14 14“Not all survivors are affected in the same fashion
or to the same degree.”
—John McIntosh,
Suicide and Its Aftermath: Understanding and Counseling
the Suicide Survivor
Nothing prepares you for the first anniversary. I steel myself for weeks beforehand, warned by other survivors to fasten my seat belt for the rough ride ahead. I trust that my customary neutral regard for special occasions such as birthdays and holidays will somehow insulate me. I make plans to busy myself. I attend extra support groups. But like a tornado striking its target with exact precision, as December 16 approaches, the minute-to-minute, hour-to-hour, day-to-day recollections of my husband’s suicide engulf me, temporarily blowing down whatever stability I think I have achieved over the past year.
By the second anniversary, my protective numbness burns off, propelling the details of Harry’s suicide to the surface with exquisite sharpness. Yet, I decide it is finally time for me to look at his photograph. I pull out the last of the many albums Harry and I had accumulated during our twenty-one-year marriage, selecting the most recent picture of him I can find. I look in his eyes to see if I can discover the turmoil. But he looks happy, smiling at our muddy dog emerging from the lake in Central Park. When did Harry start thinking of death? I begin to anguish. How could I have missed it? I quickly shut the album, ambushed by a grief as raw as the day he died.
Each year, I believe myself to be inured against the pain; I will it. Yet, now, as the seventh anniversary of Harry’s suicide nears, I am again transported to that time of horror and chaos, of total disbelief and utter madness. I am filled with unremitting regret: What a waste, I say to myself over and over, obsessively repeating a mantra that offers no comfort. Harry has missed so much over the years. I’ve grown older while he has remained young. And, of course, the why. The never-to-be-solved riddle of another person’s private desperation. I know instinctively that even as I move on, as my life falls into place without him, the effects of Harry’s decision to kill himself will be with me always.
According to John McIntosh in Suicide and Its Aftermath: Understanding and Counseling the Suicide Survivor, suicide survivors share many of the same psychological reactions as people who have experienced traumatic events such as rape, war, and crime victimization. The mental health community now recognizes that suicide survivors can suffer post-traumatic stress disorder, defined by the American Psychiatric Association as “the development of characteristic symptoms following a psychologically traumatic event that is generally outside the range of human experience.”
The initial symptoms of post-traumatic stress disorder include “physic numbing,” or “emotional anesthesia,” where one is unable to recall important aspects of the traumatic event. This is followed by feelings of detachment or estrangement from other people, a loss of interest in previously enjoyed activities, and an inability to feel emotions of any type, especially those associated with intimacy, tenderness, and sexuality. There are also difficulties in falling or staying asleep, nightmares, an inability to concentrate or complete tasks, and a fear of losing control. Long-term effects include intense psychological distress when exposed to events that resemble an aspect of the event, especially the anniversary of the trauma.
“I tried having a picnic on the first anniversary of my sister’s death but I couldn’t carry it off,” says Pam, a thirty-seven-year-old social worker from Springfield, Illinois, whose sister killed herself two years ago after undergoing exhaustive chemotherapy for ovarian cancer. “Although I wanted the occasion to be a joyous celebration of Caroline’s life, as the day got closer, I couldn’t stop crying. I had no idea it would be that rough—I had never put great stock in anniversaries before, but this was different. I began having vivid recollections of the events that occurred before and after my sister’s death, images I must have previously suppressed. It was as if I were finally watching a home video about Caroline’s suicide without the jumble of static obstructing the reception.
“Caroline was a year older than me—we were practically twins. She had been completely devastated by the effects of her chemo; all her hair had fallen out and she was thin as a rail. She had lost all hope, knowing the odds of making it were against her. One night, when her husband was away on a business trip, she swallowed all the pills she had in the house, drank some alcohol, and turned on the gas in the kitchen. I called her the next morning before I went to work, like I did every day, and the minute her answering machine picked up, I knew something was wrong. I drove over to her house in a panic, figuring that she was unable to come to the phone because she had fallen or fainted. The possibility that she might have killed herself never entered my mind: At that time, suicide was a totally foreign concept to me.
“Weeks later, when I was going through her things, I found one of those books that tell you how to kill yourself. Caroline had underlined specific passages in yellow Magic Marker, following the step-by-step instructions on how to die to the letter. She had even lined up the bottles of pills and alcohol on her dresser, like the book advised, so the police would know it was a suicide, not a murder. As I looked through the death manual, my hands began to shake. Why couldn’t Caroline have called me instead of listening to that garbage?
