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Speaking Ill of the Dead: Parental Suicide as Child Abuse

Barry Wright and Ian Partridge Clin Child Psychol Psychiatry 1999 4: 225 DOI: 10.1177/1359104599004002008 The online version of this article can be found at: http://ccp.sagepub.com/content/4/2/225

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Speaking Ill of the Dead: Parental Suicide as Child Abuse

B ARRY WRIGHT & IAN PARTRIDGE
Lime Trees Child, Adolescent and Family Unit, UK

A B S T R AC T Many authors have written about the psychological consequences for the survivors when a family member commits suicide. Most clinicians use bereavement as a paradigm for planning therapeutic interventions. We have not been able to nd any articles which recognize that the experience may be a form of child abuse. We believe that using the model of child abuse as well as traditionally used models of bereavement and trauma may be helpful when understanding the childs predicament and planning therapeutic interventions. Two cases, involving four children, illustrate this perspective. K E Y WO R D S child abuse, suicide

Introduction
F O L L O W I N G PAT E R N A L S U I C I D E the majority of children are reported as missing their father, becoming upset on thinking about the event, avoiding reminders, suffering somatic complaints and being fearful that something similar may happen again within their family (Grossman, Clark, Gross, Halstead, & Pennington, 1995).

AC K N OW L E D G E M E N T :

We wish to thank Kate Wurr for her helpful comments during the preparation of this article.

B A R RY W R I G H T is a Consultant Child and Adolescent Psychiatrist at Lime Trees Child Adolescent and Family Unit in York NHS Hospital Trust. In addition to working in a community setting in York he provides a paediatric liaison service at York District Hospital. C O N TA C T :

Lime Trees Child, Adolescent and Family Unit, Shipton Road, York YO3 6RE,

UK.
I A N PA R T R I D G E

is a Social Worker based at Lime Trees. Both authors work as part of a multi-agency, multidisciplinary bereavement team.

Clinical Child Psychology and Psychiatry 13591045 (199904)4:2 Copyright 1999 SAGE Publications (London, Thousand Oaks and New Delhi) Vol. 4(2): 225231; 007451 225

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CLINICAL CHILD PSYCHOLOGY AND PSYCHIATRY 4(2)

The adjustment of children after the death of a parent is better where children have a good pre-morbid emotional history and a stable family before and after the bereavement (Elizur, & Kaffman, 1982; Palombo, 1981; Tennant, 1988). This also seems to be true of paternal suicide (Grossman et al., 1995). Children who have witnessed violent deaths may experience post-traumatic stress (Pynoos et al., 1987) and some young people may have some feelings of responsibility for the death (Valete, Sanders, & Street, 1988). In parental suicide the disillusioning impact upon the child raises questions of accountability, the control of destructive impulses within a developmental context of dependence and helplessness (Pynoos, & Eth, 1985). It has been argued that the typical traumatic responses illustrate that a parental suicide is unique for its profound long term alteration of the parent-child relationship (p. 36) wherein the child may attempt to remove the responsibility from the suicidal parent and redirect the blame either to self, the surviving parent or other (Cain, & Fast, 1966; Pynoos, & Eth, 1985) and such consequences can be particularly strong in latency aged children (Pfeffer, 1981). It seems reasonable to ask whether these consequences, which affect the developmental and psychological well-being of children, could be understood within the framework of an abuse model, as well as within the more usually utilized models of trauma and loss. Within this is a recognition that suicide may occur in different contexts with different motivations. Distinctions can therefore be made in terms of suicides where the abusive element is deliberate or planned, and suicides where there has been no specic intent to cause emotional damage to the child, but where there has been a failure to consider the consequences for the child, which may still nevertheless be an abusive experience. In this article our case examples are of paternal suicide and we recognize that there may be other dynamics involved with the suicide of a mother (Hawton, Roberts, & Goodwin, 1985).

