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Relief in Suicide Bereavement

August 21, 2012 by Marjorie Antus

Odd as it may seem, some who are grieving a suicide may simultaneously experience relief. Researchers Jordan and McIntosh cite two reasons for a possible sense of relief following a suicide. First, the “disruption and problems” of dealing with a depressed and suicidal person “diminish or disappear” with his or her death. In some cases, the researchers note that a suicide survivor even feels guilty about feeling relieved.

The second reason for relief in suicide survivors is the perception that “their loved one’s psychological pain is now over and they no longer must bear that pain.” (Grief After Suicide. New York: Routledge, 2011, p.32)

I never experienced relief of the first kind. It was not the case that my daughter Mary caused disruptions and problems for our family. The opposite was true: she enhanced our lives uniquely, and her death was our diminishment.

But two mornings after my daughter died, I walked into the kitchen with this announcement: “I always wanted what was best for Mary. So if dying makes her happy, well . . . maybe it had to be.” Seated at the kitchen table were my mother, my sister, my sister-in-law, and some family friends. They looked at me as though I had lost my mind; and in a certain sense, I had.

Shock and denial had overtaken me. From the first hour of grief, in fact, shock had wrapped my inner devastation in cotton and denial had refused to admit the overwhelming loss. Despite the psychological defenses my mind had erected, there was a fragment of peace to be found on that dismal morning. It was the relief–the hope, really–that Mary’s pain had come to an end.

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The Anger That Many (But Not All) Suicide Survivors Experience

August 11, 2012 by Marjorie Antus

“Angry feelings [in suicide survivors] may exist toward the deceased, oneself, or others,” state clinical scholars John Jordan and John McIntosh. (Grief After Suicide. New York: Routledge, 2011, p.31). “The reactions of many (though not all) suicide survivors resemble the intense anger of homicide survivors toward the perpetrator. This anger may, of course, be made more complicated after suicide, considering that the ‘perpetrator’ is also the ‘victim.'”

To say that anger after the suicide of a loved one “may” be more complicated is understating, at least for those who feel anger. My youngest daughter has said she never felt angry toward her sister Mary for taking her own life, and my mother also said she’d not gotten angry with Mary. I eventually came to believe them on that point, but it took me a few years.

It’s probably that my own anger toward Mary was so fierce I couldn’t imagine others not sharing it. It’s been called rage, actually–this anger that suicide surviors often feel. Part of it stems from the sense of rejection, abandonment, and accusation that lingers no matter how many well-meaning people say, “Let it go.” (Christopher Lukas and Henry Seiden. Silent Grief: Living in the Wake of Suicide. London: Jason Aaronson, Inc., 1997, p. 56)

In my case, part of the anger also came from Mary’s inability–or what seemed at the time refusal–to grasp the wonder of her own life. While I now can empathize with her and understand better what she was thinking on the night she died, it took a dozen years for that empathy and understanding to arrive.

What complicates grief after suicide is that the “perpetrator” is also the “victim.” As Mary’s mother, I know this to be true. I would alternate between anger toward her and compassion for her, sometimes twice within a ten-minute span. But I also know there’s more than one victim in a suicide–all the caring people left behind–and that vicitimization by suicide is a source of justifiable anger.

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With Respect to Suicide, Hope

August 5, 2012 by Marjorie Antus

There is hope to be found in the teachings of the Roman Catholic Church for those who die by suicide and those bereaved by suicide. The Church has denounced suicide in the strongest possible terms since the fourth century; true enough. But in the twentieth century, psychological sensitivity entered into Church teachings on the topic of suicide.

First, a brief look at history. In a fourth-century pagan world enamored of “heroic” self-destruction, St. Augustine condemned suicide, making it clear to early Christians that life in Christ requires virtuous living, not dying at one’s own hand. He held that the killing of oneself is the killing of a human being and is therefore prohibited by the fifth commandment–“Thou shalt not kill.”

Thomas Aquinas in the thirteenth century offered three reasons why suicide should be prohibited: the responsibility of loving and cherishing oneself, the responsibility toward community of which each person is a part, and the responsibility of recognizing God as giver of life with power over life and death.

The following seven centuries of Church teaching about suicide were characterized by an accent on law and penalty. In the sixteenth century, the Council of Trent maintained, for example, that the law forbids suicide and that no one has such power over his or her life as to end it. Up through the early decades of the twentieth century, in fact, the Church taught that Christians who broke God’s law by choosing self-destruction removed themselves from the spiritual jurisdiction of the Church and were to be considered, lamentably, as lost.