“The suicide feels very fresh, even after two years. I still have a hard time reading books or seeing television shows related to sisters. I find Caroline’s birthday to be incredibly stressful, the same for Christmas. I also find myself having thoughts of suicide, even though I don’t think they’re for real. I had been so inspired by my sister’s struggle to survive: What pushed her to finally give in to her despondency? My life feels on hold now, all my thoughts seem to revolve around suicide. I recently joined a survivor support group and people there assure me that it gets better—I pray that they are right.”
Because of the traumatic nature of suicide, certain dates such as anniversaries, holidays, and birthdays take on greater significance for the survivor, observe Karen Dunne-Maxim, Edward Dunne, and Marilyn Hauser in Suicide and Its Aftermath: Understanding and Counseling the Suicide Survivor. “We have seen many families who dread the approach of these occasions as unwanted reminders of their pain. It is our belief that holidays and birthdays should be observed recognizing the loss but using new family rituals which promote both celebration and healing.”
Dennis, a college junior from Indiana whose sixteen-year-old brother hanged himself ten months ago, describes the immense solace his family found from lighting a candle for his brother during Thanksgiving dinner. “The burning flame in front of what would have been Brad’s place at the table made it seem as if he were still with us. Although there was this gaping hole in our family, it helped to acknowledge my brother’s presence in whatever way we could. Brad was only a kid, a kid who killed himself after his basketball team lost an important game because he had nervously thrown the scoring shot for the wrong side. No one from my family had attended the game and we only found out what happened later. Even now, I don’t think I have really quite processed his suicide. It’s too difficult to think that my brother was so humiliated and ashamed, that he could have been hurting so intensely. On some level, I’m still waiting for him to come home. There’s a part of me that wouldn’t be surprised if the phone rang right now and it was Brad, going on about some football game he had just seen. I suppose the shock of his death is still too great for me to grasp.”
Like Dennis, many survivors find it almost impossible to absorb the totality of losing a loved one to suicide. “After four years, there’s a part of me that believes Max might really be alive,” says Vera, a sixty-three-year-old trustee of several cultural and educational institutions in Pittsburgh. “My husband was a very successful businessman who started getting nervous that his company would go bankrupt. This was a very real fear because he had expanded during the 1980s and was now overextended. Even though I tried to reassure him that things would work out—they always did—he became consumed with money fears. As Max became more overwhelmed financially, he started not being able to cope. He would come home from work earlier and earlier and would watch television or just look out the window. He even stopped reading, although it had been one of his greatest pleasures.
“As Max became more depressed, I felt myself pulling away from him. He refused to go for help, arguing that no shrink could solve his business problems, so what would be the use? As he was becoming more dependent on me to make all the decisions, he was also acting more combative, like a small child. The worse he got, the deeper I went into denial. Looking back at that time, I believe there was a certain inevitability to my husband’s self-destruction. Three months before he died, he said to me that we should both consider killing ourselves. I answered that if we did that, the kids wouldn’t get any life insurance. He responded, so uncharacteristically, ‘Who cares?’
“The weekend before Max took his life, we went to our country house. On Monday, I returned to the city for a doctor’s appointment while he stayed up there. As I was sitting in the doctor’s office, I suddenly had this intense feeling of apprehension about my husband’s safety. I asked the receptionist if I could use the phone to call him in the country, but there was no answer. I then left a message for him at our home and his office, just in case he had changed his mind and decided to come back to the city. By now, I was extremely agitated; I felt myself losing control. I left the doctor’s office without seeing him, driving home at what seemed one hundred miles an hour.
“I knew in my gut that something was wrong. For several hours, I called the country house every twenty minutes, praying that Max would pick up. Finally, I phoned our next-door neighbor up there to ask him to check if Max was all right. After what seemed like an eternity, he called me back. As soon as he said, ‘Are you alone?’ I knew that Max was dead. I heard myself screaming, as if I were very far away. He said he had found Max dead in his car in the garage, with rags stuffed under the doors to keep the exhaust from escaping. ‘You’re a liar,’ I screamed at him. ‘That’s a stranger in the car. Max would never do this to me.’ I was hysterical.
“I somehow remember calling my daughter. She drove me up to the country house in a two-hour ride that seemed completely unreal. When we arrived, there were police all over the house. I ran over to them, shrieking that it was impossible the dead man was my husband. The house was a total mess because the police had ransacked it looking for evidence. We had a large collection of antique clocks and I noticed that they had all stopped. This fact struck me in the middle of the insanity.
