Tell Them It Is Going to Hurt: On Meg Kissinger’s “While You Were Out”

IT IS 1951 in Milwaukee, Wisconsin, and Jean Gutenkunst is having second thoughts. Her wedding is only a few weeks away. She met the man she plans to marry, Bill Kissinger (known by his loved ones as Holmer), a little over a year ago; the two were set up on a blind date. Now engaged to be married, Jean—mother of the yet-to-be-born journalist Meg Kissinger, author of While You Were Out: An Intimate Family Portrait of Mental Illness in an Era of Silence (2023)—confides in her fiancé. The secret has plagued her especially since her mother’s death from cancer a few years earlier. “I have these spells,” she tells him, “times when the air feels thick and it is hard even to move.”

For readers of Meg Kissinger’s electric new book, Holmer’s response to this unexpected revelation—which includes mention of medication and a psychiatrist, of which only one is listed in the city’s phone book at the time—remains a mystery. When Jean’s father finds out about his daughter’s doubts later that day, he insists that there is no way to cancel the nuptials. Three hundred invitations have gone out. The big Catholic wedding transpires as planned. “Take two alcoholics—one with bipolar and the other with crippling anxiety—and let them have eight kids in twelve years,” writes Kissinger, the couple’s fourth-born. “What could possibly go wrong?”

Kissinger discovered a passion for reporting as an undergraduate at DePauw University in Indiana. She has since forged an award-winning career in investigative reporting, focusing on issues of public and mental health in her hometown of Milwaukee and nationally. Here, she writes about her own life with a journalist’s clear and focused gaze. Rather than skip over painful details of the many tragedies her family has endured over the years, Kissinger confronts the silences and hesitancies that have affected her family head-on. Her approach is not dissimilar to that of the many assignments she has undertaken as a journalist over the years; she carefully investigates every related source she can find, including, for example, medical records and interviews with friends and relatives. Still, writing about a subject this close brings up a whole new set of challenges. Kissinger must grapple not only with the coping habits she has developed over the years—namely, concurrently sweeping her feelings under the rug and taking on responsibility for events outside of her control—but also with the recognition that this story belongs as much to her siblings as to her. Luckily, her six living siblings give the gift of their approval.

Kissinger divides her memoir into three parts. The first and longest section—which occupies a full two-thirds of the book—tells the tumultuous story of her early family life through to the eventual death by suicide of two of her siblings. Some of Kissinger’s first memories include her father’s blisteringly abusive presence, often heavily drinking when he was home from work on weekends. Her mother provided a more tranquil (if equally mystifying) force, continually tidying up and organizing, cooking, and planning for a family of 10, even as she self-medicated with tranquilizers and martinis every evening and occasionally disappeared for reasons then unknown. Later, our narrator learned to attribute these absences to psychiatric hospitalizations. Kissinger also remembers late-night squabbles and games with her “wingman” younger sister, Patty, in the bedroom they shared; she further recalls many childhood accidents among her siblings, who were often left unsupervised.

Kissinger goes on to trace her older sister Nancy’s struggles with serious mental illness, including multiple suicide attempts. She grapples too with her own adolescent confusion and frustration regarding her sister’s experiences. Returning from study abroad to find her sister once more under suicide watch, Kissinger remembers not being alarmed, but angry: “Nancy had screwed up my dramatic homecoming plans. Once again, she was stealing all the oxygen in the room.” The writer seeks not only to track what happened but also to better understand why it happened, wondering whether, or how, she, her parents, her siblings, or anyone else could have done anything differently. In doing so, Kissinger poses a very intimate and difficult question: was her sister’s tragic early death preventable? From both a personal and writerly standpoint, this is an unbelievably thorny, not to mention emotionally courageous, angle. She wonders similarly about her younger brother Danny—who also died by suicide about 20 years later, after decades of his own painful struggles. In writing about her brother, Kissinger outlines the anxieties that often accompany proximity to severe mental distress and suicide, questioning whether she, or one of her family members, could be next.

The book’s second section turns to a broader discussion of all Kissinger has learned in her years of writing about mental illness and recording other individual experiences of pain and suffering. The writer outlines the huge institutional cracks and failings that she has often uncovered in her journalism—an almost complete lack of appropriate support systems for people with serious mental illness. She also recognizes the ways in which ignorance and prejudice serve to pressure families into cycles of silence brought on by shame. “I knew only too well,” she writes, in a sentence that could easily apply to her own family story, “how we tend to blame [individuals with illness]—or their families—for their sickness, as though they brought it on by some moral failure.”

