Tuesday, September 11, 2018

Challenging Conversations: After Asking if Someone is Thinking of Suicide

When survivors of suicide loss go to suicide prevention trainings, we fortify ourselves with information and strategies we wish we’d had when our loved one was in crisis. Often we're hoping to stumble on some stray piece of the puzzle that will unlock the mystery of their suicide. Sometimes we recognize our family member in the lists of risk factors and warning signs and the testimonials of suicide attempters; sometimes not. Sometimes we are triggered; sometimes numb. We’re spurred by the need to spread suicide awareness on the chance of saving a life, sparing another family our torment.  

At a recent conference, I learned more about how to talk to people who are suicidal. I was reminded of the two times I managed to ask my son Noah if he was thinking of suicide when he was suffering from major depression and anxiety disorder. Somehow I knew then that it was important to ask; what I didn’t know was how to respond to the answer.  

The first time I asked Noah about suicide, he scoffed and said he would never do such a thing. I was relieved, though I knew he could be bluffing. I assumed he meant that he valued life and knew how devastating it is to be left behind; he had felt bereft and betrayed after a close friend’s suicide at college.

The second time I asked was on the phone when he’d gone back to college with great difficulty a few weeks after a psychotic episode. He had already called twice to say he was coming home, then changed his mind. This time when I asked The Question, he paused and said, “not right now.”

To my great regret, instead of hearing him out, I went mama-bear ballistic on the phone. “That’s all the more reason you need to go back to the therapist and tell him what’s been happening!” I shouted. “Please promise me you’ll do that.” He never did, though he did call a previous therapist 3,000 miles away, who told Noah to see a psychiatrist immediately.

I know better now. I’ve learned that, rather than suddenly provoking thoughts of suicide, being asked if they’re thinking of suicide can be a relief to people who have not been able to express their thoughts. I’ve learned that a helper’s role in these horrifically challenging conversations is to listen calmly, without judgement or efforts to persuade. That’s almost impossible advice for parents—or for anyone who feels alarmed and protective with someone in crisis—which is why we have to practice these lines and make them our own, in readiness for when they might be needed. I’ve learned the difference between passive suicidal feelings (wanting to go to sleep and never wake up) versus active ones (intending to take one’s life), and the risk of having a general plan for the method of suicide versus a detailed plan (how, when, where). (You can read about a simple 6-step screening tool here.)  

After the conference, I sat down with pen and paper for an awkward do-over of that second exchange with Noah. With what I know now, some things I wish I’d said:

I’m really, really sorry to hear that. Thank you for telling me. I appreciate your honesty.

I love you; I want to hear what you’ve been going through. I promise to stay calm and listen.

That sounds really hard.

When you said you thought about suicide recently, was it just thoughts or did you plan to act on those thoughts? Did you know how you would do it? Did you start preparing?

We know you’ve been suffering terribly and we want to help you get healthy. We’re here for you, every step of the way. Let's talk about some ways to keep you safe.

Noah might have shut me down with, “Forget it, Mom, you’re not my therapist.” Or he might have opened up, even a little.

Might words like this have helped lead Noah away from the brink? I’ll never know. It’s too late for my family, but it’s not too late to inform myself and others so we can try to make a difference when someone is suicidal.
For Suicide Prevention Month and beyond, please: Know the signs. Find the words. Reach out .

Tuesday, August 21, 2018

Waiting for the Dove

I recently returned to a retreat center in the dry California hills where I first learned to pray.

It was 2012 and I was consumed with worry over my son Noah’s worsening depression. “Have you tried praying?” the rabbi asked and seeing my startled expression, offered a formula that seemed instantly right: May you be blessed with peace, joy, lovingkindness, compassion, and wholeness. The prayer became my mantra, calming my rising panic about Noah.
I revisited the retreat in 2013 after Noah’s first psychotic episode. And again in 2014 nine months after his suicide, peeled raw with grief and shock.

This year at the center, walking through the rustle of pepper trees into the silence of the hills, a new mantra fills my head: This is where I learned to pray. This is where I came after my prayers failed. This is where I still seek solace for my broken soul.
Because I'm still convinced it wasn’t really my prayers that failed so much as myself as a mother, unable to predict or prevent my child’s suicide. The burden of self-blame has lightened with time, shifting toward regret, but I’ll always carry it with me in some form.