Case reports Case one

James was 11 years old, and his sister Marie was 8, when their father committed suicide. He did not consider his heavy drinking to be a problem, and never sought advice or help. He was jealous and possessive of his wife, did not let her out without him and regularly accused her of having sexual relationships with other men, including members of the wider family. He never harmed the children directly, but would be verbally and physically aggressive towards his wife in front of them. He also used to be verbally unpleasant to the children but they developed strategies for keeping out of his way, especially when he had been drinking. Family relationships deteriorated when the childrens mother got a job: her husband became more jealous, more aggressive and regularly checked up on her at work. She found this increasingly difcult and then discovered that he had previously had an affair with one of her best friends. At this point she decided that she wanted to separate from him, but because she could not bring herself to say this to his face, she took the children away for the weekend and left him a letter from her and her solicitor. When she returned he was found hanging in the stairwell of the house, in plain view of the front door. The childrens mother felt that he would have known the children were always rst through the door and felt that he had deliberately chosen this spot for that reason. In fact the dogs had been barking so much that a neighbour had gone to investigate and called the police when they suspected that something was wrong, thus the children did not nd his body. The childrens mother arranged for them to go to their grandparents house. She was
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WRIGHT & PARTRIDGE: PARENTAL SUICIDE AS CHILD ABUSE

reluctant to tell the children what had happened in order to protect them, and initially told them that he died of a heart attack. This was against the backdrop where most of the community knew the facts, as did many children at the school they attended. Before long James was playing games in which he was hanging teddy bears from the banisters. The main therapeutic tasks were enabling the mother to see that the children were bound to nd out sooner or later the details of what had happened, and helping her to discuss the truth with the children in a sensitive fashion. This work was done directly with her but with some sessions for the family together. Subsequently the children entered a bereavement group with some other children, some of whom had lost a parent by suicide, with a parallel parents group. At the beginning of this group the mother reported that James had been saying that he wanted to die and had been putting his hands around his neck. This occurred on one or two occasions when he felt very frustrated in the context of being told off for minor misdemeanours. This settled when his mother dealt with the situation calmly and addressed the context of the behaviour rather than the behaviour itself. The children have done well, with no serious problems at school or at home.

