What if your spouse committed suicide? Your child? Your parent? How would you feel? What would you go through? How is this different from any other kind of death?

How many will be or have been in a position of needing to comfort a family member of a victim of suicide? Do we know what to say or do? What is helpful? What is not?

Psychologist Lawrence Calhoun at North Carolina State University at Charlotte has studied these issues confronting the survivors of suicide for over 10 years. He has conducted research with survivors, the immediate support system of survivors, funeral directors, support groups and the general public. Here are some of his conclusions:

Stigma. Besides the normal issues of grief, loneliness and sadness, survivors of suicide feel blamed and stigmatized. A significant minority feel subject to gossip, experience negative reactions from officials or are accused of having caused the suicide.

Suicide survivors absorb the negative attitudes attached to the suicidal act and toward the deceased. Shame and embarrassment are common emotions.

Anger. Along with being emotionally distraught and feeling shocked, confused, saddened, abandoned and hurt, the survivor feels immediate anger - "How dare he or she do this to me!"

The survivor has a need to talk and the anger comes tumbling out. He or she has been wounded permanently and in ways the victim could not have anticipated. The survivors will never be the same again.

Guilt. The survivors feel overwhelmed with guilt and self-blame. A sense of failure comes from wondering how they did not meet their loved one's needs. "Where did I drop the ball? Where or how could I have helped more?"

They beat themselves up with 20/20 hindsight. Details discovered after the suicide help explain what was going on. Guilt comes from not having foreseen the danger or the signs of suicide. "If only" thoughts torture the survivors.

Memories. The painful memories of how the loved one died intrude and taint the special memories of the life that was lived. "Goodbye's" were not said. Unfinished business, especially unresolved conflict, will remain unfinished.

Search for meaning. The survivors have an intense desire to reach an understanding and make sense of the suicide. Every clue, every event in the chain of events leading to the suicide is analyzed.

The search for meaning happens at another level as well - the effort to understand how things like this can happen in a just world and to good people. Also, there is a need to reconcile religious understandings on the sinfulness of suicide and the status of their loved one. Suicide of a loved one challenges the deepest core of one’s spiritual belief.

Isolation. Members of the survivors support system feel awkward in knowing how to comfort the survivors. They may know what not to say. The problem is that they don't know what to say or do so they do nothing. Most people feel more compassion for a suicide but actually express less support. It is easier to avoid the bereaved than to risk making a social mistake.

They avoid talking about the deceased. They act like the suicide never happened. They pull away because of their own anxiety. If they are supportive, they stop their support too soon. The survivors feel blamed, alone and deserted in their pain.

The bereaved feel they are expected to provide answers to the questioning attitudes of others. They are in their own struggle to understand the reasons for their loved one's tragic actions and are not ready to explain them to others. Survivors of suicide sense that probing questions about the details of the death is a subtle way of trying to assess blame.

One study showed that with a suicidal death, 75 percent of comforters mentioned the cause of death to the widow while only 40 percent did so for an accidental death and 15 percent for a heart attack.

Fifty percent mentioned blame or guilt to a suicide survivor while this came up only 15 percent of the time with either an accident or heart attack. Seventy-six percent of survivors of accidental deaths found the support they received as positive while only 27 percent of suicide survivors felt they received positive support.

What is seen as positive support are expressions of concern, sympathy, bringing food, cards, just being there and allowing for expression of grief.

Support groups. Survivors of suicide feel that other suicide survivors give them the support they want most. Within a group of fellow sufferers they can explore honestly their own emotions and reactions and feel fully understood.

Within the group, they connect with others who genuinely soothe their trauma and help them understand the path to recovery. Veterans in the group serve as informed role models and help them to face and express their pain. With the strength of these healing bonds, the survivors then reconnect and identify with the larger community.