11 11“We believe that suicide occurs in all types of families:
the functional and the dysfunctional; the very good,
the not so good, and the just good enough.”
—Edward Dunne and Karen Dunne-Maxim,
Suicide and Its Aftermath: Understanding and Counseling the Survivors
Before Harry died, I was aware of suicide from a comfortable distance. I would read stories about rock stars overdosing or politicians shooting themselves or children of celebrities jumping out windows. I would hear news of high school classmates or casual acquaintances unexpectedly taking their lives. I would see thoughtful essays exploring the suicides of prominent writers and artists. These startling accounts of interrupted lives and early deaths seemed to have a faraway, almost unreal quality. I could not imagine a desperation so unyielding that ending your life became the only possible refuge.
Although suicide is almost universally condemned, it is also admired for its boldness and audacity. Killing yourself is considered dramatic; there is a certain cachet to knocking on death’s door instead of waiting for it to sneak up on you when you are not looking. Yet, suicide is not a self-contained act: For those of us who are left behind, the violent disruption of life’s natural order throws us off balance, leaving us shaken and confused.
We are also afraid. We are told about a possible “suicide gene” that can be passed down from generation to generation. We are informed that after our exposure to a loved one’s suicide, we are more psychologically receptive to consider it as a viable option for ourselves. Survivors learn that our chances of killing ourselves are now significantly greater, with rates estimated at up to 400 percent higher than those of the general public.
“The idea of suicide as a solution to a problem often becomes implanted in the mind of the survivor,” states Dr. Edward Dunne in Suicide and Its Aftermath: Understanding and Counseling the Survivors. “Survivors have had the ‘veil’ of death lifted and are forced to confront existential reality.… They view the suicide as a way to handle a difficult interpersonal, financial, or legal problem or situation. What’s more, the closeness of the survivor’s relationship to the deceased promotes an openness to options suggested by the deceased.”
According to the National Institute of Mental Health, one out of four people who attempt suicide has a family member who also tried to commit suicide. Current research suggests that suicide tends to run in families, possibly as a result of such genetic factors as depression, or because the family member serves as a role model.
After Harry’s death, I was terrified of the suicidal images that suddenly crowded my thoughts. Killing myself had now joined the list of answers to the multiple choice question of what to do if life became too frightening or overwhelming. My husband’s experience confirmed how easy it could be: If you want to leave, nothing can stop you.
“Suicide is part of my family legacy,” says Lisa, a forty-one-year-old director of a homeless shelter in Cleveland, Ohio. “Twenty years ago, my brother hung himself in the backyard of the house where we grew up. He was in his junior year of high school and had just been elected president of his class. I was away at college and my older sister found him. Eight years later, my father killed himself with carbon monoxide from his car. He left a note for his remaining six children saying that he blamed himself for my brother’s suicide and he hoped his death would break the cycle of self-destruction that had already appeared in our family. Even after many years of therapy, there is a part of me that still believes my family must be cursed.
“We came from a nice suburban household outside of Cleveland. After my brother’s suicide, my parents got divorced. I went to a counselor at my college, who told me I should forget about my family and live my own life. I just felt numb at his response. There was no place to go for help.
“My reaction was to throw myself into my work. I was on the dean’s list for the next four semesters and graduated with honors. Even though I was successful, I started on a course of progressive and intermittent drug and alcohol use. On the day my father killed himself, I stopped all drinking and drugs.
“I knew my brother had been depressed. He would call me up to ask me to take a drive with him to the lake, then he wouldn’t say a word the whole time. He started to get worse and worse. Finally, my father took him to a psychiatrist, who gave him pills. He killed himself the day he was supposed to start his medication.
“Both my father and brother drank. I understand that alcoholism is a terminal disease where you end up dead. But my father stopped drinking six months before he killed himself, using his anger to complete the act. My mother is a very religious Roman Catholic and has found great comfort in her faith. Both my father and brother had formal church funeral services and burials. But I’m bothered by that. I was taught that suicide is a mortal sin. Yet, if you kill yourself, all seems to be forgiven.
“I’m furious at my father. His selfish act has only continued the self-destruction in our family, not stopped it. On the way to my father’s funeral, my sister, the one who found my brother, had a nervous breakdown. She began screaming, threatening to kill herself. We had to commit her to the hospital that night, and she’s been in and out of mental institutions ever since. My youngest brother is the only one of us who has a normal life. He explains his escape from the dysfunction of our family by saying that he was watching from the balcony while the rest of us were sitting in the front row.
