When a Loved One Chooses Death

What Sam and Lois Bloom remember is a scatter:

The son’s empty room. The unexpected knock at the door. The call to a minister. The living room filling with friends.

An old life, suddenly in jagged shatters--unfixable as a broken heirloom family platter.

“What’s so hard is that you really don’t know what to do,” says Lois, a whisper of a woman, in a whisper of a voice. In a pause in this crisp, sea-cooled Palos Verdes afternoon, she and her husband, Sam, sit in matching blue wing chairs, in the same living room where their son, Sammy, often practiced his golf swing; where he broke the picture window more than once; where a policeman sat to impart faith-testing news. Here, as they do every day, they stare point-blank into the past and the future.

“I had sensed that Sammy was really depressed again,” Lois recalls. “A few nights before, I said to him: ‘Are you going to kill yourself?’ And he said he was. And I said, not knowing anything about this at this point, ‘Do you know what you’re going to do?’ And he said to me, ‘I know that it will be soon.’ ”

It was.

Days. Not quite a week. It was his second try.

Banging in Lois’ head then was Sammy’s new therapist’s chastising tone. The warning: “Don’t interfere; don’t overreact.”

“I really knew in my heart that he was wrong,” she recalls. “But I didn’t trust myself. And that is my big guilt. I should have.”

After the funeral service, Lois remembers, sorrow still sagging her voice, that “a lot of parents came, and they were very frightened. I remember being cornered in every place in this house: ‘Well, what can I do so my kid doesn’t do this?’ We’re grieving, and they are asking us these questions. I wanted to run from the house! I didn’t have any answers. I still don’t have any answers. But now we can talk about it.”

“After Sammy died,” Lois says, “I remember . . . saying, ‘I will learn about this! I will become better informed, better educated.’ ”

“So we got informed,” says Sam, matter-of-factly. “We thought we could teach the whole therapeutic community. . . .”

Instead, they became the therapeutic community--and then some.

When Sam and Lois Bloom arrived at the Los Angeles Suicide Prevention Center in 1983, it was at the threshold of a series of historic, theory-shifting experiments in therapy for suicide survivors, the term that the mental health community uses for the family, friends and co-workers who have lost a loved one to suicide. The Blooms not only would become part of those experiments, but also would help refine and, ultimately, lead them as trained lay people.

They worked with the center’s crew of doctors, therapists and researchers, pioneers in suicideology, to broaden the scope of prevention and to create the basic architecture for suicide-survivor group therapy worldwide.

For survivors, a death by suicide is a tragedy further embossed by a series of unexpected nightmares. It is a death too often assailed by questions, speculation or whispered assumptions rather than assuaged by foil-wrapped dinners, greeting-card condolences and the prayerful soberness more typical of last respects.

What suicide wills survivors is a shawl of shame and a tangle of guilt, anger and disbelief, with few shelters where they can repair.

It’s been almost 20 years since Dec. 13, 1982, when Sam and Lois’ son drove his car off a cliff at Rancho Palos Verdes, a child afraid of heights, aiming for relief in an ocean. He was 23. He left a note on the car seat, and three other letters to be distributed among the family.

But more important, he left a hefty stack of memories in sharp, clear focus, to be passed around as frequently as the snapshots at his parents’ home.

After almost two decades, thousands of session hours and hundreds of survivors’ stories, the Blooms have not just watched the conversation around suicide shift from an embarrassed whisper to urgent, assertive declaration, they have helped give it voice.

“They have been there for people in the worst moment of their lives,” says Jay Nagdimon, director of the Suicide Prevention Center at Didi Hirsch Community Mental Health Center in Culver City. “When resources were stretched thin, they filled a gap that helped so many people.”

The Blooms are often the first stop for those trying to pull themselves out of the pit of grief and into a place called “life after suicide.”

“I’d look to Lois,” says Robin Person, who attended one of the Blooms’ survivor groups at the suicide prevention center after losing her own son to suicide. “She could live and laugh. Her son was still very much a part of her, but she was still able to go on and be happy, and I received great solace in that.”

“You’re suddenly foisted into this world full of should’ves, would’ves, could’ves,” says survivor Corky Davis. “But the Blooms taught me that you can’t go under, above or around it. They taught me that you have to go through it.”

After a suicide, family and friends suffer a complex sense of grief, says U.S. Surgeon General David Satcher, who has made suicide prevention a national health priority. “And we as professionals have often overlooked their plight. We have to do something to assuage this, to make it OK to begin to talk about this issue. Because we can learn much from their stories.”

The Blooms have generously offered up theirs--in both words and deeds. Lois is the author of the highly regarded booklet “Mourning After Suicide,” which has sold more than 30,000 copies, and editor of the quarterly Los Angeles Suicide Prevention Center’s Survivors After Suicide newsletter, an outgrowth of a Christmas letter 13 years ago. Sam is the president of Suicide Prevention Advocacy Network-California, which the Blooms helped found, and trains volunteers for the center’s crisis line, the oldest in the country.