“The police started questioning me, asking if my husband had enemies, if he had been sick, and other really intrusive questions. I couldn’t believe they were talking about this when I was in such a state. I asked to see my husband, but they told me the coroner had already taken his body away. I was furious. ‘This is private property,’ I yelled. ‘You can’t take away my things.’ Everything became such a blur after that; it was like a nightmare come true.
“Even though I saw Max at the funeral parlor, there was part of me that didn’t believe it was him. He was such an exuberant man and this thing just lying there was not my husband. For months after his suicide, I suffered from paralyzing anxiety attacks and constant nightmares. My daughter entered a deep depression and my son stopped talking about his father. Four years later, my children will still not mention his name or anything about him, even at holidays or family gatherings. I find this very painful.
“Two years ago, one of Max’s business acquaintances called me to say that he had just come back from Israel and was almost sure he had seen Max there. I immediately thought it was true, that my husband had not really died. Somebody had slipped another person’s body into his car and Max was now in Israel under the witness protection program. I know I’m being irrational but ever since then, I have not been able to go to Israel. On the one hand, I’m scared I’ll see him, and on the other hand, I’m scared I won’t.
“The first year after Max died, I went to synagogue every Friday night to say Kaddish for him. I was never an observant person, but as I recited this ancient prayer for the dead, I found an unexpected comfort. There was an order in the rituals, a serenity in the prescribed traditions. I eventually joined the synagogue, not only for this sense of continuity but also for the feeling of community it gave me. I never imagined growing old without Max by my side; I still can’t believe that he left me so violently. Yet, in order for me to move on, I must create a world that is both steady and constant. Only when I rebuild can I finally put my husband to rest. I must have the faith that I will be able to do this.”
Even as we try to restore order to our lives, survivors find that we are often troubled by recurring images of sudden death and unforeseen disaster. “Ever since my cousin killed himself, I find myself waiting for something else to happen, for the other shoe to drop,” says Polly, a forty-four-year-old tour guide from Hawaii. “Three years ago on Christmas Day, my cousin walked into the ocean and drowned himself. My son, who was twelve at the time, had been very close to him and took his death very hard. Now, I’m afraid for him. I sent him to a therapist, but after several sessions, he refused to continue. I’m really scared. What happens if my son gets depressed and also decides to kill himself?
“Suicide was always something that other people did; it never happened to ‘normal’ families like mine. Now I believe that anyone is capable of doing it. Recently, a friend came over for dinner and asked to use the bathroom to wash up. She was in there for what seemed a very long time and I became convinced that she must be killing herself. I started pounding frantically on the door, certain she was dead. My friend came running out of the bathroom, looking at me as if I were crazy. Obviously, suicide is never far from my mind. It happened once, and I keep waiting for it to happen again.”
In addition to worrying that catastrophe will inevitably strike us once again, survivors are frequently overcome by powerful feelings of isolation and despair, especially as the anniversary of our loved one’s suicide approaches. Other survivors, especially those who have lost a parent, find themselves experiencing extreme emotional distress as they near the age when their mother or father committed suicide, similar to the “anniversary reaction” experienced by some children of Holocaust survivors when they reach the age when their parent was taken away by the Nazis.
“I went into a terrible depression right after my forty-fifth birthday,” recalls Gail, a fifty-four-year-old teacher from Vancouver. “Everything seemed hopeless. It took all my courage to just get out of bed in the morning. Life had no meaning—why should I even continue? I never even made the connection to my mother’s suicide until I reluctantly entered therapy. During the first session, I mentioned that my mother had killed herself when I was fifteen. My therapist asked me how old my mother had been when she died, and I casually answered, forty-five. It was like being hit by lightning. I was reliving what I imagined my mother had been going through when she gave up and ended her life.
“My mother had a drinking problem ever since I could remember, and she died from mixing pills with alcohol. I initially fought the idea that her death was intentional, telling myself she had been too drunk to know what she was doing. Even when I found out that she had refilled the prescriptions for her pills on the day before she died, I still had a hard time accepting that she had really meant to kill herself. It was my way of not having to think of how unhappy she must have been.
“Because my mother and I were having terrible fights for months before she died, I believed her death was her way of getting back at me. You know, like when you’re little and you’re mad at your parents—you imagine how they would feel when you die and how they would cry at your funeral. That’s what I thought she had done. At the same time, I was also very relieved that she was dead. Her drinking had gotten steadily worse and I was afraid she would turn violent. I felt very guilty at being so relieved—I still do.
