Hope Litoff walks down the hall of a nondescript, New York City storage facility. "This hallway feels like an insane asylum," she says. Litoff is unpacking everything that belonged to her sister, Ruth, who died by suicide in 2008 — and filming herself every step of the way. The resulting documentary, 32 Pills: My Sister's Suicide, premiering tomorrow, December 7, on HBO, captures Litoff's grieving process in stark detail.
Throughout the film, Ruth's presence hangs in the air, as Litoff unpacks the storage unit brimming with her artwork; reads her journals; and coordinates a gallery show staged in Bellevue Hospital, the place where Ruth went after her suicide attempts. For all that she discovers about her sister in the process, Litoff remains burdened — by both the belongings Ruth left behind (including countless half-empty bottles of prescription pills) and the realization that this loss will be with her forever.
Litoff spoke with Refinery29 about making the film, the most difficult items to unpack, and why she didn't want a hopeful ending. Read our conversation below.
What makes the loss of a sister different from another type of death in the family? Was there something specific to your relationship with Ruth that compelled you to make a film about her death?
"The relationship between sisters, probably of all of the family relationships — brother/sister, mother/daughter — might be the most intense. Especially when you’re close in age, and it’s just the two of you. She was my big sister. I really looked to her as my guide for everything. If I really wanted to know the real truth about boys or friendships, I would go to my sister and she would be the one to advise me.
"As a younger sister, you really look to the older one to sort of show you the way through life. My relationship with Ruth was unique because she had the desire for us to be even closer than regular sisters. She wanted us to have a secret language. She liked when we dressed alike. She really wanted to sort of merge, and I think that intensity was a strain on our relationship as we got older."
What prompted you to do unpack the storage unit of her belongings when you did, six years after her death?
"I was part of a suicide bereavement group and something that we all had in common was that we had these storage spaces of our dead people’s stuff. We couldn’t bear to part with anything and we also couldn’t bear to look at it. When you lose someone to suicide, you feel so lost and confused that you infuse objects with this sort of power. We all were striving to get to a place where we could open up our storage spaces and let the things go. That was more symbolic of letting go of the person and accepting that they were really gone.
"I thought that if I filmed myself unpacking my sister's stuff that I would be able to keep a professional distance or objective feeling about it. Maybe I could part with some of it. That didn’t happen at all. That was a total fantasy.
"A lot of people don’t know this from seeing the film, but the stuff is still actually all in storage. The making of the film helped me get to a new place, but not to the place of emptying the storage space. But that was the very beginning inspiration to make the film. And then as it grew, I saw the potential for the film to help people. This story really wasn’t being told. I would run into people who we went to high school with and they would say to me, 'How’s your sister?' and then it was impossible to say she committed suicide. I couldn’t get the words out. Then if I did, the other person would start crying. I would start crying. I was like, This is too stressful. Why should it be so embarrassing? I just wanted to make it easier for me to talk about, and then, in the bigger picture, make it easier for other people to talk about."
What was your first visit to the storage unit like? What did you feel being in there, going through her belongings?
"I felt awful. My sister was an artist, and so much of what I had in storage was her artwork. It was so personal to her. She would do things like ink up her entire hand and put her handprint on the back of her artwork, so it was like being with her. It was really scary. It made me feel like I was on rocky ground. And then reading her journals, which was the thing I was most afraid to do, was, as I predicted, incredibly difficult. Realizing how much pain she was in for how many years, and how deeply she suffered, was really something that was hard for me to come to terms with. While she was alive, there was only a certain amount of her pain that I could handle feeling. I read every single one of her emails. Sometimes I would stay up all night just to keep reading the journals, reading the emails. I was so inside of her head that I really fell apart."
There’s a scene in the film where you unpack and line up all of Ruth's pill containers — what was going through your head at that moment, both as a director and as Ruth’s sister?
"People see those pills lined up on the table, when I sit in on audience screenings, and they gasp. You can hear an audible, 'Oh my god.' But for me, it was like the same thing as organizing film. I’m an organizer — I can go into my happy place when I'm reading dates and putting things in order. It strangely didn’t have that big of an effect on me. What really surprised me was when I started unpacking her stuffed animals, thinking I was going to feel nothing. That’s when I actually had a huge emotional reaction. I was like, Oh, she wants these stuffed animals because she wants to be happy like a child.
"There was something about that moment that really created an intense desire to take care of her, wrap her up in a blanket and love her and protect her like a child, in a way that the pill bottles didn't. They were like cold little soldiers that didn’t work. If anything, I felt angry at the pill bottles. I was like, You didn’t work, and you didn’t work, and you didn’t work. When I was lining them up, I was having very angry and negative feelings. That was a much more comfortable place to be, emotionally, than being like, I want to give her ginger ale and toast and wrap her up in my arms."
Did Ruth's passing lead you to learn something new about her?
"Yes. I feel like I know her more now — and I definitely feel different about her now. She was a very difficult sister to have. She could be really loving in one moment and really cruel and vindictive in the next moment, so I always had my guard up. And she was mentally ill. She couldn’t help it, but that didn’t mean it didn’t hurt my feelings. I would sort of brace myself before I saw her and I would have this sort of necessary wall up between us. That really limited how close I could get to her. I was actually afraid of her. I loved her so much and she had so much power over me that when she would lash out at me, it was incredibly painful. I couldn’t just be like, Oh, she’s mentally ill, so that doesn’t affect me. She was still my big sister. It’s sort of heartbreaking to say this, but I feel more free to love her now. Some of the fear is gone. I don’t know what the right word is, because ‘forgive her’ sounds so tied up in a happy little bow, but I feel honestly closer to her, and that’s a nice feeling."
The ending left me feeling hopeful. Was that your intention, to end with a message that there’s a chance to gain something out of this difficult process?
"Actually, it was really important to me that the ending was not too hopeful. I made the Bellevue show and I had an expectation that I could make it really magical and just the way Ruth wanted it to be. She was so talented and such a perfectionist. I really wanted to make this incredible show for her — and it was magical. But then the next day, I woke up and was like, I still have this huge hole. It didn’t heal me. I wanted to speak to other people who have been through similar things and be like, 'It's not going to go away. Maybe it can change, but it’s an ongoing process, and it’s not ever going to go away.'"
So, truth, rather than hope, took priority for the end of the film.
"That’s how I want it to be. After I show it at festivals, people will talk to me. One young woman came up to me and she was crying. She was like, 'Is it worth it to feel the pain?' I was like, 'It’s really hard, and it might feel worse than you feel right now, but ultimately it’s worth it.' That’s the message of hope, if there is any. Go through the pain and confront your loss to get to the other side. If you turn off your emotions, either through drugs and alcohol or just by being a robot, you can make the pain go away, but you also make the happy go away. When you get to the other side, you might still have really bad days. Don’t put a time limit on it. But that way, you’ll get to have the happy."
Interview has been edited for length and clarity.
If you or someone you know is thinking about suicide, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or the Suicide Crisis Line at 1-800-784-2433.