“I once heard a psychiatrist say that suicide is the only way that someone dies by choice. I disagree with him. Suicide is a perception of choice. Since my father’s death, I constantly have to fight against my own suicidal feelings. I’m in therapy and attend many different support groups. I have told my best friend to admit me to a hospital immediately if I start talking about killing myself. I am doing everything possible to keep myself alive.”
As we struggle to put our lives back together, survivors must deal not only with the chaos that suicide leaves behind but also with the uncertainty of its future effects. Even as we begin to understand that our loved ones killed themselves in a desperate attempt to end their pain, we often feel that their anguish has not been extinguished but simply passed on to us.
“I’m terrified at the idea that one day I will kill myself like my sister and father before me,” says Caitlan, a thirty-seven-year-old fashion designer from New York City. “Ten years ago, my sister took an overdose of painkillers after her husband left her for another woman. My mother never recovered from the suicide. She became more and more isolated, holding herself back from my father and me. Four years after my sister’s death, my mother was diagnosed with lymphoma; she died three years later.
“My father, whom I always thought of as being the strong one in the family, started talking about killing himself after my mother died. He began calling me all the time, saying that life wasn’t worth it anymore. I found myself putting a distance between us. I was the only family member left and I was afraid that he was becoming too dependent on me. He would tell me that he was lonely and ask me to come visit him. But I didn’t reach out to him, just the opposite. The more insistent he became, the more I made up excuses not to see him.
“Ten months after my mother died, my father shot himself in the bedroom of his house. I feel so guilty—I’m the only member in my family who has survived, yet I couldn’t save my sister, mother, or father. I’ve just begun therapy but I’m totally overwhelmed. Is my family damned? Will I also want to kill myself one day? Is suicide genetic? I wrestle with all these questions day and night. I feel crazy because I can’t get these obsessive thoughts out of my head.”
Like Caitlan, many survivors are threatened by the possibility of an increased risk of suicide once a family member takes his or her life. “My only wish is that I die a normal death,” says Mike, a graduate student at the University of Pennsylvania. “My grandfather died by accidentally shooting himself while cleaning his gun. I was very young but I remember how my parents talked about his death, as if they were hiding something. Then, two years ago, my father was killed when his car hit a telephone pole. He was always such a careful driver, and I was bothered about his accident. I guess I’ll never know if my father and my grandfather killed themselves. If it’s true, then I feel there’s really no hope for me. I want my death to be clear-cut—I just want to get sick and die. I would not want any child of mine to be burdened with the same kind of doubts that I am living with.”
Some survivors, however, view the suicide of a family member as a courageous response to an intolerable situation. “Both my dad and his brother were brilliant men who worried about their lack of success,” says Lukas, a thirty-two-year-old musician from Los Angeles. “My uncle killed himself before I was born. My dad, who died last year from stomach cancer, suffered from deep depression his whole life. He was either on medication or in hospitals throughout most of my childhood. I believe that the only reason he didn’t kill himself was because he was too depressed. To me, suicide is an incredibly brave act. People who are able to end their lives are action-oriented—they are able to cut to the chase.
“My dad talked to me a lot about his brother’s suicide. He traced his clinical depression from the rejection and trauma he felt after his brother died. When I was in high school, my dad was so bad that he couldn’t even get up in the morning. He was hospitalized for electroshock therapy but nothing seemed to work. He talked about suicide not as a threat, only as a way of stopping how he was feeling. When I would see the way he was suffering, I began to think that death would be welcome.
“I don’t know if my dad made any suicide attempts during this period. I think what might have held him back was that he didn’t want me to be as affected by his suicide as he was by his brother’s. He began living through me and became totally involved with helping me to achieve success with my music. I have never felt so emotionally together in my life as I did at that time. I saw how much my dad needed me and how strong I had to be in order to help keep him going. I also came to believe that if my father killed himself, it would be bolder and more courageous than how he was living. Now, I still agree with that, although the feelings aren’t so pure and unshaded.
“My dad died at a point in his life when he was mentally at peace. When he developed stomach cancer, he was in a lot of pain. He talked about his fear of dying but said he now realized how precious life was. But he also insisted on putting himself on a morphine drip and teaching me how to administer it in case the doctors or nurses wouldn’t do it. I had no problem with that. It was done and it was a courageous act. My father was incredibly brave as he faced the enormity of death.
