It's been said that the grief inflicted by suicide may be the hardest of all to bear.

Karen Dunne-Maxim, RN, MS, agrees. And she should know. Her youngest brother Tim took his own life when he was just 16. She says suicide survivors often feel stigmatized and experience feelings of shame, isolation and even anger, which hamper normal mourning. And there's usually an exaggerated sense of responsibility, the belief that perhaps, somehow, it could have been prevented.

Since Tim's death, Dunne-Maxim's life's work has been trying to prevent suicide and help survivors heal their pain. "It's part of my own healing," she says.

Tim's death occurred 27 years ago. From all outward appearances, the teen was thriving. He was a good student with plenty of friends, was the editor of the high school yearbook and played the cello. Just prior to his death, he was getting rave reviews for his role opposite Olympia Dukakis in summer stock theater.

But unbeknownst to those around him, Tim - like 80 percent of all suicide victims - was suffering from mental illness. He was depressed and had been acting a bit strangely: He cut his stylish long hair into a crew cut, and he isolated himself from his friends. Once when riding in the car with his mother, Tim slammed his foot on the gas pedal. Then one night, the police picked him up for throwing stones at the headlights of cars. They took him to a psychiatric hospital, where he was examined by several clinicians. He fooled them into believing he wanted to be there. He said he was writing a novel and wanted to experience being in that type of facility first-hand. They kept him overnight and released him the next morning. That afternoon, while his mother attended the wake of a dear friend, Tim jumped in front of an oncoming Long Island Rail Road train.

"My mother had a master's degree in guidance, one of my brothers was a psychologist and I was a public health nurse," she says. "Yet not one of us - or the people at the hospital - detected the problem. Something in his illness stopped him from reaching out for help."

Shortly after that Dunne-Maxim enrolled at Rutgers and earned an advanced degree in psychiatric nursing. In 1978, she came to UMDNJ-University Behavioral HealthCare (UBHC) as a family therapist. But like many survivors, she kept her brother's suicide a secret. "I was afraid people would think there was something wrong with my family,"she says, "and I thought they'd wonder how I planned to help others if I couldn't help my own brother."

Eventually, when her supervisor noticed she was having difficulty counseling suicidal youngsters, she told Tim's story. The supervisor suggested Dunne-Maxim form a support group with others like herself. She did. "We were one of the first groups of its kind in the country," she says. "We met once a month, and didn't charge a fee. For the first time, people, including myself, could tell their stories and find out how others had learned to survive and heal."

In the 14 years since that first group met, 2,000 plus people have attended "Survivors After Suicide" meetings at UBHC, which are still run by Dunne-Maxim. Several hundred groups like it have sprung up across the country and a few just recently began in Germany, England and Australia.

Dunne-Maxim's efforts to enlighten people about suicide didn't end there. Along with her psychologist-brother Edward, and others, she wrote a book, "Suicide and Its Aftermath," published by W.W. Norton Company in 1987. The first publication to deal with suicide from the survivor's perspective, it is considered a landmark in the field.

"There was so little information on the cause of suicide, we thought talking about it openly would help prevent it," she said. The subject remained taboo until 1985, when Mariette Hartley spoke publicly about her father's suicide. Others followed: Joan Rivers, Larry Bird, Katherine Hepburn, Mikhail Baryshnikov and Peter Fonda. Their candor helped bring suicide "out of the closet."

But preventing suicide is the ultimate goal. As co-coordinator of the Suicide Prevention Project for 11 years now, Dunne-Maxim trains school and community workers in suicide prevention strategies, particularly how to recognize and deal with signs of depression and suicidal tendencies, how to "safely" talk about depression in the classroom, and how to minimize violence among teens.

She also consults with schools in New Jersey after teen homicides, suicides or fatal accidents. Her model for meeting the special needs of families and school systems after a traumatic loss is now used throughout the country.

An example of the advice she gives is to let students ventilate and to validate their feelings. She calls this "the two V words."And, perhaps most importantly, Dunne-Maxim advocates working with the media in order to decrease copycat behavior.

This year, one of Dunne-Maxim's main goals as president of the American Association of Suicidology is to try to eliminate the glorification of suicide in the media. It is often joked about or used inappropriately in ad campaigns. Even cartoons, she points out, show suicide as a way of solving problems. "Porky Pig will sometimes put a gun to his head when he gets frustrated," she explains. Some movies do the same: Thelma and Louise, Titanic, Groundhog Day, Princess Bride and Captain Hook all romanticize suicide.

"After Paul Newman's son died of a drug overdose, he formed a foundation that educated the media on the perils of idealizing this type of behavior," she says. "It has since stopped. I think we can do the same with suicide."

Dunne-Maxim is truly a pioneer in her field. She is on the board of the American Foundation for Suicide Prevention and was the recipient of its Paloma Award in 1990. She's appeared on all the major television networks and talk shows, has consulted on several films and on episodes of "Chicago Hope." She is almost always called to advise school districts after a high-profile traumatic loss takes place, like the Megan Kanka murder. She worked with school administrators on New Jersey military bases, where both teachers and students had loved ones in the Gulf War. And she consulted throughout New Jersey after the school massacres, particularly Littleton, to try to avoid copycat behavior and to alleviate students' fears.

But not all aspects of her work are morose. The clinician says she's met wonderful people and has had some delightful experiences. One of her favorite stories is of the ride she took in California with Peter Fonda. Dunne-Maxim had been asked to help him prepare a speech for a seminar they were both attending. The two had only the ride from a restaurant to the conference site to prepare the talk.

"I tell people I rode down the California coast with Peter Fonda, but I was a grandmother at the time, I wasn't on a motorcycle, and it wasn't an easy ride."

Dunne-Maxim resides with her husband, a mathematician, in Princeton Junction. When she's not working, she nurtures herself with opera and art. She also loves to travel. She's been to Europe, South and Central America and Asia. She just returned from a trip to Vienna that she described as extremely enriching. Not surprisingly, one of the things she did there was tour the opera house.

The clinician has two daughters, one a stockbroker in Manhattan and the other a lawyer in Washington, D.C. Her grandsons, 5 and 9, are a constant source of delight. "They live in Virginia so I know the Amtrak route from here to there very well," she says. "I see them as often as I can."

As for the future of violence in America, the expert is optimistic. She points out how far the country has come on matters such as wearing seat belts, curbing air and water pollution and decreasing the number of drunk drivers. "And who would have ever thought we'd win suits against the tobacco companies?" she says. "We have to have zero-tolerance for violent acts in the schools and kids must learn not to bully others but rather be respectful. It will take everyone's efforts, but we can do it."

Dunne-Maxim likes to think her brother would be proud of the work she's doing. "It gives some meaning to his life."

Fall 1999 Table of Contents


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