Extremely Dark Places: The role of empathy in healing from suicide

Walking the dog under the St. Johns Bridge one lovely evening a few weeks back, Marlene and I noticed a small patrol boat circling an area of the Willamette River just downstream from the bridge. With night encroaching, a spotlight skimmed across the shimmering dark surface of the water, searching searching searching.

I had a gut feeling. And I had in recent days seen Missing Person flyers bearing the photo of a woman last seen taking a walk near the bridge. I thought they might have found her and remarked as much to Marlene.

A few minutes later, my upstairs neighbor approached us. “Did you just see what happened here?” she asked. When we shook our heads, she replied that she had seen an array of lights from emergency response vehicles on the bridge. She assumed a car wreck.

I pointed to the boat downstream and remarked, “It was more likely a jumper.”

She reacted with shock. “What?! You mean people jump from this bridge?” She is 20-something, new to Portland, and had just moved in a week or two prior. “I can’t believe that!”

A few days later, my suspicion was confirmed. Some of the missing woman’s belongings had been found on the bridge, and her body later washed ashore. Hers was the third suicidal jump from the St. Johns Bridge since May, according to the local St. Johns Review.

Suicide-5Sadly, neither Marlene nor I had any trouble believing it. Only a few weeks earlier, a well-love friend of the family for some 50 years — I’ll call her Susan — had hung herself from the balcony of her home in Pennsylvania. Defying a common notion of suicide occurring mostly among non-functioning, isolated people, Susan had been active in volunteer organizations, owned and operated a yoga studio in her small town and left behind a substantial community who mourned her sudden death, including a large and tightly knit family. For Marlene, her death struck especially close to home.

Looking at the lonely patrol boat scanning the dark waters of the river, rather than feeling surprised like our young neighbor, Marlene and I had a similar wondering of the mind: What had those last moments been like for Susan? Why had she done it?

“I can only think she was lost in some extremely dark place,” Marlene remarked.

An extremely dark place, indeed.

There are many things I might say, personally and professionally, about suicide. But Marlene’s comment, her attempt to imagine into Susan’s experience, struck a chord. It was later reinforced during a conversation I had with Susan’s older sister, who two months after learning of the suicide complained of increasing difficulty with focus and concentration: “I feel like there are two parts of me working at opposite ends,” she said. “One is asking me to acknowledge something, and the other part is trying to prevent me from seeing it.”

As a psychotherapist with a background in mental health crisis work and a private practice focusing on traumatic bereavement, I had appreciation for what Susan’s sister was trying to describe. This phenomena, the difficulty of reckoning with and acknowledging death of a loved one, is not uncommon even in the most “typical” bereavement process, but it often seems an especially devilish aspect of traumatic loss and suicide in particular.

Grieving takes many forms, and countless factors influence how we view and process the experience of death. Cultural practices, spiritual beliefs, the nature of our relationship with and connection to the deceased, the means by which they died: All these and more influence how we respond to loss. So although I am about to address one aspect of healing from loss, nothing I write here is intended to define “appropriate” grieving. That said….

One means by which people access and process feelings of grief is through empathizing with the deceased. Each of us will die one day, and every experience of loss or witnessing someone die provides an opportunity for us to envision our own death in some fashion. In bringing the scene of death to mind — be it at home or in hospital, by cancer or car accident, alone or attended to by a circle of loving souls — we bring to mind situations we know might be our own story one day, and this creates an opportunity to feel into the experience. It allows us to wonder what the deceased’s final moments were like, to try on the suit of understanding and to engage with our own mortality. In grieving the death of others, we may grieve the eventual loss of our own life, as well.

When witnessing a “peaceful passing” from illness, or in learning of an elder who died “quietly in their sleep,” we may be gifted with a scene and attendant narrative — the so-called Good Death — that may be relatively easy to recall or imagine, one which many people claim to wish for themselves.

