Friday, September 27, 2013

What We Don't Know Hurts Us

I finally had the guts to start reading Iris Bolton’s classic suicide loss memoir, My Son . . . My Son. . . (Even the title makes me cry.) Bolton became a suicidologist and a founder of the suicide survivor support movement. So far, halfway into her 1983 book, she does not insist that suicide is caused by mental illness, like so much of the literature today. Rather, she says it’s complicated with many contributing factors. 

This rings true. Because at the same time that the literature claims that more than 90% of suicides can be traced to mental illness, it also notes that the vast majority of people with mental illness do not take their lives. So there must be more to the story.

Lately I am convinced that in addition to the effects of untreated mental illness, N died from fear, shame, and ignorance. Fear of failure at college and at making his way in the adult world. Fear of another debilitating anxiety attack. Fear that he was losing his mind and would lose control of his life if he went the route of doctors, medications, and hospitals. Shame at the prospect of being mentally ill and needing medication. Shame that he was unable to “man up” to his problem and that others (“everybody at college”) knew something was wrong with him. 

The ignorance belongs to all of us. To N about the possibilities of managing depression and anxiety and riding the ups and downs of young adulthood. To us his family about the nature of major depression, the severity of N’s despair, and the warning signs for suicide risk. To some of his friends who, like him, believed they could handle psychological crisis on their own without involving parents or professionals. To professionals, who—like family and friends-- only saw one small part of the elephant that was consuming N and did not consider him a suicide risk. To the fields of psychology, psychiatry and public health that still know so little about suicide and how to prevent it.

I know now that my own ignorance arose from fear of what I might learn. Why else would I start looking up bipolar disorder and psychosis online, only to stop after 30 minutes when it became too scary and confusing? Why wouldn’t it even occur to me to look up suicide risk? My ignorance also came from assuming too much and seeing my son through the cloud of those assumptions. I assumed that I knew enough about depression and mental health. I assumed that, like me, N could experience depression and still function in the world with his life force intact. I assumed that, like me, being exposed to suicide at an early age would make him stronger and more determined to live a good life. (I lost my father to suicide when I was 26; N lost a close friend to suicide when he was 19. More on this in future posts.) I didn’t know that major depression could be a terminal disease or that losing a loved one to suicide elevates one’s own risk for suicidal thoughts and acts. 

And the most profound and troubling ignorance for a parent: I didn’t know about my child’s inner feelings and psychiatric history—the many things he didn’t tell us that we only learned in our desperate investigations after his death. And even more things we still don’t know and will never know about what he was thinking and feeling.

My therapist says you can only know what you know at the time; you cannot read your child’s mind, especially when they are a rebellious young adult; we are none of us all-knowing. Yes, I know this in some corner of my mind. But what we don’t know hurts us, even destroys us.

The other day I went to a lecture on depression sponsored by the local chapter of NAMI (National Alliance on Mental Illness). I learned how much I didn’t know and how determined I am now to know more and ensure that others know more. If I had been sitting there at NAMI a year ago, would it have made a difference? In my behavior and understanding, I hope, yes. In N’s behavior, we can hope but never know.

Tuesday, September 17, 2013

No Silver Linings but Maybe Gifts

“Don’t let anyone tell you there’s a silver lining, because there’s not,” warned my doctor, of all people, a few months after N’s suicide. I appreciated her frankness. This was not meant to be, N is not in a better place, and this was not all for the best. He is not resting in peace and we the survivors are certainly not at peace with his death. There is no up side to this suffering. Even if there was, we would reject it because we don’t want to benefit from our son’s suicide. For my husband, that extends to reluctance to make  donations in N’s memory, lest something good come of this disaster. I don’t have a problem with donations, but I understand the ambivalence.

