Erica - 'And Still, Echoes of a Death Long Past'

by Erica Goode

Erica - 'And Still, Echoes of a Death Long Past'

The author, left, in 1956 with her sister, Lisa, and father on Glen Lake, Michigan.

I was 7 years old when my father took his own life, crashing our light-blue Buick into the concrete piling of a highway bridge between Ann Arbor and Detroit.

It was early on a Sunday morning, the 30th of October, 1960.

There was fog, but the pavement on the highway was dry, according to the sheriff's report, the road straight and level. The car's speedometer, the patrolman noted, was stuck at 95 miles per hour.

My memories of that day are a series of hazy and fragmented images. My father saying goodbye when I called out to him. The telephone ringing. My mother screaming. The horse show I rode in that afternoon, my sister, nine years older, a dazed chaperon, under strict orders from my mother not to talk to anyone about what had happened.

The word suicide was never spoken, though there were whispers, I later learned, in the corridors of the university department where my father was a professor. Obituary writers speculated that he had suffered a heart attack, or had fallen asleep at the wheel.

For a very long time, nearly two decades, my mother told no one—not her children, not her brother and sister—that my father had killed himself, that she had found a note that morning and quickly destroyed it.

Yet as I grew up, the mystery of my father's death defined my life in many ways.

Each year, as the anniversary approaches, I find myself, almost by habit, turning over the same questions, knowing that they have no satisfactory answers.

A SUICIDE is as much a prelude as an ending.

More than 29,000 Americans kill themselves every year. Each death forcibly derails the lives of parents and children, partners and siblings, hurtling them into unfamiliar and sometimes perilous territory.

But the study of suicide has for the most part been devoted to those who choose to end their lives, not to the survivors, those left behind. Only recently have researchers begun to investigate, in a systematic fashion, the effects of a death from suicide on family members.

"Survivors were always seen as a source of information about suicides, but few studies looked into the problems that survivors were having," said Dr. Herbert Hendin, then medical director of the American Foundation for Suicide Prevention, which joined with the National Institute of Mental Health in May in convening experts to assess the state of research on suicide survivors, the first meeting of its kind. The report from the conference was released in late September.

The narrow focus of scientists is in some ways not surprising. The act of self-destruction compels attention. It is, as Dr. Hendin noted, "the more dramatic tragedy."

Yet the lack of knowledge about how the survivors cope and grieve, how they change as they absorb their loss, also reflects a wider public discomfort with the subject of suicide.

Well into the 19th century, taking one's own life was considered a grievous sin. By the time my father died, the taboo had lost some of its religious undertone. But suicide was still viewed "as something shameful to be avoided and tidied away," as the writer A. Alvarez put it in his 1970 book, "The Savage God."

My mother, who died last spring, kept silent in part for fear of what people might think. Even in later years, when she was willing to answer question's about my father's death and the depression that had kept him home from work in the weeks before he died, she warned us not to talk about such things with outsiders. She was stunned several years ago to discover that some family friends had always suspected that his death was not an accident. She would not have wanted this article to be written.

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For a very long time, nearly two decades, my mother told no one—not her children, not her brother and sister—that my father had killed himself, that she had found a note that morning and quickly destroyed it.

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Mental illness has now become the stuff of best sellers. Celebrities talk openly about their experiences with depression, eating disorders or other psychic ills. And the social taint that attends suicide appears to have faded slightly.

"There is, I think, a general recognition that suicide is related to psychiatric illness," an awareness absent 30 years ago, said Dr. David Brent, a child and adolescent psychiatrist at the University of Pittsburgh.

Dr. David Satcher, the former surgeon general, in many experts' view, contributed to this awareness by designating suicide "a serious public health problem" in a 1999 report.

But the stigma is not entirely gone, nor are the misconceptions.

Suicides, Dr. Brent and other researchers say, rarely "just happen." More than 90 percent of suicide victims have a history of depression, drug or alcohol abuse or another mental disorder.

Yet when a suicide becomes public, when a college student leaps from a building or a British weapons expert's body is found, wrist slashed, a package of painkillers by his side, blame is often assigned to a single precipitating event.

Suicides are still hidden. They are omitted on medical history forms. They are spoken of sotto voce. In their aftermath, people become awkward, uncertain what to ask, what to say. No one wants to pry.

It is understandable. But the hesitancy of others can isolate a bereaved family, or worse, be taken as a judgment, proof of a wife's inadequacy, a parent's mistakes.

"Even people who are educated and enlightened and have healthy attitudes about mental health problems feel terribly embarrassed, terribly responsible," said Dr. David Clark, a professor of psychiatry at Rush Medical Center in Chicago.

It is perhaps because of this that survivors sometimes go to great lengths to deny a suicide, even in the face of persuasive evidence.

Dr. Hendin recalled the case of a teenager who had been using drugs. The mother accepted her son's death as self-inflicted, he said, but "the father thought that a drug dealer shot the boy and put the gun in his hand to make it look like a suicide."

THE year after my father died, we moved into a smaller house in town. My sister, Lisa, went off to college. My mother went to work as a secretary and rented a bedroom to a series of young women who served as part-time baby sitters.