“Suicide is not an option for me because my mother is around and I would be afraid of what my death would do to her. Yet, sometimes I think I would be dead by now if I had access to a gun, even in spite of my mother. I’m aware that depression associated with suicide could be genetic. I will just have to face it if it happens.”
Although Lukas was at peace with his decision to assist his father in ending his life, other survivors experience enormous conflict about their role in helping a loved one commit suicide. Because it seems almost impossible to distinguish the symptoms of depression from the symptoms of an incurable or painful disease, many survivors describe persistent feelings of doubt and guilt after participating in the suicide of a family member.
“I’ll never know if my brother really wanted to die or if he felt that he was being a burden to the family,” says Angela, a twenty-seven-year-old flight attendant from Miami. “Kenny had AIDS and had been hospitalized five times in the last two years. He told us that he planned to kill himself when his weight dropped below eighty pounds. Six months ago, it did. Over the years, he had amassed a whole array of sleeping pills and painkillers. Kenny wanted us all around him when he died—my mother, brother, and his best friend. I was always uncomfortable with the way he planned his suicide. Why was he really ending his life? He knew that his illness had been a tremendous financial, physical, and emotional responsibility for my family. Was he leaving for his sake or for ours? Was Kenny’s suicide ‘rational’? My mother says that we made the right decision because we helped Kenny end his suffering. I’ve been thinking about it all the time but I still don’t feel comfortable about what happened.”
Every family member reacts to the suicide of a loved one in his or her own individual manner: from anger to admiration, from identification to denial. Dr. Edward Dunne likens the suicide of his brother, Tim, to a meteorite that crashed into his family, sending each member into different and separate orbits of mourning. “Suicide destroys the original fabric of the family, forcing a reintegration of the survivors,” he says. “The pace at which individual family members are ready and able to do this will vary, necessitating individual interventions.”
Donald is a fifty-eight-year-old salesman from Kansas City whose wife killed herself one year ago with a combination of alcohol and tranquilizers. “My family was ripped apart by her death,” he explains. “My daughter, who found her, blames her suicide on my constantly being away from home. When I tell her that her mother had a drinking problem, she says I’m just trying to make excuses for my behavior. It’s really a myth that people pull together in a crisis. My wife’s suicide exposed all the problems that already existed between me and my children. Whatever fault lines were there just became deeper and more entrenched.”
With any suicide, there is often a need to blame someone other than the person who has taken his or her life. In teenage suicides, the finger is most often pointed at the youngster’s parents for their apparent failure to keep their child alive. Ann Landers, in her nationally syndicated column, offered an extremely compassionate reply to a mother who had written about how devastated she felt when people asked her why she had done nothing to prevent her young daughter from killing herself.
“You do not owe an explanation to anyone who is so insensitive (or mean-spirited) that he or she would ask a mother of a suicide why someone didn’t reach out to her child before it was too late,” Ms. Landers advised. “There are times when the best response is a spell of cold, stinging silence, followed by, ‘Why would anyone ask a mother such a question?’ ”
Youth suicide is a growing social problem in the United States, with the number of young people killing themselves increasing every year. According to the National Institute of Mental Health, suicide is the third major cause of death among all adolescents and the second major cause of death among college students. Males are six times more likely to kill themselves than females, although females have a higher rate of suicide attempts.
As part of an alarming national trend, recent statistics from the Centers for Disease Control and Prevention reveal a 120 percent increase in the suicide rate among children ages ten to fourteen. From 1980 to 1992, the rate among white boys in this age group went up 86 percent, while the rate for black boys increased by 300 percent. There was a 233 percent rise in suicide rates for white girls and a 100 percent increase for black girls. The use of guns figured prominently in these numbers: In 1992, firearm-related deaths accounted for 65 percent of all suicides among people under twenty-five. For young people between the ages of fifteen and nineteen, firearm-related suicides were responsible for 81 percent of the increase in the overall rates between 1980 and 1992.
Research describes how adolescents become curious and even excited when suicide is talked about in heroic ways as opposed to being characterized as a result of mental illness. This romanticizing of death often accounts for copycat suicides among young people and outbreaks of cluster suicides in schools and communities.
“The suicide of a student touches everyone—students, teachers, administrators, and support staff—stirring up the same kind of emotions and conflicts that affect all survivors of suicide,” write Frederick Lamb and Karen Dunne-Maxim in Suicide and Its Aftermath: Understanding and Counseling the Survivors. “In a very real sense the school community is itself a survivor, requiring the same sensitive support and help that individuals do after such a tragedy.” The authors stress that following the suicide of a young person, the focus of attention must be on the needs of the living, the survivors. They recommend that nothing be done to glamorize or dramatize a suicide, but doing nothing can be as dangerous as doing too much. They also emphasize that students in a school cannot be helped until the faculty is also counseled.
