By Dr. Micaela Wexler
Sadly, as a rural psychiatrist, I have heard several versions of this question. Each time I have heard it, it has been a painful reminder that there really is not much support for families who have lost a loved one to suicide, especially in the rural setting.
When a family loses a loved one to suicide, each member experiences the trauma in their own way. The father might be numb, and in denial. The mother can be incapacitated by her guilt and loss, fearful of losing her remaining children. And, the siblings may be angry; I have heard more than one sibling express a common, and untrue myth about suicide: that the person was motivated by selfishness, and did it to intentionally hurt those left behind.
My patients who have lost a child to suicide are the most bewildered people I have encountered as a psychiatrist. I have tried to put myself in their shoes, and have found those attempts nothing short of overwhelming. I feel I would be pulverized if such an event happened in my life; I would not be able to keep from blaming myself. I don’t feel I would be able to continue living. These are the very thoughts that these parents have shared with me, in the immediate aftermath of a child’s suicide.
However, as a psychiatrist, I know that with the proper support, these thoughts will pass as the parents heal. I have watched parents survive this most horrible of events; I have been a witness as they have made the journey through their grief and learned to live again; I have watched as the healing allows them to eventually continue to advocate for their child by increasing society’s understanding of this monumental problem.
“Where did I go wrong?”
Parents feel a deep sense of guilt, both their own guilt and the guilt which society puts on parents. The guilt is incapacitating in those early days. Mothers will spend hours upon hours day after day trying to go over every single decision they have ever made regarding their child. They will reach far into their history, examining even the most trivial events. Their surviving children will have little patience for this, most likely because it is painful for them to see their parents punishing themselves. Or, they will feel resentful that so much attention is being given to the one child. Hearing their parents express this guilt makes surviving children even angrier at their siblings for doing something so “selfish.”
Surviving siblings are in need of support themselves, and will naturally turn to the people, their parents, they have always turned to first in times of great need, only to find these people completely unable to help them. In those early weeks, it would be ideal for siblings to turn to someone other than their parents for support, and for parents to find someone besides their surviving children with whom to share their grief. However, suicide carries such an immense stigma that it is rarely possible for families to do what is ideal. What happens instead is the surviving family members turn to the only people available, which can result in them further injuring themselves and each other.
This is one of the most common questions a psychiatrist will hear. Parents will look for any clue possible to explain why their child did this. Their deep need to answer this question will cause them to overburden their surviving children, convinced they hold the key to this secret. This pushes the surviving children, who have not had time to process the loss themselves, to come up with an answer: selfishness. And, so one of the more destructive myths about suicide is given more life.
These families need to learn as much as possible about suicide, so they can understand the true causes, and stop blaming themselves. What I have learned as a child psychiatrist about suicide is that the “why” has nothing to do with selfishness, and everything to do with deep, emotional pain. Research on suicide has shown us that the person has to become sufficiently accustomed to pain to be able to consider something most of us would find too agonizing to carry out. This pain has many sources.
With time, parents will come to understand that they were not, could not, have been the source of so much pain. As a psychiatrist who provides emergency psychiatric care, I treat suicidal patients on a regular basis. What I often hear is that the parents are one of the few sources of comfort in their child’s life.
“What did I miss?”
Parents are convinced they should have seen the signs. Even parents who sought psychiatric help for their children for many years believe they should have been able to prevent their child’s suicide. This causes them to become frightened of “missing something again” with their other children.
Suicide is partly the result of irrational thinking, and this thinking leads children to believe they are causing too much suffering to their parents by being alive. Mental illness carries such a stigma that some people feel their parents are over burdened from having a mentally ill child, and will feel relieved when that child is gone. In their efforts to spare their parents more pain, these children will do everything they can to hide their plans, and their pain, from their parents. I have had suicidal patients in great emotional turmoil tell me they feel good only when they are with their parents, and will genuinely show no signs around them for this reason.
Another sentiment my suicidal patients express is a feeling they are a burden to their parents. This is especially true of gay teenagers who are not out to their parents: they feel they are too great a source of future pain to their parents, which contributes to their suicidal feelings.
With time, as they go through the grieving process, many parents come to understand that they truly were their child’s best, and many times only, advocate. Parents need the space and support, as well as knowledge about suicide, to make this important realization.
“They gave him everything they had.”
The financial toll on parents is a topic I have seen seldom mentioned among my psychiatric colleagues. The costs come from many sources. Chances are the family member lost to suicide was already receiving psychiatric care, placing a financial burden on the parents. The rescue attempt itself can result in astronomical medical costs, especially if the suicide is a teenager or young adult, since every effort will be made to save the patient.
In the case of one family I was familiar with, the suicide (which occurred years ago) took place by gunshot, in the home. That family faced costs in the clean up. The home lost value due to a suicide taking place there. This was compounded by the family’s inability to properly maintain the home during the grieving process. Most people who commit suicide have a compromised financial situation: they generally do not leave assets, many leave behind significant amounts of debt, and surprisingly few have insurance, including burial insurance. The parents are also left with one less child to share in the costs of their care in their later years.
If the surviving family members are able to heal and stay together, ie, adult children moving back in with parents, this has the potential to soften the financial blow. This is one of the advantages families in the rural setting do seem to have. The loss of value to the home will not be as relevant if they are all able to continue living in it for an extended amount of time. With time, they will form new memories in their home, and it will stop being a house where someone shot themselves and become, once again, a home where a family lived, and loved together.
Support in the form of therapy, education and medications, if needed, will go a long way in helping a family properly heal. This, unfortunately, is often in short supply in the rural setting. This is unfortunate because family members who have been given proper support and treatment are society’s greatest hope in helping to prevent future tragedies.
If you have lost a child to suicide, regardless of your child’s age, I highly recommend the following web site: childsuicide.org It is the best resource I have found online for parents dealing with this tragedy.