Archive for the ‘suicide bereavement’ Category

One morning in 2001, six years after my daughter Mary died by intentional overdose, a friend and I were talking in a parking lot. “You need to let go of your kids,” she offered.

My kids at that time were my son, then 27 years old and living at home with a disabling psychiatric illness, and my daughter, then 17 and a high school senior. Of course, there was also Mary, who would have been 23 years old had she survived her overdose.

I was not about to let go of any of them that morning. To me, letting go of the living kids meant allowing them to make their own decisions and mistakes in the belief that somehow they would find their way in the world. But neither of my kids was in a position to find his or her way in the world that day, and so I dismissed my friend’s remark as ill-informed.

Letting go of Mary, for whom I was still yearning, was an equally dismissible idea. More than anything, I wanted to overcome the estrangement between us and have her in my life once again in a good way. Letting go of her? Unthinkable.

The desire not to let go is apparently universal among the bereaved. “I’ve never spoken to anyone who mourns for someone they love who does not want to continue loving them in some way,” writes Thomas Attig, Past President of the Association for Death Education and Counseling.

The question is, how does a bereaved person go about loving someone after he or she has died? According to Attig, the first step is overcoming the mistaken notion that grieving requires a complete letting go of those we love. “There is no reason to let go of the good with the bad [in the person who has died]. The great majority of our closest relationships with family and friends have good in them. Those we mourn lived lives filled with value and meaning” (The Heart of Grief: Death and the Search for Lasting Love. New York: Oxford University Press, 2000, xi, xvi).

When a loved one dies by suicide, it is deeply challenging to retrieve the good, the valuable, and the meaningful in their lives. Those left behind have to deal for years with the ugliness of suicide and its ultimate meaninglessness. But eventually, and not easily, it’s possible to let go of the pain and begin a new relationship with the person who died. It is possible; I think I have Mary back in my life in a good way.

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Arnold Toynbee, a British historian of the twentieth century, argued that death is a “dyadic” (or two-person) event in which the survivor bears the heavier burden. “The sting of death is less sharp for the person who dies than it is for the bereaved survivor.” He adds, “There are two parties to the suffering that death inflicts; and, in the apportionment of this suffering, the survivor takes the brunt” (Man’s Concern with Death. New York: McGraw-Hill, 1968, as quoted in Stanley Lesse, M.D., Ed. What We Know About Suicidal Behavior and How to Treat It. Northvale, New Jersey: Jason Aronson Inc., 1988, 60).

While I appreciate Toynbee’s respect for suffering survivors, I can’t help asking, “How do you know? How can you speak with such assurance about the mystery of death?”

Psychologist Edwin Shneidman, who founded the American Association of Suicidology in 1968, also questions Toynbee’s assertion. “For all his wisdom, I believe that Toynbee is indulging unduly in what I would call the romanticization of death. In my view, the larger need is to deromanticize death and suicide.

“Individuals who are actively suicidal suffer–among their burdens (and especially the burden of unbearable anguish)–from a temporary loss of an unromanticized view of death-as-enemy. . . . they have lost sight of the foe: they openly sail with full lights in the hostile night; they smoke and show themselves on combat patrol. . . . They behave in strange, almost traitorous and defecting ways. Whose side are they on? They attempt to rationalize death’s supposed lofty qualities and, what is most difficult to deal with, to romanticize death as the noblest part of dyadic love. . . . Suicidal individuals have been brainwashed–and by their own thoughts” (“The Deromanticization of Death,” What We Know About Suicidal Behavior and How to Treat It. Northvale, New Jersey: Jason Aronson Inc., 1988, 66, 73-4).

My daughter Mary romanticized her suicide. The note she left describes suicide as “darkly mystical,” especially if the person is young and has suffered in silence, which she evidently thought she had done. Perhaps she considered her life a waste and her suicide a favor to family and friends; I’m not sure. But I do know she wasn’t on her own side at the end–hard as it is to conceive–and I imagine it was because of the unbearable anguish, the “psychache” that Edwin Shneidman deems to be the usual cause of suicide.