From leading bereavement group sessions to activism, the Blooms have worked to de-stigmatize suicide and attendant conditions such as depression and bipolar disorder. They are the constant conscience at the doors of legislatures from Sacramento to Washington, D.C. And of late their efforts, with those of various suicide awareness and prevention organizations across the country, have produced real steps toward legislation they never thought they’d live to see.

In December, the surgeon general’s office released his “1999 Call to Action to Prevent Suicide,” a national blueprint for addressing suicide through awareness, intervention and education. There are more than 31,000 suicides in the United States annually, making it the country’s ninth leading cause of death, a ranking higher than homicide. For every suicide, six lives are affected, according to an axiom within the prevention community.

“It’s important to recognize that survivors of a family suicide are estimated to be at four times the risk of suicide themselves,” says Nagdimon, of the prevention center at Didi Hirsch. “. . . And [in recent years] I think that more attention is being paid to survivors in the organizations that seek to learn about and ultimately prevent suicide.”

The growth in survivor resources, says Norman Farberow, co-founder of the L.A. Suicide Prevention Center, was initiated by the survivors themselves. “They have practically demanded and made professionals pay attention.”

The numbers bear this out: In the late ‘80s, an American Assn. of Suicideology survey reported that there were only about a dozen groups that served suicide survivors. By 1996, an American Foundation for Suicide Prevention survey found that number had grown to 360. A huge coup, the Blooms know, and unimaginable from the vantage of only 20 years ago.

Sometimes, when they slow down enough, they are boggled by the territory--both physical and emotional--they’ve crossed in their 50-plus years together--from Lansdale, Pa., to the West Coast, from full-time careers to full-time advocacy.

“I wouldn’t trade Sammy for all of this,” Sam says. “But once Sammy made his decision, I can’t turn that around. We see it as an opportunity. We don’t have any choice.”

Healing Through Personal Sharing

A few days after Valentine’s Day, a dozen or so women and one man sit in a great oval loop in a room that looks more like a grand hotel’s salon than a church multipurpose room. Before tables bearing tissue boxes, they fill sofas and upholstered chairs in the parlor of the Neighborhood Church, the United Church of Christ; a storybook set of nesting buildings that wrap around the edge of the Pacific Ocean in Palos Verdes Estates.

“How are you feeling? What’s going on? . . . “ says Sam, his voice a gentle nudge, opening this week’s session of the Good Grief Support Group. “I think this week brought up feelings of loss and sadness . . . for all of us. Why do you think it was rough?”

From his seat in the oval, he reads facial expressions and leans forward into the trickle that finally becomes a flow of conversation. Some are still shuttered away in silence, others more vocal in their frustration. And still others are marooned, somewhere between anger and despair.

For many of those assembled, this was the first Valentine’s Day without their loved ones. They miss specifics--the oversized cards with blossoms and hearts. The extravagance of a dinner beyond one’s means.

But it’s much more difficult to talk about the abstracts. The expanse of absence. For all assembled, this evening is about defining and understanding loss in all its shades and rhythms. Sam and Lois also have brought something to share: The Sunday past would have been Sammy’s 41st birthday.

Lois balances on her lap a gold-gilt frame that holds an 8-by-10-inch portrait of Sammy. He is 21 in a red baseball cap, striped shirt and a wide, open smile like his mother’s, with crinkles at the edges just like Sam’s.

As an antidote to the group’s pain, both Lois and Sam try to give tangible gifts--tried and true words and tools to staunch the emotional wound--the ever-yawning why.

“Be patient,” Lois begins softly, her eyes trained on the page of a slender volume of works by the poet Rainer Maria Rilke. “Toward all that is unsolved in your heart and to try to love the questions themselves like locked rooms . . .

“The point is to live everything. Live the questions now. Perhaps you will then gradually, without noticing it, live along some distant day into the answer.”

When the Blooms themselves first sought those answers, nothing like this session existed. The Good Grief Group was formed by the couple’s congregation to help them through the first months after Sammy’s death. (After their training at the Suicide Prevention Center, the Blooms decided to take over this group in addition to their other work.)

“I think most of the people do not reach out for help. I don’t think they know how,” says Lois, packing away the evening’s handouts--photocopied book lists, take-along words of inspiration. “Sam and I had never reached out for help. We were brought up: ‘You can handle it yourself.’ And I think that that is what most people think. But losing people to suicide is different.”

For many survivors, guilt is by far the most eclipsing emotion, anger a close second.

“A good example is Lois,” Sam explains. “Sammy came home, wrote his notes and ended up driving off the cliff at 5:25 in the evening. So Lo says, ‘If I had gotten home in time from work, I would have gotten home before he left.’ So she took responsibility for his death. Feeling like if she had gotten home in time she could have saved him--which would require omnipotence.

“But when other group members come in and say: ‘You did everything you could . . . ‘ these other thoughts can now penetrate. Now they have some tools, some other perspectives to apply when they bring up their guilt.”

“‘This group,” Lois explains, “is not magic.”

