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Speaking to Children About Suicide

How can adults help a child after a parent dies by suicide?

The day my mother killed herself, she had just finished preparing her house on Marlborough Street for the anticipated return of her children after a fierce custody battle. I was just four years old and the youngest of six children. Growing up in a blended family of eleven children, I was bewildered about why my mother took her own life and left me behind. My mother was defined by her absence, and in my family, we seldom spoke of her.

Finding the "right words" to talk with a child after they've lost a parent is intimidating, particularly when a parent dies by suicide. As a child psychiatrist, mother, and daughter, I know firsthand how difficult it is for families to address the secrecy, shame, and sense of abandonment that can exist after a suicide and to figure out what to tell or not to tell. Yet children will cope better when they get honest disclosure that is age-appropriate. You don't want to give too much information on the way it happened, but you also don't want to lie.

Suicide demands an explanation, but the answer dies with the victim. Research shows that with completed suicides, there is often a toxic combination of mental illness, substance abuse, and impulsivity. Often, when people die by suicide, they are in a "mind tumble" of confusion, despair, and hopelessness that comes with depression.

It is essential that surviving adults help children make sense of a newly complicated world by offering stability and reassurance and supporting children in asking questions. Conveying that the suicide was tragic, unfair, and probably unexplainable can help alleviate corrosive guilt. Children often mistakenly assume that they are responsible. When they don't get an explanation, they often fill the void with their own interpretations. Reassuring children that they are not to blame is key: nothing they did or said caused their parent's suicide. The steady presence of other adults can help with the aching loneliness, give unconditional acceptance, and help children believe that they are loveable and capable of moving on.

Without this reassurance, children may worry that a self-inflicted death might somehow be contagious. While it is true that the child of a parent who has died by suicide is five times more likely to kill herself than a child who is not exposed to this loss, it is not a prophetic death sentence. There is a window of opportunity to help families understand the role of prevention and what to look for so that they can intervene early with their children.

How well a child copes following a parent's suicide is linked to the surviving parent staying strong and providing support. It is critical to mobilize if a child isolates, has periods of prolonged crying and irritability, has changes in sleep patterns, engages in high-risk behavior, gives away prized belongings, or talks about suicide. It is crucial to communicate to these children that mental illness is usually treatable even though a parent may have died from depression. Their parent needs to convey a determined confidence that they can find an alternative to self-destruction, and take steps to preserve their safety.

The suicide of a loved one in a family can be so confusing that people will avoid talking about it; the silent grief that follows leaves children with the unspoken burden of trying to make sense of an incomprehensible mystery. Sharing memories and photos of the parent is useful as children try to make a meaningful narrative. This is not a one-time conversation, but the beginning of a dialogue that will continue throughout the child's life. Life's transitions, such as graduation, marriage, or giving birth, may prompt a return to the haunting question of why someone they loved killed themselves, and why someone who loved them would want to leave them. The birth of my own daughter raised questions anew for me.

My search to know my mother led me to discover a vibrant, highly capable, passionate, and troubled woman given to depression, who undoubtedly loved her children. The search became a testament to love lasting longer than death. As survivors, our self-preservation honors those who have died as we find words for our sorrow and confusion. I now understand that bad things happen to all of us, and in the end, it's about how we make sense of trauma and work through it. We need to try to be courageous in our journey and ask the tough questions. We can find strength in the belief that we are all loved and none of us are expendable.

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