Some of the pearls for psychiatrists are these: Always remember that the survivor, not the deceased, is your patient; it is the deceased who has brought the person to you, but it is the survivor who needs the therapeutic help. Survivors live with tremendous shame and guilt, including feeling like "damaged goods." The aftermath of suicide is a twofold process—coping with the impact of the suicide and grieving the loss; look for heightened shame when the survivor is a mental health professional. Self-blame and blaming others are not uncommon in survivors. Feelings of hurt and betrayal, inadequacy, and powerlessness are common. The effects on the family are profound, especially denial, fear, and contagion—and the ever-present risk of divorce in parents of teenagers who commit suicide. Depression in survivors may resonate with the despair of the deceased. Survivors may fear and avoid mental health professionals because we are perceived as having failed the deceased or as labeling the survivors as mentally ill. Survivors live with the psychological challenge of forgiving first the deceased and then themselves.