Families Coping with Suicide
By Nancy Rappaport, M.D., author of In Her Wake: A Child Psychiatrist Explores the Mystery of Her Mother’s Suicide (September 2009, Basic Books). She is Assistant Professor of Psychiatry at Harvard Medical School, www.inherwake.com.
With every suicide there are brothers, sisters, parents, grandparents, and countless others left behind, devastated by the challenge of how to move forward after such a tragedy. In the aftermath of a suicide, mourning families often struggle to find a way to hold on to treasured memories, and to construct a bond that transcends death and ultimately leads to healing. I share my insight from a unique perspective as a daughter who lost my mother to suicide when I was four years old. My recent memoir, In Her Wake, explores my mother’s life as well as my own journey, which includes a career devoted to preventing teen suicides and to fortifying children in hopes that no family should suffer a loss as enormous as suicide.
The strength and resiliency of any family is unquestionably tested when a parent loses their child by suicide. Parents may torment themselves with guilt, feeling that they failed to protect their child, and second-guessing the decisions they made in raising them In addition, suicide can undermine pride in who the family is, as parents struggle with their anger and a sense of betrayal– “How could my child do this to us?” Although we all have different ways of grieving, tolerating these multitude of feelings as a parent is, ironically, critical to developing a way to let go of the agonizing discomfort that these feelings can generate.
Parents may mistakenly assume that they are protecting the rest of the family if they obscure the truth (‘car accident’ versus ‘driving into a tree,’ ‘died in sleep’ versus ‘fatal intentional overdose,’ etc.). But this can be very damaging to the family compared to providing honest, developmentally-appropriate information. During this type of family crisis, it’s essential that family members know they can trust one other. Deception, even if well-intentioned, can be destabilizing when exposed. Telling the truth, even revisiting prior explanations, frees the family to understand the myths and facts about suicide and find words for the devastating loss and overcome corrosive and divisive secrecy.
Dealing with suicide is often called “silent grief,” because the feelings are so confusing and because of the stigma attached to suicide. Family members may grieve differently so there may be a tacit rule that it’s better or easier not to talk about the suicide or even to recall memories of the person. Suicide-specific support groups can be helpful; there is strength in community and members can find comfort in being together. Family dynamics shift after a suicide, and a family’s load may be lessened if they find ways to communicate about how to persevere through holidays or other special times in the absence of a family member, and find meaningful rituals to preserve the memory of that person (it may be lighting a candle, hanging an ornament on the tree, preparing a favorite dinner). This may sound very orderly, but the reality is that parents are asked to provide leadership at a time they may feel most vulnerable and question their own competency.
Suicide demands an explanation from the living because they very act defies logic and families may blame each other and ruminate on the “what ifs.” What if I hadn’t had that fight with my son at Thanksgiving? or if I had noticed how desperate she felt after the breakup with her husband? Why didn’t she let me help? Blaming one’s self for an inexplicable act like suicide derails the vital cohesion necessary for families to comfort each other about their loss and heal. Parents may worry whether it’s possible that anyone else in their family can die by suicide, and feel genetically responsible if their child had mental illness such as bipolar disorder or depression, and may even worry that they might kill themselves because without their child, life is not worth living.
Suicide’s lethal combination is untreated mental illness, substance abuse and impulsivity, and access to weapons. Parents can safeguard their family by both identifying and recognizing symptoms of mental illness, mobilizing quickly to get treatment, limiting alcohol consumption and keeping weapons out of the home. But barriers to receiving adequate mental health treatment can be daunting. Sometimes parents can be distrustful of interventions because their child was in treatment and it wasn’t enough. Yet treatment is often lifesaving. Persevering and finding therapeutic support when necessary is critical, and recognizing that a vulnerability to suicide is not a prophetic death sentence, but rather an impetus for vigilant self-care and a viable safety plan when there are signs of trouble.
Friends and family can provide enormous relief by helping out in small comforting ways: making a meal, taking the other children for special time, finding ways to console. Other people may feel awkward, asking intrusive questions that focus too much on the details of how the suicide happened, or providing false reassurance (this too shall pass, God gives only what you can handle), or suggest that the suicide was inevitable. These kinds of responses can feel insensitive and may be exasperating. It’s important to anticipate how to respond in a way that conserves your resources and allows you to be in control of when, who, and how you choose to share, and that you expect that others will respect your own process of coping.
No family should ever endure the brutal loss of a loved one to suicide. It’s hard to reconcile holding a baby in your arms, the pride of first steps, and the anticipated growth with self-destruction and a jettisoned future. Each of us may find unexpected pathways to learn and grow from a loss we would never choose, finding faith in the grace that comes from the conviction that love does indeed last longer than death.