Looking up from a yoga session at the retreat, I notice a Chagall print on the wall with a line from Genesis: And Noah sent out a dove. I flash tears. Our Noah was so bereft in the last year of his life that he didn’t have the faith or patience to launch a dove, wait for its return, and navigate to safety. Maybe if, like the biblical Noah, he had gathered up the animals he loved and held on… if he’d let their earthy smell and solid flanks brace him against the storm… if his beloved old Wags had still been alive for him to lay down beside—he would have felt the life force stream back into his heart.

“I wish Noah had stuck around long enough to find something that worked for him,” a good friend of our son told us. She struggled for several years before landing the right therapist and treatment. Now she seems transformed, both more hopeful and more wise. She had the good fortune to endure until the dove appeared—or until she could see and seize it.
The retreat is full of parents doting on their young children with full attention, like my husband and I once did with our boys. A father tries to contain his squirming toddler in his lap; a mother hunkers down on the carpet to draw with her five-year-old. They are, thankfully, oblivious to possible peril ahead. They don’t know that the most devastating, least foreseen danger for your child may come from within.  

I pray for these parents and for families everywhere, including my fellow suicide loss survivors: May you be blessed with peace and joy. And for those who, like Noah, feel trapped in desperate straits: May you find the strength to hold on. May you be visited by a dove that brings you back to yourself.

Sunday, July 22, 2018

Of Shattered Dreams and Rebuilding in Progress

I can’t get the haunting downward strains of Lamentations out of my head after hearing it chanted over and over at synagogue last night. It was Tisha B’Av, a lesser-known Jewish holiday that mourns the destruction of the ancient temple in Jerusalem. “The existential question of Tisha B’Av is not, ‘How mournful can we be?’”, writes Rabbi Noam Raucher. “Rather it is, ‘What can we rebuild after our hopes and dreams are left in shambles?’” Grievous loss contains the seeds and the imperative for renewal, he and other rabbis suggest, turning a curse, over time, into a blessing. 

I take this as a message to suicide loss survivors like me. It still pains me to remember how bereft I felt in the first few years, not only of my precious child but of our irreplaceable relationship and the dreams it carried.

What is a child to a parent but a dream embodied? From birth, we invest our kids with our hopes—scrawls on a blank slate, our best soil for the seed. They are everything we aspired to be or do, our comfort in old age, our stake in the future. We launch them into the universe not knowing where their dreams will land.  

I envisioned Noah emerging from the confusion and depression of his college years to find his passion, deep love and fulfillment. I yearned to feel close to him again, to resume our late-night conversations (even if sporadically), to share great food and art, holidays and vacations, life passages. I was excited by his young adult dreams of living in Europe and making films and all the as yet unformed dreams that would follow. 

When the dream that is a child dies, the act of dreaming dies with them. The garden lies barren; the launch pad, abandoned; our pathway, blocked under rubble. The whole edifice of what was and could be, of what we believed about love or life, laid waste. I don’t know what hurts more after suicide, the loss of our child’s hopes and dreams or our own. Maybe it’s having to give up both at once. I can’t bear to think of what it was like for Noah to lose hope that he would ever get better and, one by one, let go of his dreams.

Where do we want to go after we’ve sat in the ruins and let grief pour out of us? How can we crawl through the curse of suicide to come out on the side of blessing? Initially, I resisted the conventional wisdom of finding silver linings and new doors that open when others slam shut. I was still finding and grieving each dream that we’d lost in losing Noah. Meanwhile, new opportunities and compassion arose, opening a return to joy and a life of purpose.

This week marks a year since the publication of my book, I’ll Write Your Name on Every Beach: A Mother’s Quest for Comfort, Courage and Clarity After Suicide Loss. I had always aspired to write a memoir but never expected that it would be about the end to all my child’s dreams. My book and book talks have widened my world and put me in touch with many people in the past year, from fellow survivors to concerned therapists, from young mental health advocates to spiritual seekers. I’ve felt the release of baring tender, vulnerable parts of myself that others can honor and recognize in themselves. I’ve been showered with love by friends and strangers. The sweetest praise I’ve had is that the book is a tribute to Noah and that for one new suicide loss survivor, reading it was “like getting a big hug.” 

