Of course, I have wondered through the years since his suicide
whether there was anything I could have done to help him.
Everything I read or heard of psychotherapy
I thought of in relation to my husband,
questioning, and always I got the same answer:
”With him, it wouldn’t have worked”.
This made me wonder whether I was whitewashing my own failure.
But if so, why couldn’t I ever be satisfied? Why didn’t I let it drop?
Did I know that I was guilty, deep down in some sub-non-conscious way?
(When I mistrust me, there is no end to it,
because then what I live with is mistrust.)
Sally’s hug and kiss were warmer than I’d expected. She wanted to hear all about my trip, which was unusual. The kids were nowhere to be seen. Instead of greeting me, they were at a neighbor’s, which was strange because they are always eager to see what presents I have brought home from my trips for them.
After ten minutes, Sally held my hands and said; “I know I must tell you now. I wish to God I didn’t have to. Linda called two hours ago. Bob committed suicide this morning. He’s got a flat EEG, but they’ve still got him on a respirator.”
I saw tears in Sally’s eyes as she suddenly seemed very far away, at the end of a blackening tunnel. Ten years later we would divorce. Sally would mark this time as the turning point. “You changed after Bob’s suicide,” she would later say.
Knowing that it was going to happen was no protection against the shock of its reality. Bob had been suicidal many times before. I believed he would actually commit suicide when the reality of what he had done the previous October broke through his defenses.
His arrest for a homosexual molestation of a minor at a rest stop was such a violation of his self-image that death or total transformation of his life were the only alternatives. He was a protester against social injustice and a brilliant graduate student struggling to put a major theoretical perspective into the context of a dissertation. He was a counselor for alcoholics. A trial and an almost certain conviction would have destroyed his world.
Bob was also addicted to drugs, easily prescribed to him by a psychiatrist in another town. He was deeply in debt. He alienated friends with his neediness and self-centered behaviors. My offers to help him detoxify went unheeded. When he was manic, he didn’t need help. When he was depressed, he wouldn’t accept it.
On the way to the hospital, I remembered vividly the horrible week during October when Bob had been arrested. He called me at the tennis club, using the only call he could make from his detention cell at a county jail. He asked me to come bail him out. I hesitated; I was his therapist, not family or a friend.
Bob heard my hesitancy. “John,” he said, “I know I shouldn’t have called you. I know I am overstepping our therapeutic relationship. I can’t call anyone else. I would rather kill myself than have anyone know what has happened. Besides, this is the only phone call I get.”
I had never been in a jail before. I could see Bob in the receiving cell, behind the desk. Everything was out of proportion; it was too bright, the pitiful little seat and sink were much too small for Bob, who looked like an animal in a cage. He struggled awkwardly to stand when he saw me, fell sideways, grasped at the bars. Relief and a childlike smile flashed on his face.
Bob talked more freely on that twenty-mile trip to his apartment than he had in three years of intensive psychotherapy. He told me what had happened; the misunderstanding, his surprise that the guy was under age; he told me nothing happened except the approach. He spoke of the awareness of his loneliness, the despair over his dissertation, a recent break-up with yet another girlfriend. He was grateful for my help. He talked of wanting to use this incident as a way to force himself to change: to get off drugs, to make a life for himself that was simple and fulfilling, helping others with drug problems.
I was in shock, I think. I listened to Bob, knowing he wanted to believe what he was saying. But from the moment I heard what had happened over the phone at the tennis club, I knew he would commit suicide. He had been razor close before. Nothing would stop him now.
In the following months, it became clear that Bob needed a friend more than he needed a therapist. He needed someone to validate the reality of the enormous change facing him, when he was willing to face it. The event or its significance from his past wasn’t explored. He needed someone present with him as he stood for arraignment, when he plead no contest. He needed help with filling out the incident report, which he never did finish.
He did tell Lois, the one constant friend who had stuck with him through many hard times. As a friend of mine, she’d referred Bob to me for therapy three years previously.
Just before Christmas, Lois and I talked about Bob. We both knew his choices were now down to a very few: a prison term, radical reform of his life, giving up drugs, abandoning his career and his own self-view. Suicide was a much simpler alternative. We talked of hospitalization while he was suicidal and withdrawing from drugs.
He said he’d already stopped the drugs two months before. Hospitalization would be out of our control. He’d still have to face prison. The rural community where this had happened wasn’t going to plea-bargain with one of the hated homosexuals they caught at the interstate rest stop.
Lois and I knew we must remain his friends, whatever happened. We knew we’d also need to support each other. We knew he would at least attempt suicide, but we didn’t know when to expect it.
Lois and I hugged in the intensive care unit. She told me what had happened; apparently, he had wanted to be found, but help came too late.
A neighbor was supposed to stop by at noon, but had forgotten and didn’t arrive until five. He had apparently panicked when he realized she wouldn’t come, and desperately tried to make to the phone or the door, ripping down bookcases, knocking over chairs. He’d written a very angry, chaotic note, blaming everyone except Lois and me for his plight and fate.
