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Suicide Calls Everything Into Question

January 10, 2013 by Marjorie Antus

At funeral Masses, my pastor has been known to say that even expected deaths come as something of a shock to those left behind, that we’re never truly prepared for the death of someone we love. If that is true, and I have certainly experienced it, what can be said about deaths that are sudden and unexpected?

Writer Joan Didion offers a viewpoint in The Year of Magical Thinking, a memoir written in 2004 several months after her husband died of cardiac arrest at the dining room table as the two returned from visiting their sick daughter in a New York City hospital.

“This [book] is my attempt to make sense [of that time], weeks and then months that cut loose any fixed idea I ever had about death, about illnesses, about probability and luck, about good fortune and bad, about marriage and children and memory, about grief, about the ways people do and do not deal with the fact that life ends, about the shallowness of sanity, about life itself” (New York: Alfred A. Knopf, 2005, p.7).

Didion’s entire view of reality was turned on its head by the shock of her husband’s sudden death and the lingering illness which later proved fatal to her daughter. At the end of Didion’s account, she acknowledges she has to “go with the change” that swept away her life.

While suicide absolutely disturbs the perception of reality that Didion describes, it also invades other areas. “Suicide brings into question all of the things that the bereaved individual took for granted about the identity of the deceased, the nature of their relationship with that individual, and the mourner’s own identity,” write clinical scholars John Jordan and John McIntosh (Grief After Suicide: Understanding the Consequences and Caring for the Survivors. New York: Routledge, 2011, p. 181).

For me, those questions took this form: “Who was she? How could I not have known who she was? Who am I that my daughter could take her own life?” Answers did emerge, but I won’t say they came easily. The one question that hung around longest–the one for which there will never be an answer–is the question about survival instinct and why it went missing on the day my daughter decided to die.

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Comforting the Suicide Bereaved

January 3, 2013 by Marjorie Antus

Once upon a time in my life, “to comfort” in the wake of death meant offering phrases like “God’s ways are not our ways” and “she’s in a better place.” I heard those phrases many times and used them myself.

But after my daughter died by suicide in 1995, words of any kind–especially precise, logical, reasonable ones–did nothing to alleviate anguish and even added to it. The only words that helped, I finally realized, were Psalms that highlighted human pain. Psalm 77 became a favorite:

Aloud to God I cry; aloud to God, to hear me;
on the day of my distress, I seek the Lord.
By night my hands are stretched out without flagging;
my soul refuses comfort.

Recently, I found a definition of “to comfort” that, in considering its Latin components, offers a useful perspective. It allows that com + fortis = “to be strong with.” In my experience, “being strong with” a bereaved person has less to do with offering words than with offering presence. My spiritual director, for example, used to apologize for not having the right words with which to comfort me after Mary died. What she did have, and I knew it even then, was the courage to sit with me for an hour at a time, month after month, year after year, until healing arrived.

Henri Nouwen writes, “The friend who can be silent with us in a moment of despair or confusion, who can stay with us in an hour of grief or bereavement, who can tolerate not knowing, not curing, not healing and face with us the reality of our powerlessness, that is a friend who cares” (The Road to Daybreak: A Spiritual Journey. New York: Doubleday, 1988).

The reality of suicide bereavement is that there are not moments of despair and confusion, but months and years. There is not an hour of grief, but a decade. The kind of friend who could
be silent with me through the long haul of grief was not the usual kind of friend, as it turns out, but a professional trained in the arts of silence and listening.

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Merry Christmas to You, Mary

December 27, 2012 by Marjorie Antus

This year, my family reached an odd milestone: we observed our eighteenth Christmas without Mary after having celebrated only seventeen Christmases with her. She died by suicide in the fall of 1995, a life-altering wound to her survivors that presents itself regularly to me, her mother, but which no longer has the power to dampen an entire day, much less a day of celebration like Christmas.

It’s impossible that Mary has been gone for eighteen years. But suicide changes everything, as I’ve learned, including the way time seems to pass. So life events now tend to fall into two categories: those that occurred before Mary died and those that came afterward. And in our eighteenth year of “afterward,” I can’t quite believe my family is surviving–even thriving–without our beloved daughter, sister, cousin and niece. But maybe we’re not exactly without her.

“One of [suicide] survivors’ greatest fears,” write John Jordan and John McIntosh, “is that their loved ones will fade from memory and their very existence forgotten as if they never existed.” The authors say that as major religions use ritual to “make God [Yahweh or Allah] present during a ceremony in a sacred way,” families can make sure their loved ones are not forgotten by using ritual, as well. They suggest song or poetry, perhaps a toast, at a family gathering in memory of the one who has died (Grief After Suicide: Understanding the Consequences and Caring for the Survivors. New York: Routledge, 2011, pp. 393-394).