It has always been easy, for example, to envision the scene of my grandmother Mimi’s departure after living her final years with cancer. She died at home, surrounded by a circle of female love in the form of my two aunts and a few of my cousins, all of whom possessed personalities of deep warmth. Although I was driving to the airport in Portland when Mimi died in Miami, I see the scene as my Aunt Liz painted it for me: my grandmother surrounded by candles, enveloped in the warmth of caring family, and passing compassionately.

What’s not to wish for in that picture, save the business with cancer? Unless we have a complicated relationship with the deceased or are riddled with death anxiety to the point of phobia, empathy in such situations is often relatively easy to access. Our hearts may open in compassion, and some soulful understanding of our loss may be experienced, allowing us to accept what happened and begin the work of adjusting to a new life without the deceased.

Suicide tends to confound this process. By stepping out of the presumed natural order of things, those who commit suicide create a different vision with which they posthumously force us to grapple, if we are to experience such depths of such empathy and compassion. And it’s a vision that, if my professional experiences ring true, very few of us want to encounter.

To empathize with one who commits suicide asks us to imagine into their final moments, to try to feel and understand the despair or pain that brought them to the bridge’s edge or left them believing that being on the receiving end of a gun or knife or deadly bottle of pills was their last best option. It asks us to grapple with the gaping psychic wounds of humanity, the holes in our systems of care and social safety nets, the bleak realities of our fragility in the face of unrelenting physical pain or overwhelming economic or interpersonal stress, the vagaries of romantic attachments, the agony of being bullied at school, the humiliation of losing a job and not being able to find another, the sense of such loss of control as to necessitate taking ultimate control, the profundity of anger and self-hatred that brings violence against the Self, and so on and so on.

Extremely dark places, indeed.

How can we go there?

It is not a path many initially choose to take — and for good reason. Such journeys into empathy for the hardships of being human causes us to recall our own pains and sorrows — and then perhaps to imagine them somewhat worse, because we have, after all, continued to live with our own experiences and may reason that suicide is caused by a depth of anguish we could not endure. Either that, or we face recollection of our own failed suicide attempts. (In 2013 alone, the CDC reports, 1.3 million people in the U.S. attempted suicide and survived.)

It is far easier — or so it seems at the time, on the surface anyway — to inhabit other realms of consciousness, other emotional experiences, other embodiments of response to suicide or trauma.

Some of the more stoic, resilient or cheerfully tempered among us may seem to carry on with life rather quickly, perhaps appearing to others as if they are avoiding their feelings. They may in fact be completely fine; effective coping comes in many forms, allowing some to quickly resume life in their usual fashion.

Others may find themselves feeling conflicted to the point of numbness, or perhaps as if their life is in suspension. Some report waiting for a blunt realization of loss to settle in, not yet feeling whatever they expect to feel. Such states may last for days or months — and years are not unheard of — then abruptly resolve in a dam-breech of emotion.

Others may seem to become embroiled in one emotional response or other: anger being one of the more commonly aroused feelings in response to suicide, along with confusion, sorrow, longing, anguish. It is not unusual for people to consume intoxicants to avoid the intensity of such feelings, nor to ask their doctor for medication evoking some numbing effect.

Still others may begin to live somehow more recklessly, impulsively, perhaps in unconscious longing for the “freedom” enacted by the deceased in taking such a solitary and final act.

And last but not least, innumerable are those among us who have deeply held somatic troubles through which grief makes itself known. Chinese medicine, for example, understands a connection between grief and respiratory troubles. This is not surprising given how crying, which involves the entire respiratory system, is a common outlet for sadness. If crying or sadness is repressed, perhaps the grief is trapped in the lungs. In Western medicine, we are increasingly linking muscular tension, digestive ailments, sleep and appetite disruptions and hyper-vigilance with experiences of grief and trauma, both.