In 1994, though, the Catechism of the Catholic Church revealed a shift in thinking about suicide. While maintaining the traditional regard for the sanctitiy of human life and the human responsibility to “preserve” our lives for God’s honor and our salvation, the Catechism takes account of psychological disturbance, anguish, or grave fear which can diminish responsibility for the person committing suicide.

Moreover, the Catechism urges the faith community to pray for those who have taken their own lives and not to despair: “By ways known to him alone, God can provide the opportunity for salutary repentence.”

The Church’s contemporary teaching about suicide, put forth one year before my daughter’s suicide, continues to be a source of hope.

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“Psychache” and Suicide

July 30, 2012 by Marjorie Antus

I have held in my hands two suicide notes. My daughter Mary left hers in her bedroom after overdosing on anti-depressant medication in 1995. An elderly medical patient of my husband’s sent his in the mail just before shooting himself in 2009–the subject of my last three posts.

My daughter wrote that she hoped every night she wouldn’t wake up the next morning, that she couldn’t take the “hassle” of life anymore, that she was weak and hated herself.

My husband’s elderly patient said he could hear the “rapids” in the distance leading him–all alone in his canoe–to the waterfall of death. Before reaching the waterfall, however, he planned to go ashore by means of a revolver.

There is a certain composure in both notes; neither comes off as the product of extreme mental agitation. Studying them, however, I have to remind myself not to underestimate the pain underneath the words. “In almost every case,” writes Edwin Shneidman, “suicide is caused by pain, a certain kind of pain–psychological pain, which I shall call psychache” (Edwin Shneidman. The Suicidal Mind. New York: Oxford University Press, 1996, p. 4).

As professor at the UCLA School of Medicine and founder of the American Association of Suicidology, Shneidman maintains that the keys to understanding suicide are “made of plain language . . . . [They are] the words that suicidal people say–about their psychological pain and their frustrated psychological needs–that make up the essential vocabulary of suicide.”(The Suicidal Mind. New York: Oxford University Press, 1996, viii) These “keys” to understanding someone’s suicide usually appear in their suicide notes.

If anything might have given my daughter and the elderly gentleman hope before their deaths it was having someone ask them, “Where do you hurt?” and “How can I help you?” (p.6)

If only anyone had known to ask those questions.

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“When You Read This, I Will Have Left” (part three)

July 26, 2012 by Marjorie Antus

Just days before he commits suicide, the 88-year-old man of the two previous posts is writing about his “biological life” as a stream on which he rides in a canoe. He goes on to say that downstream are rapids–“biological problems of severe injury, disease, disability, Alzheimer’s”–rushing to a waterfall which marks the end. “When a person’s canoe gets there, everything vanishes–stream, shores, canoe, and passenger. That life is over.”

Two years prior, in 2007, he himself had begun to hear the rapids in the distance, calculating that by mid-2009, he might be near enough to the rapids to consider “quitting while he was ahead.”

“My timing was sound; now I have entered the rapids. ‘Paddles up!’ When the prow of my canoe touches shore, the result will be the same as reaching the waterfall. But, I will have avoided most, and certainly the worst, of the rapids. I provided myself with the real-life equivalent of that virtual paddle in the summer of 1995—a .32 caliber revolver. No one knows of its existence nor will until I paddle ashore.”

On the back of the note, he added a picture of himself waving to the camera and a final remark about his sense of duty: “For those who will receive this but do not know me really well, I should add that I am a widower with no dependents and no debts. Otherwise, I wouldn’t think of doing this now.”

And finally: “No nursing home for me! Adios!”

Shortly after writing those words, he joined the more than 5000 elderly people who die by suicide each year in the United States, the majority of them men. (Jordan and McIntosh, Grief After Suicide, p.66)

According to the American Association of Suicidology, the elderly die for more than one reason, usually. Risk factors include the recent death of a loved one, physical illness, uncontrollable pain or the fear of a prolonged illness, perceived poor health, social isolation and loneliness, and major changes in social roles such as retirement (www.suicidology.org).

What hope might have been offered the gentleman of these posts?

