9/1/13 by Amy Waldman- This is the first article in a projected series on little discussed or publicized problems and issues within the Jewish community.
On Rosh HaShanah and Yom Kippur, we recite the “Unetanneh Tokef” prayer. It reads, in part, “On Rosh HaShanah it will be inscribed and on Yom Kippur it will be sealed — how many will pass from the earth and how many will be created; who will live and who will die… But repentance, prayer, and charity avert the severe decree.”
Decent, generous and pious people die in many ways, including by suicide. When that happens, it can leave us — and those who want to comfort us — at a loss for how to proceed.
A generation ago, suicide was simply not discussed. Both mainstream America and the Jewish community have gotten better at addressing issues around suicide and suicide prevention. But better is a relative term. In the past few months, there have been several suicides in Milwaukee’s North Shore area. The individuals ranged in age from teen to adult, and were male and female, Jewish and non-Jewish. All left family and friends, who need and will continue to need understanding and support.
Rabbi David Cohen’s said his first experience with suicide occurred during his first year out of seminary, prior to moving to Milwaukee, where he has served as rabbi at Congregation Sinai for 25 years. “It’s understandable that people ask questions like ‘Could I have done more?’ and ‘Is there something we could have done?’” he said, “but the truth is that sometimes you can bring all the tools to bear and it’s not sufficient to keep someone alive.”
He also spoke about Jewish law regarding suicide, which differs from other religions in a significant way. “Before the fact, Judaism says it’s completely forbidden and anybody who would do such a thing doesn’t get funeral rites,” he said. “But after the fact there’s an attempt to re-categorize it as the act of someone who is not in his or her right mind and therefore cannot be held responsible.”
Mental illness can play a part. But having a brain disorder is not a predictor for death by suicide.
Dafna Berman, a psychotherapist at Jewish Family Services, emphasized that a lot of people who live with mental illness never attempt suicide, and some people who die by suicide have no documented history of mental illness.
“That’s somewhat contrary to the perception that’s out there,” Berman said, “because in the mental health system we see a lot of people that have a long history of depression or other self-harm behaviors. Those are also the people who reach out or are more likely to reach out for help. So our margin of intervening is very narrow, because we can only reach out to those we are aware of.”
For that reason, Berman said, it’s very important that non-clinicians and community members are aware of the warning signs indicating that someone might be in danger of taking his or her own life.
“People who have [died by suicide] do interact with loved ones, with colleagues and with neighbors,” she said. “If you know how to identify them, the signs are there.” Berman said signs might be comments that a person feels that his or her life isn’t worth living or that they’re a burden to others. They may give things away, or say goodbye.
“Take all declarations of suicide seriously,” Cohen said. “Don’t bear the knowledge alone. You want to make sure that someone, preferably a mental health professional, is involved in the situation.” In a situation where a death by suicide occurs, Cohen said he does not talk around the cause during the eulogy.
“I want to, in some way, reflect and address the deep feelings people are bringing with them, which can include — but aren’t limited to — guilt, anger, emptiness and loss, and questions about what mourners possibly could or should have done.”He has also taken steps to address those feelings off the bimah. Cohen has created a resource guide on the subject. And Rabbi Chaya Gusfield, a Renewal rabbi in California, has written “A Prayer for Those Left Behind After The Suicide of a Loved One.”
It reads, in part, “When the memories of their life’s suffering come to us, give us the strength and courage to feel compassion and love for them. Help us feel the companionship of families, friends, ancestors and the Divine Presence to protect and nourish us in times of distress. May we find the healing possible through sharing our whole experience with others, including feelings of regret and shame, relief and anger, grief and sorrow, unanswered questions, and deep love.”
Both Berman and Cohen said there are specific things that friends of a suicide survivor can do to help start that healing process.
“It’s not so much about what to say,” Berman said. “It’s about being there. It’s a traumatic event, and a friend is like a first responder. So actions, such as bringing meals and going grocery shopping, are helpful.” Berman also recommended avoiding any verbs that might imply judgment. Cohen agreed. “You avoid trying to make sense of what happened,” he said. “You try to help out in every way you can through actions, depending on the kind of relationship you have with the survivors. Try to let them know you are there for them and will continue to be there for them in the weeks, months and years ahead.”
For family and friends of a person who dies by suicide, support groups can play an important role in the grieving process. “I highly recommend that anyone struggling with the loss of a person to suicide find a support group because it’s a very safe place to talk about their experience, and it’s a unique experience,” said Melanie Wasserman, a psychotherapist in private practice at Health Psychology Associates in Milwaukee.
Wasserman said that the stigma that still surrounds suicide can make it difficult for survivors to talk openly about what they’re feeling. “We live in a society that appreciates and expects happiness,” she said. “Everyone is supposed to ‘Have a great day!’ It’s not socially acceptable to talk about depressing subjects, and support groups can be helpful because you can walk in and say, ‘I’m having a terrible day,’ and it’s okay.”
Ellen Abrams Blankenship co-facilitates an open-to-anyone monthly suicide survivor’s support group at the North Shore Library through Mental Health America of Wisconsin. A counselor and professional facilitator, Blankenship said support groups differ from therapy groups in that the focus is not on treatment outcomes.
“Everybody in that group has a shared experience, so immediately on coming in you know that other people get you. They understand what you’re feeling,” she said. “Death by suicide leaves a lot of unanswered questions, often times a feeling of guilt. That isn’t always associated with other deaths. However, at some point it is grief and must be dealt with as grief.”
Blankenship said that in the two years the group has been meeting — she joined as co-facilitator a year ago — it has been as small as three and as large as 15. Both men and women attend.
Although she and co-facilitator Linda Berman, let attendees define the scope of the sessions, Blankenship said that she and Berman always begin them the same way.
“What we always say is,” she said, “that we welcome you to the group and we’re sorry for the reason you’re here.”
Amy Waldman is a Milwaukee-based freelance writer and coordinator of the ACCESS Program for Displaced Homemakers at Milwaukee Area Technical College.
The American Association of Suicidology has designated the week of Sept. 8-14 National Suicide Prevention Week: www.suicidology.org.
The National Suicide Prevention Lifeline, run through the federal Substance Abuse and Mental Health Administration, is a 24-hour phone line staffed by trained counselors: 1-800-273-8255.
Jewish Family Services: 414-390-5800.Mental Health America of Wisconsin: 414-276-3122 and www.mhawisconsin.org. The North Shore Library Support group meets from 6-8 p.m. on the third Wednesday of each month.
Prevent Suicide Wisconsin: http://www.preventsuicidewi.org.For people in crisis: www.metanoia.org/suicide; suicideproject.org.