32 Pills My Sisters Suicide32 Pills My Sisters Suicide

By Olivia Armstrong

How 32 Pills: My Sister’s Suicide Was a Tumultuous Journey

Director and subject Hope Litoff and producer Beth Levison on how they navigated the volatility of Litoff’s journey into her sister’s past.

HBO: Hope, when did you decide to turn your sister's story into a documentary? Did you have any expectations as to how this journey would unfold?

Hope Litoff: In a suicide bereavement group, what I found fascinating is we all had storage spaces of our deceased person’s stuff. I had all of my sister Ruth’s beautiful artwork along with her other belongings. We couldn’t bear to part with anything and everything became infused with greater meaning. We were paralyzed.

Because I’m a documentary editor and have to keep a certain distance with the footage — no matter how sad or disturbing — I had this fantasy that if I could film parting with her belongings, I would have this protective, professional barrier. I didn’t initially plan on making a film. It was more, if I could get this on film — like her empty pill bottles — it could still exist somewhere and I’d be emotionally protected as an editor. And that ended up not being true: It was very emotional.

HBO: Hope, as an editor, what goals did you have in mind? How did you and editor Toby Shimin work to achieve this?

Hope Litoff: Because of my struggle with my sobriety, Toby did a lot of work independently and I totally trusted her. I never predicted I would break down reading Ruth’s journals. When I was at rehab, we had phone calls about how to give Ruth a voice. Joy Reed, our associate editor and animator, talked about how we could best use those journals to create the beautiful animation of Ruth’s work and drawings. We thought this film could be different by being honest and bold, and really wanted it to be a work of art — very much like Ruth’s art.

HBO: Besides Ruth’s journals, was there other inspiration that helped shape her voice in the film?

Hope Litoff: We spoke about the documentary In a Dream, about artist Isaiah Zagar, and the way his artwork was animated. We also talked about Kurt Cobain: Montage of Heck. I really liked the way they animated Cobain’s journals and the way the words on paper came to life. Then there was 51 Birch Street by filmmaker Doug Block, who discovered his mother’s journals after she died that revealed a lot that he didn’t know.

HBO: Was there debate about including your relapse?

Hope Litoff: We always knew we were going to include it. We did have questions about the scene where I take the pills, not only on an ethical level, but in the sense of: What does it mean when your main subject is falling apart but the film continues?

As a result, Toby, Beth and I ended up seeking a psychiatrist; we were concerned about whether to continue and tried to come up with boundaries and safeties to keep going. I was the bullheaded one who didn’t want to take a break. I was obsessed, and maybe part of me wanted to get it over with.

Beth Levison: We have to challenge the underlying assumption that we knew Hope was going to relapse because we had no idea. As is shown in the film, Hope lived through her sister’s suicide and through the loss of both of her parents without returning to alcohol. So when she relapsed, it became an ethical issue about moving forward. It wasn’t that she happened to be drinking because of something going on in her life; she relapsed because of the making of the film. When you’re making a film and something happens to your character, you film it. But what do you do when what’s happening to your subject is happening because of the very act of filming?

There’s a point in 32 Pills where Hope says, “I always thought Ruth and I were so different. Now I realized we’re not so different after all.” Ruth ended up taking her own life, so at that moment it seemed really volatile. When Hope took the pills, we couldn’t believe it. As a filmmaker, I knew we should probably shoot it because that’s what was happening in the story. But then the ethical issues were so complicated.

Someone the other day said to me, “When the film started to go off the rails, that’s when it got really fascinating.” But a lot came with the film going off the rails — a lot of questions about how to manage it and how far to go. Also, none of us live with Hope, so we were just catching the tip of the iceberg. Hope wanted to proceed and had this feeling that if she could get through it, she’d be OK. Then what happened was, we kept going and it didn’t get better.

HBO: Hope, how are you feeling now that the film is out there?

Hope Litoff: Now that it is on the screen and I’m lucky to be in sobriety, I value my sobriety so much. One audience member said, “I’m in AA and I’m sober and it seemed like you so glibly threw your sobriety away.” I filmed that first drink but there was a lot of mental anguish happening before that with video diaries and in my own head. It really was much more of a process of falling apart.

I am glad that it’s in the film. I feel like we’ve touched a lot of people because it’s made the film much more universal. It’s not just about suicide or mental illness, it’s also about addiction and, more generally, how do we manage grieving and what kind of help is out there for those of us left behind? Now that it’s done, we realized there’s a lack of resources for those who are left behind and it’s really helping shape our outreach campaign. It’s definitely the live Q&As that have been the most healing. People ask me if making the film was cathartic and my answer is no. But the sharing of the film? It’s incredibly cathartic.

32 Pills: My Sister’s Suicide is available to stream.

32 Pills My Sisters Suicide
Support and Help

Help is available 24/7 nationwide. If you are in crisis or know someone who is, reach out immediately to the following for help.