Sometimes she would scream in her sleep and I would go in to comfort her. She raged at small things, a dropped plate, a perceived slight. She became exquisitely attuned to noises -- car horns, backfires -- outside the house. For a while, she kept an unloaded shotgun under her bed.

At school, I grew angry when teachers said they were sorry about my father. "Why are you sorry?" I would shout. "It's not your fault." Later, if people asked, I would say "a car accident." Yet I sensed the incompleteness of the answer, its failure to adequately explain the complexity of the emotions that suffused our household.

I fought my own rounds with depression. Like many adolescents, I became enamored of suicidal poets, a devotee of Sylvia Plath, John Berryman, Anne Sexton, a convert to the romantic mythology of self-destruction that much later would draw unhappy teenagers to Kurt Cobain or Elliott Smith, the singer and songwriter who died last week, an apparent suicide.

I admired the purity of the act and its power. I felt its seductiveness. It did not occur to me to wonder about the parents and the spouses left behind. Or the children.

ALL deaths leave their mark. But studies suggest that the psychological legacy of a suicide may differ from that of other deaths.

"Suicide flies in the face of people's beliefs abut how life is and how it operates," said Dr. John Jordan, the author of a 2001 review of research on suicide survivors and the director of the Family Loss Project, a group based near Boston that conducts research and offers treatment to the bereaved.

"Survivors spend a great deal of time trying to figure things out," Dr. Jordan said. "What was the person's frame of mind? How could they have done this? Who is responsible for it? What does it mean?"

Some people pass through a normal grief process and heal quickly.

But studies suggest that suicide survivors often experience more guilt, rejection, shame and isolation than those who grieve other deaths. If they have spent years dealing with a relative bent on an escalating course of self-destruction, they may also feel relief.

Some studies have found that family members bereaved by suicide feel worse about themselves and are viewed more negatively by others. In a 1993 study, wives who had lost their husbands to suicide were seen as more psychologically disturbed, less likable and more blameworthy than wives whose husbands had died from heart attacks or in accidents.

Suicide survivors themselves have an elevated risk of suicide, and according to some studies are more vulnerable to depression, a risk factor for suicide. In a 1996 study, Dr. Brent and his colleagues found higher levels of depression in the siblings of adolescent suicide victims six months after the death, and in the mothers of the victims one year afterward, compared with a control group. At three years, the siblings were no more depressed than a control group, but the mothers were still having difficulty.

The issue of accountability, Dr. Jordan said, of who is to be held responsible for the death, often gnaws at suicide survivors.

In German, he noted, the word for suicide literally means self-murder, and like a homicide, a suicide often stirs anger. But that anger is also, by necessity, laced with ambivalence.

"If you have a loved one murdered, you feel rage at the perpetrator," Dr. Jordan said. "But the problem is that in suicide, the perpetrator is also the victim."

THE obituaries described my father as a gifted mathematician, a charismatic teacher. One, written by a colleague, said he had "a manner disarming in its directness." For several years he ran a large research center not far from the highway where he ended his life.

I was too young to know him well. When he died, I lost mostly a physical presence, a sense of warmth, the masculine smell of shirts and shaving cream, the sound of a voice, the feel of arms lifting me in the air.

My sister, a senior in high school, in some ways lost more, a mentor, a cheering section, the man whose opinion she valued over any other.

Yet in one way our losses were the same: we no longer thought of the world as safe and predictable.

LOSING a parent in early life, from whatever cause, affects children deeply. Like adults, they are prone to feelings of anger, shame and guilt. They may feel it is up to them to take care of the parent who survives.

But researchers still know little about the lasting effects of a parent's suicide. And attempts to follow the tracks of such a death through children's lives have come up with conflicting results.

A few early studies, involving children receiving psychiatric treatment, found troubled youngsters who grew into troubled adolescents. Other studies, based on interviews with adults bereaved in childhood, also suggested that serious emotional difficulties were not uncommon.

More recent studies, with broader samples and more rigorous methodology, have found that, at least in the first years after a suicide, many children show surprising resilience.

In a 1999 study of bereaved children, for example, Dr. Julie Cerel of the University of Rochester found the rates of depression, traumatic stress and suicidal behavior to be no higher in those who had lost a parent to suicide than in those whose parent had died from other causes.

Yet a parent's suicide, Dr. Cerel found, led to more feelings of anxiety, anger and shame, and greater difficulty accepting the death. It was also linked with more behavioral problems in the two years after the suicide.

Such studies are far from conclusive, experts say, in part because there are so few of them. Most involve only small numbers of children. Suicide is a rare event, and researchers often have difficulty gathering subjects. Most of the studies focus on the first months or years after a suicide and cannot say much about what happens later on.

"We don't know what the longer-term issues will be as children get to the age of higher risk," said Dr. Cynthia Pfeffer, a professor of psychiatry and director of the child bereavement program at Weill Medical College of Cornell University, who has studied the impact of suicide for many years.

Experts say that how the surviving parent copes has a significant effect on how a child ultimately fares, but more studies are needed to understand what it is about the parent's way of dealing with bereavement that makes children's passages smoother or more difficult. It makes intuitive sense, for example, that telling a child the truth about a suicide is better than keeping it secret, but researchers do not have enough data to guide parents in deciding when to talk to their children or what to say.

