Harvard Book Store; WGBH Forum Network; In Her Wake: A Child Psychiatrist Explores Her Mother's Suicide

Tonight I'm very excited to welcome Nancy Rappaport to Harvard bookstore to discuss her new memoir in her wake. Doctor at four is an assistant professor of psychiatry at Harvard Medical School specializing in child development and child psychiatry. She also works with the teen health center at Cambridge Rindge and Latin High School and has worked in the past with the Cambridge Public School System and the American Academy of Child and Adolescent Psychiatry in her wake is the result of Dr. rapports attempt to understand her mother who died by suicide when Dr. F4 was for using court records from her parents divorce newspaper coverage interviews with friends and family. Her mother's unpublished novel and her own training as a Psychiatrist Dr. Rappaport tries to reconstruct something of the woman she lost too soon. Publisher's Weekly called in her wake a fearless memoir of loss and grief. And Kay Redfield Jamison the author of An Unquiet Mind called the book a new journey of learning and reconciliation. I want to welcome everybody. Many people here I know. So that's

so nice for me to have people from my Harvard freshman seminar course and colleagues from Cambridge Health Alliance and neighbors and friends. And this is really for me a culmination of a long journey. And my daughter too. And I'm what I'm going to do is read. I took excerpts from my memoir and tried to read them together. So I still want to get the book. But it's meant to really give a flow of what my journey's been. And for those of you who just need a look but what to know what the background of one of them start to be reading about. My mother committed suicide when I was four years old and I was the youngest of six children. And there had been a fierce custody battle with my father. And she died on the day that it was state for her

to get the kids back. So it was a fairly kind of dramatic suicide it happened in 1963. I just turned 50 yesterday. So this is my birthday present to you. Thank you thank you. Thank you. And I can't think of a better place to be because on than such a long term fan of Harvard Book Store and I always am sneaking in here to to buy books and so it's such an honor to be in this in this room sharing this with you. Thank you Jeff and Christine and Mike. So I'm just going to start. The day my mother killed herself. She had just finished preparing her house on Margot Street for the anticipated return of her children after a fierce custody battle with my father. It was a house expecting people. Fourteen rooms and five and a half baths in a turn of the

century townhouse on a tree lined street near the Boston Public Garden where I mother lived with her new husband Alex. I imagine that when my mother heard Judge would emerge decision cold dread must have overcome her in my mind. She is what she was white as powder. Her body slack and weighted down stumbling from one wear him to the next. Overwhelmed by the vacancy. It is family lore that I am the last person my mother saw before she killed herself. She drove to my father's house pleading to see the children. But I was the only child at home. My father didn't mandated that she leave be our housekeeper hustled me out the door and down the driveway toward my mother who waited desolate on the street. She bent down and caressed my

hair. I remember as she whispered instructions to be to watch over us especially me. And then she left. She left a suicide note as well as a grocery list a list in preparation for our arrival that would never happen. Six tangerines two boxes of Kleenex pink is crossed out and replaced by blue sugar free rootbeer blue toilet paper four pounds of rump roast lettuce tomatoes food for a family. I am often asked if I remember my mother. I appreciate that that the question is a way to express the hope that my loss has been tempered at least by a photograph a necklace are her words anything I might call and to evoke her presence. But I have a few mementos and even fewer memories. My

mother is defined by her absence. Yes some treasures can kindle her presents a dainty birth announcement an elegant paper stamped with the date of my birth. A tarnished silver baby Cup dented at the RAM and inscribed with my name my worn woolen baby blanket. A pamphlet from my mother's campaign for the Boston School Committee. I have a few photographs. The pictures a teddy blanket a baby's Cup. These objects are all that I have after my mother's death. When I was young I thought a fire had destroyed all her belongings. My father eventually told me when I was about 14 that my mother had attempted suicide two years before her death. My sister and I discovered the facts ourselves and our trusted library's microfilm collection. We found a picture of my mother in the record American looking much younger than she