Case two
David was 9 years old, and his brother Keith was 6, when their father committed suicide. Their mother was visiting friends and their father was caring for the children at home. The father said he was going to the garden to have a cigarette. After his failure to return the children went out to nd that he had hung himself from a beam in the garage. The referrer described the boys as distraught, with Keith refusing to talk about the matter and David presenting as extremely angry. When we met, David was indeed angry. He had been very close to his father and had wanted to live with him following the parents planned divorce. He could not understand why his father should want to kill himself. He spoke a good deal about his father, and his mother was concerned that he seemed to identify greatly with him. Keith was closer to his mother and was more reticent and avoidant. The mother was very angry with her deceased husband, and concerned that they were neither coping individually nor as a family. It was recognized that the mother needed some space in her own right to ventilate and share her feelings. During the subsequent individual sessions the disharmony and hostility within the family prior to her husbands suicide became much clearer. The marriage was in the process of disintegration. The father had lost his job and had suffered from a serious and chronic alcohol problem. The father had taken to presenting himself as a victim of ctitious muggings. He had informed the family falsely that he was suffering from bowel cancer, and had made up a story involving hospital admission and operative treatment. At times he had been violent towards his wife. There were tensions within the wider family that compounded the dynamics of marital disharmony, and the family were also stressed nancially. While in this case there had been a degree of openness with the children, the mother still felt unable to speak ill of the dead. This resulted in overcompensation and guilt, with concern to win back the affection of her elder son in particular. We met with the family on a couple of occasions and allowed the children to give their account of events. Keith, who had previously been silent about the matter, was able to do this in great detail, which was to his mothers surprise. He did so slowly and quietly, while David, who had initially presented as very angry, expressed his great sadness, crying and hiding his face. We were able to name some of the uncomfortable feelings and acknowledged the needs of all the family members. Individual support was necessary for the mother and this was successfully instigated with further family work at a later stage. Group work was also provided for all of them via parallel children and adult bereavement groups. The boys are now able to speak openly with their mother about their father.
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Discussion
It has been demonstrated that fathers who subsequently kill themselves may make threats of divorce and/or suicide in front of their own children (Grossman et al., 1995). They may also commit suicide with the children present in the home. Such studies have concentrated on the sequelae for the child and family without much reference to the motives and actions of the parent. The notion that this experience was abusive has not been considered. It has been argued that being married with young children is a protective factor against suicide (Durkeim, 1951). However, other factors such as familial disharmony and hostility (Richman, & Rosenbaum, 1970), the number of children and the age of the parents (Kozak, & Gibbs,1979) suggest that this may be rather too simple an analysis. Given that previous studies have shown that attempted suicide is more common among parents who neglect or abuse their children (Roberts, & Hawton, 1980) and the fact that there are high rates of child abuse in parents who have attempted suicide (Hawton et al., 1985) we should perhaps not be surprised to discern abuse in the act of suicide itself. Claussen and Crittenden (1991) have listed types of psychological maltreatment including rejection, exploitation, degradation, terrorization, isolation, corrupting acts, acts which missocialize and acts which deny emotional responsiveness. However, none encapsulates the experience of the child whose parent has committed suicide, particularly if the child was intended to nd the body. It is important to draw a distinction between the parent who commits suicide without thought for the consequences to the children (neglecting to consider the emotions of the child), and the parent who wishes to inict emotional harm on the child or both the surviving parent and the child through the suicide (actively emotionally abusive). It should be recognized however, that both are abusive experiences. It is the quality of those abusive experiences that differs. The actions of the parent result in signicant harm to the child. The denition of emotional abuse suggested in the context of the 1989 Children Act is that there needs to be . . . likely adverse effect on the emotional development of a child caused by . . . severe emotional ill-treatment or rejection (Home Ofce, Department of Health, Department of Education & Science, & Welsh Ofce, 1991). In our view paternal suicide can be seen to represent just such psychological maltreatment. We recognize that such an understanding must be viewed in the wider context of familial dysfunction (and often abuse itself) but would argue that this does not necessarily lessen the impact and indeed may enhance it. The act of commission (suicide) is compounded by the act of omission (recognition of the needs of the children). It exposes the child to a catastrophe, not only in exposure to an unpleasant death with the attendant bereavement and post-traumatic symptoms, but also to the death of a key gure in the childs life. After parental suicide, emotional problems such as anxiety, depression, withdrawal, anger and aggression seem more common in children with pre-existing psychological problems (Cain, & Fast, 1966; Shepherd, & Barroughclough, 1976) than those without (Grossman et al., 1995). The quality of parenting after loss may be a factor in this and in subsequent adult adjustment (Tennant, 1988). The experience of the two mothers we have described was clearly detrimental to their parenting. They experienced anger towards their dead partner and grappled with guilt, wondering whether they could have helped events to have taken a different course. They also sought to change their childrens view of events. However, for the most part they were understanding and sensitively honest, and were reassured in this process by the therapists. The cases reported here have similarities in that the suicides can be seen within the