In the suicide loss literature and in my survivors’ support group, more seasoned survivors emphasize the “gifts” that this experience can bring. Presumably, they do this to give themselves and the rest of us hope—and that is no small thing. The gifts, or blessings, may not be easy to recognize at first, says a group facilitator, but they will come and they will be part of your healing. Intellectually, I can see that some survivors rebuild their lives to be more fully present, mindful, and compassionate, with a more urgent sense of the fragility and preciousness of life. Through support groups, conferences, and crisis lines, they meet a new community of friends with whom they share a deep and instant bond. Of necessity, I’m guessing, they grasp for and find a new lease on life. Over time, they are grateful for the changes in their lives—and maybe that is the real challenge of being a survivor, learning to find a way back to gratitude. All this gives them hope rather than dread for what lies ahead.

“The jury’s still out,” says my husband doubtfully. Six months after N’s death, I’m not counting on any magical transformation or even counting my blessings.  And yet, I notice change.
Once someone who projected strength and confidence, I have been showing my vulnerability and sharing my feelings more openly with others, including strangers. With this blog, I have found a new vehicle to pour out my heart and recapture my love of writing. I have stumbled on support in unlikely places, with fellow survivors, distant relatives, old friends I hadn’t spoken with in months or years, and at unexpected moments. 

These changes have happened as part of grief work. They will never make up for the horror of N’s death and the sinking sense of despair when I think of losing him. But they make sorrow a bit more bearable, the future more conceivable. And maybe they count as blessings . . .

Wednesday, September 11, 2013

Approaching Yom Kippur: On Sin & Forgiveness

On Yom Kippur, I will join with Jews around the world in the Al Chet prayer, striking our chests as we confess collective, potential sins and ask for pardon. In Hebrew, the word for sin literally means “missing the mark”--a gentler, less alienating concept that can encompass all sorts of behavior. This year, my son’s abandonment of life and my failings toward him both feel so far off the mark that the gentler wording seems a euphemism. When one is so weighted with remorse, only the powerful, classic notion of sin is fitting.

The first step in repentance, during the 40 days preceding Yom Kippur, is to face and name our failings. I have been endlessly cataloging my personal Al Chet for N in lists of the many things I failed to do in the last months of his life. I have cried out these sins to N at his grave and elsewhere, though I don’t yet sense any listening presence. The list only seems to get longer as I grasp (or at least intuit) more of N’s suffering.

The next step is to seek forgiveness from the people we have wronged. As poet Marge Piercy writes in “Head of the Year”: Now you must void yourself/of injuries, insults, incursions./Go with empty hands to those/you have hurt and make amends./It is not too late . . . In the past, I wrote notes to my children for this purpose. They never responded, but N treasured the notes enough to save a few in his box of memories; I will have to take that as his answer. One of the hardest things about suicide loss, especially with a rebellious young person, is that we lose the chance for future forgiveness and reconciliation—the validation parents hope to get once the fog of adolescent anger lifts and adult children can look back more calmly on their upbringing. I will never have that conversation with N, the chance for reconnection and redemption. The chance to work out old hurts over a lifetime of relationship.

Now, I am the only one who can forgive myself. And I am not ready. All I can do is listen to teachers like Rabbi Joseph Telushkin, who suggest that we balance the traditional accounting of sins in the liturgy with an alternative prayer detailing all the good we have done in the past year. Slowly, I can add to the list of what I gave N  as a mother over the year, over the years until I am more ready to let go of self-blame.

As for forgiving N for leaving us at this time in this way, the task is formidable and it is far too soon. I do not believe that suicide is a sin in the sense of a moral breach that must be punished and anyone associated with it ostracized; to believe that is to perpetuate the deep-rooted stigma that still plagues suicide survivors today. Yet at the moment, suicide feels like a crime against humanity, a violent upending of the natural order and perhaps the worst hurt anyone can inflict on their loved ones. Like murder, the act is irreversible and there is no way to make amends. Blogger Marjorie Antus, in Mary’s Shortcut, writes eloquently of how long it has taken to understand her daughter’s state of mind that led to suicide: “Knowing has given rise to forgiveness that I think, after 17 years, is finally in place.” So I may be forgiven for not being ready to forgive after only five months!

As I approach this first Yom Kippur since N’s death, this first step toward the hardest act of forgiveness I will ever face, I take courage from a Benedictine nun quoted by Antus: “Only if we can care for another enough to try to understand what drove the behavior that hurt us so, can we put our own pain down long enough to forgive. Forgive is what we do when our love is as real as our pain.”* N and others who take their lives could not put down their pain long enough to see the consequences of their actions or the possibility of another way out. Will we, too, as survivors continue to be blinded by pain?

* From Chittister, J.D. (2004). Called to Question: A Spiritual Memoir. Lanham, Maryland: Sheed & Ward.

Friday, September 6, 2013

One Incredible Thing: For World Suicide Prevention Day 9/10

Amidst the shock and grief of the first days after losing our son, Noah, age 21, to suicide, there was one incredible thing: A friend was in the airport when she heard the news. After crying and talking loudly on her cell phone trying to make sense of what had happened, she was approached by a teenage girl with blue hair and multiple tatoos, who gave her this note penciled inside a heart (names have been changed):

Hello there. I know I’m just a stranger in the airport but I’m writing this to say hello… I’m Allie, 15, going to be 16 in July… I heard your story; indirectly you have given me the will and drive to live… I’ve suffered from depression a while and at times was suicidal. I recently lost my step-dad, I’ve never known my real father. I would frequently self-harm and thought no one would care if I was alive or not… Seeing others mourn in a situation that could have easily been my own made me realize how valuable my life REALLY is… so thank you… Sorry if this is strange but I wanted to say thanks. You’re beautiful. –Allie

This message from a stranger was the only gleam of hope in a desperate time, and we seized on it. My friend read the note aloud at Noah’s memorial. We’ll never know if Allie’s change of heart was lasting, but we know that the suffering she heard in our friend’s response to suicide gave her a glimpse of the devastation that follows for survivors. And that, in turn, reconnected her to the living. 

Five months later, I realize how intertwined suicide loss is with suicide awareness and prevention. The rabbi’s eulogy at Noah’s funeral, which spoke frankly of depression and suicide, became a quick lesson for many people present. The few words I managed to write for the memorial at Noah’s college urged his friends to cherish their lives and reach out for help when in despair. I am heartened that as part of World Suicide Prevention Day, Tuesday, September 10 at 8pm, people around the world will be lighting a candle in the window to bring attention not only to suicide prevention but to those who died by suicide and those left behind in the wreckage. 

As survivors of suicide, we are beset with endless “if only’s,” desperately rescripting our loved one’s last minutes, hours, days. Instinctively, we want to insert ourselves and somehow block the hand that would take its own life—if not our own child’s, then someone else’s child. To say, especially to the young, who lack the life experience to know that moods can be managed and that calm can follow the storm, “It doesn’t have to end this way. With time, with help -- it gets better.” To say, especially to young men, “You don’t have to ‘manup’ to your problems. There is no shame in getting help.” If we couldn’t change the trajectory for our own loved one’s life, maybe, at least, we can shift it a bit for someone else—like Allie.

Some people told me, along with “there was nothing you could have done,” that “there was nothing anyone could have done.” They believe that when someone is determined to die, there is no stopping them. I don’t know much yet about suicide prevention, but I have to believe that there are points along the path to taking one’s life when many people could have potentially made a difference. The challenge is to reach out and connect while those at risk can still hear, feel, and love—before they are complete shadows of their former selves. 

People at risk for suicide and their friends and families need to hear the voices of those left behind, like Allie did in the airport. Every panel on suicide awareness at high schools and colleges, hospitals and libraries should include personal testimony, especially by young people, about suicide loss. Every suicide prevention web site should have links to the cries of anguish in suicide survivor blogs, web sites, and memoirs. Some of my treasured parent survivor blogs, found through the excellent resources on Franklin Cook’s Grief After Suicide Newsletter are the beautifully designed and written Lala’s Mom: Life After the Suicide of a Child  and the wide-ranging, reflective Mary’s Shortcut: About Suicide Bereavement  

September 10 Suicide Prevention Blog Day Badge
To learn about more blogs related to suicide awareness and prevention, as well as suicide loss, check out the Blog Day for SuicideAwareness & Prevention web site, sponsored by the USC School of Social Work. And please light a candle in your window on September 10 at 8pm.