Suicide And Girls

07/11/2008 05:12 am ET | Updated Nov 17, 2011

Q: My niece just committed suicide. She is the 20-year-old daughter of my older sister. Needless to say, my sister is devastated and doesn't understand why this happened. I, of course, hesitate to tell her that Pam had long been on a path of self-destruction with drugs, anorexia, and depression. She was being treated, but I always felt that the family should have been involved in some kind of family therapy and recognized the tension within their home and Pam's apparent need to identify strongly with the popular girls at school.

I feel pain for my sister. But I am also concerned about my own 18-year-old daughter who idolized her cousin, Pam. Our mother committed suicide when my sister and I were in our early teens. Needless to say, the effect on our family was devastating. My mother had been a typical mother -- baking cookies and all -- and after her death, we were mostly left to our own devices. Our dad seemed to retreat into his own world and our close-knit family just fell apart.

My sister and I have always tried to maintain a strong family bond in spite of our vast differences in values and lifestyle. We live close to each other and we include each other in family holidays and celebrations. Our children are close and we have even taken several vacations together. But I, being the younger sister, was always painfully aware of her severe judgment of my husband, who is not as successful as her husband, and of my two sons, who are not as athletic as her son. Yet, as I mentioned before, I don't believe that she has as close a relationship with her kids as I do with mine. I have wonderful children. Pam's children don't confide in her. In fact, sometimes they confide in me. Her children are painfully aware of their mother's need to be accepted by the country club set. They don't respect that. They seem to always be asking if they can come over to our house - a form of running away from home.

Back to my daughter. I don't know how to handle this. She has told me that she doesn't understand why Pam would want to die. She feels Pam's life was wonderful. Pam was beautiful and she had her family's financial security. Her future seemed boundless. (She wanted to be an actress.) My daughter, Linda, always tried to follow in Pam's footsteps and to copy her lifestyle. Will she copy this? I am very scared.

A: My condolences to you and to your family. Death is a horrendous thing to accept no matter what the circumstances, but suicide and especially the suicide of a child is the worst. Pain, questions, and permanent scars are to be expected.

Your daughter should go into counseling, preferably with a psychiatrist who can prescribe medication if she needs it. That sounds like the typical response of a shrink. But taking into account Linda's closeness to your niece, her desire to identify with Pam, and her perception of Pam's life, it is better for Linda to be able to talk to someone outside the family. In that way, she'll be able to get a true picture of who Pam was - a picture not filtered through you, for better or worse. Your own judgments or viewpoints may influence her, or even worse, keep her mum about her feelings about her own family. If she becomes depressed, then you will be confident that someone is monitoring her or is giving her the medication that she needs. She will definitely have some kind of response.

Suicide leaves everyone with questions. Some experts feel that it seems to run in families - a kind of genetic predisposition. Some see it as much more complicated behavior that spirals out of control and results in death. This could be heavy drinking, drug abuse, risk-taking (like picking fights in bars) or anything else you can name that sooner or later will end badly. And some see it as an extremely selfish act that is meant to cause intense pain to others.

It seems that your niece could fall into any of these categories. Her grandmother committed suicide, which supports the genetic factor. At the same time, her apparent lifestyle had several self-destructive or harmful qualities to it -including, oddly enough, an apparent desire to identify with her mother's social values - popularity and inclusion in the "right" social set - while at the same time seeking shelter from all this at your house. If she actually couldn't communicate with her mother and felt anger toward her, the suicide can be seen as a call for attention or even an extreme need to hurt her family. I am not sure if one or all of these is the correct analysis in this case. It would take a deeper analysis of the individual to see which one applies.

There are many studies that try to isolate the sort of people most likely to commit suicide. A recent one says that young women living in urban areas are more likely to commit suicide that those living in rural areas. And of course we all know that stress, pressure, disappointment, and living up to societal standards are all cited as reasons for suicide. Sometimes I feel from what I've seen in my own practice that the cart gets put in front of the horse. For instance, some experts attribute anorexia to a need to be as thin as the models in the magazines - in other words, a form of societal pressure. What I see, instead, is a slow form of suicide. The pressure to be thin was the superficial explanation.

Aside from trying to understand your niece, your sister, and most importantly your daughter, you need to also take a moment to understand yourself. Your mother's suicide had to have an effect on you. You and your sister seem to have taken two very different approaches toward reconciling that event. You focused on your family, emulating your mother and continuing what her life choices had been. Your sister, though, focused on a sense of accomplishment in life, perhaps attempting to make up for what she saw as lacking in your mother's life. Are you unconsciously angry that your sister seemed to have disrespected your mother by turning her back on your mother's values? Are you angry that your sister seemed to put you down even though, to your mind, you were the one leading an exemplary life - similar to the one your mother did? Are you in the least bit jealous of your sister apparently greater wealth? Do you think she didn't respect your maternal qualities, qualities you extended even to her children? Do you feel she in some way contributed to her daughter's suicide - a form of payback for her superficial lifestyle choices? Do you feel justified therefore in your life choices?

While you were describing your scenario, I had a strong feeling that you were skirting some of the pain that extended beyond your fear for your daughter. In fact, there is some fear for yourself, if not in suicidal ideation, then about your lifestyle and the confidence you once had that it was grounded in real, wholesome and eternal values. Given what has happened and the profound impact it has had on you and your family, it is both appropriate and, ultimately, useful, to question the path you have chosen. It is important to be able to reach out to someone for help. I think you should also seek therapy. These are rough times for you. Good luck -and stay in touch.