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context of a dysfunctional setting, with both fathers neglecting the needs of their children. Where they differ is that in Case one the maternal approach to the children had been protective and secretive about the suicide. In Case two there had been more openness with the children, partly because they had found the body. The therapists took note of the abuse paradigm and considered the parental agendas. This raised questions about the intent of the fathers and the consequences of their actions. It also allowed us to acknowledge the negative effects and emotions. This was particularly important in terms of freeing the mothers up to renegotiate their relationships with, and responsibilities to, their children. There is a cultural expectation that we should be kind to the dead in the way that we remember them, particularly in the immediate aftermath of death. It is also usual for us to attempt to leave surviving children with positive memories. Despite poor marital relationships and poor experiences of parenting, children may still have intense positive feelings for their dead parent. The reality of some suicides, however, is that children are exposed to experiences which are profoundly abusive, leaving them with strong feelings of guilt, anger, helplessness and sadness. Factors that motivate suicide, and the effects on survivors that those killing themselves are wishing to produce (if any), may be important. However, equally important are the attributions of the survivors, and the systemic effects of the act itself. Perpetrators of child abuse often avoid, or have little understanding of, the childs perspective, as they seek their own goals. Paternal suicide bears some similarities to this, particularly since in both our cases it is hard to escape the reality that the fathers had intense feelings of anger which were directed at their childrens mother, and they may have intended their children to nd them. This process of triangulation betrays at the very least a disregard for the consequences for the children, and it may be that the thought of the child suffering gives the suicide victim some comfort as he knows this will cause maternal suffering. It may be difcult to speak ill of the dead, but we feel it important to present for discussion a perspective which may give insights to inform our work with this group of children. How does this way of perceiving the experience for the child change our understanding of it or response to it? Psychological maltreatment may lead to withdrawal, anxious attachment, anti-social behaviour or depression in children (Claussen, & Crittenden, 1991). These responses are similar to those found in bereavement and may be seen only in this context when in fact they are related to abuse or are multi-faceted. When considering the treatment of a child whose parent has committed suicide, our therapeutic interventions may be guided not just by bereavement issues, but also by considering the abusive elements of the experience. Surviving parents sometimes pose the question of whether to tell the children about the fact that the death was a suicide. This would not arise where the death was witnessed or discovered by the children. Many suicides are reported in the press and known to the local community and so hiding the cause of death may be difcult. If attempted it risks the child nding out from other sources. Children may be told in unhelpful ways (for example teasing in the playground) or may have to deal with feelings of anger or exclusion if they nd out some time later. In the rst case it would have been impossible to hide the truth from the children, even though their mother attempted initially to do so. In the second case the children found their father. The paradigm of abuse may help inform our response to the child. For example, as in our rst case, the surviving parent may consider that she needs to protect her child from the abusive experience of knowing about the suicide. However, it is rarely possible to keep such a secret when continuing to live in the community in which it happened. In such circumstances it may be considered abusive not to tell the child. Careful discussion needs to take place to make
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a wise decision and parents rights respected, but by considering the consequences in terms of abuse as well as trauma and bereavement a more child-relevant decision may be possible. Emotions such as guilt may be very powerful. These are recognized in the context of bereavement with guilt about interactions prior to death or feelings of what if. The abuse paradigm adds another dimension since survivors of abuse may experience guilt about the relationship or guilt about provoking or not preventing abuse (in this case the suicide). Similarly there may be anger towards the surviving parent for not preventing abuse. This occurred in Case two where the elder boy was very angry towards his mother for not stopping his father from killing himself. His mother found this extremely difcult to cope with, and initially not being able to speak ill of the dead, made this difcult to discuss. In therapy it was possible to open up some of these areas of discussion. This acknowledged and validated the mothers position and made her less anxious to keep attempting explanations and reconciliation with her elder son. When she backed off in this way it became easier for him to explore his own feelings in a way that was less dependent on the dynamic with his mother, and with time his anger was no longer evident in their interactions. Identifying with the abuser, a known response to abuse, appears to have occurred in both cases. The elder child in Case one was threatening to strangle himself when upset, and the elder boy in Case two had very much aligned himself with his father prior to his suicide in the context of impending separation. Clearly the combination of identication with the abuser with powerful feelings of sadness or guilt may have tragic consequences. Regarding suicide as abusive allows us to consider this in therapy. Allowing children to discuss their feelings about their dead parents may include allowing them to express negative feelings. This may in turn make it less likely for them to blame themselves for events and may allow them to healthily renegotiate how they perceive themselves in relation to their dead parent. A psychological autopsy may clarify intent, but may be unhelpful, and the question of motive will therefore usually only be tentatively understood even with the existence of a note (which was not present in either of these cases). By recognizing that an act of suicide may be abusive, we broaden our eld of understanding in terms of the potential consequences for the surviving family. Within the context of marital and family disharmony and conict, suicide can be seen as the ultimate last word with profound effects on future communication within the family. Once again the abuse paradigm is useful in therapy. In just the same way that unnished business may be addressed in the context of bereavement work, it may also take some of the power from the abuser by allowing the child the right of reply. This was done in group therapy where the children could write messages to their dead fathers, and either read them to the others in the group, or release them on helium lled balloons into the sky. Just as the sexually abused child may love the perpetrator, and the therapist must be sensitive to and informed by this reality (without losing sight of the distorting and disturbing impact of the abuse), so in the cases of parental suicide we must be sensitive to the need for some family members, often the surviving parent, to speak ill of the dead. Clinicians faced with parental suicide may nd it useful to consider the paradigm of abuse alongside established models of loss and trauma. The motive of the dead person may have been to inict harm and may have occurred within abusive relationships. However, even if these factors are not present the dead person has either chosen to ignore or not considered the powerful effects on the family system. This is profound neglect. Children may identify with the abuser, experience powerful feelings of guilt and anger towards others for not preventing events. There may be issues about secrets
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and unnished business after the death of the abuser. We feel that consideration of these issues may usefully inform the way we help children and families in this situation.

