05.18.12

When a Parent Commits Suicide: A Psychiatrist’s Advice

It’s the kind of death that’s doubly painful for children, who often need help handling conflicting and disturbing feelings. How to help the kids who are left behind.

When a parent dies, it’s always painful for a child. And a parent’s death by suicide—especially, research shows, a mother’s suicide—has an even more painful and potentially disturbing effect.

The apparent suicide this week by Mary Richardson Kennedy, a mother of four children under age 18, raises difficult questions about how children cope—and how to help them.

As with all traumatic events, the way in which kids are supported in processing their feelings about the loss affects how successfully they will recover. Children are very resilient, and while a parent’s suicide will never stop being an important event in their lives, with help they can recover their emotional health and vitality.

When children experience the sudden death of a parent, they go through what we call traumatic grieving. This kind of death is not just a painful thing to assimilate; it triggers an emotionally complicated or conflicted process.

On the one hand, when a death is shocking and disturbing it generates frightening thoughts, images, and feelings a child may want desperately to avoid. In the case of a suicide, children may have feelings toward or about their parent that they feel are unacceptable, that they want to deny. So they try to block them out, by not talking or thinking about the person they’ve lost, who they may feel has betrayed them, or rejected them. But to grieve in a healthy way, it’s necessary to think about the person you’ve lost, and allow yourself to feel sadness and pain. They need to be able to remember her as a loving mom, before she succumbed to the disease, depression, that caused her death.

Even more than an accidental death, a suicide generates horror, anger, shame, confusion, and guilt—all feelings that a child can experience as overwhelming. The biggest risk to a child’s emotional health is not being able, or encouraged, to express these feelings, and get an understanding of what happened that he or she can live with. When a mother who has been depressed commits suicide, we want that understanding to be that she suffered from a mental illness, a disorder in her brain that caused her death, despite the efforts of those who loved her to save her.

Researchers at Johns Hopkins Children’s Center found that children who are under 18 when their parents commit suicide are three times as likely as children with living parents to later commit suicide themselves. The likelihood increases when the parent who commits suicide is the mother. This highlights the vital importance of providing support to children who are grieving. Not only are we treating the trauma of sudden parental loss, we are also trying to break the suicide cycle in families.

What do children need most in the aftermath of a suicide? First, they require simple and honest answers to their questions. They need to know that their feelings are acceptable: anger at a mother who killed herself is normal, and it doesn’t mean a betrayal of the love you feel for her, or the terrible loss you may be feeling. If the person who died has been mentally ill for a long time, a child might actually feel relieved at the death, and that, too, he or she needs to be allowed to feel.

After a suicide, children need to know that they’re not to blame. Being natural narcissists, kids tend to put themselves at the center of the narrative: If I had behaved better, if I had come home right after school, if I had tried harder to cheer Mom up, etc., she wouldn’t have done this. What we want them to understand is that mom was ill. We did our best to help her, but it didn’t succeed. This isn’t an understanding that’s achieved in one conversation; it’s something that has to be worked on over time.

Researchers at Johns Hopkins Children’s Center found that children who are under 18 when their parents commit suicide are three times as likely as children with living parents to later commit suicide themselves.

If there is media coverage of the death, it helps children to turn off the TV and stay away from the tabloids. It helps children recover to keep their lives as normal as possible—to return to routines as soon as possible, to return to school and regular activities.

When should you worry about a child failing to recover in a healthy way? Though it’s difficult to distinguish problem behavior from the expected process of grieving, there are some key things to look for.

With a “regular” traumatic experience, like being close to an accident, an attack, a disaster, we expect signs of recovery in about a month. But the timetable for grieving is less clear, so the recovery process can take longer. If a child’s sadness and withdrawal from normal activities don’t dissipate over time, and they begin to cause impairment—refusal to go to school, changes in sleep habits, a decrease in appetite, irritability—they can be cause for concern.

The biggest sign that someone is not grieving in a natural way is a confused relation to the memory of the loved one. This can include avoiding places or situations that might remind a child of the parent who died, emotional numbing, or selective amnesia about the traumatic loss. On the other hand, it can manifest as intrusive thoughts about the event. These all get in the way of the process of forming memories of a parent that’s part of the healthy grieving process.

Who is at most risk for suffering long-lasting trauma? Children with avoidant personalities or extreme anxiety will more easily fall into an unhealthy coping style. Children who have experienced other traumas are also more likely to respond poorly, given the “practice” they have had. Kids who lack strong support networks—both within the family and within the community at large—suffer more. And girls, for reasons we don’t fully understand, appear three times more likely to have traumatic reactions to disturbing events.

Finally, when we imagine a child’s experience of the loss of a parent to suicide, we need to recognize that the family may have been struggling with mental illness and addiction for years, which must surely have taken a toll. The most important thing to keep in mind is that the antidote to traumatic grief is honesty, loving support, and the continuation of the family in its strongest possible form.