, 2006).Author of three books
(Spanish); Methodological Intervention in Social Work: intervention and context
strategies (CGTS, 2004), Bases of Social Work: Social Work and Epistemology (Ed.
Tirant lo Blanch, 2006), and Professionalization of Social Work in Spain. Genealogy
and indicators of organized social action (Ed. University of Granada, 2021). Recent
publications: From paradigm to intervention, common models in health social work;
special attention to the model of psychosocial intervention in crisis. Social Work and
Public Health (Ed. Sanz y Torres, 2023), and Photovoice as an emancipatory peda-
gogical practice in the training of social workers. Social Work in Contemporary
Society, Ethics, care and digitalization (Ed. Tirant lo Blanch, 2023).
Maximiliano Garciá-Carmona is Diploma in Social Services & Social Worker,
Master in Organizational Management and Human Relations, University of Valparaiso
(Chile). International postgraduate studies and courses in Quality Management in
Education, Harvard Model Mediator, Teamwork and Conflict Resolution, Ph.D. ©
Social Sciences Pablo de Olavide University, professor at that university in the areas of
Family, Community Social Services and Social Policies. and Social Policies, expert in
Atlas Ti.