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Archive for the ‘questioning in suicide bereavement’ Category

img_0095-edit-2Late on a rainy night in April, 2002, my mother and I were driving home from a nearby town after watching my brother, George, perform there as “Brandy Bottle Bates” in Guys and Dolls. My extended family had finally begun to enjoy some of life’s pleasures even while mourning the suicide of my daughter Mary that had occurred seven years earlier. So as my mother and I chatted that night, I was also privately searching for answers about Mary as I had done every night: why did she intentionally overdose on her antidepressant medication? How could she do that to herself and to her family? How could she?

But then this: a white cat running across the road not ten feet from my front wheels. After a sickening bump under both front and back tires, I stopped on the road, windshield wipers clicking, wondering what to do.

“Drive on,” my mother said. “The cat’s dead, and the owner might live a mile away. I know you feel bad, but there’s nothing you can do.”

I did drive on, but the death of that cat troubled me for days. I visualized the owners finding the crushed body by the road and shouting, “How could you?” at faceless me just as I had shouted at Mary.

It finally dawned on me that those owners deserved an apology they would never get and that their not getting an apology made me something of a culprit. “I felt for them. I felt for Mary, as well. It wasn’t that I placed suicide and accidental animal slaughter in the same moral category; it was that my daughter and I had both done damage, and neither of us could apologize for it. However, merely imagining that Mary would want to apologize [as I wanted to] put an end to my ‘How could you?’ question and brought peace” (Marjorie Antus, My Daughter, Her Suicide, and God: A Memoir of Hope, CreateSpace, 2014, 198-9).

Then or now, I wouldn’t imagine Mary apologizing for the mental suffering she tried to end (and did end, I believe) with an intentional overdose. The agony of mental illness leading to suicide is described by psychologist Thomas Joiner as a “force of nature” nearly impossible for the rest of us to grasp or expect an apology for (2011 Suicide Prevention Conference: Myths About Suicide, YouTube, Google, Inc.).

Still, it’s restorative to imagine those who have died by suicide apologizing for the heartache, the bewilderment, the life disruption, and the chronic sorrow their deaths have brought. I’m also glad I was able to feel like a wrongdoer for a time. That feeling brought empathy, and empathy brought love.

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“It was so sad,” writes Colbert King in The Washington Post describing what he witnessed one recent September morning. “The body was covered with a white sheet. It was lying on a grassy area beneath the Duke Ellington Memorial             Bridge. . . . The only movements were the flashing red lights of police cars and motorists directed around the scene by officers.”

Later in the day, King learned that the body was that of a young woman, a seventeen-year-old high school senior, who had jumped from the bridge. “Of course [her] life was more than that leap to her death. A lifetime went with her. . . . All of it had to have added up to something–at least enough to want to keep living. . . . I wished I had known her long enough to have had the chance to do something: to hear her out, help her out. To try to undo whatever damage had been done . . .” (Colbert King, “I Didn’t Know the Woman Who Committed Suicide, But I Mourn Her,” washingtonpost.com).

When my seventeen-year-old daughter Mary died by intentional overdose in 1995, I agonized similarly: I wished I’d known her; I wished I’d heard and helped her out, undone whatever damage had been done to her. But unlike King, I was no passerby: I had known the person who died by suicide. I’d already had my chance at hearing and helping her. I’d thought that the damage done her by major depression was being undone by psychotherapy and medication.

As a responsible journalist, King includes some of the warning signs of suicidal thinking and behavior offered by the American Foundation for Suicide Prevention that everyone should know and take seriously: someone talking of killing himself or herself, an increasing use or abuse of alcohol or drugs, internet searches for suicide methods, the purchase of weapons, reckless behavior, withdrawal, saying good-bye, giving away possessions, etc.  (See afsp.org for complete list.)

Sixty-four people commented online about King’s column. Most were sympathetic to the young woman, some thanked King for his sensitivity, a few tried to blame the harshness of life and the general inability to attend to another’s pain.

Memorably, one person appealed to literature for the truth about love that is capable of transcending human limitation and devastating, inexplicable behavior. From A River Runs Through It, a compilation: “Help . . . is giving part of yourself to somebody who comes to accept it willingly and needs it badly. . . . we can seldom help anybody. Either we don’t know what part to give or maybe we don’t like to give any part of ourselves. Then, more often than not, the part that is needed is not wanted. And even more often, we do not have the part that is needed. . . .  It is those we live with and love and should know that elude us. . . . but you can love completely without complete understanding” (Norman Maclean, A River Runs Through It, Chicago: The University of Chicago Press, 1976, 81, 103).