None of the above are uncommon experiences for people grieving the loss of someone to suicide. Some may experience all — or none — of what I’ve described. Again, there is no wrong way to deal. The concern comes when we feel stuck, or when, months after the loss, our means of coping with it are causing problems in our daily functioning, interfering with our work or relationships, or resulting in harmful behaviors.

In fact, most of us have the capacity for resilience and weather our losses without the need for therapy. But one thing people do commonly need, especially where suicide is concerned, is a good source of supportive listening. This may be provided by friends, family, members of ones spiritual community, counselors, support groups, hotlines — whatever works. Journaling can also be used effectively as a sounding board and source of reflection.

Supportive listening can be helpful in many ways — banishing feelings of isolation, for one, which are commonly expressed by many of the people I treat for grief-related concerns. But I believe one of its more helpful aspects involves assistance in reflecting, examining and, where necessary, challenging the stories we have, the beliefs we hold, about the experience of loss and all the underlying sediment it disturbs.

Suicide has a way of stirring up our belief systems. We operate our daily lives within a complicated context of assumptions about the ways people ought to behave, what specific types of relationships mean to us, how the world is supposed to work. Most of us hold these beliefs as an unconscious contract with society, and when someone engages in a behavior — such as suicide — that violates the contract we have come to rely upon, it throws these expectations into chaos.

In such situations, how does a sense of order return? Are we to cling ever-harder to the expected contract and live with bitterness about how a loved one broke it? Do we pretend it didn’t happen? Do we become suspicious of others breaking the contract and refuse to extend our trust in future relationships? Do we become social activists in a bid to prevent others from breaking the contract?

Perhaps. Perhaps. Perhaps. Perhaps.

And perhaps we may also find empathy and compassion for the one who has taken their own life and eventually come to forgive them.

Though this idea is one of the hardest things some of my clients ever hear me suggest — usually because the pain of suicide stings so hard, so deeply and for so long — I believe it is fundamental for long-term recovery from such experiences.

The equation is relatively simple, though not always easy: Empathy helps us to understand, compassion allows us to experience some sympathy for what we have come to understand, and forgiveness allows us to release our expectations that things “should have been” otherwise. In doing this, we can regain what Stephen Levine in his beautiful work on grief, Unattended Sorrow: Recovering from Loss and Reviving the Heart, so eloquently called a sense of “trust in life.”

Such trust in life is, after all, precisely what the person who commits suicide has lost — and also what most of us need to live with a sense of fulfillment. In finding empathy, compassion and forgiveness for their dramatic final exits, perhaps we also find some compassion and forgiveness for ourselves, for all the ways we have stumbled and faltered on our own life paths, for the times we have been discouraged and disappointed by our own choices, our limiting self-doubts, our dashed dreams, our ruined relationships, our aging bodies, and all the other fundamental hardships and inherent frailties of being human.

The vast majority of us, for much of our time, carry on with these hardships in largely unconscious fashion — and quite necessarily, for if we were to live full-time with such awareness, far more of us would live in deep despair. But when the suicide of a loved one touches our lives, it may eventually force us to reflect on what Marlene apply called those “extremely dark places.”

In the depths of such reflection, we have an opportunity to take stock of our own resiliency in the face of obstacles and loss, to recognize the power and meaning underlying the choices we make, each and every day, to carry on with this whole business of living. We do so despite the inevitable accumulation, and spreading, of pain for which we must each account on our own journey through life. But it’s also possible in such reflection to understand why someone might choose not to continue.

From here, we have the power to forgive others for their own struggles and choices. And from the same vantage point, rather than judging the value of our own lives — a trouble at the heart of so much narrative in protracted grief, as well as depression and anxiety — we may come to understand that this simply is the way of life. In doing so, we are presented the choice to have compassion and forgiveness for ourselves, as well, which is the greatest healing journey of all.

Tamara Webb, LPC, LMHC, is a psychotherapist and writer in Portland, Oregon. Contact her at tamara@fivebodiescounseling.com.