“We try to tell them that it is a lifetime process. It doesn’t matter how a person died,” Sam says. “Even in general bereavements, people wish they had a better goodbye.”

A New Approach to Survivors

In its early incarnations, suicide survivor therapy faced previously uncharted issues. Farberow, of the L.A. Suicide Prevention Center, recalls, “The approach before, and we ourselves were guilty of it, was to approach the needs of survivors in a group therapy way. But there is a very essential difference. They are not disturbed. They are persons beset by a number of problems that people who are mourning other kinds of deaths don’t ordinarily encounter. We had to learn to treat them as ‘normal’ people, who were in a temporary period of emotional distress.”

To Sam and Lois Bloom, the pain felt anything but temporary. But help did come, from an unexpected quarter--the staff at the Neuropsychiatric Institute at UCLA, with whom Sammy had spent part of an arduous final year trying to come to terms with all that had begun to roil up within him.

“Three days after Sammy died, we got a phone call from the suicide center’s Edwin Shneidman,” Lois recalls. Shneidman had been asked to do a “healing session” for the institute’s staff, which had treated Sammy 10 months before. (Sammy had received a provisional diagnosis of schizo-affective disorder.) “Shneidman said . . . he couldn’t do that until he talked to the family to find out what had happened those 10 months out of the hospital. So we agreed to see him.”

After five sessions, Lois still struggled. She had dropped more than 20 pounds; her sleep was broken by a recurring nightmare.

“I would wake up rubbing my arms and I saw ‘Bad Mother’ written all over them . . . I just felt so, so responsible.”

She found momentary calm in books--”When Bad Things Happen to Good People,” stories of the Holocaust, but they weren’t enough.

“I told Sam, ‘I don’t know about you, but I’m going to need some help.’ So we called the [L.A.] Suicide Prevention Center, and they said we could talk to this group.”

All of it was still in very early stages, says Sam Heilig, a psychiatric social worker who is part of the prevention center’s team. He and a survivor had been trying to hammer out an experimental project--a group that would be conducted by both a survivor and a professional therapist.

Sam and Lois arrived just in time for the revolution.

“In the ‘80s, things were coming out of the closet,” Heilig says. “People talked about drug addiction, sexual abuse. I think in that climate more people were able to talk about suicide.”

Although both the Blooms were at loose ends, Heilig saw something else at work within them.

“Not everybody is capable of doing this sort of thing,” he says. “But they were drawn to it. By nature, they are inclined to take a helpful attitude. So I invited them to be co-leaders.”

Their enthusiasm and natural skill surprised even the seen-it-all Heilig.

“I couldn’t kick them out of the building,” he says. “I would want to get home! They would hang around. Go and meet for coffee and continue with the group. But they all needed the camaraderie and mutual support--to be around people and not feel stigmatized with a group of people who shared the experience.”

It just made sense, Lois figured.

“Sam and I have always been very active in the church, in the community. . . . And . . . we decided we needed to do something to put ourselves back together.”

Since their first group in March 1984, the Blooms, working mostly as volunteers, have taken the Survivors After Suicide program through funding crises, from one end of the city to the other--even developing and running the phone counseling line out of their home office when the prevention center’s programs were without a roof.

“It’s hard to explain how much they have given this program,” says the prevention center’s Nagdimon. “Some survivors feel the need to do something. They may need to make a donation, they may write an article for a newsletter. Some may even talk about wanting to return to lead a support group, but few people throw themselves into their work like the Blooms have.”

Although most people want to get as far from the pain as they can, if there is anything that Sam and Lois learned early on, it was that you don’t hide it.

“Once you’re out, you’re like a magnet,” Sam says. “People really do want to talk about it.”

Today, books on the subject make the Blooms’ shelves buckle. The Internet abounds with sites offering help. TV newsmagazine programs tackle it from a range of angles. It’s a different world.

But not a cured one.

“We haven’t learned how to convert our subject to something like the AIDS people have,” says Sam, who sees shifting to an emphasis on advocacy as a logical outgrowth of grief counseling. “When we get the public really believing that a good deal of mental illness is biological . . . when they can get rid of the idea that ‘a good swift kick in the pants will snap Jack out of it,’ then we will make a lot of progress with suicide prevention.”

“It all started out because we really wanted to honor Sammy,” Lois says. “But it’s more than that now: We want to save lives.”

This work, they know, saved theirs.

“Most people don’t want to do it,” says Sam, as he assembles his briefcase, getting ready for his Wednesday group. “Our daughters were concerned . . . and even our friends [would] say, ‘Are you still hanging out with those suicide people?’ But we don’t have many real friends asking that anymore.

“We have to make people understand,” he continues in a voice much like his gait, unwavering and purposeful. “Through [Suicide Prevention Advocacy Network]-California we’re trying to push this legislation through. Understanding mental illness is important. Asking questions is important. Prevention is important. This is important for your people. We’re doing this for your people. Your people are the ones whose kids are going to kill themselves. Ours have already done it. We’re trying to help you.”

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Lynell George can be reached at lynell.george@latimes.com.