Right after Mass on Christmas Day, my husband and I went to the cemetery to place silk poinsettias not only on Mary’s grave but also on the graves of my parents. It was a windy, cold, and sunny few minutes of securing wire flower stems to brass vases so the arrangements wouldn’t catch the wind and blow away. We prayed out of gratitude before trudging back to the car and heading, eventually, to my sister’s for Christmas dinner.

After dinner, eight of us swapped stories–most of them funny–about our parents and Mary. Out of respect for raw grief, those stories weren’t always told at family Christmas gatherings. But they were told yesterday and, like the cemetery flower-arranging, made present to us family members we love and miss and cannot forget.

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What About Prayer in Suicide Bereavement?

December 18, 2012 by Marjorie Antus

A few months after her husband died on a treadmill in 2009 at the age of fifty, Amy Welborn took her three children on a trip to Sicily which she descibes in her memoir Wish You Were Here: Travels Through Loss and Hope. One day, they all visited a fourteenth-century castle dungeon: “Dungeons are, of course, dark,” writes Welborn. “There’s no apparent exit, no way out, and who can help falling into despair down there” (New York: Image Books, 2012, p. 158)?

Welborn then relates how, in early grief, she visited online discussion boards for widows and widowers and was struck by the people who wrote about their “utter despair, of barely being able to get out of bed even a year after their husband or wife had died. How they couldn’t see a way out.

“I read those heartbreaking posts and I wondered why I’ve not been to that place. Part of it was [my husband’s faith], his preaching God Alone at me for so long. But I am also pretty convinced there’s another reason. I’m thinking it is prayer, and maybe not just my own” (p. 158).

On the hidden power of prayer, I agree with Welborn. Prayer was intimately connected with my daughter Mary’s suicide in 1995. Her father and I were, in fact, praying at a monastery 40 miles from home on the day of her death. Not knowing what else to do as we sat in the emergency waiting room, we prayed. We prayed with Father Don that afternoon and my parents’ Methodist minister, as well.

We held a Catholic wake beginning and ending with prayer and prayed throughout Mary’s funeral Mass. Over a period of weeks, her friends sent scores of cards saying they would pray for her as did neighbors, friends, and acquaintances. It was an ocean of prayer that equalled, in certain ways, my ocean of grief.

But I also like Welborn’s dungeon metaphor for its stark resonance. In writing of both human physical activity and prayer in the shaping of the world, Welborn asks, “Who knows how it all works together or why. I certainly don’t. All I know is that in those months after [my husband] died, I was kept out of the dungeon. Darkness waited beyond the door, but strangers stood in front of that door, praying. I’d turn and twist on the road . . . but then I would see it: a candle lit by a friend or stranger, left burning at the bend of yet another hairpin turn” (p. 160).

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Is Suicide Courageous, Selfish, or Something Else Again?

December 7, 2012 by Marjorie Antus

My daughter Mary’s suicide in 1995 inflicted so much pain on our family that I ended up calling it “cruel” and Mary “selfish” in the weeks following. As a matter of fact, Mary’s suicide note itself described her self-destructive act as “thoughtless and selfish.” As I read that phrase some weeks after her death, all I could think was, So why were you doing it? Surely you knew better than that.

Her note also romanticized suicide as “darkly mystical,” especially if the perpetrator (victim) was young and had suffered in silence which, clearly, Mary felt she had done. Not a word of her “selfish” talk or her “darkly mystical” talk made any sense to me.

Only much later did a kind of sense begin to take shape in the question that writer Adina Wrobleski poses: “Does it take courage to kill oneself, or is suicide a coward’s way out?”

“Neither,” she answers. “People who are contemplating suicide are not debating large issues of right or wrong, nor are they facing life bravely or ‘slinking off’ to die. The desperate anguish that results in suicide is not ‘taking the easy way out’ . . . Dying from pneumonia is not cowardly or courageous; neither is suicide. The taboo [regarding suicide] causes people to look at suicide as a moral issue rather than a health issue” (Suicide: Why? 85 Questions and Answers About Suicide. Minneapolis, MN: Afterwords Publishing, 1995, p. 22.)

Kay Redfield Jamison also removes suicide from the realm of morality where it has resided for centuries. Not only is she professor of psychiatry at Johns Hopkins University and author of several books about mood disorders, Jamison writes of suicide from the personal experience of having attempted it. “[I] did not consider [my suicide attempt] either a selfish or not-selfish thing to have done. It was simply the end of what I could bear . . . It was the final outcome of a bad disease [bipolar disorder], a disease it seemed to me I would never get the better of” (Night Falls Fast: Understanding Suicide. New York: Alfred A. Knopf, 1999, pp. 290-291).