The last and final section of the book concludes by reiterating what Kissinger has learned during her writing process. She recognizes that there will never be concrete answers to the many questions she has about her and her family’s past. Indeed, shortly before his death, she asks her father, Holmer, whether knowing what her family would inevitably face might have prevented his marrying her mother when he had the opportunity. Yet even as she asks the question, she knows it is a hypothetical—as compelling as it is, in its way, it’s beside the point.

Kissinger’s memoir, lucid and narrative-driven, is in turns distressing, earnest, heart-wrenching, and hopeful. Make no mistake: the author is acutely aware of the ways her siblings’ and her parents’ entwined lives bent and twisted each other out of shape—mostly by way of violence and ignorance, common twinning effects of intergenerational trauma. Both her siblings and parents underwent the agony of living with and losing loved ones whose illnesses proved challenging not only to diagnose but also to treat and support within the United States’ woefully inadequate mental healthcare framework. Crucially, she suggests that perhaps most challenging of all are the stigma and shame that accompany individuals and their families dealing with serious mental illness.

Though this is Kissinger’s first book-length work, the memoir is not the journalist’s initial foray into writing intimately about mental illness. In 1986—when such pieces were almost unthinkable—she published an article about her older sister Nancy’s death eight years earlier. In 1998, she discussed her younger brother Danny’s difficulties. She has written similarly about her older brother Jake’s lifelong struggles with serious mental illness, as well as how these have impacted her relationships with him, her other family members, and herself.

It is perhaps unsurprising, then, that no stone is left unturned here. Though the author remains connected to the Catholic Church in her way, she vividly describes the pressures her mother experienced to stay away from birth control until—after her eighth child, and multiple bouts of severe postpartum depression—she was finally, reluctantly allowed reprieve. Kissinger details, too, the myriad incarnations of her parents’ neglect. At one point, the dynamic grew so extreme that she attempted to tear paper cuts into her eyes so her mother would be compelled to take her (hopefully alone) to see an eye doctor.

Still, as the narrative comes to a close, Kissinger also gratefully recalls the affections bestowed on her from various members of her family. It can be hard to remember anything positive after such pain and tragedy. Even so, she describes the joys of knowing her vivacious sister, flaws and all, as well as her once-spirited, now lost brother. These recollections remind her of the dynamic people she once knew and loved—people who loved and cared for her in return. A former babysitter reminds the author of the unequivocal warmth she witnessed in the Kissinger household during the two years she lived there. “You were all such good, happy kids,” she tells the now adult Kissinger 60 years after the fact. “There was a lot of love in that house.”

With While You Were Out, Kissinger joins other on-the-ground campaigners, including but not limited to journalists and writers, looking to unmask the inaccuracies and misrepresentations posited around serious mental illnesses; their various and complex sources and impacts; and possible effective supports, many seemingly tried-and-true but yet to be fully tested or resourced by the powers that be. Recent publications such as Thomas Insel’s Healing: Our Path From Mental Illness to Mental Health (2022), Rachel Aviv’s Strangers to Ourselves: Unsettled Minds and the Stories That Make Us (2022), and Clancy Martin’s How Not to Kill Yourself: A Portrait of the Suicidal Mind (2023) undertake similar projects, building outward from the foundations of their authors’ own lived experiences (including, notably, those of their workspaces). By challenging popular mental illness discourse, these books urge readers to move beyond commonly manufactured platitudes and clichés. They call for consideration of what it means to suffer deeply, as well as what it means to live in close proximity to those who are suffering deeply.

Of course, it can be difficult to tell how much of a tangible impact such works as these can have. Despite the increasing publicization of personal mental illness narratives, there remains a lack of efficacious measures to help protect deeply vulnerable populations. And stigma abounds. Unfortunately, it is often much easier for individuals to move away from, rather than toward, people who are undergoing mental health emergencies and their loved ones. On some level, however, it can only help to share—as Kissinger does so candidly in her new book—the specific agonies associated with mental illness, as well as the fuller, richer contexts of individual stories, to make space for meaningful change.

“Tell them it is going to hurt,” Kissinger is advised by a wise doctor she encounters later in her career. Kissinger has become a teacher for budding journalists looking to accompany her in reporting about similarly difficult topics, and this is the doctor’s advice for being at the forefront of looking closely and directly at the harshest realities. Of breaking what is still too often treated as taboo. “That’s how the healing starts.”

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Tahneer Oksman is a Brooklyn-based writer, teacher, and scholar.