Many other questions await answers, and larger studies are under way at several universities.

But investigators face a difficult task because each suicide is different and leaves a different imprint. An adolescent boy finds his mother's body. A young girl experiences her father's death as just one more violent wave in a turbulent family sea. Another grew up in her stepfather's house and had little contact with her biological father before he took his own life.

Dr. Steven Bailley, a clinical psychologist and researcher in Houston who leads groups for survivors, said that in some cases the imprint left by a suicide may be so subtle that even the best research will fail to capture it. "Do you trust people? What happens in your intimate relationships? It's so hard to measure," he said.

Dr. Bailley speaks from personal experience: his mother killed herself when he was 16.

"Everything changed in that moment," he said. "It takes everything that came before and everything that comes afterward and puts it in a different light."

MY father's suicide was not the first in my family. My mother's father, a veteran of World War I, shot himself when my mother was 12.

Our family's penchant for abrupt exits has been difficult for me to ignore. At various times, it has seemed an embarrassment, a mark of distinction, an unavoidable sentence. As I have grown older, it has become simply a fact of my history.

I was startled to discover, in the course of writing this article, that my eldest niece, two generations removed from my father's death, has also struggled with its meaning.

"It's always been something that's been at the back of my mind," she said. "When I was having a particularly tough time, I felt it could be evidence that our genes were somehow flawed. As a teenager, when the drama was really high, I took some sort of perverse pride in it."

In fact, studies over the last several decades have shown that suicides cluster in families.

Researchers who conduct "psychological autopsies," interviewing family members and friends of suicide victims and examining written records, have found higher rates of suicide among the victims' relatives than among people who died from other causes. Similarly, adults and adolescents who have attempted suicide have more family members who have tried to end their lives.

One recent study, based on Sweden's meticulously kept death registry, found that suicide was twice as common among the first-degree relatives of suicide victims born between 1949 and 1969 as it was in the families of comparison subjects. The study, by Dr. Bo Runeson and Dr. Marie Asberg, was published in the August issue of The American Journal of Psychiatry.

Drawing upon such research, experts estimate that a first-degree relative's risk is two to six times as great as that of someone with no family history of suicide.

"We know that it's heritable," said Dr. John Mann, a professor of psychiatry and radiology at Columbia.

Yet the experts are quick to add that family members are by no means doomed to follow a similar path. Though they are at higher risk, that risk is still very low. And simply knowing that the risk is there can, as Dr. Brent put it, be "a wake-up call," providing the impetus for change.

"It's not destiny," said Dr. Brent.

Why suicide selectively sprinkles family trees is still unknown.

One possibility is that such a death lowers social barriers, in a sense giving permission for other family members to consider suicide an option.

But genes are also at work.

More suicides are found among the biological relatives of suicide victims who were adopted in childhood than in their adoptive families, one study found. Identical twins, who share the same genes, other studies show, are significantly more likely than fraternal twins to commit suicide if their twin has done so.

Such findings hint of something written in strands of DNA that, combined with environmental pressures, impels some people toward suicide.

Yet what that genetic message says is an open scientific question.

Suicide is closely intertwined with psychiatric disorders like depression that, in turn, run in families and appear to have strong hereditary roots. Studies, by Dr. Mann and others, have linked serotonin, a messenger chemical known to be involved in depression, to suicide.

But recent studies raise the possibility that a predisposition to suicide is transmitted separately from a vulnerability to mental illness.

For example, in a 1996 study, Dr. Brent and his colleagues found higher rates of suicide and suicide attempts among the relatives of adolescent suicide victims, even after psychiatric disorders were taken into account. Another study, published last year, found similar results for the children of people who had attempted suicide.

Some experts speculate that what is inherited is impulsivity, a tendency to act on aggressive urges without thought to the consequences. Add depression, alcoholism or other problems to the mix and suicide may result.

Yet how impulsivity or other traits -- pessimism, for example -- interact with mental disorders is still unclear, and the identity of specific genes remains elusive.

When scientists do find out more, a family history of suicide may become something more useful than a disturbing backdrop.

NEXT year I will turn 51, the age my father was when he died.

Despite the passage of four decades, I still wonder what he felt and thought, how he could have left his children, why he would trade the possibilities of the future for such a bleak certainty.

I wonder about the note he left for my mother to find. She could not remember what it said.

Over the years, I have searched for answers, interviewing my father's friends and colleagues, digging up documents.

But his friends, it turned out, knew little about his internal life. The documents -- an autopsy record, a patrolman's notes -- provided only the explicit details of a death I already knew intimately.

Several years ago, I dialed the number of a retired Roman Catholic priest living in Ohio.

I found the priest's name on the sheriff's report, listed as a witness. He had been driving behind my father's car.

When he picked up the phone, I explained who I was and what I wanted.

He paused and thought, then said he did not really remember.

He had driven the highway a lot in those days, he said. He had stopped at the scene of many accidents. People had died. He had given them last rites.

"I'm sorry," the priest said.