By the time the paramedics arrived, Bob’s heart had already stopped beating. For almost twenty minutes, they tried to resuscitate him, finally succeeding in getting his heart going. But his brain was already gone. He couldn’t breathe on his own.
Bob’s parents were sitting in the waiting room, tears streaming down their faces. I’d not met them previously. We held each other’s arms as I told them how sorry I was. We cried as they shared their shock and their loss. Bob had told them about me. They wanted me to know they didn’t blame me. They knew about the drugs and his addictions, and had lived in dread for years, fearing his suicide. Now, in some strange way, they felt relief. Perhaps Bob was finally out of his suffering.
The exhausted intern came to talk with them. His tears moved them, as he told them how sorry he was that he couldn’t do more.
Lois and I went with him as he went to shut off the machine. I held Lois’ hand as we watched. Without the machine, Bob did not breathe. His body did not move. His colors stayed pink and warm. The swaying intern found no heartbeat.
I touched his arm and face. “Good-bye, Bob,” I said, “I hope you finally find some peace.”
Lois hugged his body and sobbed.
It took me two days to clear my schedule so I could go to the place at the lake. During that time, I listened to Bob’s parents and his sister share their grief. Lois and I shared support for each other and the guilt we felt for knowing and not preventing. The neighbor who had found Bob amidst the shambles of his apartment came in desperation on the second day, saying she couldn’t shut her eyes without seeing that scene. She shared what she’d found, how horrified she was, how guilty she’d felt for not coming when she had promised Bob she would. I listened. I acknowledged what an enormous feeling of guilt and responsibility she was feeling. I told her that if Bob had survived this time, he would have succeeded in killing himself at some other time. It wasn’t her fault. She sobbed, felt relief, and left.
The relief I’d felt as I listened to others quickly disappeared as I drove toward the cottage the next day. Now nothing distracted me from myself, except driving. The pit of my stomach was leaden and acidic.
It was bitter cold, windy and snowing when I reached the lake. The waves were angry, crashing against the shore, creating huge ice sculptures over the lighthouse, snow fences, along the beach itself.
I was angry too. Furious with Bob, for making me a failure that he couldn’t find another way. Furious at the unknown psychiatrist who kept him supplied with drugs. Furious at myself for not stopping him, for not hospitalizing him, for not being a good enough therapist, for not being a good enough friend.
I screamed into the waves until my throat was so raw it was agony to swallow. I beat my hands against the snow and ice until I could feel the pain shooting up my arms. I stood in the wind until I felt so cold I began to shake. I could barely move. I wanted to be punished, to punish myself if no one else would do it. With the child logic of a four-year-old, I believed that Bob would return if I punished myself.
The bitterness and clarity of the ice-cold wind and the stinging snow penetrated my child-like stubborn shield. I went back to my room. I got under the covers. Shaking uncontrollably, I began to sob. I continued until nothing was left. I faded into sleep.
I wrote a lot those days at the lake. A lot of things seemed clear then. For the first time death was real for me. I felt changed. I felt freer. I felt relief that Bob was dead. I could understand now how he could make that choice. In those previous few days, I had felt it was a choice I could make, too.
My life did change; not quickly or dramatically, at least not for many years. I spent a lot of time sorting and trying to go back to the old ways. It didn’t work. I lacked time for everything, for everyone. Only I could make the necessary changes. Only I could find ways to enjoy what life I had left—and to change the way I was leading it.
Eight years passed. I was both leading and participating in a workshop in Denmark. We were asked to select an issue that felt unfinished for us and address it with a partner with our eyes closed, with them holding our hands, fantasizing the person. Bob came immediately to me. I saw his face. I felt the old anger. “Please let me rest, he said to me in my fantasy. Please let me go. Forgive me. ”
“I can’t.” I replied. “I haven’t been angry enough.”
So I began a litany of anger at Bob: Bob, I am so angry that you killed yourself.
I am angry that I didn’t get to say good-by.
I am angry that you threw away your life.
I am angry that you didn’t love yourself enough.
I am angry that I couldn’t help you.
I am angry that you left all of us to deal with this while you got the easy way out.
I am angry that I can’t hold you and help the pain go away.
I began crying. I felt the warmth of my partner’s hands, the energy she was sharing with me to make it possible to do what I was doing. The anger had flown outwards with each statement. I felt sadness, grief—and then for the first time in eight years, I felt love for this man who had been in so much pain.
“I forgive you, Bob.” I whispered, with no one except my partner Marianne hearing. “I forgive me, too.”
I saw tears and a wispy smile on the image I had of his face, fading, leaving. I’ve never seen a vision of him since. I think he felt released.
I have never been the same therapist or person as I was before the loss. As with any disruptive loss, what’s important gets shifted. I found that the usual developmental tasks of the thirties had been radically altered for me. The illusions I had about my inherent goodness, the protection my qualifications supposedly gave me against death, or being able to handle all things and be all things for others, came crashing down. I, like many others, was not able to adjust to such losses. We transform them or else life loses its meaning and purpose.