“I know now that I will never have any definite closure about my mother’s suicide. Her death has entirely shaped my life, and the only way I can move on is to accept her decision, not be destroyed by it. I’ll always be angry—and confused—that she chose to leave me in such a hurtful manner. But I have no more time to lose.”
Like Gail, many survivors seek out professional guidance to help sort through the consequences of losing a loved one to suicide. But how does a therapist feel when one of his or her patients commits suicide? According to Dr. Frank Jones, Jr., a New Jersey psychiatrist who established one of the first survivor support groups for therapists, the suicide of a patient in therapy is the most difficult bereavement crisis a therapist will ever have to encounter and endure. “The situation is compounded because it presents not only a personal crisis, similar to that experienced by family members and others intimately involved with the decedent, but also a professional crisis related to a therapist’s special role in society,” he writes in Suicide and Its Aftermath: Understanding and Counseling the Suicide Survivor.
A survey of randomly selected psychotherapists in the United States conducted in 1986 revealed that 38.2 percent of the respondents had experienced the suicide of a patient. “Working through this loss is difficult,” explains M. Gorkin in the Bulletin of the Menninger Clinic, “because the therapist cannot expect to arrive at an absolute conviction about whether and, if so, when he erred.”
For a patient to lose a therapist to suicide can be equally devastating. “It is clear that when a therapist takes his or her own life we can anticipate clients’ short-term reactions to be of great intensity, including increased risk of suicide,” observes Edward Dunne in Suicide and Its Aftermath: Understanding and Counseling the Suicide Survivor. “We can also anticipate long-range reactions that may seriously impede functioning and possibly close off the patient’s accessibility to help from the therapeutic community.”
Wayne is a fifty-one-year-old business executive from San Francisco whose psychiatrist killed himself last year. “When I was laid off from my last job, I found myself at loose ends and decided to seek out counseling,” he says. “It was a very big step for me to admit that something was wrong, but I knew I needed help to get back some control in my life. My doctor was wonderful, practical yet empathetic. One day, after seeing him once a week for almost seven months, I got a call from his secretary telling me that he had died. I was shocked: He was a relatively young man and seemed in fairly good health. When I asked his secretary what happened, she started crying. She said he had jumped off the Golden Gate Bridge on Sunday, just before dawn.
“To be honest, my reaction was totally selfish. How could this man who was supposedly encouraging me to face my problems just get up and leave? And what was he trying to tell me by committing suicide: that life wasn’t worth it, so we should all just go jump off a bridge? His secretary offered to give me names of other psychiatrists so I could continue treatment. Forget it—there was no way I was going to expose myself to that again. Three months after my doctor killed himself, I was hired for a top management job at a leading pharmaceutical company. I then realized that even though my doctor had his own problems, the reality was that he had helped me regain much of the self-confidence I had lost when I was fired. Even though he must have been suffering, he did help me in many ways. I’m not angry now, just sorry at the death of such a good man. I guess we’re all human, after all.”
Regardless of our relationship to the person who chooses to commit suicide, the first step in the survivors’ journey of healing is the recognition that this final and irrevocable act will forever reverberate throughout every aspect of our lives. Yet, as time goes by, the crushing grip of our loved one’s decision eventually starts to ease, allowing us to honor his or her memory with even greater clarity.
“Each year, I find myself both more resigned and more at peace about my father’s suicide,” says Fran, a forty-seven-year-old nurse from a Chicago suburb. “But my mother still doesn’t admit that my father killed himself, even after eight years. She continues to insist that he was cleaning his gun and it misfired. At the beginning, I also tried to convince myself his death was accidental. But I can’t pretend anymore, not to myself and not to others. I have finally let air into my world, which was once sealed with secrets and lies. I feel I am giving my father the respect he deserves by acknowledging that his death is part of his life.
“After you called me, I told my mother I was going to be interviewed for a book about people who have survived the suicide of a loved one. She seemed surprised, asking me who we knew who had killed themselves. In the past, I would have said to her, ‘Your husband, for God’s sake. My father.’ But now I let my mother be. We’re all affected in different ways and we have to get through this the best way we can. It’s hard enough being judged by others without judging ourselves.”
With the passage of each anniversary of my husband’s suicide, I am overcome by the irreversibility and irrationality of his loss. Yet, now my mourning is colored and affected by the changes that have occurred in my own life during this inevitable passage of time. The gradual diminishing in the intensity of my grief stirs the promise of unexpected possibilities, of unknown options. Although this feeling of hope is mixed with an inescapable sorrow, it is hope, nonetheless. Tentatively, I embrace it, and welcome it home.