The Persuasion of Suicide Contagion

"Dr. Armonson stitched up her wrist wounds. Within five minutes of the transfusion, he declared her out of danger. Chucking her under the chin, he said, "What are you doing here, honey? You're not even old enough to know how bad life gets."

And it was then Cecilia gave orally what was to be her only form of suicide note, and a useless one at that, because she was going to live: "Obviously, Doctor," she said, "you've never been a thirteen-year-old girl."

― Jeffrey Eugenides, The Virgin Suicides

I first read The Virgin Suicides in high school. I remember being gobsmacked that words could do this, that this writer could paint such a lyrical, dreamlike world that still managed to feel authentic. The marrying of what was told with the way it was told felt nothing short of some kind of miracle.

And though it's easy to feel The Virgin Suicides is among my all-time favorite books thanks to those qualities, it is hard to admit that aloud; though the language is lovely and haunting and the world it creates so absorbing, the plot is so raw and jarring. Several plot points are so catastrophic they are beyond belief, and admitting to any enjoyment of it feels a bit like admitting to enjoying watching a car wreck.

But in high school, I thought the plot going to such unbelievable extremes gave it a slightly safe unreality. Admitting aloud I loved it became somewhat safer because the tragic story was so unthinkable as to be implausible. So the persuasion of it for me as a 16-year-old was both hit and miss:

Choked by the same despair that destroys the characters? Yes.

Successfully seducing the reader and making them believe all it tells them? No.

It was not entirely a real world. This world was at least partially a "fantastic" world. I thought five sisters all killing themselves was so unlikely, so divorced from reality, the author had to have had a slightly sick brain to have cooked it up.

I was not yet old enough to understand how bad life can get. I was not yet old enough to know how successful the persuasion was.

(And clearly, I'd yet to read any Hemingway.)

***

Twenty years later, I found myself in a room with 11 other people, crying in a circle. There had been a recent suicide in the news, a Sandy Hook victim's father, so the group doubled in size that particular week. Celebrity suicides have this effect on group - it stirs grief up in survivors who haven't been to group therapy in years, and they come out of the woodwork. So many people showed up we had to split into two groups to make it manageable.

The whole of suicide bereavement is uncommon knowledge, but the part that trips me up most is this contagion.

Suicide contagion wasn't entirely unknown to me before being in that room. I remember seeing on the news throughout my life that there was always an uptick in suicide rates after a celebrity's death. I was well aware of contagion at that level. But to sit in that room and watch it swell after one was entirely another thing. To begin to see firsthand how contagion includes direct as well as indirect exposure to suicide began to take me from knowing to understanding. The more I understood, the more I saw the unbelievable reach of contagion, a complete scope to the spectrum of the heart-breaking dimensions of it.

As the years passed to sit in that room week after week and watch groups of friends, co-workers, siblings, grandparents, spouses, etc., all follow their loved ones was heart-rending. It was a revelation into a world I had no idea existed. It was something I realized I'd never fully be able to wrap my brain around.

My friends couldn't wrap their heads around it, either. When I shared one group story with a friend once about a brother killing himself a few years after his sister's suicide, my friend said, "That's impossible to comprehend."

It's impossible to comprehend for a million reasons - one of which being ignorance to how common that direct contagion is. If there's an uptick in suicides after a celebrity's death from people who never knew the celebrity, can you even begin to imagine the effect on loved ones when someone they knew and loved does it?

***

One day in group, one woman announced: "We're all at heightened risk, you know." According to statistics, we - the bereaved - are 65% more likely to die of suicide now that we've lost a loved one to suicide. "That brings the absolute risk up to 1 in 10, reveals new research funded by the Medical Research Council."

The group caps at 12. To look around the room and know that at least one of us was likely to follow our loved one was harrowing. The woman who announced our heightened risk knew it not from statistics but from her experiential reality - she had lost two family members to suicide.

So here is where I begin to depart from some ideas formed at 16 while reading The Virgin Suicides. Here is where I start to learn how bad life can truly get.

Here's where I learn the inspiration for The Virgin Suicides was actually very much gleaned from reality. It turns out Eugenides got the idea for his book after a conversation with his nephew's babysitter. She told him about how as teenagers, she and her sisters all attempted to take their own lives.

***

There was a 10% increase in suicides in 2014 when Robin Williams completed suicide. In 2017 my ex watched a multi-part documentary about Williams that rattled him to the core. He was so shaken he immediately rushed over to my place upon finishing it to vent the crushing fears the documentary stirred.

Like him, he knew that Robin Williams had had several decades of sobriety under his belt. But he hadn't realized that Robin relapsed in 2003, breaking that 20-year streak of sobriety. It made him doubt the resilience of his own sobriety. I stood at the end of my bed while he sat on the edge of it, crying, burying his head against my belly, wrapping his arms around me while muttering, "If Robin Williams can't make it, how can I?" He equated Robin's fame, fortune, "success" as impenetrable walls that should have protected against his demons. If Robin caved to drink surrounded by everything he could ever want, what were his chances with his slew of unending hardships? He became convinced he was doomed.