The suicide of a child can tear apart the foundation of trust and mutual responsibility that is necessary for a marriage to survive. The Samaritans of New York, a suicide prevention group in New York City, report that 70 percent of the parents of teenage suicides eventually divorce.
“My wife and I separated several months after our sixteen-year-old daughter jumped in front of a train together with her best friend,” says Vic, a fifty-four-year-old pharmacist from a small town in Wyoming. “I really regret that we couldn’t work things out. We virtually stopped talking to each other after the suicide. We were like zombies. I don’t think I have spoken to my wife in the past four years, although I know she must be in agony. It seems funny that she would understand how I feel more than anyone in the world, yet we can’t share any of our feelings about our daughter’s death.”
For many parents, guilt over their children’s suicide is compounded by the real or perceived prejudgment that they are responsible for the actions of their children. “I just accepted it when people blamed me for Billy’s death because I believed it to be true,” recalls Emmy, a forty-one-year-old physician’s assistant from Santa Fe whose fourteen-year-old son shot himself five years ago. “After Billy killed himself, I had the strong sensation that I had also died. I was convinced that I had been in a car accident and was lingering between two worlds. My identity was so caught up with my son that after his death I had only a slim connection to life. Eventually, the numbness started wearing off and I realized I wasn’t dead after all. But then a wave of terror came over me. I was alive and the pain would never end; the nightmare was here. How was I going to get through the rest of my life?
“It took several weeks for my sensations to start to become distinct. The state of shock protects you from taking in the full extent of devastation, so you don’t totally lose your mind. You know something disastrous has happened but not the full impact.
“When I went back to work, I felt so disassociated. I didn’t belong there. Everyone knew I wasn’t myself and it seemed as if people were patronizing me. There was this normal world going on around me but I couldn’t assimilate it. It only highlighted my disorientation. A couple of months before Billy killed himself, one of the nurses in my office died a very painful death from lung cancer. When I visited her in the hospital, she told me she had very seriously considered ending her life but then thought, What’s the point of doing the inevitable? It’s going to happen anyway. But what does a young boy like Billy know about that?
“A couple of months after Billy died, I went out for the first time with my husband and sister. We went to the movies, then to dinner. I had an overwhelming feeling of horror the entire evening. I was trying to engage in conversation and enjoy the food but the horror inside my mind was so startling. I could hear myself talking but it was from a distance. Everything was so meaningless: I was like the walking dead, the emotionally dead.
“After Billy’s suicide, I became estranged from my husband. Our son’s death was not a shared loss, it was an individual loss. He was my son yet he was my husband’s son also. We talked about it all the time but it divided us as a couple. I thought about suicide a lot. I wanted to get in my car and slam it into a wall. I would ask my husband if he wanted to have a suicide pact with me so we could die together. He would get very angry when I talked like that. Then I would imagine killing myself alone—after all, it was between me and my son.
“Billy shot himself in the basement of our home. My husband found him when he came home from work. When he called me at the office with the news, I drove directly to my sister’s house, which was nearby. I never set foot in my house again. We stayed with my sister for a month before renting another house in the neighborhood. I didn’t care about my surroundings. This wasn’t my home, just a place to stay. Both my husband and I started neglecting our responsibilities to our marriage. We stopped cleaning the house, buying food, toilet paper, soap. We would bathe with shampoo, that’s how dysfunctional we were.
“Gradually, I started wondering if the loss of our son was greater than our love for each other. I started to fight to reestablish our life together. I knew that if our marriage was going to survive, we would have to make room for each other. I had two battles: I had to survive Billy’s suicide and also prevent the complete destruction of our marriage. We were each carrying around our own blame about our son’s death—two people, both of whom were one hundred percent guilty.
“Six months after Billy’s suicide, a coworker told me about a suicide support group. I was completely hostile about sharing my tragedy with total strangers. I didn’t care about their losses and I was ashamed of mine. I was resistant, but my husband really wanted to go. After the meetings, he would be relieved, while I would be angry. Yet, I continued attending, for his sake, as I told myself.