What is this healing process called grief? What obstacles does suicide pose to reaching beyond the clutches of tragedy, of victimhood, of life that is permanently less? What can possibly keep others from its clutches, from seeing suicide as a solution now that someone they knew, admired or loved has done it?
Grief is the process of finding meaning in senseless acts, through discovering the full nature of what was lost, and having the courage to find what is left and make it be enough to build a future that is more
than the loss. It is the only way I know of going on when there seems nothing to go on for, of expressing the fullness of our rage and futility as a part of rediscovering love and empowerment. Grief opens us to finding healing powers that go beyond our personal egos. It insists we see ourselves as a part of something much bigger than our individuality and our separateness. Grief exists because we are committed to our connections, need to honor our love and find ways to remember the best of what others give to us throughout life.
Suicide can represent many things. Sometimes it is an insane act, a faulty assessment of reality distorted by pain, irrational thinking, depression or paranoid beliefs. Sometimes it is an act of desperation designed to avoid humiliation or loss of face. Sometimes it is an alternative to killing someone else. Sometimes it is a statement of profound loneliness. Sometimes it is a powerful expression of anger, revenge against real and/or imagined hurts. Sometimes a suicide attempt was a cry for help; sometimes a successful suicide was not the intent but the accidental outcome of a gesture or a foolish whim.
Whatever the motive, the action cannot be reversed. No matter how temporary the insanity, how fleeting the betrayal, how transient the anger might have been, the solution is a permanent one. Only the survivors have to face the consequences.
My expertise is not in suicide or its prevention, but in grief. What happens in the process of grieving or failing to grieve that can make suicide an option?
Loss of the Will to Live
Grief that is not expressed erodes the human spirit. Instead of allowing ourselves to be aware of the full implications of a loss, we assume we’ve lost much more or much less than we have. When we assume it’s much more, we may be unable to reconcile continuing to live. Without grief, there’s no way to experience the ebb and flow of life and inimitable movement toward death. When loss cannot be explored, we may lose sight of why we are living:
Frances was a lovely woman who lived in her husband’s shadow. He was a well-known pediatrician. He was loved by many people, and often helped parents who had lost a child. Frances was a librarian, and lived a quiet life.
Early in their marriage, they had two children. When the youngest, Anna, was four, she contracted a virus. Karl was away at a meeting and unable to get home before she died.
Karl and Frances were unable to cope with their loss together. Frances was angry that Karl wasn’t home at the time of the death, though she couldn’t express it. Karl poured himself into his work, developing a special practice treating children with leukemia, at that time an almost certain terminal condition.
Thirty years had passed when I met Karl at a five-day workshop. During the workshop, we took several long walks in the woods. Karl told me of his daughter’s death. He began opening to the grief that had been bottled up for so long.
In the year that followed, I visited Karl and Frances many times. Karl and I frequently conducted workshops together. In their home, Frances rarely spoke unless Karl or I directly approached her. She was very shy and reluctant to share her thoughts. We spent long hours listening to music, both classical and new age. I persuaded Frances to try to do some Tai Ji to Pachabel’s Canon—she loved it.
Slowly Frances began to blossom. She began to take courses on Tai Ji. She went to a women’s support group. She mentioned occasionally in the support group Anna’s death, only to note it had happened, and that Karl hadn’t been there.
One day, after being away for several months, I called. Karl answered the phone. In his quiet way, he sadly said that it wasn’t a good time for me to visit—Frances wasn’t feeling well. This pattern continued for several months. I persisted with Karl, who finally explained that Frances was severely depressed.
She had been at a Tai Ji workshop. She looked at everyone else and suddenly felt old, out of place. “It’s too late for me”, she told herself. “I don’t deserve to be here.”
Over the next several years, Frances had the full range of treatment for depression—drugs, therapy, even electroshock. Except for a few days here and there, the depression wouldn’t lift. She did admit how angry she was about what happened at the time of Anna’s death, but she couldn’t seem to get past it. By this time, I lived far away. I only saw Frances once and it was clear she was not reachable by my friendship.
Four years passed since my last visit. I received a letter from Karl. In it he told me that Frances had committed suicide six months before. She had tried several times over the intervening years. Life had no meaning for her, she said.
Karl wrote that he lived in dread of what he would find when he came home each night, for he had already interrupted several lethal attempts. Once she had been found nearly drowned in the bay. Finally it happened. She drowned herself in the bathtub.
“It was like a long terminal illness” Karl shared as we visited the cemetery six months later. “I knew it would happen someday. She was suffering so much. She never could find someone to trust to deal with her grief. She felt that her life had little meaning once she reached retirement age and could “only” look back at her years as a librarian. She compared herself to me and to you, and found herself wanting. Perhaps if she’d had a therapist who could have made it safe enough, been confronting enough. She had the best and it didn’t work.
I’m glad she’s out of her suffering. Those last years were so painful. I can look back at the good times again–past those years of depression. We shared a lifetime. I can go on. I miss her. I don’t miss what we went through these past five years.”