Absolutely nothing I could say could convince him otherwise.

And like Robin, towards the end of his rope, this ex had devolved into not making much sense. As I described his words and actions to my therapist at the time, she became tense. She said, "I don't want to be an armchair psychologist, but it's beyond obvious that he has had a psychotic break."

Paranoid delusions, dissociation, and wild outbursts became the norm at some point. By then, we were living together and I saw these things become more and more prevalent with each day that passed. As they gained momentum and I reported it all to my therapist, she said we needed to start working on an escape route for me; she believed I was in danger.

Which was something she didn't have to tell me. By that point, my ex was frequently verbally assaulting me, backing me into corners, even sometimes raising a hand. And throughout these outbursts, his blue eyes would dilate so much they would turn black as the pupils expanded in full fight-or-flight mode. He would dissociate so much during these episodes he wouldn't remember them at all. Entire scenes were so thoroughly deleted from his memory that it would elicit another attack when I would try to talk about them the next day. He was convinced I was making them up.

He was not himself. He was long gone. And he refused to seek help. And I refused to tolerate even a hand being raised to me. Each attack got more severe, and I knew it was only a matter of time before he hit me.

Leaving the relationship safely was a narrow journey of careful maneuvering that took several months to unfold. The year that followed was dominated by harassment, protective orders, smear campaigns, threats to my life, suicide notes, and being escorted into work by security daily.

On October 21, 2018, he completed suicide.

***

As time went by in group therapy following his death, I began to see how contagion could so rampantly affect the direct relations, now being one. I could understand how entire clusters of people could follow suit.

Suicide is such an irrational act that our brains can't process it. Preservation is instinct. It breaks our brains to attempt to understand something so counter to instinct. Let alone from someone we loved and so deeply entangled our lives with. Our identities get wrapped in one another in close relationships. When someone you love leaves that way, it feels like a piece of you completed the irrational act as well.

It's so obtuse and absurd that nothing after it feels real. You become a ghost. Everything feels like a dream. So processing it comes with a bit of an existential crisis. You're not sure if you exist anymore; what even matters.

It's so fucking hard not to just lie down and die of a broken heart yourself. One night in group, a woman said that - that she believes she could let herself die if she wanted to. Everyone nodded. She wouldn't even need a gun or a rope. All she would have to do would be to lay down and let the grief hit her full force. Her heart would explode. Everyone nodded.

I was among the everyone, the nodding. That's how I felt the entire first year - like my heart might explode. Chaotic, half-aware of what I was doing, white-knuckling the urge to just lay down and let myself die of heartbreak. It felt too impossible to keep going on like that. I swayed wildly between the protection of shock to the full brunt of all the sadness, anger, and guilt bubbling beneath the surface of it. Guilt is the other factor specific to suicide bereavement that complicates it far more than normal grief and adds to the likelihood of contagion. And I was saturated with it.

Thanks to guilt, I was suicidal myself for the first two weeks after his death. The last correspondences between us amplified it to an unbearable degree. The first suicide note he wrote me was vicious. This is all your fault. I hope this hangs over you for the rest of your life. But then he would manically sway back to a sweet, pleading suicide note. He would thank me for my endless kindness and promise he just needed my company for a few minutes. He would beg me to come over.

These letters haunted me, and my refusal to see him haunted me. I would call 911 with each letter and have mental health services check on him, but I still felt I was abandoning him at his absolute most vulnerable. With these memories in tow to drown felt inevitable. To go on living myself with that weight felt impossible. I had to stay with a friend for a while to keep an eye on me.

But overnight, the guilt vanished after those first two weeks. I woke one morning with the suffocating weight of it gone. I knew exactly why: I had repressed it, shoved it down into my body, out of my awareness. Which dismayed me even more - I went into a total panic.

I pleaded with my therapist to help me to excavate the guilt. I begged her to help me bring it back up to full awareness to work through it. This was in (futile) hopes of getting to a place of being fully done with it one day. She insisted my body and mind were doing it protectively - if I had repressed the guilt, I couldn't handle the full force of it. It would eventually come back up, she reassured me. I snapped at her that I knew that, that was the problem. I knew the longer it was repressed, the longer it was in the pressure cooker of unawareness down in my body, the more force it would gain. "We both know it will come back up far worse, far stronger."

Knowing that inevitable explosion was coming terrified me. So I tried to convince myself that the guilt disappearing wasn't from complete repression. Hearing the last song he wrote about me lead to this belief. The song was another suicide note in a way where he kept repeating the line "Terlingua on rewind" in it. Terlingua was a memorable trip for us. Out of all of our adventures, probably the most special. All the friends and family who were still in contact with him at the end of his life said it was all he was talking about, ad nauseam, in the months leading up to his death. He was repeating how memories of that trip were the only thing left holding him together in the song.