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“The suicide of a loved one irrevocably transforms us,” wrote Carla Fine after the suicide of her husband. “Our world explodes and we are never the same. Most of us adapt, eventually learning to navigate on ground we no longer trust to be steady. We gradually come to accept that our questions will not be answered. We try not to torture ourselves . . .” (No Time to Say Good-bye: Surviving the Suicide of a Loved One. New York: Broadway Books, 1997, p. 20).

Others, too, characterize suicide bereavement as life-altering. “Being a suicide survivor becomes an integral part of one’s identity,” explains Karen Mueller Bryson. “I feel as though an entire segment of my life was defined by my father’s suicide. It colored everything that followed. The tragedy seemed to be like a musical score always playing underneath the action of my life” (Those They Left Behind. 2006, pp. iii-iv).

Pychiatric professor Kay Redfield Jamison describes suicide bereavement as “a half-stitched scar,” adding this note of clarity: “Time does not heal, / It makes a half-stitched scar / That can be broken and again you feel / Grief as total as in its first hour” (Night Falls Fast: understanding suicide. New York: Alfred A. Knopf, 1999, p.290).

“Suicide,” writes grief educator Harold Ivan Smith, “initiates the long shadow on survivors left to wander across the fragile landscapes of the heart toward a magic kingdom called ‘Answerland.’ Suicide, like a volcano’s lava flow, changes everything in its path” (A Long-Shadowed Grief: Suicide and Its Aftermath. Cambridge, Massachusetts: Cowley Publications, 2006, p. 3.).

Given the profound turbulence following suicide, how does anyone manage? Carla Fine speaks of the “mystery and power” of her will to survive her husband’s suicide as a “testament” to his memory that she wants to honor throughout her life (pp. 222,224). Kay Redfield Jamison offers a single line of poetry to the bereaved: “Look to the living, love them, and hold on” (p. 311).

Harold Ivan Smith extends his “long shadow” metaphor to include divine compassion. “Suicide is the long shadow . . . but a shadow can exist only if somewhere a bright light shines.” He prays, and I with him, that God “sees my wounds, hears my pains, and invades my sorrow with hope” (p. 13).

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I recall running into Dr. Matthews, my daughter Mary’s psychiatrist, some months after Mary’s suicide. She was someone I had always admired; and even to this day, my physician husband claims that she (now deceased) was the best psychiatrist he’s ever worked with professionally.

On the day in question, Dr. Matthews was wearing an expensive suit, her hair was nicely styled, and she exuded confidence. Resenting her for all of it, I began asking myself about justice. As in, how could a doctor with direct responsibility for Mary’s welfare go on living in such a nice, orderly way? After all, I wasn’t living in a nice, orderly way. My life was the opposite of nice and orderly, and the contrast was galling.

Years have passed, and now I see how wrong my perception was that day. Just because the severity of her grief makes a mother believe she is suffering at a uniquely profound level doesn’t mean that she is. Other survivors, including clinicians, also undergo unique, profound suffering.

“Twin bereavement” is the term researchers use on behalf of clinicians. “In addition to the personal grief reaction entailed in losing a client with whom there was a therapeutically intense or intimate relationship, this loss is likely to affect clinicians’ professional identities, their relationships with colleagues, and their clinical work” (John R. Jordan and John McIntosh, Eds. Grief After Suicide: Understanding the Consequences and Caring for the Survivors. New York: Routledge, 2011, p. 95).

Other researchers have found that mental health therapists describe losing a client “as the most profoundly disturbing event of their professional careers,” noting that a third of the therapists “experienced severe distress that lasted at least one year beyond the initial loss” (Ibid).

Though seventeen years late, I’m saying, “Sorry, Dr. Matthews.” I finally grasp how hurt we all were, you not least. I finally get that we were all doing our best to survive Mary’s death. I finally realize your way was to put on a nice suit and see your patients hour after hour, same as always.

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In the hours after my daughter Mary’s suicide in 1995, my grieving family was treated well. First responders–rescue squad, extended family, neighbors, medical emergency team, clergy and police–acted with compassion. I’ve always thought it was their collective good will that stabilized us and aided our recovery. And I don’t even want to think how much worse our lives would have been without the kindness of those good people–strangers, many of them.

