Harvard psychiatry professor writes book on mother's suicide

The death of a loved one is always a profoundly devastating experience. When that person takes his or her own life, the event causes a deluge of emotions beyond confusion, such as undeserved guilt, anger and feeling abandoned.

Dr. Nancy Rappaport, assistant professor of psychiatry at Harvard Medical School and school program director for The Cambridge Health Alliance, lost her mother to suicide in 1963 when her mother was 34 and Rappaport was barely four years old. It has taken her until now to be able to write about it in her recently published book "In Her Wake: A Child Psychiatrist Explores the Mystery of Her Mother's Suicide." It is at once a book about recovering from the loss of a loved one, a road map of sorts on understanding one's family as individuals and the group's dynamics, and what Rappaport calls "a psychological suspense story."

"We know what the ending is, but you have a narrator who is alive and well and trying to find a resolution to the question 'why?' The message at the end is that love lasts longer than death. There can be a presence," she said.

"In a way, my mother gave me a gift from the grave. In trying to understand my own loss, I came to both a deeper appreciation for my family and to be able to write in a way that really moves people. Suicide is always an inexplicable mystery. Those of us who are alive don't make that choice, but it's not always a choice because the brain can turn on itself."

Rappaport said the answer to why her mother took her life died with her, leaving the young girl as she turned toward adulthood building in her mind an image of the woman her mother was and transforming a relentless exploration into the mystery of her death into a comprehension of how she lived. That process also led to a deep respect for her father and a closer bond with her siblings in later years, because as children they never engaged in conversations about their parent's death.

The book relates intimate talks Rappaport had with her father when she became an adult, with him finally telling her that her mother was bright, energetic and treasured her children but also was an impulsive person who occasionally felt plummeting despair. In those days, people were not as knowledgeable about interventions that could ward off depression and potential self-harm.

She notes that studies now show that how well the surviving parent, or how both parents of a young person cope after the death is incumbent on the health of the entire family experiencing the tragedy.

Rappaport also refers to the aftermath of a suicide death as "silent grief" because usually, family members find it next to impossible to discuss the event with one another, and at the same time, they each may be seeking something or someone to blame for their loss.

"There is a host of vulnerabilities. Many of us suffer setbacks," she explained, listing them as hopelessness, substance abuse or a level of impulsivity, all of which can result in unhealthy behaviors and mindsets for the survivors. It was through therapy that Rappaport was able to overcome her private, internalized sense of responsibility for her mother's death.

Rappaport is familiar with the island's tragic loss of seven youth within a four-year span. She said it is of vital importance to her in her extensive counseling with young people to encourage them to keep the spark of life and envision a fulfilling future. She said it is essential to talk with children who have lost a parent or sibling to suicide in age-appropriate language that ensures they understand the death was not their fault and that the person who died loved them deeply.

"The important thing is to let people [who appear troubled] know you care about them and that no one is expendable — no one will be better off if they are gone. If you are really worried, don't leave them alone and get medical help because suicide results from a medical condition that is treatable," said Rappaport. "Both therapy and medications can be life saving. We do the best we can and that is all we can ask of ourselves. I feel very hopeful when I'm working with teenagers. Yes, we do sometimes tragically lose people, but there are people who get help and get better.

"My book is meant to be more universal than a book about suicide. I wanted to make it possible for people to think profoundly about the people we love, even if we have lost them in a confusing way." I