Frances had waited a long time to deal with her daughter’s death—too long, perhaps. By her mid-sixties, depression set in, but as she began to emerge from her shell the internal and external resources weren’t there to help her —in spite of a genuinely loving husband and the best of treatment.
One might also wonder if Karl had dealt with his daughter’s death. He had not openly talked about it until some thirty years later with me. Karl had found ways to move on from his grief over the death of his child. While he hadn’t consciously dealt with Anna’s death for those thirty years, his work with dying children with leukemia had given him opportunities to deal with his guilt and his sense of responsibility. His life, his work had meaning in light of his loss. Even after experiencing the five-year depression of his wife, he could grieve her death and her depression, knowing he had done what he could, that his life still had meaning.
Suicide is a major risk when we avoid dealing with loss. Our bodies, minds and spirits wear out from the stressfulness of defending against grief. Pleasure is a rare commodity for survivors who cannot grieve. Suicide can be a last desperate attempt to admit to ourselves how important this loss that we have denied all these years is to us. Unfortunately, the consequences of a successful suicide produce transformations that the living cannot comprehend or appreciate.
Only the elderly rival teenagers in terms of frequency of successful attempts at suicide. Teenage girls are much more likely to attempt suicide than boys (4:1), but boys are twice as likely to succeed (Holinger, 1978). The rate may be even higher than is reported, since accidents are the leading cause of death in the teen years, and accidents can mask suicidal intent. Suicide can be an extreme response of letting go, which tragically is irreversible. Its impact on family, teachers and adolescent peers is often one of shock, guilt, stress and identification, as happened at one large city high school:
During the winter final exams, Art was accused of cheating on an exam. Hours later, he hanged himself in the basement. His brother found him.
Art had been captain of last year’s conference champion swimming team, and was a very popular and well-liked senior who was going to college after graduation. His best friend had been aware that he had been depressed recently because of problems his parents were having and a recent breakup with a girlfriend. In the past few days, however, things seemed to be going better. He was swimming his best times ever, and the conference championships were only two weeks away.
Art was accused of cheating on one of his finals in front of his classmates, and was given a failing grade. It could have meant he would not finish high school on time, or get into the college he had chosen. He didn’t talk to anybody about it before going home.
In a discussion two days later facilitated by school counselors, Art’s closest friends, including his ex-girlfriend shared their grief. The friends had decided who would be “safe” and trustworthy to include in the group, so they could feel open in sharing their feelings and reactions.
Tom said he felt detached, numb, like he didn’t really care anymore. Tom was also on the swim team, and had done poorly in the weekend meet. Conference championships were coming up, and he didn’t really care how he would do. He identified strongly with Art, his best friend, and felt guilty and responsible for not preventing the suicide. Tears began rolling down his cheeks. He felt that he deserved to be dead, too. Since Art had chosen suicide, Tom felt strongly drawn to doing the same thing.
Melanie felt enormous guilt for having broken up with Art. If only she hadn’t done it, she repeated. She cried as she said all she wanted was to have the chance to say to Art that she loved him.
Mike hadn’t been able to sleep all week. As his brother, he had been the one to find Art’s body. Mike was a sophomore who looked up to his older brother as a hero. All he could think about and see was his brother’s body hanging. As he shared what it was like to find Art, Mike became angry with Art for doing this to him. He pounded his fist on the table, swore, and said he’d like to kill Art for what he had done. Then he began sobbing, with Melanie’s arms around him.
Tom said he was really pissed at the school and the pressures Art had been under to do well from his parents. He was angry with everyone who expected Art to be such a model student, so that the accusation of cheating would be such a loss of face for him. He was angry with the counselors for not helping Art with his problems. He was angry with himself for feeling so detached from Art’s suicide. “I don’t have any tears”, he said. “I’m just angry and bitter.”
The counselors’ also shared the impact of Art’s suicide on them: their guilt, anger, helplessness and sadness. They expressed concern about Tom’s despair and suicidal feelings, and Melanie’s guilt. They validated the reactions, and were willing to spend time with each of the students for as long as necessary.
By the end of the hour and a half, everyone in the group indicated feelings of relief for the first time in a week. They felt closer to each other, and felt they could share with each other. Melanie asked Tom to promise her that he would call her first if he really felt he would kill himself. Tom agreed, but said he still felt drawn to suicide. He wouldn’t do it, because it was a cowardly way out. If I can face all this pain, he said, I can make it through just about anything. Mike felt relieved. The image of Art hanging wasn’t so vivid anymore. He wanted to talk to his parents. Tom asked for help to find his sadness under all his anger.
It took considerable courage for these teenagers and their counselors to meet and validate for each other the pain they shared. The session broke down the isolation and perhaps even prevented drastic responses. Such programs for critical incident stress debriefing (Bray & Mitchell, 1990) now exist in many school systems and for rescue personnel as well.
