Coping With Loss Amid Holiday Cheer

The holidays can be difficult if you've lost a loved one through suicide. Guest host Celeste Headlee gets tips for coping. She hears from Eric Marcus of the American Foundation for Suicide Prevention, whose father and sister-in-law took their own lives and psychiatrist Christine Moutier.

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CELESTE HEADLEE, HOST:

This is TELL ME MORE from NPR News. I'm Celeste Headlee. Michel Martin is away. Coming up, Wi-Fi is the gateway to high-speed Internet access, but some underserved communities are getting left behind. We'll hear about one effort to bring that technology to Harlem with digital vans. But first, it is of course that time of year for parties and food and family. But for some families, this time of year is very difficult, especially if they've lost a loved one at this time.

And those feelings can be even more complicated if they lost that person to suicide. Two leaders of the American Foundation for Suicide Prevention join us now to talk about that. Eric Marcus is the chairman of the foundation's Survivor Council. His father and sister-in-law both took their own lives. And Christine Moutier is the organization's chief medical officer. Welcome to both of you.

CHRISTINE MOUTIER: Thank you so much.

ERIC MARCUS: Thank you. Very glad to be here.

HEADLEE: So, Christine, explain what some of the challenges are for someone - I mean, obviously, losing someone to suicide is complicated enough with all kinds of emotions of guilt and, perhaps, responsibility, wondering what if. But how does that get complicated when it comes at a time of the year when you're supposed to be celebrating?

MOUTIER: Well, let me just start by saying that regardless of what time of the year it was when the death occurred to suicide that the holidays become very complicated times simply because the holidays are a time when families get together and there are traditions and sort of familiar things and the way things go. And so it's not even necessarily that the death had to occur near the holidays or even necessarily that recently for the holidays to bring up a lot of challenges for the people who are left behind.

HEADLEE: I mean, I guess it's the person missing at those family gatherings that their loss is felt like an absence at the family table.

MOUTIER: Yes, that's right. And the reminder of, what could be viewed in a way, as traumatic loss. So that it sort of reopened the wound of the kind of horrifying loss that losing someone to suicide can be for people. It's - obviously, it's very complicated, and time does matter. And many of the family dynamics play into it as well during the grieving process.

But you're so right about the fact that those questions about why and what if and trying to grapple with an understanding of what could have been done differently or what were even the factors at play because many times, it is a complete shock to loved ones. And they did not actually see it coming, may not have known that the person was experiencing that level of suffering or despair.

MARCUS: And, Celeste, if you can imagine bringing all those people in a family unit together in the aftermath of a suicide when there are all kinds of conflicting feelings. Some people may blame other family members, some may be experiencing extreme guilt. So during the holidays when people often gather or even at any family celebration - a wedding, for example - and you bring together people who may have experienced this very differently or feel differently about each other, it can be incredibly explosive. In my own family, my father's name was never mentioned from 1970 until just 15 years ago at a family function ever.

HEADLEE: Because he took his own life when you were still young?

MARCUS: I was 12 when he took his life. And it was such an extremely painful thing for the entire family. And there were all kinds of conflicting feelings, including a lot of blame, shame and guilt, that no one spoke of him. It was as if he didn't exist from the day he died.

HEADLEE: And in fact - pardon me, Eric.

MARCUS: Sure.

HEADLEE: But I understand they didn't even tell you he had committed suicide. When did you really know or get confirmation that he hadn't died of pneumonia. He'd actually taken his life?

MARCUS: I found out - or I realized it - and perhaps it's unfortunate that I was a very inquisitive 12-year-old. But when I was ushered out of the kitchen on a Sunday morning when my aunt called my mother, which was also something very unusual - and that's something about children. We do notice things at a very young age. And even if adults think we don't notice, we do. And we listen to everything. So I was ushered out of the kitchen, and my mother closed the door.

And I listened through the keyhole and heard my mother say, hospital and pills. And I knew enough about my father and his mental illness, and I knew enough from movies about pills and hospitals that he had attempted suicide. He died a few days later. It was not confirmed for me. Do you know, I can't even tell you when. I know that I confronted my uncle five years later, my father's brother, and said, we need to talk about this. I need to talk to somebody about this. It was always presented as pneumonia. And I'd kept it as a deep secret and didn't even tell my friends that my father had died because I was too embarrassed to say that he died of pneumonia because I knew it wasn't the truth.