Note
To protect the identities of individuals, names and some details have been altered.

References
Cain, A.C., & Fast, I. (1966). Childrens disturbed reactions to parent suicide. American Journal of Orthopsychiatry, 36, 873880. Claussen, A.H., & Crittenden, P.M. (1991). Physical and psychological maltreatment: relations among types of maltreatment. Child Abuse and Neglect, 15, 518. Durkheim, E. (1951). Suicide. New York: Free Press. Elizur, E., & Kaffman, M. (1982). Childrens bereavement reactions following the death of the father II. Journal of the American Academy of Child Psychiatry, 21, 474480. Grossman, J.A., Clark, D.C., Gross, D., Halstead, L., & Pennington, J. (1995). Child bereavement after paternal suicide. Journal of Child and Adolescent Psychiatric Nursing, 8, 517. Hawton, K., Roberts, J., & Goodwin, G. (1985). The risk of child abuse among mothers who attempt suicide. British Journal of Psychiatry, 146, 486489. Home Ofce, Department of Health, Department of Education & Science, & Welsh Ofce. (1991). Working together under the Children Act 1989. London: HMSO. Kozak, C.M., & Gibbs, S.O. (1979). Dependent children and suicide of married parents. Suicide and Life Threatening Behaviour, 9(2), 6775. Palombo, J. (1981). Parental loss and childhood bereavement: some theoretical considerations. Clinical Social Work Journal, 9, 333. Pfeffer, C.R. (1981). Parental suicide: an organising event in the development of latency age children. Suicide and Life Threatening Behaviour, 11, 4350. Pynoos, R.S., & Eth, S. (1985). Witnessing acts of personal violence: suicide. In S. Eth, & R.S. Pynoos (Eds.), Posttraumatic stress disorder in children (pp. 1943). Washington, DC: American Psychiatric Press Inc. Pynoos, R., Frederick, C., Nader, K., Arroyo, W., Steinberg, A., Eth, S., Nunez, F., & Fairbank, L. (1987). Life threat and post-traumatic stress in school age children. Archives of General Psychiatry, 44, 10571063. Richman, & Rosenbaum (1970). A clinical study of the role of hostility and death wishes by the family and society in suicide attempts. Israel Annals of Psychiatry and Related Disciplines, 8(3), 213231. Roberts, J., & Hawton, K. (1980). Child abuse and attempted suicide. British Journal of Psychiatry, 137, 319323. Shepherd, D.M., & Barroughclough, B.M. (1976). Aftermath of parental suicide for children. British Journal of Psychiatry, 129, 267276. Tennant, C. (1988). Parental loss in childhood. Its effect in adult life. Archives of General Psychiatry, 45, 10451050. Valete, S.M., Sanders, J., & Street, R. (1988). Adolescent bereavement. Journal of Counselling and Development, 67, 3.

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