So I convinced myself the guilt disappeared because that song gave me a little bit of reassurance that maybe he didn't die completely hating me for leaving him. It allowed me a sliver of a belief that he was still holding on to at least one happy memory between us.

Because despite all the drama that unfolded at the end of our relationship, I was still holding onto all of our happy memories myself. The him at the end was not him, and I refused to give up the dream of our past.

***

Though the guilt was buried, inaccessible, I did my due diligence with individual counseling and group while swaying between fits of both maladaptive and healthy coping mechanisms. I was somehow simultaneously unhinged and assiduous. I made terrible decisions and put myself in some very dangerous situations while also drowning in work, night classes, and counseling.

Meanwhile, my ex's sister, best friend, and I leaned on each other a little. We checked in on each other regularly, and sometimes his sister even made the 5-hour drive to visit. I would take them to his favorite trails. All of us were swaying between erratic functioning - over socializing and overworking to keep our minds as occupied as possible - to total paralyzation. I would lay curled in a ball in bed for days on end, unable to do anything, not comforted at all to know this rollercoaster was the norm in complicated grief.

At some point, his sister stopped answering messages, though. When his best friend became concerned, I became dismissive - she was probably just going through one of the grief roller coaster's isolating phases. She would come back up for air soon, I reassured him.

We kept messaging her to no avail, though. She never came back up for air. She was dead. She shot herself. And the family was so destroyed they kept it a secret. It took months of us messaging her with no response before we finally caught wind of her suicide.

***

"The so-called 'psychotically depressed' person who tries to kill herself doesn't do so out of quote 'hopelessness' or any abstract conviction that life's assets and debits do not square. And surely not because death seems suddenly appealing. The person in whom Its invisible agony reaches a certain unendurable level will kill herself the same way a trapped person will eventually jump from the window of a burning high-rise. Make no mistake about people who leap from burning windows. Their terror of falling from a great height is still just as great as it would be for you or me standing speculatively at the same window just checking out the view; i.e. the fear of falling remains a constant. The variable here is the other terror, the fire's flames: when the flames get close enough, falling to death becomes the slightly less terrible of two terrors. It's not desiring the fall; it's terror of the flames. And yet nobody down on the sidewalk, looking up and yelling 'Don't!' and 'Hang on!', can understand the jump. Not really. You'd have to have personally been trapped and felt flames to really understand a terror way beyond falling."

- David Foster Wallace, Infinite Jest

Agony reached an ultimate unendurable level when I learned of his sister's suicide. With that trigger, as expected, all the repressed guilt erupted forcefully. I had to leave a relationship, and now not one but TWO people are dead. Smoke was filling the room, and I couldn't breathe; I fought the urge to jump.

After the call that brought the news of her suicide, I stood in my dining room doing an awkward, stilted dance. I would start to turn to exit the room towards the bathroom, where razors and pills were just waiting, to stopping myself and taking a few steps back into the room. All while berating myself at the insanity of spreading the contagion. I couldn't put my family through this. But I also couldn't endure this.

So I continued that dance of a few steps out, a few steps in, pacing and wailing until I thought to call a friend. The friend I called to talk me off the ledge wound up admonishing me for being so one-sided, not asking how she was doing.

I was so shocked at the moment I sobbed and apologized for being so selfish. I hung up the phone, feeling even more suicidal than when I picked it up. Now instead of just guilt for indirectly killing two people, I had the guilt of being a terrible friend who selfishly talked too much about it.

But feeling so much worse had a paradoxical effect of snapping me awake. It cleared the shock off, and the anger over this friend's lack of compassion rushed in. Who in the living fuck chooses to interrupt someone's suicidal call with criticism for talking too much? The outrage was so intense I had an out-of-body experience.

Ultimately, that anger that saved me; kept me from spreading self-destruction. Anger is better than despair because it is energizing. It is information that tells us when our boundaries have been crossed. That anger made me realize I had surrounded myself with some people who were so wrapped up in their own pain that they could not see or handle anyone else's with any degree of grace. It made me realize it was time to burn everything to the ground and start over.

***

One day, Mothership and I took a break from the chaos of my nephew's birthday party in his room. We sat on the floor and talked while a bunch of 6-year-olds screamed and chased each other beyond the door.

She asked why I was no longer talking to that particular friend from that call. I hesitated. I didn't feel capable of outright lying to her or evading out of either her discomfort or my own. I was too angry to let the ignorance of complicated grief continue to do its damage by staying in the shadows. Something in that call with that friend had opened something in me up. I didn't feel capable of holding my tongue out of politeness or discomfort on any topic anymore.

Plus, I knew I'd write about it one day. So there was no keeping it from Mothership ultimately anyway. I figured surely she'd much rather hear it directly from my mouth rather than years later in an essay when everyone else learned of it.

So I delicately gave the disclaimer that I was no longer in danger first. But when I learned of my ex's sister's suicide, all the guilt I had repressed erupted, and I became suicidal myself. I told her how my friend mishandled it when I called for help.

No one wants to hear about suicide, most especially parents from their children. Mothership was understandably very visibly upset to hear this. She winced, closed her eyes, and put her hands over her ears for a split second as if to block any further details from coming in.

"I wish you hadn't told me that."

But that is why so much of complicated grief is shrouded in mystery and misunderstanding. We keep closing our eyes and putting our hands over our ears. It's too upsetting to hear, so we avoid it. Then we're left in the dark of ignorance.

But with this ignorance doesn't come bliss. Avoiding is just repressing, pushing the information down in the pressure-cooker of silence and unawareness. What we avoid eventually erupts because there's no successfully avoiding what is in the long run.

And when we avoid, we mishandle those most vulnerable because what they need most is support - to be seen and heard. Without that support, they flail and wither in suffocating isolation, leading them to the very same edge. Avoidance, ignorance, and subsequent lack of adequate support spread the contagion.

One day after group, I was so distraught after hearing about the contagion in the cluster of one family that one of my friends urged me not to attend group anymore. He argued my sensitivity, my sponge-like ability to absorb everyone's emotions around me, made group a detrimental place for me, not a healing one.

I pushed back. Based on the context of that one tiny slice of group, it might be easy to come to that conclusion. He hadn't seen or heard the parts where the benefit began outweighing the risk, though. It was absolutely rattling to hear of this person's cluster of suicides within their family. But seeing how the entire group shifted focus in response to it was another story. It went from being a typical night of round-robin sharing to everyone piling love, comfort, and witness all on this one particular member. It was one of the most beautiful things I've ever witnessed. I left both rattled and chilled, sick to hear of such tragedy but edified by the group's response to it.

This is not a virus. Covered mouths and isolation and avoidance are what spread, not prevent, suicide. We need each other like we need air and water. We need to speak our truths. If not, we suffocate beneath the weight of words unspoken because those words are what connect us to each other. Everything is interconnected and interdependent. Though we try with all our might to deny that fact.

***

Though the rise in numbers of suicide rates and celebrity suicides correlate, correlation doesn't equal causation.

Four of the sisters in The Virgin Suicides all took their lives in one fail swoop after a prolonged experience of isolation. The mom shut them up in the house, trying to protect them after the grief of the youngest sister's suicide. That isolation suffocated them, taking their agony to unendurable heights, eventually culminating in their suicides as well. They didn't kill themselves directly because of their sister's death; they killed themselves from the lack of adequate support following it.

Just as I didn't come so close to it myself because of my ex's or his sister's suicide, I came dangerously close because while I had the support of group, everyone else around me was sticking their heads in the sand, avoiding the topic, or outright asking me to not talk about it.

And my ex didn't kill himself because Robin Williams did. He killed himself because he was suffocating in the isolation of his mental illness and addiction with nowhere to turn. Which was something I didn't have the power to cure no matter how much witnessing I gave him. He needed far more than that. He needed a different childhood; he needed a tribe of support, not all his eggs in the one basket of me. He needed so many things that our broken systems do not provide. Our culture of toxic individuality leaves so much room for drowning and few avenues for rescue and reclamation. Because we believe everyone should be able to pick themselves up by their bootstraps. To need help is weak.

Individualism is a fantasy we've built our culture around that states every man should be able to fend for himself as if we weren't all here together. And in buying into that false belief, we are repressing the reality of what is - that we are interdependent.

***

I am old enough now to know how bad life can get. I am old enough now to find the persuasion of The Virgin Suicides to be genius rather than evidence of a sick mind because I know how real that plot can be now that I've lived such a similar one.

But much more importantly, I have also learned how much we need each other. It makes it crystal clear exactly why we are all chomping at the bits now to reopen the country after so much isolation through this pandemic. I hope because of it more people now see what I see: that we are all here together. And I wish we'd start acting like it. It truly is our only hope.

The ripple effects of suicide can include clusters of more suicide, but there is a flip side of that coin: there are likewise ripple effects to community and collective action that can save people's lives by connecting them and allowing them to be seen and heard, something we need as much as air and water. Or, as a wise friend once said, "One breeze stirs another."

For it is when one breeze moves another that life has us by the force in our hearts.

***

Thank you so much for taking the time to read my article. I appreciate you devoting your valuable time to consider my experience and all the beliefs that have sprung from it. I share in hopes that it will help others and hope you gleaned something of importance from it. 

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Thank you again for your readership, it is greatly appreciated.