Coping With a Parent's Suicide

It is a topic child psychiatrist Nancy Rappaport has spent decades trying to make peace with—the mystery of her own mother's suicide. She was only 4 when it happened, the youngest of five children, and like so many families dealing with mental illness, hers decided that the less said the better. But the silence soon became a shadow over her life as Rappaport came to believe that her mother's death was somehow her fault. When her father casually mentioned that her mother's problems with depression began after Nancy's birth, she felt responsible. When everyone seemed wary of discussing the topic with her, it reinforced her sense of guilt. "I used to have this dream where I would come into the bedroom of my mother and see an open bottle of sleeping pills. I see it and no one else does, and then I leave the room," she says. "In truth, I wasn't even in the house when it happened."

So after earning her medical degree and starting a family of her own, Rappaport, an assistant professor of psychiatry at Harvard Medical School, found herself compelled to begin a personal search for answers. "There were times when I didn't feel that this was a choice, that the momentum behind this was bigger than me," she says. It was the only way "to understand, to free myself. It was like I carried these dreaded assumptions in my bone marrow."

Over the next 18 years, she tracked down members of her mother's extended network of family and friends, and searched through old newspaper clips and court records. Combining her findings with her professional knowledge, she tried to piece together answers to the mystery of who her mother was and what led to her death. Her efforts culminated in the publication of her new book, In Her Wake: A Child Psychiatrist Explores the Mystery of Her Mother's Suicide.

Rappaport didn't find all the answers she was looking for, but she found enough to give her peace. Where there were once only fleeting memories of a mother's touch, there is now the complex portrait of a highly capable woman and mother plagued by childhood trauma and skirmishes with mental illness. And the experience of writing the book has created a new mission for her: helping other families learn to talk about suicide, particularly when it affects children.

"Suicide demands an explanation," says Rappaport. "Adults often have a hard time putting words to their grief, so they try to move on and don't want to talk about it." Or they're paralyzed by the fear that they'll say the wrong thing, so they say nothing. "But when children don't get an explanation, they often fill the void with their own interpretations, and those tend to gravitate toward blame," she says.

Suicide is more common than many realize, and each one affects a family somewhere. "There are 33,000 suicides a year, compared to 11,000 murders," Rappaport says. "Every 16 minutes a suicide occurs in the U.S., and another family is devastated. We don't track how many victims each suicide has. We don't know how many had young children. Did they have a mother and father, brothers and sisters?"

As children grow older, they can also develop a sense of shame about their family history. Rappaport recalls being interviewed for medical school and stumbling around for an appropriate answer when asked about her mother. "I said I didn't want to talk about it. When the subject came up, I instantly felt exposed, like people were judging me, trying to determine how stable I was. I felt for a long time like I had a scarlet S on my forehead," she says.

Her experience taught her that the lack of information and reassurance can leave kids with a lingering fear that suicide is contagious, that the same thing is likely to happen to them. "The truth is that children of parents who die of suicide are five times more likely to die of suicide themselves than a child not exposed to this kind of loss," Rappaport says. "But that's a dangerous statistic, because the truth is, that child is still more likely to die of a heart attack. This is not a prophetic death sentence. This does not usually happen like a bolt of lightning. The truth is, it takes a lot of damage to lose the will to live. The real lesson is to understand that you may be more vulnerable to mental-health issues. So parents should watch these kids like hawks and help them learn to take care of themselves so they have positive outcomes."

Researchers are working to develop formal guidelines about how to talk to children about a parent's suicide, but overall, Rappaport says, it's important for the surviving adults to provide stability, to reassure children that someone will always be there to care for them, and to signal that it's OK to ask questions. "You don't want to give too much information on the way it happened, but you also don't want to lie," she says. "That will come back to haunt you."

Margo Requarth, a certified therapist in California who now leads a children's bereavement program in Santa Rosa, says she knows how true that is. Her mother also died of suicide when she was 4, but no one ever told her that her mother was dead. "Instead they told me that my mother had gone on a long vacation, and then they never spoke of it again," she says. "But she never came back. When I later heard my father on the phone saying he was taking me and my brother on a vacation, I was scared that we would go and never come back." It wasn't until she was an adult that she discovered the truth. "I grieved all over again."

Adults often struggle for the right words, but that's no excuse for avoiding kids' questions. "I believe in telling children simple truths," says Requarth, who is the author of After a Parent's Suicide: Helping Children Heal. "You can say, 'Daddy had a brain illness and didn't know he could get help,' or that he took medicine but it didn't work. A lot of people want to tell white lies, but you need to resist that urge because it will interfere with the trust bond the child needs." Children's understanding of suicide changes as they age, so adults should expect new questions to emerge as kids grow. It also tends to be a lifelong issue—like divorce and adoption. "This is not something you can answer in one discussion," says Rappaport. "Children younger than 8 may not really understand what it means to be dead and gone forever. Teens may look unfazed," but that reaction is usually a cover for their need to "process an unimaginable loss," she says.

Requarth says adults also need to reassure children that the parent who died of suicide didn't choose to abandon them. "One of the most poignant things we hear from kids is 'If she loved me, why did she leave me?' It's important to tell kids that Mom's illness made her very confused, and she didn't really understand what she was doing. It's a choice that's not rational."

Rappaport admits that her decision to devote so many years to this search deepened her relationship with some family members and put off others. But ultimately, she says, it's been personally liberating. "I now understand that bad things happen to all of us, and in the end it's about how we make sense of it and work through it. We need to try to be courageous in our journey and ask the tough questions."