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An earlier blog post, “Weathering the Seismic Event of Suicide,” briefly addressed the relationships we take for granted that tend to shatter when suicide occurs. Specifically, these are our relationships with the person who died, with ourselves, and with significant others.  “Suicide . . . can rock the foundations of a survivor’s personal world of meaning” and compel a person to try to make sense of that which makes no sense, write clinical researchers John Jordan and John McIntosh.

However, the researchers also point out the healing and new meaning that await a grieving person who can develop an “ongoing relationship with the deceased” by engaging in a three-part grief process. First is the “trying on the shoes (of the deceased),” or understanding our relationship with them; then comes “walking in the shoes,” or reconstructing our relationship; and finally there is “taking off the shoes,” or repositioning our relationship.

Though this three-part grief process does not necessarily follow a straight timeline, I was mostly trying on my daughter Mary’s shoes right after she overdosed on her antidepressants in 1995. In the early trying-on phase, that is, I attempted to decode whatever message I thought Mary’s suicide must have been sending. I also felt she’d betrayed me and that I’d never known her at all. Furthermore, I felt that she’d erased good memories of herself and our lives together. According to Jordan and McIntosh, those are all normal aspects of the grief process of trying on the shoes of the deceased and coming to a new understanding of who they were.

But there is more to the trying-on: a bereaved person must also deal with relationship to him or herself. In my experience it was certainly true, as Jordan and McIntosh state, that someone grieving a suicide focuses on “why” questions, agonizes about personal responsibility for the death, and experiences guilt and shame among several other negative features of raw grief.  Yet, Jordan and McIntosh maintain that wading through those difficulties ultimately contributes to a more accurate understanding of self.

Trying on the shoes of the deceased also leads to fresh understanding about relationships with significant others. To get to that place of enlightenment, however, a suicide survivor must first wade through the fear that suicide could recur with someone he or she loves; and a survivor must contend with the realities that stigma (real or imagined) is intruding, that other people could be blameworthy, and that talking about the suicide has been disallowed. I experienced most of those antagonisms, but only in early grief (Grief After Suicide: Understanding the Consequences and Caring for the Survivors, New York: Routledge, 2011, 252, 249, 262, 263).

That’s the good news about trying on the shoes of the deceased and thus coming to improved understanding about relationships: a suicide survivor may have to wear the shoes for a while, but they lead somewhere and they can eventually be taken off. Future posts will explore the wearing and the taking off.

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My teenage daughter’s suicide in 1995 was a seismic event that sent shock waves through my world of meaning. To say the least, Mary’s death shook my belief in the sweetness and predictability of life and rattled my identity as a knowing mother-protector.

“Suicide appears to be particularly potent in its ability to shatter the most fundamental assumptions in life,” clinical researchers John Jordan and John McIntosh write. “For a period of time, many survivors are truly unable to make sense of why the suicide has happened, what role they played in the death, and its implications for their identity and their understanding of the world.”

According to Jordan and McIntosh, those shattered assumptions revolve largely around relationships. For a time, that is, a person bereaved by suicide must weather the wrecked presuppositions that he or she held with respect to the person who died, to his or her self-identity, and to other people, leading to a “protracted search for sense in a seemingly inexplicable death.”

For nearly two years, this blog has regularly concerned itself with relationship assumptions that have imploded. “Knowing Mary,” “An Insight About How,” and “Choosing Suicide” are posts that reflect my disoriented bond with Mary and my effort to repair the “psychological havoc” that Jordan and McIntosh report as common in suicide bereavement (Grief After Suicide: Understanding the Consequences and Caring for the Survivors, New York: Routledge, 2011, 249, 252).

Blog posts about guilt, anger, and post-traumatic stress disorder have addressed the collapse of certain givens about my self-identity just as other posts (“A Priest Waits with Us in The Emergency,” “My Suicide-Bereaved Family and the Police,” and “Social Uncertainty”) have spoken of my assumptions about relationship to others that have been altered, sometimes for the better.

In categorizing our overturned assumptions in terms of relationship, Jordan and McIntosh provide a potentially clarifying way of dealing with the inner chaos of suicide bereavement. Their work also points to a possible path of bereavement healing that will be addressed in future posts.