Only a couple weeks after the suicide, though, awkwardness set in. By that, I mean social uncertainty–the raw emotion, avoidance, silence–that marked my interactions with others and seemed, in fairness, to cut both ways. In the first place, I wasn’t the person I’d been before Mary died. Whatever meaning Mary gave my life, and it was considerable, had been buried along with her. I was driven to talk about my daughter in order to make sense of that catastrophe, and I craved getting her name into conversations because I simply needed to say and hear it.

It was too intense for what would normally have been polite conversations. Friends were trying, it seems, to help me and protect themselves by switching to lighter topics, getting my mind off the devastation of my daughter’s life and giving me perspective. One motherly friend said, “Well, Marj, it could have been worse.” My unspoken response to that was, My daughter is dead. Please tell me how it could have been worse. I guess if she’d machine-gunned us all, that would have been worse.

Before long, my family began receiving professional therapy. I did finally learn to modify my comments about Mary, saving the unvarnished ones for my spiritual director behind a closed door. I learned discretion, eventually.

But I still appreciate the honesty of a sixty-five-year-old college professor several years after the suicide of his son: “I will keep friendships only with people whom I can bring up with ease these issues [of my son’s suicide]. Some people have a knack of saying insensitive and uncaring things. One good friend said why don’t you go out dancing instead of attending a suicide support group meeting. People can sometimes be hurtful and say stupid things. I’m glad some of the jackasses are gone—pseudo-friends and kin who are unable to handle anything like this—good riddance” ( Karen Mueller Bryson, Those They Left Behind, p.18).

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When my seventeen-year-old daughter Mary died by suicide in 1995,  one thought confounded me from the first: “She couldn’t take her life another day. The life that God, her father, and I gave her–that precious life–she didn’t want. So she threw it back in our faces. ” 

 Mary’s death was incomprehensible, a rejection of the values she’d grown up with not only at home but also in Catholic classrooms for almost a dozen years. 

In Grief After Suicide: Understanding the Consequences and Caring for the Survivors, researchers John Jordan and John McIntosh highlight the bewilderment of parental guilt following suicide: “It’s bad enough to lose a child . . . but the guilt [that other parents who have lost a child to some other form of death] have over not getting them to a doctor ‘soon enough,’ the guilt over not being able to protect them from cancer or drunk drivers or whatever can’t be as fundamental and soul-searing as knowing they couldn’t endure the life you gave them” (Sue Chance. Stranger than death: When Suicide Touches Your Life. New York: W.W. Norton, 1992, p. 50 as quoted in Jordan and McIntosh)

“Soul-searing” is an apt phrase; it describes the anguish better than most.

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Suicide bereavement often includes the following features: a sense of abandonment and rejection, feelings of shame and stigma, a desire to conceal the cause of death, a tendency to blame others, and an increased self-destructiveness or suicidality (John R. Jordan and John L. McIntosh, Eds. Grief After Suicide: Understanding the Consequences and Caring for the Survivors. New York: Taylor and Francis Group, LLC, 2011, pp. 30-31).

In my experience as a survivor of my daughter Mary’s suicide in 1995, I did feel abandoned and rejected by her for several years. I also felt accused. It was as though Mary was telling everyone I hadn’t done enough for her. And really, how was I going to deny the truth in that?

Owing to the immediate support my family received from our Catholic faith community, however, the shame and stigma of my daughter’s death was not a prominent part of my bereavement. In fact, even while members of the rescue squad were trying to revive Mary, I decided not to hide the fact that she had overdosed on her anti-depressant medication. When a neighbor asked, “What happened?” I told him the truth, believing that the truth would bring the help we needed. And it did.   

Mary’s psychiatrist joined my husband and me in the emergency waiting room, lamenting her misjudgment regarding the state of my daughter’s mental health. My husband would not allow the psychiatrist to blame herself, though, and I tried to follow his lead. Inevitably, I did end up blaming the psychiatrist, my husband, and myself for my daughter’ s suicide. Blaming is a normal part of suicide bereavement, I have come to see, but it did eventually fade away.    

As for the increased risk of self-destructiveness following a suicide, I understand a bereaved person’s desire to die. But in my grief, the desire to die was countered by hard-won awareness of the devastation another suicide would inflict. I never considered taking my own life, though I could see that people were concerned I might be thinking about it.   


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