Staff Perspective: An Afterword to “The Hilliest Course I’ve Ever Run”

Staff Perspective: An Afterword to “The Hilliest Course I’ve Ever Run”

Carin Lefkowitz, Psy.D.

Two years have passed since I publicly discussed my brother’s suicide and how it impacted me in this very forum. It was a huge step for me at the time, disclosing this secret that I guarded carefully. I had the sense that it would be cathartic for me, but I also knew I couldn’t take it back once it was out there. In retrospect it’s one of the most important things I’ve ever done.

The week it was published, I worried about how people would respond. I obsessively checked the CDP website and social media postings to see if people commented. Would colleagues look at me with pity? Would friends who hadn’t known avoid me out of awkwardness? Or even worse, would readers roll their eyes at this egocentric piece of self-exploration? What actually happened is that I was immediately inundated with emails, texts, and Facebook posts. Messages from casual friends and colleagues I barely knew began with “Thank you for this!” and continued with “when my spouse/friend/ex-boyfriend/uncle committed suicide, I felt shocked/guilty/ashamed/angry/confused, too.” Sadly, stigma and loneliness are common experiences; in addition to the outdated and pejorative phrase “committed suicide,” many of those messages also included the statement, “no one talks about it.”

At the risk of overstating or sounding cliché, those messages changed me. Intellectually I knew that other people were coping with losing a loved one to suicide. 45,000 Americans die by suicide each year (NIMH, 2018) and it is estimated that at least six people are intimately affected by each one. In fact, more recent estimates suggest that up to 135 people are impacted by every suicide (Cerel et al., 2018), so it should not have been a surprise that readers related to my blog. But I was shocked to learn how many of my own friends and colleagues had similar stories. So many of us are unwilling members of this secret club and the membership list is so closely guarded that we don’t even know our friends are on it. This realization alleviated any residual shame I felt and inspired me to be more open and forthcoming.

Since the blog was published, I’ve gotten the requisite semi-colon tattoo ( and explain its meaning to anyone who asks. I watched both seasons of “13 Reasons Why” and engaged in impassioned discussions about how Hannah’s actions were portrayed. Most importantly, I’ve had conversations with friends and acquaintances that I would have avoided in the past. On one occasion, showing off my new tattoo led to sharing Wayne’s suicide with a newer group of friends, which prompted a conversation about misconceptions related to suicide. My friends were honest about their ignorance and allowed me to challenge the ideas that “you have to be really messed up” to harm yourself or “someone who really wants to die doesn’t make a cry for help.” I think they felt a little uncomfortable at first and I know I felt defensive, but it was so meaningful to me to talk openly about this. Even better, we’ve returned to the conversation several times over plates of nachos and spinach-artichoke dip. It’s officially acceptable to discuss suicide during happy hour – take that, stigma!

A far less eloquent exchange took place with my favorite server at my local pub. He looked upset one night and disclosed that his friend recently died by suicide. He was dreading attending the funeral and wondered what warning signs he missed. I shared that my brother’s birthday was coming up and I was feeling sad about that. We commiserated briefly, agreed that “it just sucks,” and hugged it out. That’s our standard greeting now and it’s reassuring to me to feel understood in that way. I hope it’s helpful to him, too.

Although I know I’ve healed quite a bit in the past two years, I’m not done. I still have professional limits for myself. For example, despite my passion for the topic, I don’t think I could tolerate being a full-fledged member of CDP’s Suicide Prevention Team. I can talk about insomnia or PTSD all day, but I have an unpredictable limit on the topic of suicide, so I couldn’t be counted on as a regular contributor to the team. I’ve also identified a personal vulnerability: the fear that someone else I know will die by suicide and the lengths that I will go to in order to prevent it. I’m not saying this in a “During a job interview, take something that’s really a strength and present it as a weakness” kind of way. While I am genuinely empathic and don’t want to see anyone in pain, I will also consciously go to ill-advised lengths to protect myself from experiencing the pain of suicide again, or from wondering “could I have done something to prevent it?” I respond to histrionics instead of walking away, overextend myself when a friend is distressed, and disregard my own needs if someone else appears to be suffering. This is not sustainable and I am working on it. I’m adding it to my elusive “10-Point Plan.”

The most important lesson I’ve learned is also the most obvious and saddest one: suicide is an epidemic. In the past two years we’ve lost more incredible talents to suicide – Musicians Chris Cornell, Chester Bennington (who coincidentally shared Wayne’s birthday) and Avicii, writer/chef Anthony Bourdain, and designer Kate Spade – again demonstrating that even the most adored and successful among us are not immune. The only silver lining that has emerged from those deaths is that we are talking more openly about suicide. Frankly, “no one talks about it” is no longer an option.

As September is National Suicide Prevention Awareness Month, my colleagues are making a concerted effort to foster discussion and address the epidemic via this website takeover (as well as during the rest of the year) with blogs, webinars, and workshops. To survivors of suicide loss, I hope that my experience resonates with you and instills hope. There’s certainly no timetable for healing, no rules for coping. While I wish I had shared my story and tapped into these sources of support earlier, the reality is that I wasn’t ready to. But once I started to talk about it, I didn’t stop and I’ve never regretted it. I worried so much about being judged and pitied that I didn’t realize there were dozens of other people just waiting for someone to start the conversation. Thanks to all of you who are keeping the conversation going.

Visit CDP's Suicide Prevention Spotlight page here for more blogs, resources, and infographics on the topic. 

The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.

Carin M. Lefkowitz, Psy.D., is a clinical psychologist and Cognitive Behavioral Therapy Trainer at the Center for Deployment Psychology (CDP) at the Uniformed Services University of the Health Sciences in Bethesda, Maryland.


Cerel, J., Brown, M., Maple, M., Singleton, M., van de Venne, J., Moore, M., & Flaherty, C. (2018). How many people are exposed to suicide? Not six. Suicide and Life-Threatening Behavior. doi:

National Institute of Mental Health. (May 2018). Suicide. Retrieved from: