August 21st, 2010

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

Compelling work chronicles author’s loss

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

By Nancy Rappaport

Basic Books

New York, N.Y., 2009

Reviewed By Paul Efthim, Ph.D.

This book is a gift to anyone who has lost a family member, friend or patient to suicide.

In 1963, when Nancy Rappaport was four, her mother killed herself in the midst of a bitter public custody dispute, leaving behind six children and countless questions. Four decades later, Rappaport, now a psychiatrist in Cambridge, felt driven to investigate this tragic loss and its impact on herself and her family.

Rappaport’s “In Her Wake” tells this compelling story from several vantage points. First, she pulls the reader along on her search for answers as she interviews family members and friends, piecing together a picture of a mother she never really knew. Part detective story, part clinical post-mortem, she combs through her mother’s diary and unpublished novel looking for clues to her emotional state and the chaotic marital dynamics surrounding her self-destruction.

Another perspective is that of loving daughter seeking to find her mother and to help her own children know their shadowy grandmother. Rappaport struggles to come to terms with a loss that is all but irreconcilable: how can one grieve the loss of an object that can barely be remembered?

On another level, the book gives a detailed account of how trauma reverberates across the life span, within families and across generations. The author shows how the loss of a parent can distort normal processes of child and adolescent development. Her account shifts seamlessly between the experience of her mother’s absence and her efforts to mother her own three children.

Rappaport risked alienating members of her very public family by publishing this sometimes unflattering portrait. Her father was a prominent Boston attorney and controversial real estate developer. Her mother, prior to her fatal overdose, was an ambitious but troubled socialite who had her sights set on a political career. Their divorce and custody battle were covered extensively in the newspapers. An older brother, Jim, was the Republican nominee in the 1990 Massachusetts US Senate race and ran for lieutenant governor in 2002.

After her father remarried, the young Nancy grew up in a rather chaotic blended family of eleven children. She describes how she raged at her father, the parent who stayed, rather than direct at least some of her anger at the parent who abandoned her. One of the book’s most poignant moments is her account of a rapprochement with dad after he read a draft of the book.

Clinicians and lay readers will value Rappaport’s clinical insights. She cites research suggesting impulsivity is more closely linked to suicidal behavior than the severity of depression or psychosis. “It is not the hopelessness that gets you,” she argues; “what suicide needs, ironically, is an adrenaline rush, a reckless abandonment of the survival instinct.” Had her mother been able to quiet her impulsive nature, she might have been able to ride out the storm she was embroiled in around the custody dispute and live to see her children grow up.

Naturally, Rappaport struggled for years with feeling responsible for her mother’s death. As her therapist pointed out to her, “When someone kills herself, it is as if she puts her skeleton in your closet.” She notes how survivors of suicide are particularly vulnerable to guilt, blame and responsibility feelings, which pose a real challenge when one is a therapist working with suicidal patients. Clinicians face limits to keeping individuals alive if they are determined to kill themselves.

The book’s tone is smart, literary yet accessible. Rappaport writes like a poet psychiatrist, mixing Anna Freud with Anne Lamott, Winnicott with Wendell Berry. A disarmingly honest, brave memoir, “In Her Wake” will appeal to both professional and general audiences.

 Paul Efthim, Ph.D. is a licensed psychologist in private practice in Brookline, Mass. and holds a faculty appointment at the Boston Institute for Psychotherapy.

By Paul Efthim PhD

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