With proper treatment, Jamison did get the better of it. Seeing suicide for what it is–neither an act of courage or selfishness but, rather, one of illness–is a move toward humanity and prevention.

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“Choosing” Suicide (part two)

December 2, 2012 by Marjorie Antus

One of the persistent questions following my daughter Mary’s suicide went something like this: “What was that moment of decision like for her? What must it have been like not to be choosing suicide one moment and then to be choosing it the next? What happened to Mary in that lonely and horrible instant of choice?”

In writing of her sister’s suicide, Jill Bialosky offers insight about the question.”[My friends] wanted a clear reason to explain [my sister’s] death. I didn’t know what to say. For those whose lives are secure and steady, it must be difficult to imagine the inner fragility of an individual who chooses to die rather than live with despair. I imagine that the thought of suicide was something Kim had held up to the light like a many-sided crystal, thought about, toyed with in moments for years” (History of a Suicide: my sister’s unfinished life. New York: Washington Square Press, 2011, p.13).

Having spent a good part of his career studying suicide notes, psychologist Edwin Shneidman reinforces Bialosky’s intuition about Kim “toying” with the idea of suicide: “Suicide is the result of an interior dialogue. The mind scans its options; the topic of suicide comes up, the mind rejects it, scans again; there is suicide, it is rejected again, and then finally the mind accepts suicide as a solution, then plans it, and fixes it as the only answer” (The Suicidal Mind. New York: Oxford University Press, 1996, p. 15).

So at least I now have an idea about the process my daughter went through in arriving at her horrible instant of choice. Her suicide was not an impulsive act so much as a woeful wearing away of the ability to keep on living and an increasing attraction to suicide as the “only answer.” From what I read in her journals after her death, Mary’s wearing away took place over at least a two-year period. But recognizing that reality gives rise to another question without an answer: how could I, the rest of her family, her psychiatrist, and the many who loved her not have picked up a sign that she was toying with the idea of suicide for two years and intervened to help her?

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“Choosing” Suicide

November 23, 2012 by Marjorie Antus

A year before my daughter died by suicide in 1995, an aquaintance named Anthony told me that after being diagnosed with an inoperable brain tumor, a friend of his had driven out west and shot himself on a desert highway. In his anguish, Anthony received little comfort, I’m sure, from my ill-considered response: “Well, you know, it’s all about free will.”

(When I began to grieve for Mary the next year, Anthony generously sent me a Mass card with an inscription from Lamentations [1:12] that I treasure to this day: “O all ye that pass by the way, attend and see if there be any sorrow like to my sorrow.”)

Talking to Anthony the year before, however, I was just saying “stupid things.” Jill Bialosky describes “stupid” this way: “Friends, meaning to help and offer sympathy [about her sister’s suicide], said stupid things. One of the most common was that suicide was her choice. How would it have been her choice, when she was only twenty-one years old? She hadn’t yet developed the maturity to understand how to cope with her challenges and believe she could get through them or have the foresight to understand the repercussions of what she did.” (History of a Suicide: my sister’s unfinished life. New York: Washington Square Press, 2011, pp. 11-12.)

I appreciate Bialosky’s insight regarding the lack of choice surrounding her sister’s suicide. What she writes applies to my daughter, as well. Mary was not using free will when she chose death; her will was not free. Like most suicide victims, my daughter’s reasoning ability was clouded by the “psychache” of despair which drug therapy and psychotherapy had not yet alleviated.

But she also lacked a depth of knowledge–a heart knowledge–that is essential to the task of profound and human decision-making. One of my first reactions upon finding Mary after her overdose was, “She can’t possibly have known what she was doing. She can’t possibly have known what her death is going to mean.” She was seventeen and not, I insist, freely choosing suicide.

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Happy Birthday to You, Mary

November 14, 2012 by Marjorie Antus

Today is the thirty-fifth birthday of my daughter Mary who died in 1995 by suicide at the age of seventeen. So I drove out through the Manassas National Battlefield Park which surrounds the Stonewall Memory Gardens containing my daughter’s grave. On this morning of sleet and sunshine, I thought it mattered that I be with Mary on her birthday; and I thought somehow she might know I was praying over her grave.

The Mary of 1977 was mostly on my mind this morning–her pinched red countenance bringing forth not only relief for a normal delivery but also gratitude for the unrepeatable gift I knew her to be. Poet William Blake describes the transcendence of the newborn this way, “Sweet babe, in thy face / Holy image I can trace” (William Blake, “A Cradle Song,” Songs of Innocence and of Experience. Franklin Center, Pennslyvania: The Franklin Library, 1980).