As I continue to promote the book, I’m expanding my public speaking to bring suicide prevention information to as many people as I can. With young people, I want to spread the message of “be a lifeline” for others and, if in distress, “stay” --for the sake of your dreams and your future self. With parents, schools, and faith communities, I want to help nurture youth resilience and understanding of suicide risk and response. 

These are my new dreams for the moment, along with continuing to write in the key of grief and see where it leads me. The new dreams will never replace the ones I had for Noah, but they are a sign of rebuilding in progress.

The Three Weeks of mourning in the Jewish calendar, capped by today’s holiday, are followed by Seven Weeks of Consolation. I’ll try to keep that proportion in mind.

To my fellow survivors: What dreams have you had to set aside? What new dreams may be starting to form? Take note of any sign of rebuilding, no matter how tentative, and take heart.

Tuesday, July 10, 2018

Why I Cried at the Triplets Movie: Please Don't Blame the Parents

Image result for three identical strangers trailer 
SPOILER ALERT: If you plan to see the documentary, Three Identical Strangers, you might want to read this post after you see it or, as the reviewers say, “tread carefully” below.

Three Identical Strangers is a widely acclaimed new documentary about adopted triplets who were secretly separated at birth and reunited by chance at age 19. It’s meant to stoke audience rage at an adoption agency and research team that misled and manipulated families for the sake of a psychological study done under false pretenses. I found myself raging instead at the film’s cavalier treatment of mental illness and suicide, feeling attacked as the mother of a young man who died by suicide. A young man who could have been kin to these triplets with his curly dark "Jewfro" and radiant smile.

There are hints of the film’s dark undercurrent amidst the bubbly story of the triplets’ reunion: can such elation last? With a middle-aged Eddy absent from the interviews, I began to sense that he was either in prison or dead. When someone mentioned depression, I knew where we were heading even before I heard “bipolar” and “psych ward.” Like too many people with mental illness, Eddy took his life soon after being discharged from a hospital. The film briefly registers Bobby and David’s dismay, just as it briefly notes that the triplets had had psychiatric problems as teenagers. We’re given few details on Eddy’s mental state and how it compared to that of his brothers, whether at 15 or 35.

How do people become who they are? The film poses the question but barely explores answers. While the first part highlights the triplets’ similarities in spite of their different home environments, the second part stresses their differences—the implied health and success of Bobby and David, the failed life of Eddy. The story seizes on Eddy’s strict, presumably unloving father as the source of the young man's problems. It was David’s warm, gregarious father who all the triplets loved and who kept the peace among them in adulthood; Bobby’s father was a busy doctor who was less present but benign. By contrast, Eddy’s father, puttering around with his bony face and wild hair, looks lonely and clueless. A former teacher, he tears up as he wonders if he missed teaching Eddy something that would have kept him alive. As other interviewees weigh in on the primacy of nurture over nature, the message is clear: The triplets started life with the same nature, but nurture made them who they were. Eddy killed himself because of bad parenting.

This tidy moralizing reinforces stereotypes about mental illness, and especially suicide, as rooted in family dynamics rather than in  a complex mix of biochemistry, stress, and other environmental factors. This misrepresentation does a disservice to suicide loss survivors everywhere, especially parents who have lost children. It left me in helpless tears as the credits rolled.

Among the questions left hanging: How did Eddy’s suicide affect Bobby, David and other family members in 1995 and beyond? How did Eddy’s smiling wife and their children manage in the aftermath? Did the suicide drive a wedge between the two surviving triplets? Did the film not dwell on the suicide because Bobby and David were reluctant to discuss it? At the premiere at Sundance, when Bobby and David got sympathetic hugs from the audience, did anyone offer condolences for the loss of their brother?

I doubt that many people noticed the treatment of suicide in this fast-paced, many-layered film. I can't help seeing it through a lens tinged with grief and regret and ever wary of misrepresentation. Maybe I’m more sensitive to the poor parenting trope right now because I’ve been reading Sue Klebold’s memoir about surviving her son Dylan’s murder-suicide at Columbine High School in 1999. She received hate mail and messages for years, accusing her of being a bad mother for not knowing what her son was planning. She takes pains in the book to show how “brain illness” can happen in any family and how love and attentive parenting may not be enough to prevent tragedy. More on Klebold in a future post ...

