This book review is meant to be informational only, not for self-diagnosis or treatment. Please do not use it in lieu of being under the care of a trained and licensed medical professional. Thanks, Kathleen

In Her Wake: A Child Psychiatrist Explores the Mystery of Her Mother's Suicide

By Nancy Rappaport, MD, www.inherwake.com.

By Kathleen Kenneally, LAc, LMP, LMHC
Copyright August, 2010

Sadly, Dr. Nancy Rappaport's mother passed away by suicide in 1963. Nancy, the youngest of six siblings, lost her mother at the tender age of four years old. Nancy grew up to be a child psychiatrist helping children and families cope with mental illness because she realized that treating the internal processes of children who experience trauma is vitally important. Her own life was uplifted through the psychotherapy she received as a young teen - Nancy stopped blaming herself for her mother's death. As a college-aged woman, Nancy noticed that an "inner-impoverishment" affected traumatized children more than struggling to find food, clothing and shelter.

The book In Her Wake is written as a memoir and reads like a mystery. Why did Nancy's mother kill herself? The book's narrative provides many details about the character of Nancy's family members and family relationships. Nancy is trained in psychodynamic/psychoanalytic work that supports the idea that family-of-origin issues impact mental health. Nancy took over twenty years to write the book. While she points out some probable culprits in her mother's demise, the issues are complex and ambiguous enough to allow you to think critically and decide for yourself, all the while learning about family dynamics and suicide.

Nancy's mother was in the middle of a bitter and public divorce from a husband who wielded a great deal of political power and seemed to have been vengeful towards Nancy's mother. Nancy's mother lost custody of her children. Likely, depression and bipolar issues were present and left untreated and this lack contributed to the suicide. In reading the book, I was struck by Nancy's courage in speaking about her family's challenges. Family secrets are revealed. Powerful conflicts exist.

The book was written for many reasons. Nancy writes the book to make a presence of her absent mother, to fill in the many gaps an early loss naturally and painfully engenders. She utilizes family treasures of photographs, letters and mementoes of her childhood and interviews friends, family and her mother's lovers to learn more about her mother. Nancy explores the psychoanalytical perspective that trauma passes through from generation-to-generation in families if not actively healed with psychotherapy. She explored her mother's and her father's individual family histories and her early experiences in her family of origin. These events and relationships are considered to be useful keys to understanding life choices like suicide.

Another reason Nancy wrote the book was to help her understand herself and help her individuate or become "more herself" as a woman, a mother of three, a wife, a psychiatrist, a writer, a long distance runner, among other defining characteristics. Nancy shares the same name "Nancy" with her mother and she looks in appearance very much like her mother. Nancy, with the mind of a four year old, imagined that she herself was to blame for her mother's death - that, as the youngest child, her birth into the family killed her mother. The loss of a mother at a young age creates a difficult psychological situation. Nancy has engaged herself in years of ongoing therapy to help become more conscious about her own inner-world and her life choices. The sadness, guilt, shame, and anger linger and need to be acknowledged in order for the psyche to be made whole.

Finally, Nancy writes to share the experience of having had a suicide in the family with others including the general public. The book is written for the lay person. If you have ever wondered how to speak with children or others about suicide, I recommend Nancy's book or website for more information, www.inherwake.com. There is a section on Nancy's website entitled "advice" that contains helpful information for such tragic situations and a "resources" section that may also offer assistance.

Through writing this book, Nancy shows that her mother's life is not defined solely by her suicide. A mother's presence is an extremely essential aspect to the developing human psyche. If death or trauma removes a mother, the child's needs for a mother must be addressed in order for health and wellbeing to be re-established. Nancy is writing about her mother's death and about how she herself addressed this devastating loss. Despite the early absence of her mother through suicide, Nancy is managing to find a broadened identity of her mother beyond her untimely death through suicide. Nancy is creating an identity for herself as a mother of biological children. Nancy herself is representing an archetypal mother through the doctor-patient relationships where her client "children" and their families can benefit from Nancy's resolving of her loss. Finally, Nancy is speaking to us all about the necessity of having a mother in our life in order to be fully human.