Losing Mary is also on my mind today. But to try to understand the eventual suicide of a newborn, my newborn, is to “try to comprehend the ungraspable phantom of life,” writes Jill Bialosky: “the power of darkness, fear, and weakness within the human mind, a force as mysterious, turbulent, complex, and uncontrollable as the sea, a force so powerful it may not be capable of withstanding its own destructive power” (History of a Suicide: my sister’s unfinished life. New York: Washington Square Press, 2011).

The holy image in Mary’s face has not faded. I regard her as an innocent overcome by mysterious darkness and fear, defeated by inner turbulence and psychological complexities. I celebrate the day she was born just as I honor innocent victims of suicide who bear holy image. And they all do.

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Warning Signs for Suicide

November 1, 2012 by Marjorie Antus

Yes, I saw some but not all the warning signs for suicide before my daughter Mary committed suicide in 1995. Had I been aware of the significance of the behavior patterns I was picking up in my daughter, perhaps I would have understood the urgency of her medical condition and acted protectively on her behalf.

The National Alliance on Mental Illness (NAMI) lists the following behaviors as suicide warning signs:

1) Talking about death or suicide
2) Talking about specific plans someone has made to attempt suicide
3) Severe depression, hopelessness, or guilt
4) Reckless, violent, or self-destructive behavior
5) Alcohol or drug abuse
6) Expressing a sense of worthlessness
7) Suddenly appearing much better, or happier, for no apparent reason; and
8) Loss of interest in usual sources of pleasure

Mary never talked about death or suicide; certainly there was no mention of a “plan.” I saw no sign of alcohol or drug abuse. She was suffering from and being treated by a psychiatrist for depression. I thought a sense of worthlessness and loss of interest in the usual sources of pleasure were to be expected and would be alleviated by the drug therapy and psychotherapy she was receiving.

What I didn’t do that NAMI says I should have done was ask Mary if she ever thought about suicide. If she’d said “Yes,” I then should have asked if she’d thought about suicide recently and whether she had a plan. If she’d said “Yes” to that question, I should have considered her condition a medical emergency and not left her side until she got the medical help she needed.

But there was terror, denial, and general human messiness working against that logical strategy: I was terrified on some level for my daughter and denying all along that she was truly sick and in desperate need of a hospital. I think she might have been terrified and swimming against denial, too, incapable of admitting her self-destructive thoughts either to herself or to me. Had I been better educated about the warning signs for suicide, however, I believe it would have made a crucial difference (“Do You Care for Someone Who’s At Risk of Suicide?” http://www.nami.org).

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Rejecting Guilt in Suicide Bereavement

October 27, 2012 by Marjorie Antus

“When asked to note the most distressing aspect of their grief, parents of children who had died by suicide most frequently listed guilt first, followed by feelings of loneliness,” write clinical scholars John Jordan and John McIntosh.

Fifty-four percent of suicide-bereaved parents experience “death causation” guilt stemming from actions they performed or failed to perform which they feel contributed to their child’s death. Half of all suicide-bereaved parents experience “childrearing guilt” either for a parenting style they think could have been more loving or for “negative or ambivalent” feelings toward their child. Twenty-eight percent of suicide-bereaved parents deal with “illness-related” guilt centering on their feelings of either not having provided the best possible medical care for their child or for having been absent when their child died (Grief After Suicide: Understanding the Consequences and Caring for the Survivors, New York: Routledge, 2011, pp. 49-50).

Not only did I harbor all that guilt when my daughter Mary died by suicide in 1995, I believed that not feeling guilty would show I’d not loved her enough, that I’d been callous–even inhumane–toward her. In my mind, rejecting guilt would have been tantamount to saying, “Mary, I had nothing to do with your death and am not taking responsibility for it.” But in time, expending energy on guilt proved to be a waste. Mary’s death was so much more significant and mysterous than the mere assignment of blame could ever address. Her suicide called for admitting human frailty–hers and mine–and finding a way forward.

There was the Roman Catholic sacrament of reconciliation where I was able to confess the ways I’d willfully failed my daughter over the course of her life. It was healing at a depth which I couldn’t measure.

I was also recently helped by advice from the National Alliance on Mental Illness to people with mental illness in their families: “We forgive ourselves and reject guilt.” As America’s leading grass roots organization dedicated to improving the lives of individuals with severe mental illness, NAMI has my respect. If it advises family members living with mental illness to forgive themselves and reject guilt, I apply that wisdom to suicide bereavement, as well.

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