To my fellow survivors: What did you think of this film or of others you’ve seen that deal with suicide? Am I over-reacting? I’d love to hear your thoughts below or privately by email.

Thursday, June 28, 2018

Juggling Joy and Sorrow on Noah's Birthday

Today is Noah’s birthday, what should have been his 27th

Last Sunday was Juggle Fest! 2018, a festival in memory of Noah organized by my husband, Bryan, and the South Pasadena Juggling Club. Noah was a fanatic (and fantastic) juggler from about age 9 to 14 and a founding member of the club. He learned how to juggle from Bryan and forced himself to master the skill by juggling three balls 100 times until he could do it without dropping. He learned tricks effortlessly, especially complicated passing patterns. He reveled in camaraderie with people of all ages at festivals and workshops. 

Juggling gave Noah a fun activity to do anytime, anywhere (Parthenon, anyone?) with his brother and dad. It gave him an identity and a way to be involved in his community when he juggled at shows, parades, and a hospital children’s ward. It even gave him a topic—persistence--for his college application essay. 

It was riveting to watch the joy and fluidity of his juggling. And bittersweet at Sunday’s festival as we shared memories of Noah’s juggling days with the crowd in a speech and slide show. You can see some slides and short video clips of Noah juggling here

This morning Bryan and I walked to Noah’s favorite doughnut store. I was mulling over other things I might do to remember him, like look at photos he took on his travels or attend the Women’s March, when an old friend called with terrible news. Her daughter, 29, took her life yesterday amidst an onslaught of health problems. How is it that this horror keeps happening, cutting down young lives and laying low a whole circle of people around them? I hope I can be a companion in grief for my friend as she so sensitively has been for me these five years.

For everyone who is hurting from suicide loss right now: I'm thinking of us as I admire two newly opened sunflowers, turning toward the sun. Let's help each other keep turning toward hope and light.

Friday, June 22, 2018

The Surround of Silence

If past celebrity suicides are an indication, all the noise about suicide and suicide prevention of the past few weeks will soon subside into the usual uncomfortable silence that surrounds the topic. “This silence about suicide can be deafening,” writes Stacey Freedenthal on Speakingof Suicide , “making it exquisitely hard to hear those whose cries most need to be heard.”  

In the five years since losing my son, Noah, to suicide, I’ve learned there are many varieties of suicide silence. Most often, it’s the silence of stigma that needs to be broken, again and again, so that it’s no shame to admit to suicidal feelings and seek help. We need to Send Silence Packing, as the organization Active Minds signals with its exhibit on youth suicide that travels to college campuses. The huge collection of backpacks represents the 1,200 American college students who die by suicide every year, including Noah in 2013. I gazed down on the exhibit last month from a terrace at UCLA, sobered by the many long lines of backpacks radiating across the lawn. Up close, other visitors and I browsed among the photos and stories of young people attached to each pack. Some accounts were upbeat biographical sketches; some, anguished outcries—each story different and tragic. Between the packs were signs from Active Minds, which works to destigmatize mental illness on college campuses: Seeking help shows strength. It’s OK not to be OK. Keep asking and keep searching until something helps; something will. Your story isn’t over yet.

What if this exhibit had been on view at Noah’s college? What if he’d strolled by and leaned down to read about a student whose desperation reminded him of his own? Would he have been emboldened to tell us about his terrifying anxiety attacks or to tell a therapist that he was feeling suicidal? My hunch: not likely. I think he would have avoided the exhibit, fearing exposure or another anxiety attack. He would have walked right past posters with crisis line numbers, though secretly, he may have longed to call them. As he told me a month before his death, he felt he should “man up” to his problems. Many young people who are struggling agree, though surely campaigns like Send Silence Packing give many others the courage to speak up and seek help.

What if Noah’s friends had seen an exhibit like this or called a crisis line to voice their worries about him? I’m grateful to his hometown friends who contacted me in concern when Noah was having a psychotic episode. What if they’d broken the code of silence with my husband and me before it was too late—before the once exuberant, adventurous, witty conversationalist that we all loved sunk into alarming silence? Better a mad friend than a dead friend, youth suicide campaigns insist.