does in her formal poetry. She wears a sporty silk scarf tied casually around her neck. She's spunky with her upturned nose. Takes three handfuls of sleeping tablets The caption reads. Why did my mother kill or self. My memories don't provide an answer and I'm wary of my father's account because it's not my own. And my mother's affair that led her away from the marriage must have chilled to him. But as a psychiatrist I'm prepared I hope to understand that in the anatomy of a suicide the clinical researcher Weston Haven writes that suicide is the final common pathway of diverse circumstances of an interdependent network rather than an isolated cause. A knot of circumstances tightening around a single

time and place suicide demands to be explained by the living as a way to absolve or condemn the survivors. I have tried to create a meaningful narrative to understand what happened. Recognizing that the truth is buried with the victim and the questions will always linger. When I met people as I was growing up all the way to medical school interviews if I told them that my mother died when I was four. They were curious about how she died. The question was irresistible. Most people seemed relieved when I said barbecue it as if death and sleep are siblings. People wanted to know why and what was the cause. Such questions are usually edged with fear that premature death.

Especially a self-inflicted death might somehow be contagious. Why would she kill herself. Because what does this mean about you somehow confessing that my mother committed suicide felt incriminating proof that my mother's life was out of control. I worried that they would mistakenly assume I somehow played a part in that I. A secure mother child bond is created when a mother provides her baby with the comforting rhythms of feeding sleep and an organized home. Without that gentle sense of order children may have difficulty managing their emotions lack self control and lose confidence in their likeability. I either I have a very active imagination or my mother must have

been able to keep her sadness at bay long enough to nurture me as a baby. During the 1950s my mother was unusual an upper class woman who had six children and worked outside of the home. The prevailing cultural expectation was for a woman to tend to the home not orchestrate campaigns. My mother had enough resources to hire support to care for her brood so that she could conduct a career also. Because she had grown up as the daughter and granddaughter of Massachusetts politicians she was a name heard with politics. Many pundits of that time however were disparaging about women in public life. In 1956 Life magazine published interviews with five prominent male psychiatrists who

blamed the rising divorce rate on the quote unquote fatal error that feminism propagated. They warned that women were neglecting their maternal instincts competing with their husbands and causing psychological damage to their children. Those were the times my mother lived in and forged a career as she raised a family. And here I am a wife and mother with a very full career. I am aware of the impact of my past. And I do not want to distance distance with my children. The shadow of unexplored grief. Rather than burdening my children with my bereavement I want to let them see how I deal with the painful longing for a lost family without depriving them of my presence. I don't want to be overly nostalgic about my mother.

I don't want the upheaval for my loss to undermine how I connect with my children. Rather I want to find strength. In understanding her. My children have watched me as I have tried to understand who my mother was. Knowing that I write what I used to call letters to mama that are my way of telling my mother who I am and who my children are becoming. I try to penetrate the incomprehensible mystery of her death and disarm him. Show them our enduring connection to those we love Koori ever the concrete thinker once asked me. Where was I sending the letters. He was younger than he seventeen now lying low said that maybe

in my dreams my mother would write back. Sometimes I peer into an apparent void a one way dialogue with too much room for projection. My family history gives me a fragmented and sanitized view of my mother. I often feel as I am figuratively tugging on her apron strings pleading for something more starved for a tasty morsel that will satiate my desire to know her in a way that is intimate and familiar. For years I had nothing of my mothers nothing concrete studly a trunk of her belongings came to light. A blue truck

with brass hinges with drawings letters of all the kinds of My Tears of kinds of material that my mother had saved. Seeing these objects stunned me. I stood there staring. I was nervous and intreat about what I would discover. Here was evidence of a life I did not know. Small calendars with hand scrawled appointments. A high school year book report cards school awards newspaper clippings and chatty letters from friends. A photo of my mother cradling me me as a baby in her arms. A photo of my mother and father their eyes filled with laughter. Her handwriting big and full. And the novel she was in the

process of writing at the time of her death. I was disturbed that it had taken so long for dad to give his children the contents of the trunk. Dad later told me Understandably he said he had enough integrity not to destroy it. He said I kept it for a couple years and didn't know what the hell to do with it. I didn't want to be involved dividing things. God forbid something was missing. I never opened the trunk and I didn't know what was in it. Her novel was an amazing discovery. This was an irresistible chance to know my mother's mind. Her writers cannot escape that the person in charge of organizing a story reveals who she is just

by the nature of how she fabricate the narrator's voice. My mother wrote in her notes about her novel is this sheer purgative autobiography or two I want others to see it. I can understand her trepidation. It's hard to be exposed and feel judged. As a psychiatrist I live in the land of thoughts and at the risk of over interpreting. I hoped that this unexpected access to my mother's mind would reveal how she constructed a narrative of meaning her personal truth. Perhaps it would illuminate how my mother came to see suicide as an option or how she came to accept the apparent futility of life.

As a daughter who has longed for a connection to my mother. I want to know her inner thought to discover her secret messages to me. I want a good story so I can be proud of her. I want to read as a detective and discern what is autobiographical and what is fiction. I know I must have known her long enough to love her or I wouldn't be working so hard to try to understand who she is. My mother's journals were another rich source of insight into her joys and her anguish. It is clear that she was given to bouts of depression. She wrote vividly

about the depth of it and the hopelessness that her affair plunged her into. She said long and uncertain stretch this black road urging one into forgetfulness. Deceiving one into daydreams long black insomniac night. This is her voice broken only by the white line of consciousness. And hateful solitude. As indistinguishable from one another is KERS and crossroads before the headlights consciousness. Uniqueness slowly drains away from the asphalt and from the cottony lonely wakefulness until finally there is nothing but the black road ahead and death. She says death is a change in degree rather than in kind. And for many of us

is a blessing in neon rather than in disguise. She goes on to say. My Holy Ghost are my babies. This is my last testament. Perhaps they'll never be strong enough to read my naked soul. Most children prefer a mother to a human being. So to most mothers my great cross is the inability to lose me in my mother. Whether the mother is me or the woman who carried me. Those of us who fight must die. We are all consumed one way or another. This is hers talking it's one nature you know. I just choose to die from life rather than the slow creeping death of boredom and rote and repetition and habit and conformity and vial hatred

passed off as love the flame of desire desire for truth for reality can burn up all the peace. We're rationed Oh God where are you. I can tell you what I want to be for but what do I want now. I guess I'd settle for peace but that second best. These are hard to read. As a daughter. Her pain is palpable. She seems to be making a choice for this passionate and beautiful woman. There clearly was no answer and she could find no viable choice for herself. Or well in his essay Why I write said that authors are driven on by some demon

whom one can neither resist nor understand. My journey was one of on relenting sadness curiosity and passion in a quest to understand how. If my mother loved her six children and clearly she did how she could have abandoned us in this brutal way. As I charted her journey I revolved around a fixed point. My mother's suicide and followed any lead that helped me to understand who she was. It was as if the Northstar of my existence was framed by trying to resolve this mystery. Sometimes on my odyssey of discovery I had interviews that made the story more complicated and challenging.

Her talking to my mother's ex lover after 40 years revealed both disturbing and insightful information. The doctor who took care of my mother after her final overdose when she was in a coma taught me more. My five brothers and sisters offered their poignantly different perspectives. Through the scrutiny of her unpublished novel with the ominous title and freedom I learned more about the tremendous challenges she faced and to accept her more fully realizing that what she did had nothing to do with us her children through all those searching and introspection I've gained new understanding not just of her life but of mine and been able to examine some of my greatest fears. The process has led me to be more open and present for my patients

and able to go deeper with them in their own traumas. It's freed me to be a better mother to my own three children. I offer my own story as a tribute to the endurance of the human spirit. When loss happens we can find a way forward. No one is expendable. And we are all loved. By looking at her traumatic childhood I understand the confusion she must have lived with and her deep dilemma by sharing her journey as best as I can reconstruct it. Perhaps I can lend a little light to this widespread tragedy. Every 16 minutes a suicide occurs in the US. To help break the terrible silence and dispel the shame that so

often surrounds suicide and to encourage people to get the support they need. If my book touches anyone that way then my mother's journey was not in vain. I often say. It's a gift from the grave that my mother gave me. Suicide is a forbidden topic and the investigative energy to understand the intensity of it served as a certain reminder of how precious it is for me to be a mother to my children. As Blake said Joy and woe are woven fine and there is a certain freedom that comes from looking at the dark side and weaving a tapestry of meaning that anchors us in survival and the living soul. Every time I am introduced as an author

or sign a book or get a wonderful response from a reader who is moved to think deeply and ask large questions that defy easy answers it is delicious and I savor the journey. Writing may be about demons and self-doubt but at this point I would highlight the rewards. It took me eight years of painful delving into the pass to write. Did I find all the answers. No. As I said they're buried did I reclaim a lost mother. Yes to a certain degree I did. I feel she is present to

me now. Not just fleeting impressions and yearning. I have grown to love my mother in a way that's different from when I long for her as a little girl. There's a joy in that. And at last to becoming a writer. I am profoundly aware that when I die a part of me will remain in my children in the same way that our bones carry the same minerals that compose a star. Thank you. The question was did my father read it more than once. And he has been a true and I hope when you read it you see he has been a true hero in this story. One of the things that we know about

those kids who are left by a parent is that the surviving father and how are the surviving mother whatever the surviving parent. How well they cope and how stable they are for the child is absolutely critical. So some of the reasons I can stand before you is because I've had understanding father. So thanks for that question. The question was whether my father read it and I said Yes yes and gave me feedback. And additions look at the end notes. Sure. So the two questions were did someone replace or provide support and the other was did I have a lot of anger at my mother. So yes to both. In terms of. The first question about other mothers that's the way I think of them. You know I work in a school based health center and the reason I'm there is because I work with a

tremendous staff of school nurses and social workers and teachers who are always two children who have had. Severe losses in their life acting as other mothers. And it's a critical role that many of us in the healing are teaching profession's play with kids which is to provide an anchor. And I had a wonderful. Naomi's and the white doesn't quite capture it but she was very present in my life and she knew my mother and stayed with us after my mother died and I was with her when I was small enough to be able to sleep on her pillow. She was Bea that I mention in there. And I think that made a huge difference for me in terms of the anger at my mother. You know I've had like 700 years of therapy and I'm a slow learner. It's a professional kind of development.

And so I think that there are various stages of idealization and anger that you go through when you lose a parent. And when you have a parent that's living and my dad could testify to it to this you can rage at a parent and be upset with him and they get clay feet. But when you have a dead parent it's very easy to freeze them in time and to think of them as being all present because they're not there to. So that was actually I sort of almost felt like I went through my adolescence when I got the novel because I was like there were parts of the novel I didn't really like or that the narrator that much I thought she was a little bit. High strung and a little bit self-centered and I thought oh boy maybe my mom stuck around it when I liked her sometimes you know so I don't know if that answers your question. The question was was there conflict in my family with me releasing the novel. And did people have different interpretations in it. And you know what I would say is that with suicide it is a silent grief

often and people don't talk about it including in my family. So even though we're very verbal opinionated family we really were raised to not really talk about it with each other and just pretend that somehow she just exit it and we didn't really have a conversation about it. So I didn't go back to talk with my brothers and sisters about it until chapter five when I spent one summer going back and talking to each brother and sister. And if I were to say one of the biggest gifts of this book is the transformative quality of the relationship of many of my brothers and sisters from that journey now it wasn't a quick Czerny and it was 18 years and. So you know it wasn't always smooth. But now there's a level of depth in my relationship with you know many of my brothers and sisters my older sister who is seven years older than me her. My mother took an overdose

when it was her her 11th birthday. My my it was two days before my my. I didn't appreciate that growing up and I didn't know what that would mean as a mother and how tortured would be for you to exit on your child's birthday. So I both had a growing closeness to my sister from this so I would say that when you if you ever write a memoir for sale you probably won't win a popularity contest with your family. You just have to give it up because you can try to please everybody but it's not probably going to happen. But you have to and this is your narrative arc. If one of my siblings or my dad told this story they would tell a very different story. And I appreciate that. And I really honor that they would allow me to tell my story in the hopes that you know I hope that my book can be lifesaving to someone who feels like this is an acceptable solution. I want there to be a sense that. When I've worked with depressed

patients they think that it won't matter that they had their family really will be OK. And this is testament to say you know what it is 45 years later and here I am talking about it so that and you know what we know is that well first of all if they so I want to make sure I get the question the question is have they my kids approached me about being worried about my me being fragile or them being fragile. OK both take the first one first Me being fragile. I mean one of the things I feel like I'm very clear about is I'm not going anywhere. You know I love life and I value it. And that's not and that's not something I'm planning on at all and. You know what. What we do know is that just as to say that if you have a parent who's killed themselves you are five times more likely to kill yourself than the normal

population. That said that's a disturbing statistic particularly if your child who is in that category. But it should be qualified. I'm much more likely to get run over by a car or to have a heart attack than I am to kill myself. And the confounding factors we're still trying to figure out what makes that vulnerability. Is it the. A biological propensity to mental illness because clearly bipolar disorder and depression if untreated you can get suicidal. So that's why treatment so important so a message to anyone who would have a family member that killed themselves is keep an eye out for symptoms of depression or bipolar get treatment you know. And. Impulsivity the toxic combination of suicide is mental illness impulsivity and substance abuse. Well if you are someone who is vulnerable to suicide or has a biological predisposition there are two things that you can really support yourself substance abuse. If you treat

your Seven's abuse you'll be much less likely to kill yourself so that's a piece that I feel like we're not we're not biologically determined. If we have suicides in our family to end up going down that road and I'm really really lucky I have three incredible kids and you know I don't know. I've often said I don't think I could do this work if I didn't have the kind of support I have in my home and that kind of security that my kids are OK. I couldn't take care of other children otherwise. So the question was that as a psychiatrist you're taught to be you know reserved and here I am like almost stark naked in front of you all. And how is it depends when you ask me I mean about four hours before Iraq went to go get my nails done and I was like Could I also like you know push on my face. So that my nails look really good.

So you know there are periods of trepidation for me that I think I am taking a risk and I have been stunned by how generous people have been with me that has given me a faith in humanity that's been truly remarkable. And I never was a very orthodox child psychiatrist anyway. I mean I do home visits in safety assessments for the Cambridge Public School System. Some of the administrators here from the Cambridge Public Schools can testify that I will do what I can to reach kids. And so I wasn't and have never been the kind of psychiatrist that just nods and waits for positives and I probably never will be that patient I've treated for a long time often will ask me when I'm really anxious I interrupt and they'll say wait a second listen so you know. I don't know what to say.

I hope I hope my patients still find that I can be helpful to them. I hope that's true. So the question was from a beloved administrator at one of the high schools I worked with for five years was. When did I just choose to become a psychiatrist and do I think that this might have you know propelled me to become a psychiatrist. And never one for easy questions. I chose I actually thought I was going to be a pediatrician and that I was going to work in Harlem at a school that I had worked at as a elementary school teacher. Preschool through third grade I had been a teacher for a year in between college and medical school so I thought that's what I was going to do and then when I was in my third year of medical school I realized I you know I was not so interested in looking at your infections and I was just dying to talk to the patients. So I migrated to child psychiatry. I don't know. I always knew from when I was very young that I wanted to be a

doctor. And the reasons were fairly prosaic it was that the doctor toy kit had more candy than the nurses kit. But you know if I was actually you know reflective I would say there's certainly an element that I wanted to save myself and figure out you know how I could care for patients in a way that I wish to be cared for myself. And that has been a big joy of me is to take care of patients and you know one thing I think is important is I I want my patients to know that too. I am not taking care of them because I couldn't save my mother. I am taking care of them because I want them to be alive. And when I work with families I don't want a family to lose someone they love. So the work I do is immense and it's very gratifying. This is someone from my Harvard freshman seminar course where I really have fun because I would read sometimes chapters from this

but the memoir course and I was agonizing in November about the title because and we went through 700 titles and we finally got to in her wake which I actually have come to really like and the way we got it was my editor and me that that worked on it was first of all I learned something about titles Darcy that I didn't know which is that they have to be short. So some of mine were too long and people couldn't remember them by the time they left in her wake. That's something you can remember from here until you get over to the cash register. So that was one thing and this and the other. Jokes aside was it had multiple meanings which I also think is true when you're trying to interpret a suicide is that at different points in my life going from being a teenager to being a mother to being 30 40 50. It's changed the so there are multiple meanings and it's been

redefined so in her wake has a quality of being a following in the ocean when you're I can't explain it but my daughter Delilah does Crucis she could explain it something about you go in the wake you follow something and then the you know the idea of being in a wake and the death aspect of it. So. I have you know the big question actually if you want to know was the first subtitle was in her wake a child psychiatrist explores the mystery of her mother's death. And they did. I don't know marketing focus group with bookstores. Jeff could probably tell us about that. And people came back and said you know that's very confusing because people don't know is the death a murder was the death of poison it doesn't it's too ambiguous. So basics which has been an amazing publishing company for me if any of you are thinking about publishing books basics by far is top down unbelievably supportive and

the I don't know what you call on the president the CEO came to me and sort of said well you know is it OK if we change it from death to suicide. Like yeah I mean I mean I'm writing about it to say let's not have there be a stigma around those of us who've been impacted by suicide and you think I can't put it on the cover of my book. But you know still it's I always trip a little bit when I say I often mumble when I say my mother killed herself when when I was four years old. I people sometimes asked me a second time because I can't quite get it out and now you know I have to say this title like 700 times and so I'm saying it over and over again and that maybe I should have said something different on that subtitle but I'm stuck. So the question just so for people who can't hear it is you know was she was someone who was ahead of her times was this a decision which is always a question whether

suicide is a situation that was biological or was it something that was a statement that she wanted to make. And I think you know it goes back to what I started to say which is the answer dies with her. So I can speculate with you what my best guess is and that oftentimes when a suicide happens there are multiple things that happen and that's why it's so hard for people who are left after suicide because they can attach to one thing that happened. You know I've done some speaking at a patient group and you know someone can describe being in a situation where they are blamed for a death of a parent when clearly it couldn't have been because there was a fight at the dinner table. I mean we had we had fights all the time at the dinner table. We don't you know so. I guess I can't answer that. Simply I can say that yes I think she probably had a mood disorder although I never interviewed her and I don't feel comfortable saying that if I say at one

point in the book that probably if I could have given her lithium I would've because if you are bipolar you're eight times less likely to kill yourself if you're on lithium but was it a statement if it was a statement I wish she'd written the statement. You know I don't I don't. And actually in the book I say a lot committed suicide. Though the wording now that I found from being involved with different organizations like the American Foundation of suicide prevention or Samaritans which are both terrific organizations is that you say died by suicide because committed suicide has a voluntary aspect to it and we all know that it's probably a very tortured decision and that the language doesn't capture the complexity of it. That's them thank you for clarifying it to the question was I'm a little confused if she killed herself on the day she wanted no what happened was she had won it in the Probate Court. And then after a two year battle she lusted after her first suicide attempt she had signed over in

all those details are in the book but she so it gets a little confusing and don't worry about it because it's lower in the book than the way that I'm talking. But she had had a two year custody battle. She had won the kids back in July. Then it was bumped up by my father to the Massachusetts Supreme Judicial Court. And so September 10th she was supposed to be getting the kids back she goes into court and it gets state so the decision was for the kids to stay the way they were which was to remain with my father. So that was when she thought. Which is also though what I would say is divorce is her brutal you know. And people's best selves don't always come out during that time. And when you put in that with depression what happens is you think something's permanent. And it's never going to change. And part of the work you do in cognitive behavioral therapy is to help people recognize that it may be temporary and that what seems permanent There's a little bit of hope that it can be different.

So. It's my Harvard freshmen that are asking me the vast question. No no you are asking great questions. I know 18 years seems like a long time but you know when you're doing other things it was mostly during the summers. So I would work really hard and some people at the school baseball players will testify this or Ed and you could tell a former principal that I you know work like a maniac During from September to June but in the summer I have more time to be reflective and to kind of go deep so that that was actually really good. I don't think I envy I don't envy anybody who's a full time writer at least in this kind of journey. It was really nice to go deep and then put it away. I think repression is a really good thing sometimes and. And so I was so happy to come and you know teach Harvard freshman and take care

of patients and grow a family and write chapters on violence and aggression in children and the meaning of medication and anything else but the book. And so I didn't plan on it taking 18 years there were twists and turns. But I mean in some ways now that it's out I'm glad I'm really proud of my book. I feel like it's a very carefully tied treated book with a lot of thought and objectivity hopefully I know and it sounds like I'm being self promoting but. So I don't know if I could have gotten that if I had just been able to write it in three months. So I didn't have much choice about it it took its own life and dominate me. So it's very sweet. She was asking me if watching her grandmother die because I was with her grandmother right as my book was coming out. Whether that made me think of my mother first of all it was an amazing privilege to be with your grandmother when she was dying. And

you know your grandmother was very supportive of me writing this story and very present during this time. So you know to get you know to have your family asked me to be there during her time of passing from this world to another and her being a two years old. It was an honor and it was a different kind of death than my mother's death but definitely Kay was another mother to me. So I you know I hope I die the kind of death that and live the kind of life that your grandmother did because she knew how to be present in people's lives and to be loving and I watched her as a grandmother because I didn't you know I don't really I didn't have a I have some step moms that have been grand parents to my kids but I haven't had you know my mother be that way so I've I've. I've learned from her. And so I carry her with me to and.

So I think of her differently. But but thank you for asking. OK. So the question is like why did you get started on this journey was your impetus. Well Laila when alive I was born I held this like beautiful baby in my arms. And actually when I went in I thought you know what. I just knew my mother loved me. I knew it. On this visceral level and I suddenly shifted from being a daughter to being a mother. So that made me try to understand if my mother love me then where is she right now. And so the intensity of wanting to know that and you know you'll see when you're a parent if you end up being a parent that. You end up being reflective about who your parents are at that juncture of becoming a parent and you know we read that article in our class about ghosts in the nursery so the shadows of your

parents comes into play and you want to figure that out because you don't want the shadow of a longing or a sense of abandonment or rage to get played out on your kids. So there was a you know at the beginning there was a certain missionary quality and maybe a bit of being an overachiever I mean I don't think I needed to be a child psychiatrist and write a book for 18 years to be a good mom. But that was my path. But in the last two chapters that's what I'm trying to get people to be both attached to my mother to know me to know my family to care about us. And then I spend the last two chapters really looking at what are the causes of suicide how do we know what do I think about it as as a clinician and as a mom and as a daughter but it's done in a way that you know I'm doing a carefully tie traded. Journey because I don't want to turn my mother into a case study. That would be

violating her memory. And yet I am a child psychiatrist and I'm trying to have the book also be a teaching tool and to make to have it also be digestible. So I'm There's a quality where I wanted to be a psychological thriller. And I also want it to be more than a book about suicide I think when we tell a story that we often wanted to have universal themes. So in my greatest hope what I would want is for this to be a story about. We all have things that have happened in our family it doesn't have to be a suicide it could be that we were adopted it could be that we had an alcoholic grandfather or some any kind of multiple things that happen in the life of living. And. How do you ask people that you care deeply about uncomfortable questions and how do you trust yourself that you can find out the answers. Even if you're frightened which sometimes I have to confess there were times when I thought these are questions I don't want to know the answer

to. So you know my father. Well the question was did you think that that by you know that's a great question and I want to answer to the question was do you think that by your mother dying there. She became larger than my father. Well it's a beautiful question. I can tell you definitively. My father I have huge loyalty to him. This is not a story meant to polarize our family or to her suggest that my father is somehow to blame for this. It's really a story about the damage that happens when there are. Very very strong feelings and sometimes where situations unfold in an in a excruciating painful way. And you know my father has been there for me and I'm 50 now and I got a you know a wonderful birthday card from

him that said I was not he but yours is Dibble. So. And you know I have tremendous respect for him. If you read the book the last chapters about conversation that we had at lunch and you know he he taught a very important lesson that I used as a child psychiatrist and what he said was never allow the child to define the relationship. And I think that's an extremely wise comment that he made. So he's alive and well and someone that I have. You know that I love deeply and my mother has not tortured him so. And he OK we're done now you can get Fox right.