HEADLEE: If you're just joining us, we're talking about coping with suicide during the holiday season. And our guests are Eric Marcus, who you just heard, of the American Foundation for Suicide Prevention. Also, psychiatrist Christine Moutier who is the chief medical officer for that group. Christine, how would you advise someone to, in a healthy way, handle the holiday season whether it's 42 years ago, as in Eric's case, or maybe it could be something recent? Is there a good way to move forward to meet again as a family and handle some of these complicated emotions?

MOUTIER: In terms of the holidays in particular, I think the main thing to think about is to, perhaps, put aside one's fear, shame, whatever may keep one from really kind of facing it and even thinking it through to try to be as proactive as possible. And that ideally would include having a conversation with family members where you talk to each other about, how do you see it going? What are going to be the difficult things to deal with when all of those memories and the things that the holidays evoke for each member of the family that it will bring on?

And to kind of care for one another in a way. And I will say, what we've seen is that people can really, I think, do well if they just start with all the previous rules of the family and what needs to happen during the holidays, kind of all bets are off and that that's OK. It really depends on the individual person, the family unit and where they are in the process.

HEADLEE: I wonder, Eric, I mean, very tragically, your sister-in-law also took her life in November of 2008 shortly before Thanksgiving. I wonder what the difference was for you in your reaction to handling your father's death so many years before and when it happened with your sister-in-law. How was that experience different for you?

MARCUS: I experienced one as a 12-year-old child. I experienced the other as a fully grown adult who'd had plenty of therapy. And I'd also - I also wrote a book about my experiences and a book for people who lived through the suicide of a loved one. So I actually experienced some guilt around my sister-in-law's suicide because as an expert, shouldn't I have been able to help prevent her suicide, which I could not.

It brought up so many of the feelings I'd had around my dad's suicide. It was a very traumatic experience living through her suicide, and the family really struggled. If you can talk with your family and address these issues in an open way, it's ideal. But sometimes, depending upon the family, you may need to remove yourself. And what my partner and I did is we didn't spend Thanksgiving with family. We didn't give a Thanksgiving. We had the means. We went to a country where they don't celebrate Thanksgiving. And we had a chance together - it was his sister - we had a chance to process the experience between the two of us in terms of how we experienced it before we addressed how we felt in relation to our other family members.

HEADLEE: If one of my friends or loved ones is going through this, is there anything I can do or say to help them?

MARCUS: Yes. Yes. How are you doing? One of the things that I've seen happen over and over again around suicide because people are afraid of bringing it up, they will retreat. And the worst thing you can do is retreat. You don't have to say a lot. I remember one woman who I know, who works in this area as well dealing with people who've been through the suicide of a loved one, her husband took his life. She went back to work after several weeks, and one of her colleagues said, I don't know what to say. And she said in return, I don't know what to say either. I just need a hug. So when all else fails, just say, I'm so sorry, or how are you doing? And if you are comfortable reaching out in a physical way to give a person a hug - and don't assume that the pain goes away in a week or six months or eight months. It's very important to let people know that you are there.

HEADLEE: And, Christine, a question for you, which is that, if you have a family member that you see at the holidays and you think maybe they're having a tough time with the holidays, maybe they're having a tough time in their lives, is there anything that you can do to reach out to a family member that you might suspect is in a depressed place or might thinking of harming themselves?

MOUTIER: I think letting the person know that you care, and you'd love to set aside some private time and place to meet and chat over coffee. The way the conversation can go, ideally, a lot of space and listening, asking specifically about any suicidal thoughts, what kinds of things are they thinking of, how do they view their future. The fact is, most people who are thinking of it find relief to be able to talk to somebody who's trusted and safe about it.

Then, once - if the person does seem to be having some either feelings of suicide or ambivalence about life being worth living, I think connecting them to professional help is clearly the most important thing at that point. Just start the conversation. Think to yourself, it's going to be OK if there are silences. If I raise a question and if my loved one, my friend starts to cry, that is going to be OK. It's going to be OK if I start to cry.

HEADLEE: That's great advice. Dr. Christine Moutier is chief medical officer of the foundation - American Foundation for Suicide Prevention. And Eric Marcus chairs the Survivor Council of the foundation. They both joined us from New York. Thanks so much to both of you.

MOUTIER: Thank you, Celeste. It was a pleasure.

MARCUS: My pleasure.

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