Coping and Awareness
Still we’ll look for ways to delay having to deal with any major loss in hopes of a miracle, a reversal, and a reprieve when we can. We’ve wanted to escape, to get a break from the oppressive and crushing reality of the loss. Yet even in our search for ways to escape or overcome the loss, we may admit that our lives are being transformed into something they were not before. At this point, early in our grief, we believe we are being transformed into something much less than we were before the loss.
Coping with the loss episodically dissolves and awareness hits home—hard. Just when we thought it couldn’t be worse, it got worse. We went beyond our worst nightmares. Almost anything seemed preferable to life with our loss—perhaps even death.
In awareness, we may stop to contemplate suicide. Our fear of dying varies. There are times when living is more painful—there seems nothing to live for. Our fear lessens. We feel freer—we have a choice.
We may reach the time when fear of dying is missing—if our time has come, it has come. We welcome death as a transformation that liberates us from this lifetime. The peaceful acceptance of perspective can mean that pain, loneliness, having outlived all our loved ones and our health will mercifully end.
Integration involves times when we may have choice about death or the way we die. It may not be something we feel the need to do anything about. Knowing we could take that action may also create opportunities for peace and even joy.
What keeps us going?
Considering suicide as an alternative is a radical reformulation that liberates us from the prison of suffering and the role of a victim. The capacity to reformulate our losses as something more than tragedy means we’re not ready for life to end, as empty and as miserable as it might seem at the moment. We go on, not knowing why, but curious.
Considering suicide gets our attention. Our motivation for change increases when death appears preferable to the status quo. It vitalizes us for transformation.
Perhaps we delay acting on suicide as a choice, knowing we have that choice. We can’t easily feel trapped again. When suicide is an option, we can no longer easily claim that “we didn’t have a choice” in staying in an abusive relationship, carrying out orders as a concentration camp guard, living as a passive victim of fate the rest of our days. Death as an option has transformed other possibilities we have. It empowers us to a greater vitality while we can.
Perhaps we delay acting because we realize we are not alone. Others will be affected by what we do. We are loved and we are connected. That awareness takes us beyond suicide as an option, to tolerating the pain for the sake of others who love us and would be devastated by our actions.
Reformulating our lives by considering suicide may lead us to develop integrity and wholeness. Life isn’t worth living this way becomes the motivation to living life differently—with more meaning, purpose, less strife, pain, more pleasure. Our ways of responding lead us to reformulate our losses—to see new ways we can be empowered by them.
What other choices do we have now?
We restore what we can. We act, knowing how precarious our lives are. Our courage in the face of life’s bullies and fate creates a life of its own. We challenge old beliefs about life and death and life after death. We mobilize our resources. We learn to distinguish between grief and depression.
Knowing How Grief and Depression Differ
The themes of grief and depression have been interwoven through the lives of the people I love as well as those for whom I am a health care provider. These recurring themes have allowed me to recognize the broken connections that characterize loss and depression as well as the invisible connections that support us when we healthily grieve losses.
On The Personal Side
My father died suddenly and unexpectedly when I was eighteen. His death at the age of fifty-five from a heart attack came two weeks after he realized his dream of moving back to Michigan could not be fulfilled. His family doctor, a personal friend, had missed the signs of impending illness the morning of the heart attack: The flu-like symptoms of sweating, congested breathing, and chest pains along with a dramatic drop in Dad’s chronically hypertensive blood pressure, were all retrospectively seen as missed warning signs.
I came to believe that my father died of a broken heart, the result of a sense of disconnection from his hopes and dreams. Returning to Michigan’s friendships and healing environment from upstate New York had been his goal. His last letter to me, received on the day he died while I was a beginning freshman in college, was one of seeming depression—dreading the winter, despairing that spring would ever come. He was a Horatio Alger of a man, an oldest child whose own dad had died when he was nine. He had supported his mother and three siblings from age thirteen until he was twenty-seven, only then putting himself through high school, college, and graduate school, to be stopped by the Great Depression which kept him from medical school. Now, stuck in a job he felt was an enormous burden, in a place that felt alien, with children departed from home and a wife whose recent dependency he did not understand, his one dream was dashed by the impending death of his boss. Ed’s heart, friends would say later, was broken by not being able to return to the place of his dreams, where the healing of many wounds might have taken place.
Dad’s death had major ramifications for others as well. His doctor, distraught over losing his friend and a patient, blamed himself. He was also my doctor. His hands shook so badly the following summer when he tried to give me a polio booster that the nurse had to do it. He left practice within a year and was dead in two years of his own heart attack. I’ve often wondered what his deterioration was due to: His grief—or was it depression? Had the thread of meaning in his work, the grace to forgive himself for missing a diagnosis, been broken? Had anyone listened to and validated his loss and his right to grieve? My subsequent career in medical education tells me he probably did not have such support.
My mother’s life was also profoundly affected by my father’s sudden and untimely death. Immediately put on an antidepressant and a major tranquilizing medication by this same distressed physician, for the next six months she was a “zombie,” merely going through the motions. Grieving what she had lost was not possible. Eventually she resumed her career, did well for seven years, and then became severely psychotically depressed, for she had not honored the meaningful connection of her life to my dad. I had to arrange for her hospitalization; reluctantly agreed to electroshock treatments. She received counseling, grieved Dad’s death, and restored the thread of his memory into her life.
Again, seven years later, as she retired at the age of seventy as a public health nurse, she had difficulty. This time her situation was complicated by being on an anti-hypertensive drug that had depressive side effects and for recently undergoing cataract surgery that might potentially have resulted in blindness and losing her much loved capacity to read. Once again, her depression required hospitalization, shock, and therapy. Once again, she was able to subsequently grieve—this time, the loss of a career of forty years in nursing and the loss of having her family close by. In the remaining fourteen years of her life, she replaced nursing with volunteer work, distant family with a nearby adopted family with five children who called her grandma, enjoyed friendships that hadn’t existed when Dad was alive, joined a religious community, campaigned politically for a friend, traveled, spent time with her five grandchildren. In short, she lived fully until she died.
Other members of my family also have suffered from the disconnectedness of depression. In some cases, alcohol eroded their spiritual connection to others and to meaningful lives. In others instances, the inability to forgive was to blame. These personal connections contributed to my becoming a psychologist, and why I started out being so interested in depression.
On the Professional Side
A mentor in my graduate school and early career days, Gordon Deckert, a psychiatrist at the University of Oklahoma Medical School, taught me that something besides depression was possible in the face of overwhelming loss. He introduced me to the notion that the normal, even healthy, reaction to loss was grief.
Gordon didn’t neglect depression—as a teacher of first- and second-year medical students, he stressed the medical necessity of accurately diagnosing depression when it existed, for it is a condition that can be life-threatening and require intervention. However, he also emphasized the importance of respecting grief as a naturally occurring process resulting from loss. He believed that grief was a way to retain, even to transform, connections and that it was important to know the difference.
Gordon was a wonderful example of someone who knew how to grieve, transform, and find meaning. The result was a flexible, creative, resourceful teacher and therapist whose zest for living, practical jokes, creativity, vision, and ethical standards are still renowned in the medical community.
In stark contrast to Gordon Deckert, however, were many other professional colleagues whose insensitivity to anyone’s grief, including their own, was obvious. Although I didn’t recognize it at the time, these were disconnected people, both from those they served and from themselves.
The first such disconnected professional I encountered was a psychiatrist during my graduate training who used electroshock treatment as punishment for breaking the rules at a school for retarded women, covering his One Flew Over The Cuckoo’s Nest behaviors with depressive diagnoses. A second was a psychotherapy supervisor of mine who had survived but never dealt with losing his family in the Holocaust. He warned everyone of the dangers of missing depression, but never mentioned grief.
Many other colleagues in the Department of Psychiatry at Michigan State University where I worked for twenty-three years either ignored my grief or questioned my competency after the suicide of Bob, a long-term intensive client who had a bipolar disorder (manic-depression) and addicted to drugs. After Bob’s death, they reacted to me as if nothing out of the ordinary had happened. Their ignoring of my suffering was intended, I believe, to deny that my experience, an “occupational hazard” of being a therapist, could happen to any one of them.
But I also brought my own issues, the unresolved loss of my father for one, to my career. I, too, was prone to disconnecting and depression as I relentlessly pursed graduate training, evaded the culturally dictated responsibilities of an Irish-Catholic son to his mother, left my religious faith, became super competent and a workaholic, allowed alcohol to become a crutch, and otherwise did not honor my personhood. I was looking for ways to avoid reminders of my loss and everything and everyone connected to it—a sure-fire way to get depressed.
When additional losses are piled on unattended ones, an even greater sense of urgency to avoid ensues. As a result, after losing Bob, I did not want my clients to face their losses. I wanted to control them—to teach coping skills, the use of behavioral strategies I had learned in my training. Learn to survive, I insisted, and think positively. I exhorted them to be optimistic, to use distractions, to rely on my expert interpretations and recommendations for what was good for them. Impatient with their “resistance,” I was easily frightened by their feelings and worried about their potential for suicide—and what that would once again say about me.
I inevitably bailed out when they reached the painful stage of awareness and when they faced what I feared to face: The quite natural need to grapple with feelings of helplessness, hopelessness, loneliness, and the realization that suffering was a part of their lot in life, all manifestations of grief. I blamed them for not wanting to “overcome” (I meant “avoid”) their problems. I failed to honor the necessity of grieving as a way to do just that. At that time, I could not see how what I was doing was contributing to the depression I was diagnosing, but it was my lack of grieving and my resulting depression that I needed to have mirrored back to me.
As I read articles and books on depression these days, most of them still reflect the dangers of missing depression while ignoring grief as a potential alternative, I recognize myself from years ago, unaware of what harm I was doing my clients by failing to validate the reality of their losses and the courage it took for them to face them. I did not understand that by doubting their strengths, I, a powerful authority figure in their eyes, caused them to doubt themselves. I was actually contributing to the conditions that made suicide more likely.
The Blending of the Personal and the Professional
It was several years after Bob’s death before I found the resources that allowed my grieving to be activated. I found safety and sanctuary in day-long solitary trips to the beaches of Lake Michigan. They became monthly rituals, for it was water as a healing force and nature in general that were connections I could trust.
I found validation in the experiences of others who had lost loved ones, and whose grieving had brought out their strengths and growth. Jean Newman was one, a nurse-writer whose early life experiences with losing both of her parents had left her traumatized and in need of rather dramatic debriefing that we did together. Subsequently, Jean became a major source of validation of my grief and is the person most responsible for encouraging me to start writing to creatively express what was going on inside.
With those resources available, it wasn’t enough to break the pattern of denial. Still, it took two subsequent near-death experiences at the age of thirty-seven to break me loose from my pulls toward depression which were manifested by my workaholism, drinking, and insensitivity.
I had a choice to make. As a highly successful academic, I could have continued a focus on my career that was consuming all my time and energy and might well have died, probably quite prematurely, renowned for my devotion to work. Probably I would have been felled by a heart attack, like my father, or through carelessness in an accident, as almost did happen.
It was during the second of my two near-death experiences that I found the sense of direction I needed. In an incident in which I felt out of my body and moving towards a distant light, I re-experienced my connections to my father and grandfather, felt my own forgiveness, and eventually believed I was still here for a reason beyond my control or comprehension.
In facing death, I found the desire to live and I began to recognize the key difference between grief and depression: When we grieve, we retain the ability to benefit from our connections to others, connections that uphold us and carry us through life. We don’t have to feel trapped by obligations, duty and responsibility. We can choose to honor the meaning of these connections and balance them with respecting ourselves as well.
I’ve been blessed to discover that helping others find these connections in times of suffering can be a deeply intimate time, and I believe it is this ability to share such intimacy that eventually allows those in grief to know they aren’t alone and to know that there is nothing they can think or feel that will drive us away. In honoring that web of interconnectedness that is both material and immaterial, we learn to live with such connections, not to judge, fear, or try to change them. But witnesses also need to believe in the capacity of people in grief to find courage, grace, wisdom, and their own connections. I know of no training or educational process that can create this capacity. Only life experiences can, and even those experiences aren’t a guarantee.
My own experiences with suffering and vulnerability have softened my defenses, taught me humility, given me patience, and helped me to recognize how important it is to experience the full extent of being lonely, empty and helpless. Psychologist Clark Moustakas’ writings about loneliness first gave me that sense of intimacy, of empathy, with myself:
Being lonely is a time of crucial significance, an entering into an unknown search, a mystery, a unique and special moment of beauty, love or joy, or a particular moment of pain, despair, disillusionment, doubt, or rejection.
Being attentive to my own loneliness, vulnerability, and grief enables me to respect and understand when others experience it. I didn’t learn easily, which helps me to be more patient and less judgmental with those who’ve not yet had things get “bad enough” to face fully their own limits and losses.
The emergence from depression can be exhilarating. I have been tempted by the exciting developments of the human potential movement to believe that we can all achieve an enduring state of higher consciousness. Indeed for periods of time, I am able to do so. In learning how to experience a variety of states of consciousness, including the capacity to voluntarily have an out-of-the-body experience, I believed that it was possible to transcend ordinary existence and to leave behind the necessity to worry about grief or depression.
I had yet to learn not to confuse enthusiasm for new discoveries with becoming a “true believer,” convinced I had found the one true pathway. I had yet to learn that the seeking of transformative experiences was another way of avoiding the necessity of suffering in our lives.
There are limits in every discipline, whether it be physical, mental or spiritual. The limits of the growth oriented approaches, I found, was they had no place for suffering, for grief, for genuine choice that included the choice to die or the acceptance of its inevitability. Existentialist Rolo May in his critique of the human potential movement, found it lacking in the desire to find meaning in pain and loneliness, challenge in loss, or absent of a willingness to witness other’s genuine suffering without having to persuade them it was just their perception that was faulty.
I am now in my sixties, having retired early from a tenured professorship where I had conducted and encouraged research on the topic of this book since my early thirties. While I was on the faculty at Michigan State University, I wrote two books, Stress, Loss and Grief and Finding My Way, to present a model of the grieving process that is based on a wide variety of losses. (This model is discussed in Chapter Two.) I developed a self-test which focuses on grief as a process that involves discovering what is lost, what remains, and what is made possible after a major life change. This self-test led to extensive research by a number of doctoral students who have studied how grief differs from depression for over twenty years. This research and the discussions it precipitated are an important part of the information in this book.
I also had the opportunity in the mid-1980s to spend time in Denmark and later in Japan and to study cultural differences in grief and depression. While the ways people have of coping with loss vary considerably between cultures and in many places certain losses are prescribed as permanent (for example, in several southern European countries, widowhood is assumed to be permanent by the wearing of black the rest of the widow’s life), grieving is universally accepted as a necessary human response when something important is lost. The potential to grow from it, however, is often limited by the degree of oppression, poverty, and cultural sanctions experienced.
Twentieth century America poses an interesting paradox when it comes to grief and depression. By escaping the ravages and unavoidable reality of two world wars which were not fought on our soil, I believe that people in the United States have evolved a new mythology, based on material wealth, that postulates there are ways to avoid suffering loss, perhaps even death, if one is lucky, wealthy, or famous enough. Further, our mythology now includes the belief that it is possible to transcend ordinary life with all its pitfalls and choose to live permanently on a higher plain.
The possibility that we can escape suffering as it has been experienced for generations before creates an anxiety that does not exist elsewhere. In fact, I believe it promotes the neurosis of our times. In late twentieth century America, it is assumed we can avoid
loss, never need to grieve. Suffering is an optional life experience. If we suffer, it is a personal failing and an alienation from others still able to pursue the American Dream of fame, fortune, and material wealth or the spiritual dream of transcendence.
Like any mythology, eventually we encounter circumstances that attack its validity. Everyone suffers but few know about it. Loss is inevitable—except when we remain unattached to anyone or anything. Excessive material, intellectual or spiritual pursuits aimed at evading suffering are, I believe, major sources of alienation and depression.
Parents substitute toys for spending time and giving attention and affection to their children, while too exclusive a spiritual pursuit denies attachments to loved ones as necessary. Adults use possessions and fame as a substitute for having a sense of purpose or meaning or a functional role in society. Meditation and prayer can be used to avoid resolving everyday conflicts. Sexual expression is substituted for loving connections and committed relationships. In short, we keep ourselves so narrowly focused we don’t stop and ask: “Is there more to life than having everything?”
Not even the richest or most enlightened live forever, nor is anyone immune to the fragilities of body, mind and relations. When we finally do stop, or are stopped as happened in my life, we may lack the experience with grieving or the support system of a healing community that would allow us to reorder priorities, gain perspective, and learn from our experiences with loss and change. Instead, we may become depressed, for reliance on only the material, intellectual or the spiritual does not give us the resources necessary for positive transformations.
The paradox is that when we Americans do accept loss and suffering as a part of life, we can grieve losses and not take them as a personal failing. In grieving, our culture has the resources to help us grow and learn from our losses. Our material well-being, our longer life expectancy means we do not have to always focus on survival. We can do things differently—even transform our lives from a material focus to include a simpler, more spiritual, lifestyle.
I believe suffering to be an inevitable part of living life fully, for if we embrace fully our connections to loved ones, to nature, to dreams or missions, we will grieve when there is loss of any of them. And paradoxically, it is suffering that makes the joy of new connections or new possibilities all the richer. Life can be sheer joy—amidst the moments of suffering.
For my part, I have moved to the beautiful place of my father’s and my own dreams. I am working as a part-time therapist with people I enjoy, writing and savoring a slower pace of life than I allowed myself at a younger age. The goal of life, I’ve discovered, is not to detach but to find joy. Suffering comes from attachments, but I am willing to do so as long as my relationships add meaning to my life. I am better at letting go of what no longer is while continuing to hold on to what remains and to discover new possibilities—together that constitutes the great gift of being alive.
Discovering Invisible Connections: The Gossamer Threads of Grief
The notion of a gossamer thread conveys what I consider to be the essential difference between grief and depression. The word “gossamer” comes from an old English source and literally means “goose summer,” the time when geese fly south in the autumn attempting to recapture the warmth and life of summer. When used with “thread,” the meaning changes to “of things material and immaterial.” I like to think of a gossamer thread as something hard to see, a web of interconnections that only becomes apparent when we face loss, when we accept mortality, when we are forced by circumstances beyond our control to look for meaning and connection because the old ways are now gone.
When one is depressed, gossamer threads cannot be seen or appreciated. When we are able to find those invisible connections, our capacity for knowing how to love and feel joy is restored, even when we acknowledge that the innocence of “happily ever after” is permanently gone. “I can feel moments of joy,” observed Marilyn at the age of fifty, a year and a half after her son Zach was killed in a car accident:
But I no longer expect to be able to sustain happiness. Joy is something of the moment, while reality means forever being devoid of Zach’s presence. I cannot be happy under those circumstances, for I will never be able to touch him or hear his voice again. I do have a circle of friends who’ve had similar losses, and I’m very grateful for them. We help keep each other going. After being together, we find there is a lot to keep us going!
Without question, the idea of the gossamer thread has helped me to realize that none of us can make it on our own. We all need to believe in something greater than ourselves. Otherwise, in those dark and isolated times of depression, we all would choose to die, not in most cases by active suicide, but by a lack of will to honor our connections.
In the end, finding our “gossamer threads” is what I believe grieving and recovery to be about. “I see with different eyes” is something I have heard in one form or another from many individuals who have lost important people or aspects of their lives and who have been transformed by their subsequent grief. What they see with these different eyes are the gossamer threads that once were invisible to them and which now help them to be reconnected to others, and to life.
John M. Schneider, PhD
Distinguished Professor Emeritus
Michigan State University
College of Human Medicine