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“When You Read This, I Will Have Left” (part two)

July 24, 2012 by Marjorie Antus

The previous post concerns an elderly gentleman who sent my husband a suicide note in 2009. The man wrote that while he had no fear of death, he was “particular” about how he might die and that he was planning to quit while he was “ahead.”

Far from being “defeated,” “disabled,” or “discouraged,” (among several negative adjectives he provided), he said that positive words best represented his mental state.

He then employed a metaphor to show how biological life–“the route from birth to death”–can be distinguished from the “real” life of  “experiences, hardships, education, hope, love, joy, sorrow, etc.”  To him, biological life is a “stream on which I ride in a canoe. There is a paddle, but I don’t use it. I am carried down the stream of life with no effort on my part. This is a very personal stream: each person has his own and is alone on it. I have drifted along on mine for going on 88 years. Keep that in mind: it affects one’s perspective.”

The metaphor is perplexing:  1) In what sense could it possibly be true that our biological life–our “route from birth to death”–is distinguishable from “real” life?  2) How can biological life symbolized as a “stream on which I ride in a canoe”  capture the fullness–variety, color, mystery, transcendence–of his or anyone’s life?  3) If he means “I am carried down the stream of life with no effort on my part” to argue that, like everyone, he’s growing older, the idea makes sense. But to say he is alone on his stream (and apparently thinks he always has been) makes no sense to me. Reading it, I imagine his grown children found the comment jarring and wrongheaded.

There’s still more to say about this good man.

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“When You Read This, I Will Have Left”

July 20, 2012 by Marjorie Antus

With the Christmas cards in 2009 came a newsletter from one of my husband’s elderly medical patients. Printed five times along the top of the newsletter were the words FINAL ISSUE. “The moment of culmination of years of planning has arrived,” it begins. “When you read this, I will have left for my next post.”

He goes on to explain that from time to time he had “inflicted upon some of you these egocentric declarations: 1) I have absolutely no fear of death but am damn particular about how I get there!  2)  I plan to quit while I’m ahead. 3) I intend to choose the time, the place, and the manner of my departure. (And how many people get to do that? Or want to?)”

It was not that he was in a “really lousy mental state,” as he thought some might conclude. Only months before, in fact, he had sat down with a dictionary and gone through words beginning with “de” and “dis” to find those that did not describe him. That is, he was not to be considered  “debased, decadent, decayed, deceived, decrepit, defeated . . . disabled, disappointed, or discouraged.” 

“There are a lot more words than this on the positive side,” he added, “but they aren’t conveniently grouped for easy listing!”

The tone throughout the writing is most reasonable and considerate.  At the end of the suicide note are the names of immediate family members, three of them married children who likely received the FINAL ISSUE around the same time as–maybe even a little later than–my husband.

I’ve wondered for years how reasonable and considerate they felt their father’s suicide to be. Feelings of rejection–not to mention shame and stigmatization–are prominent among adult children bereaved by the suicide of an elderly parent (John Jordan  and John McIntosh. Grief After Suicide: Understanding the Consequences and Caring for the Survivors. New York: Taylor &  Francis  Group, 2011, p. 67).

More to follow.

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Confounded

July 18, 2012 by Marjorie Antus

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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“Guilt is a Bear”

July 14, 2012 by Marjorie Antus

One memorable comment the grief therapist made to my family after my daughter Mary’s suicide  was, “Guilt is a bear you’ll be wrestling for a long time.”

In Grief After Suicide, editors Jordan and McIntosh write that guilt results from what a survivor did, didn’t do, or imagined he or she might have done to prevent the suicide death (p.31).  In my experience, guilt usually showed up in “what-iffing” questions: what if I’d been home that day, what if Mary had seen another doctor, what if I’d gone into her bedroom and read one of her journals?  What if I’d been more attentive?

“What-iffing” questions waned only when, a couple years into the grief, I got tired of asking them. For one thing, I started giving myself credit for doing the best I could do with what I knew about Mary at the time of her death.  Yes, I had fallen tragically short; but whatever I did or failed to do was the best I could do at that time.

Our family grief therapist also said something to my husband and me one day that helped quell the what-iffing: “You’re just not that powerful.” John was lamenting his inability to protect our daughter, and I was admitting how little I had known her when she most needed to be known. We were both frustrated and sad and rattled by failure. “You’re just not that powerful,”  Jane told us.  Far from discouraging me, her words rang with truth.

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What Many (But Not All) Suicide Survivors Experience

July 9, 2012 by Marjorie Antus

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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