My children’s Montessori instructor endured the tragic loss of her son to suicide several years ago. Upon learning of her son’s passing, a rush of memories enveloped me. I remembered Tom’s upper school project where he showcased a hoverboard. This sparked immense admiration and inspiration in my son, who attempted to recreate it later. Tom’s mother had cared for my daughter’s minor injuries on the playground and assisted her in phonics. I gathered the children and shared the news, informing them that we would attend his memorial the next day.
Having been raised in rural Appalachia, I was accustomed to the customs surrounding death in a small community. In a place where almost everyone knew each other, it was not unusual for me to accompany my mother to a “showing” after school. When I first mentioned this term to my husband, who wasn’t well-acquainted with the funeral traditions of small-town West Virginia, he was surprised. He recognized that “showing” referred specifically to the display of the deceased. That had never occurred to me, as I had always viewed it as a means of offering support to grieving individuals. I have since adopted the term “visitation.”
At that point, my children had attended two visitations. These events were not frequent, and the tragic age of just twenty-one at which Tom departed this life, coupled with the nature of his passing, made it even more uncommon.
Both children are naturally introverted and felt uneasy about going. My son expressed his apprehension by asking, “Why do we have to go?” I explained that it was because he was important, because he inspired dreams, and because he cared for his mother. He seemed to understand, at least theoretically, though my explanation did little to alleviate his concern. He then quietly said, “I don’t know what to say.” Taking his hand, I reassured him that no one truly knows what to say, and honestly, it’s okay not to say anything at all.
Neither he nor my daughter fully comprehended the concept of suicide. Although children are increasingly confronted with such losses at younger ages, their understanding of pain had been exclusively physical until that moment.
As a psychiatrist, I was well-versed in the academic discussions and educational studies about death by suicide. I could recite risk factors and barriers that inform our predictions, as well as the statistics and facts I have memorized throughout my career. However, I did not possess answers. Somewhere along the way, I struggled to articulate the pain of a non-physical nature—pain that is just as piercing, stabbing, and genuine as, say, the abdominal pain caused by appendicitis. Appendicitis involves the actual deterioration of tissue within the abdomen and requires immediate attention. The same urgency applies to psychological afflictions. Both types of pain can lead to death if left untreated, but also, like other medical conditions, psychiatric illnesses can signify an advanced stage of various disorders, even when addressed.
Our urge to see and conduct tests for diagnosing and triaging conditions, while vital, has permitted a certain skepticism to infiltrate our understanding of ailments lacking objective indicators, such as lab results, imaging, or vital signs measurements. When a child has a scraped knee, the sight of vibrant red blood serves as tangible proof of their need for treatment—a band-aid applied, and a dose of love administered. While the agony of mental illness is equally real, it often does not present itself outwardly. There is no clear trickle of red fluid running down a child’s leg to signal: I require help! The invisible ailments do not easily lend themselves to expressions that children can grasp, yet they are no less genuine. Somehow, the urgency, the suffering, and the trauma become lost in translation.
Despite my inability to articulate the right words and explanations to convey the complexities of this challenging conversation, I wanted them to grasp that our presence was significant. I explained that some people might abstain from attending due to their uncertainty about what to say when someone’s life concludes tragically. However, we would go because we knew what to articulate, which was crucial: “We are sorry.”
They probably wouldn’t understand for years that witnessing pain and grief typically requires no words. We pressure ourselves to perform and express the correct sentiments—somehow, we force words out, painstakingly hoping they are appropriate. There are no perfect phrases, no miraculous expressions. Words cannot encapsulate the depth of sorrow when a child passes away. Even the most skilled poets and linguists often fail to convey the sadness of such a significant loss. There may be no vocabulary in English or any other language that, when combined, communicates the magnitude of this type of bereavement.
I explained that words can be bodies—standing