“There was a couple at one of the meetings who had lost a daughter five years earlier. I was totally disgusted—I thought, Five years down the road and they’re still going to meetings. Obviously, this doesn’t work. But then I started listening to people who were just beginning to go to meetings after many years of suffering in silence. It was even more terrifying to think you could live a ‘normal’ life and then be hit with all these feelings you had been repressing for so long. The fear it could happen to me made me stick it out.
“At first, I didn’t relate to the other stories. Eventually, though, I started listening to the other people and caring for them. I saw their horror in all kinds of manifestations, with a common link running through the different variations. I began noting patterns in the process of survival: the numbness, the horrendous guilt, the fear of becoming suicidal and insane. This was a prevalent fear among the group members, that the act of suicide was a contagious disease and we would contract it from our loved ones. The similarities between us were so strong. I have to admit I was unprepared for the realization that I could have such a powerful connection to people I didn’t know.
“In the groups, you can achieve some degree of objectivity concerning others. I forgave everyone and wanted them to forgive themselves. But I couldn’t find the same compassion for myself, because I knew that I had committed the worst crime by allowing my child to die. Yet, the people in the groups were describing the same emotions I was experiencing. I began to see how suicide affected other people and this gave me the distance to understand my own feelings. Before, it had been a nightmare where I couldn’t wake up. Slowly, I realized that I would not feel this way forever.
“The support groups were essential to me on a personal level. They did not work, however, for my husband and me as a couple. We were helped with our individual losses as a mother and father, but not as a husband and wife. We decided to go to marriage counseling for awhile, but that didn’t seem to help very much either.
“My husband wanted to have another child right away. He wanted to be a parent again. But I felt very alienated by that. It seemed to have nothing to do with our marriage, just my husband’s desire to be a father. I was not ready for a child because I felt we were living in chaos. I was also deeply hurt that my husband’s need to be a parent appeared more important than his being a husband to me.
“What really seemed to be a turning point is that we got a dog two years after Billy’s suicide. The dog helped us rediscover all the roles and responsibilities of nurturing that we had lost. Basically, we had stopped caring for ourselves and each other after Billy died. The primary function of being a parent is to nurture; we both still had the feelings but nowhere to put them. The dog was sickly and we shared in the responsibility of bringing him back to health. This was an important first step, because my husband and I started being concerned about the same thing. We also began to show feelings again to each other, emotions that we thought had been obliterated. The dog put us back in the role of caretakers.
“We are now trying to have a child. Both of us want this very much. I know that my husband will be a responsible and caring father, like he was with Billy. I also believe I will be a good mother even though there are times when I’m afraid something will go wrong again. Both my husband and I have worked hard against very strong odds to put our marriage back together. I am thankful that we really didn’t die with Billy but allowed ourselves to have this second chance.”
Like Emmy, survivors must constantly fight to put the pieces of our lives back together and reestablish our own identities. Often, it seems an impossible task. Several years ago, when the sale of Harry’s medical office fell through once again and my financial situation was on the verge of crashing, my resolve to keep myself above water in spite of my husband’s suicide began to desert me. I was convinced that my life would never get better. It seemed as if I were on an inevitable spiral downward, that hope was an illusion and faith an empty dream.
This is how Harry felt, I told myself. I found myself resonating with his despair. My escalating depression connected me closer and closer to my husband. I confided my fantasies of self-destruction to my therapist; I began retreating from my friends. What’s the use? I would ask myself over and over. Life did not seem worth the effort anymore.
As my mood went from gray to black, I came home one day to a message on my answering machine. An important project of mine had just been sold. Jubilation swept over me. Not only would my work be published, I now had an extra cushion of money to keep me going until I could try once again to sell the office. Within seconds, my despair evaporated. I was filled with plans for the future.
Weeks later, I was having dinner with a friend who has battled depression her entire life. I told her the story of what I had recently experienced, how I could now understand what she must go through when she is racked with feelings of hopelessness and despair.
“No, Carla,” she corrected me. “When you are truly depressed, even the best news in the world cannot make you feel better.”
“How is that possible?” I asked incredulously. It seemed inconceivable that desperation could be so fixed that the inevitable changes and movement in our lives would not shake it loose.
And then I realized the difference. Although suicidal fantasies might help us make it through the bad nights—there is always a way out if things become too intolerable—most people do not want to die. Survivors have walked through the fire without being engulfed, propelled forward by our courage and will. For those of us who have been left behind, the legacy of suicide lies not in reconciling ourselves to inevitable defeat but in recognizing that our spirit of survival remains both resilient and intact.