Then there are the forms of silence that come after a suicide. The helpless silence of friends and family who don’t know what to say to the mourners, especially after a child’s suicide. Though honest and well-intentioned, “there are no words” can feel hollow to loss survivors; try asking us instead how we’re taking care of ourselves or if we’d like to talk about what’s on our mind. Or give us a hug and sit or walk beside us in shared grief and loving silence.

Incredibly after five years, there is still the dismaying silence of relatives who can’t speak Noah’s name or reminisce about him at family gatherings. They fear that doing so will upset Bryan and me by reminding us of the tragedy, when, in fact, it’s their silence that upsets us and we need no reminders for what is always in our hearts.

And of course, there’s the inexcusable silence of public policy and medical research on the tenth leading cause of death in the U.S. And the baffling silence of media on how gun violence results in nearly twice as many suicides as homicides in this country. We need to lift the weight of all this silence with information and support, research and advocacy, compassion and understanding—a sustained national conversation and action plan. (Kudos to CNN for hosting a one-hour town hall, “Finding Hope: Battling America’s Suicide Crisis,” this Sunday, June 24, 2018, 7pm ET, both on cable and streaming live on CNN.com, with an impressive panel of guests.) 

Like many fellow survivors, I’m helping promote more informed public conversation around suicide while still haunted by the most private of silences: When our loved ones didn’t tell us how much they were hurting. When we didn’t ask if they were suicidal, or did and fumbled our response. Worst of all, the endless silence that reverberates after they’re gone.

Sunday, June 17, 2018

Too Much Suicide

Suicide seemed to be everywhere the first week of June. Not one but two beloved celebrity suicides dominated the media, prompting soul-searching and tweets of “RIP” and 24-hour crisis line numbers. I purposely didn’t overload on the media coverage, partly because I barely knew the work of Kate Spade and Anthony Bourdain. I heard about some irresponsible stories that focused on the means of the suicide and used the term “committed suicide” rather than “died by suicide”—both counter to suicide prevention media guidelines . But the media pieces I saw were thoughtful and compassionate, stressing the importance of help-seeking and putting a face on suicide by giving voice to those who struggle with suicidal thoughts, as well as suicide loss survivors both famous (Karl Rove!) and not so famous. 

At the same time, the CDC released a new report on a 25% increase in the U.S. suicide rate since 1999. This brought broader context to the deaths of two famous people and a factual basis to a national conversation that needs to be urgent and ongoing, rather than sporadic. Because we should be saddened about the other 862 Americans who take their lives each week and turn that sadness into policies and programs that give suicide—the tenth leading cause of death in the U.S.--its due as a public health crisis. 

Friends gingerly wondered if I was having a hard week. I was, but not because of the media frenzy. It was a hard week because I was immersed in suicide for too many hours each day. I attended three suicide-related meetings, where everyone was processing the public deaths, the media coverage, the people they knew who had been triggered. I was working on a project that involves reading and editing articles about suicide loss. I was emailing a dear friend whose daughter had just lost a middle-aged aunt to suicide and planning a dinner for new friends whose son’s death anniversary is this week. And I was slogging through messages on a suicide listserv that had accumulated while I was out of town. As I’ve become more involved in suicide prevention, I’m learning that I need to dose myself by limiting the time that I focus on suicide —just as loss survivors need to “dose” our bouts of grieving when it becomes overwhelming. I also need to take care that I’m not over-compartmentalizing by tamping down my own reactions. 

In the early months after losing my son, Noah, any news of suicide could be traumatizing. It was scary how much suicide there was in the world. Still raw with pain and obsessed with my loss, each well-publicized suicide seemed to magnify my own private nightmare. But over the past few years, as grief has become more integrated into my life, my mind has filled with other emotions and preoccupations. I can still be triggered by talk or images of suicide—I had a terrible flash of the scene of Noah’s death about a week after Bourdain's death--but the upset is more fleeting. 

Maybe friends and family of survivors worry about us when there’s a media frenzy over suicide because it reminds them of what we can never forget. 

To my fellow survivors: I’m sorry if recent suicides in the news have made your loss even harder to bear. Let’s hope these stories open up conversations with others who sincerely want to help and understandand spur action to save lives and spare other families.