Archive for July, 2013

Over the months, I’ve noticed that some are led to this blog through an online search for words of comfort for those grieving a suicide. The sincerity of that search is beyond question. But when my teenage daughter Mary died by suicide some eighteen years ago, my response to well meant verbal comfort was usually silence accompanied by this thought: “Nothing you can say will make me feel better.”

I was wrong about that. There are words of comfort that would have helped. They just require know-how and practice. “For many of us,” writes Val Walker in The Art of Comforting, the most difficult way to offer comfort is face-to-face—just sitting quietly and talking with someone in distress. In these intimate moments, we can get so hung up on trying to use the ‘right’ words that we lose track of what it is we really want to say.”

Walker advises thinking ahead about the larger message of comfort we wish to convey. Here are examples of a larger message: “I’m here for you, I’m available, I care.” There’s also, “I’m listening, I’m following you, I’m with you” as well as, “I’m feeling some of what you’re feeling, I’m not going to judge you, I’d like to offer my support with something specific.”

We need to prepare our larger message, Walker says, so that we don’t default to the platitudes we’ve heard all our lives. “Our words can distance us from others, especially if they express that we think we know ‘what is best’ for them. Devastated people in the first weeks . . . of a loss or trauma can feel unheard, invalidated, or ‘preached at’ by well-intended teachings and words of wisdom.”

So what might a loving friend, family member, or acquaintance say to someone bereaved by suicide? First, among the “be strong” platitudes to be avoided is this: “God doesn’t give you any more than you can handle.” It can be replaced with, “It sounds like this is really hard.”

A “be positive” platitude such as “Something good will come out of this” can give way to, “It sounds as though it’s impossible to see what’s ahead.”

“Be faithful” platitudes such as, “Keep up the faith,” “This was part of God’s will,” and “God works in mysterious ways,” were, in my experience, particularly alienating. Someone who wants to comfort a grieving person should put them to rest and use life-giving statements instead. “I’m thinking of [and praying for] you every day,” “I hope things get easier for you,” and “I can offer my help,” are responses that soothe and draw a grieving person closer (The Art of Comforting: What to Say and Do for People in Distress. New York: Jeremy Tarcher, 2010, 107, 109, 110, 111, 112).

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After my daughter Mary died by intentional overdose nearly eighteen years ago, I was jolted by the realization that I hadn’t known her at all. I hadn’t known the high school senior I’d eaten with and talked to every day, for if I had known Mary, I believed I would have recognized her fears, her sadness, and her suicidal thinking and acted to protect her.

Just the same, “People can only know the observable behavior of another person,” write clinical scholars John Jordan and John McIntosh on the topic of suicide bereavement. They add that unless a person verbally or nonverbally expresses what is really going on inside, no one else can know it.

“Human beings are capable of masking their inner thoughts and feelings,” they state, “while outwardly acting in ways that can be quite incongruent with their internal state. . . . This existential ‘separateness’ of the inner consciousness of each of us from others is the foundation for the psychological boundary between self and others. . . . It is also the condition that allows suicide to happen in a way that people who ‘know’ the deceased may be utterly stunned by the act” (Grief After Suicide: Understanding the Consequences and Caring for the Survivors. New York: Routledge, 2011, 253).

My daughter did not express what was going on inside her until it was too late. Only in her suicide note did she reveal sadness at not fitting in with her friends and a sense of personal weakness that she despised. She wrote that she’d not been silent about her suffering and doubted anyone would be surprised by her suicide. Those comments bewildered me. She had been silent, and we were all horribly surprised.

But I was also off-base about something else: I had known Mary, at least on a heart level. I had daily experienced a depth in her that was open to love and capable of love, and I’d seen life-giving values arising out of that depth.

While it’s taken years, I finally realize how inaccurately Mary’s final act reflects who she was and still is. She was not her mental illness and suicide. She is someone I know and someone I love knowing.

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In a May, 2013, press release, the Centers for Disease Control and Prevention announced that in recent years, the number of annual suicide deaths in the United States has surpassed the number of people dying yearly in automobile accidents. In 2010, for example, 33,687 people died by automobile and 38,364 by suicide.

“Suicide is a tragedy that is far too common,” says CDC Director Tom Frieden, M.D. “[We] . . . need to expand our knowledge of risk factors so we can build on prevention programs. . .” (www.cdc.gov/media/releases/2013/p0502-suicide-rates.html)

Fortunately, Harvard psychologist Matthew Nock is attempting to do just that. In 2003, Nock and a colleague began developing a series of tests they consider potentially capable of detecting suicide risk. The tests are modeled on the Implicit Association Test originated in the late 1990s which uses word associations to reveal biases about race, sexuality, gender and age that people either don’t wish to acknowledge or cannot even recognize in themselves.

In short, Nock and his Harvard colleague have devised a series of tests to measure a person’s bias for and against being alive or dead. On a computer screen, “life” and “me” appear on one side and “death” and “not me” on the other. A person is asked to rapidly categorize a series of words such as “thrive,” “breathing,” and “funeral,” under one of those headings. Though complex in the execution, the tests basically detect how quickly a person identifies with either “life” or “death.” Hesitation in responding to the “life” heading, for example, might signal an association with dying that reveals a risk factor for suicide.

“Doctors of all kinds, including psychologists, do no better than pure chance at predicting who will attempt suicide and who won’t” writes Kim Tingley in a recent article in The New York Times. “Their patients often lie about their feelings to avoid hospitalization. Many also appear to mislead by accident, not realizing they are a risk to themselves or realizing but not knowing how so say so.” (www.nytimes.com/2013/06/30/magazine/the-suicide-detective.html)

Along with the hope Nock’s system brings to the worrisome field of suicide prevention, it brings deeper appreciation of my daughter Mary who died by suicide in 1995 at the age of 17. Several months before her death, Mary’s psychiatrist asked her whether she was thinking about suicide and heard, “No, I would never do that.” But maybe Mary wasn’t simply lying; maybe she didn’t recognize her risk or know how to talk about it.

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