In Her Wake: A Child Psychiatrist Explores the Mystery of Her Mother’s Suicide

Whether treated or untreated, if the outcome of mental illness is suicide, it is a devastating end to a life and it wreaks havoc on family members left behind. Child psychiatrist Nancy Rappaport of Cambridge, Mass, has written a moving memoir of her mother’s suicide that took place during an acrimonious custody battle. Rappaport, at age 4 years, was the youngest of 6 children left behind. She shows great courage as she risks discovering painful information and creating potential ruptures with her father and siblings, some of whom disagree with her decision to write the book.

This personal story is Rappaport’s attempt to learn about the mother she never really had a chance to know. As Rappaport recounts, her mother was a talented and loving woman whose mood instability and grief reaction to the threat of losing her children in the face of divorce led to a fatal overdose. Rappaport’s father’s third wife eventually turns over a chest of her deceased mother’s papers and belongings. Here, the author finds journals, letters to the children from parental trips abroad, diaries, and even a semi-autobiographical novel. Strong emotional forces motivate Rappaport to learn about a beloved mother who would choose to end her own life and inexorably alter the emotional growth and development of the children she left behind.

In her discovery process, luck is sometimes on the author’s side, first with the chest of information, and then with her ability to find people who knew her mother and were willing to talk with her. This includes the physician who cared for her mother in the emergency ward when she entered in a terminal coma over 40 years ago. She also obtained court records of the custody battle, which included both her father’s and maternal grandmother’s testimonies.

Rappaport writes candidly and with evident emotion. It is painful to read about her childhood, disrupted by death and another divorce when she is a young teen. She grows up in a family where her father and his second wife try their best but never give the children the support or opportunity they need to mourn the loss of their mother. Nor do they give the children help to rework the trauma as they age and acquire the emotional and cognitive skills to try to comprehend the incomprehensible.

Rappaport smoothly weaves in the story of her own adult-life nuclear family-how her children’s needs and her need to provide for them push her forward to seek help, to stay well, and to make emotionally sound choices. She tells anecdotes about her children’s dawning awareness that children can lose a mother.

Amid flowing prose that propels the narrative and carries the reader into a deep and richly emotional well, Rappaport adds child developmental and psychological facts that will be useful to the subset of readers who are themselves survivors of suicides. For example, she describes a common reaction in children who suffer such a loss: They construct an explanation for the event that blames the child for both the death of the parent and for the failure to save the parent. With the understanding that the younger child might make sense of the tragedy in this way, the child’s false conclusions can be debunked.

This well-written memoir, with appendices that list scholarly articles as well as Web-based resources, will enable therapists to better understand the full impact of suicide and early maternal loss.

Dr Helper is a psychiatrist in private practice in Newton, Mass. She has written previously about managed care, the diagnostic assessment of children, the therapeutic space, and the developmental aspects of tree houses.