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Last week, a column appeared in The Washington Post entitled “Losing two Langley High School students to suicide: Unthinkable until it happened.”

“These two 17-year-olds were athletes and students at one of the finest, most affluent high schools in our region,” writes Petula Dvorak. “They had families, friends, a future. Losing them to suicide . . . seemed unthinkable.” While one boy died on Monday and the other on Tuesday, officials considered the two deaths unrelated.

I followed this story online as readers began posting comments about it. I expected a barrage, because reader comments on the Post website can number in the thousands for provocative news stories. But after an entire day, only 17 people had commented on Dvorak’s column. The silence seemed respectful more than anything else.

Not only that, the seventeen people who did respond refrained from blaming anyone, remarked on the profound sadness, and noted the intimate connection between mental disorders and suicide. (In Myths about Suicide, clinical researcher Thomas Joiner writes, “My view is that virtually everyone, approaching if not 100 percent, who dies by suicide had a mental disorder or a subclinical variant thereof at the time of death,” 188.)

The most incisive comment following the Post column took issue with the notion of suicide as unthinkable. “That headline is out of touch with reality,” one reader remarked. “You can’t call teen suicide ‘unthinkable.’ . . . Acting like teenage suicide, or any suicide, is unthinkable isn’t going to help us. It is thinkable. And we can do a much better job of helping people open their minds to other options” (The Washington Post, online Feb. 6-7, 2014).

When my teenage daughter Mary died by suicide in 1995, her death was unthinkable to me and everyone who knew her. But it was thinkable to her; she’d been thinking about it for two years as her journals later revealed. I used to agonize over Mary’s ability to conceal dangerous thoughts and my inability to read them, just as I imagine the families of those two high school students are agonizing now.

Yet, psychologist Kay Redfield Jamison offers this insight from her experience as a suicidal teen: “Because the privacy of my [suicide] nightmare had been of my own designing, no one close to me had any real idea of the psychological company I’d been keeping. The gap between private experience and its public expression was absolute; my persuasiveness to others was unimaginably frightening” (Night Falls Fast: Understanding Suicide, New York: Alfred A. Knopf, 1999, 6).

Yes, we must do a much better job of helping people open their minds to options other than suicide. Before we can do that, however, we have to know that suicide is an option under consideration, and that’s sometimes far from clear.

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At the wake following my daughter Mary’s suicide in 1995, a high school teacher said with apparent bewilderment, “But she handed in a paper just last Thursday!”

“It makes no sense,” I said. “Why would she be doing homework if she was planning to do . . . this?”

Another teacher explained that perhaps Mary had been ambivalent to the end, that possibly her resolve to die had wavered along the way. Overwhelmed by the brute fact of her suicide, however, I silently brushed off that theory. My daughter must have carefully planned and then moved directly to her own self-destruction without hesitating. The way I saw it on the night of her wake, the handing in of a school paper was her attempt not to arouse suspicion; that’s all.

But psychologist and clinical researcher Thomas Joiner argues that those contemplating suicide usually are torn between their desire to die and their innate will to live. “The suicidal mind is characterized by ambivalence,” he writes, “with competing forces tugging at the suicidal individual from the sides of both life and death.”

To illustrate, Joiner writes of several people who have gone over Niagra Falls or jumped from the Golden Gate Bridge and survived to tell about it: “One survivor stated, ‘I instantly realized that everything in my life that I’d thought was unfixable was totally fixable–except for having just jumped.’ Another said, ‘My first thought was What the hell did I just do? I don’t want to die.’ ”

According to Joiner, “Those who die by suicide have two simultaneous mental processes unfolding. One is mundane (and yet in a way incredible) and is happening in virtually everyone (including those whose deaths by suicide are impending): ‘Should I change jobs? What will I do this weekend? Should I get a new car?’ . . . The other is far from mundane, and is difficult for most people to even conceive of: ‘Why don’t I just die? It would be a relief. . . . Why don’t I just get it over with?’ ” (Myths About Suicide, Cambridge, MA: Harvard University Press, 2010, 64, 63, 69).

So now I understand a little better how it was possible to be in the same room with Mary hours before her death and not recognize in her behavior the devastation that lay in her thinking. After all, she filled water glasses before dinner, made a witty remark during dinner, and cleaned up the kitchen with her father after dinner. Maybe she was not merely trying to hide her thoughts; maybe she really was wavering between life and death.

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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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