Science and health The "triple duel" of the surviving twin sister: "They have to get her to express herself so that she does not try to take her own life again"

They were born and raised together, understanding each other like no one else could, and sharing everything

Science and health The "triple duel" of the surviving twin sister: "They have to get her to express herself so that she does not try to take her own life again"

They were born and raised together, understanding each other like no one else could, and sharing everything. Also intense suffering. On the afternoon of Tuesday, February 21, they decided to end their life at the age of 12, believing that it was the only way out. One of the adolescents survived and the other passed away, leaving an irreplaceable void and a lot of pain. The emotional impact on the surviving minor after this experience, the death of her twin and her own suicide attempt, places her in a state of extreme vulnerability. An expert in grief explains some of the necessary steps in accompanying minors to reduce their suffering.

"The duel that this girl is going to go through has nothing to do with any duel that is stipulated." She assures it with regret Mercedes Jiménez-Carlés González-Barba, an expert psychologist in emergencies and catastrophes, and not only as a specialist but from her own experience. She has a twin and knows that the affective bond that is established is not comparable to any other. "They are like a part of ourselves, no one else understands us, he is not a normal brother," he explains, emphasizing the importance of taking into account in this case "the degree of union" that existed between them and that reached such a point. point that the minor who survived had decided to follow her twin until death.

What she is facing now is a "triple duel", for the "loss of her sister", of a "part of herself" and that of the "relationship with her parents because they can be immersed in their pain and be less present to attend to the needs of their daughter", she explains, quoting the psychotherapist Alba Payás. In this difficult moment of facing death, Jiménez-Carlés González-Barba warns that thoughts of guilt could appear ("I would have preferred it to be me instead of my sister", "why do I live and my sister not...) or suicidal ideation again ("I don't want to be here without my sister"). In this case there is the added risk of that deep "loyalty" that she feels for her sister and that she has already expressed in the most extreme way and that she "continues in her". "They have to get her to express herself, for the girl to cry what she has to cry" if that's what she needs, not everyone expresses pain in the same way, she emphasizes.

Understanding your environment is key to coping with them and reducing risk. "What can calm her the most is that they understand her even if they do not agree," says this expert. When a person with suicidal thoughts expresses them, they usually say, with the best of intentions but in the wrong way, "don't feel that, don't think about it" when what they need is to "validate" their feelings, what they are experiencing internally . Doing so does not mean agreeing with his action or that suicide is the solution and thus we can let him know, giving him hope to find another way out, but we do show him that we understand that his degree of discomfort is so high that it leads him to have thoughts self-destructive.

It is vital that she "feels heard so that she is able to express thoughts of suicide if they return, that she is not judged and neither is her sister because going against her sister is going against her, that she be taken into account, that she decide if whether or not she wants to go to the funeral rites for her sister, to ask her opinion, not to stay on the sidelines to protect her from further pain, to be told the truth, to take an interest in her things...", explains this expert because Only in this way, by truly listening, will an adult be able to know their thoughts and their level of suffering. Mercedes Jiménez-Carlés González-Barba offers a simile to explain how adolescents feel at this time in their lives and which is included in the book by Françoise Dolto 'The cause of adolescents', comparing them with the moment of change in lobsters: "When They change their shells, they are very vulnerable because they do not have hard protection. The stage of adolescence is the same, they are uncovering many things from childhood but they still do not have the protection of adults. Imagine the vulnerability of this adolescent, with a sister who He has committed suicide and she has tried. She does not have that protection for many things."

The adolescent group is especially vulnerable due to factors such as their greater impulsiveness, the magnitude of some emotional responses to bad experiences, and their low tolerance for frustration. Shouting, slamming doors, angry responses, defiance, and risky behaviors of a sexual or drug use nature could all be symptoms of depression.

This expert, coordinator in Andalusia of the National Suicide Prevention Network Princess 81, explains that what is usual in the case of the death of a minor is that there is a "social minimization", that is, that the support will be focused on its greatest measure in the parents due to the devastation of losing a daughter and in the siblings often falls the burden of taking charge of the mourning of their parents. They receive pressure from the environment to "be strong for their parents", who "need them", preventing them from expressing their own emotions. It is usually done with "good intentions" to "protect the family" but it is "unprotecting the adolescent." In this case, moreover, the girl, who will possibly now be plunged into a state of fear, guilt and confusion, already had a previous and very significant burden of suffering that led her to decide to take her own life together with her sister. she.

This tragedy has also hit the educational center where they have been studying for two years and has turned their teachers and classmates into survivors of a death by suicide, which implies the need for specialized psychological intervention to reduce the emotional impact.

"Teachers have to ask for professional help yes or yes. They can help contain, console, prepare the class, the classmates before she returns and that can only be left in the hands of a specialized person. Not in teaching they have taught us [suicide prevention and post-vention]," says Jiménez-Carlés González-Barba, who in addition to being a psychologist is a teacher at a school in Seville. Returning to the routine when she is ready can be helpful for the minor. How should that return be?

One of the most important actions is to look for an "adult reference" and a "reference of his age" in which he can lean especially. "The person who welcomes that girl on the first day should not be her guardian but the person who she trusts the most. Let the team of teachers consider who is the closest person or ask her. And you have to carry out a previous work in class with a professional to address what has happened, the communication of bad news, fostering respect among the peer group, explaining to the students how they can accompany her, what to say and what not to say", she explains. In this case, it is necessary to apply "exceptional measures" such as allowing them to leave the classroom when they need to and always accompanied by a friend to avoid the risk of a new attempt, giving them facilities to complete their studies, such as extending the deadlines for the assignments or the dates of the exams, not judging her, not putting pressure on her and that she perceives that she is not alone and that her educational environment understands that she is grieving.

It is also important to never "romanticize" suicide by using phrases such as "he is in a better place now", "there is another angel in heaven", "he is finally resting" or "you have to be very brave" because it can make him into something desirable or even imitable. You must insist on the idea that it was a mistake and that there is always a way out.

A death by suicide in a minor causes a strong emotional impact among their friends and peers in a stage of life such as adolescence where there is a greater risk of an imitation effect. It is necessary to talk to the students about what has happened, listen to them and give them the opportunity to express themselves and organize awareness actions with the rest of the parents because in all probability more cases will be detected as a result of this one.

A grieving adolescent can have very different reactions. They may be overwhelmed by guilt, disbelief, suffer anxiety, irritability, aggressiveness or, on the contrary, apathy, they may suffer from insomnia or not stop sleeping, lose their appetite or not stop eating, have headaches, gastric discomfort, intense exhaustion ; refuse to go to school or lower their school performance. They are all normal, but when they take a long time or you cannot express your emotions, it is advisable to consult a specialist.

What can parents do to accompany them? "Speak to our children from the heart, without judging because if you judge thoughts will be silenced. No matter how tremendous or brutal it is, you better find out and let them express their emotions. We can tell them that there are stages in life when you suffer a lot but sharing them is fine and that is the only way we can help them".

1. Be aware of warning signs: changes in behavior, hopeless comments, increased isolation, irritability, abandonment of activities and relationships that were previously pleasant...

2.Listen to them and not relativize the situations that overwhelm them

3. If we have suspicions, we should ask without fear, directly, warmly and progressively, first raising suicidal ideation: "With all this that is happening to you, that I see you badly, have you ever thought that life is not worth it? live it?"

4. If they answer that yes, that they have thought about death, we have to resort to suicide prevention telephone numbers such as 024 where they will inform us at any time of what measures to take.

5. It is important that the boy or girl feel taken seriously and see that we act. These are the next steps:

6.We must prevent the possibility of suicidal ideation appearing whether he says that he has thought about taking his own life or if he says no. Intervene to reduce their pain: showing understanding, alleviating the guilt they may feel for feeling bad. It is not about fixing his problems, but about making him feel guilty and feeling accompanied in his difficulties. You don't need to encourage him to fight or fight discouragement from him. It is very important that you know that your suffering is not going to destroy us, that it will never be a burden for your family, that they want you to recover, but that being with you at that moment is one of the things that gives meaning to your life as parents. , never think that they will be better off without him.

7. Strengthen the bond and make them feel capable (remembering moments when they were capable, or simply acknowledging that if they can't now, it's not because they are not capable, but because they are not at their best moment and encouraging them to allow it, that they be pious and understanding with themselves). Promote their autonomy to the extent that they can assume it. Don't help someone who doesn't need help.

8. Offer hope. Accompany and transmit the confidence that everything will improve, without excessive optimism. Optimism sometimes translates into trying to stop the person from suffering at this moment by looking at things in a different way. Hope is different, in it you recognize the hardness of your current moment and you are allowed to be bad, but it reminds us that, as so many times before, in the end it will dawn.

9. Prepare a security plan to avoid an attempt: identify situations that may upset you, activities or people that help distract you and write down trusted contacts or helplines.

10. Create a community network in which we are all participants that gives care, listens and supports a minor who is suffering.

Facing the possibility of hearing a child say after a case of suicide "I suffer the same thing" is overwhelming, but you must avoid "putting your hands to your head even if it is what comes out" and "understanding that suffering and validating it" saying, for For example, "it is true that she did not see any other exit but there are, if you share it you can find more exits that one alone is not capable of seeing". "Let's not say 'don't think that', 'how can you think of it' because they will shut us down, but 'I see what you're saying, it's very important to you and it makes you suffer'." And if we find ourselves without the resources to face it or they feel ashamed or believe that we can give them the help they need, tell them honestly "I don't have the tools but this is so important that we are going to ask for help from whomever we need". It is also necessary to know how to respect their silence and look for more propitious moments. Being present and always available without invading their space and not falling into indoctrination or sterile sermons. "Only from the heart and naturalness can one help, it is true listening," she insists.

The classmates and the educational environment in general are experiencing the tragedy with the added weight of the suspicion that the deceased minor was bullied. In this sense, this psychotherapist warns that "the school is experiencing its mourning and this is not the time to blame. It is unfair and also does not help. When things happen that we have not been able to see, we are not guilty," she says, stressing the need to good training in the classroom to prevent suicide and know how to accompany in mourning.

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