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A difficult sibling’s tragic death is the catalyst in “32 Pills: My Sister’s Suicide.” But if documentarian Hope Litoff initially expects belatedly confronting the titular event will result in some sense of inner peace, she — and everyone around her — are alarmed when instead the “process” sends her down a personal rabbit hole of guilt, denial and addiction. Gripping and discomfiting, this first directorial feature by the veteran editor is the kind of diaristic inquiry that can seem self-indulgent but here sports a fearlessness that transcends vanity — at times it’s downright unflattering.

In late 2008 photographer Ruth Litoff was found in her Manhattan loft, having finally “succeeded” after 20 or more suicide attempts over many years. Police on the scene said they’d never seen anything like it — her entire apartment was meticulously prepared for the event, with umpteen notes, presents, etc., left labeled with instructions for disbursement to various friends and family.

Six years later, younger sis Hope empties out the storage locker Ruth’s remaining possessions have spent the interim in, taking a short-term Brooklyn flat to spread out and comb through the miscellany. There is, of course, her sister’s artistic work, which encompassed not just a wide range of photography but collages, sculpture and other media. Then there’s the more blatantly autobiographical evidence not just of journals, datebooks and such but a vast collection of prescription-drug bottles — some still partly full.

We gradually glean that Ruth was a dazzling, high-achieving role model who began turning into an overdependent, mercurial problem at a young age. (Her first suicide attempt came at 13.) Eventually she was diagnosed as bipolar, though in retrospect Hope suspects borderline personality disorder (not as yet prominent on the psychiatric landscape) might have been her actual condition. In any case, her severe mood swings, depression bouts and suicidal ideations left a trail of broken relationships and other external upheavals.

Both girls reacted to their affluent but dysfunctional parents’ crumbling marriage: Hope escaped into recreational drugs and blackout drinking from early adolescence. When we meet her here, she’s been sober for many years. Excavating her sister’s things proves so unsettling that at a certain point “32 Pills” offers the bleak on-camera spectacle of her ordering a double vodka at a bar — her first drink in nearly two decades. It won’t be a one-off lapse either.

Even before that calamity occurs, her husband, Todd, worries that she won’t be able to handle the emotions this investigation is sure to stir up. They also have two young children to factor in. The extent to which the director-“star” nosedives under the weight of grief and guilt is sometimes gruesomely explicit, as when Todd harangues Hope for neglecting her offspring. Elsewhere, producer Beth Levison expresses alarm over Litoff’s willingness to ingest decade-old prescription drugs, and the filmmaker justifies increasingly chaotic actions with a classic litany of addict-speak excuses and fibs.

There is light at the end of this tunnel, embodied in the light boxes Hope installs of her sister’s photographic images at Bellevue Hospital—celebrating Ruth’s work by completing an unrealized project at the psychiatric institution where she’d committed herself several times. But it’s to the film’s credit that this symbolic act only brings a limited sense of catharsis. Hope may have laid Ruth to rest at last to a degree, but her own issues will be alive and kicking for some time.

Talking-head footage is kept brief, embracing a range of viewpoints (old boyfriends, schoolmates, professional colleagues) but never becoming a dominant factor. Litoff and editor Toby Shimin nimbly package a complicated story whose myriad themes — artistic expression and mental illness being just the tip of the iceberg — emerge in a not-strictly-chronological telling comprising diverse present-day and archival materials.

Film Review: ‘32 Pills: My Sister’s Suicide’

Reviewed at Hot Docs (Artscapes), May 2, 2017. Running time: 85 MIN.

  • Production: (Docu) An HBO Documentary Films presentation in association with Impact Partners, Chicken & Egg Pictures, Chicago Media Project and The Documentary Channel of a Little Darkroom Films production. (International sales: The Film Sales Company, New York City.) Producer: Beth Levison. Executive producer: Sheila Nevins.
  • Crew: Director: Hope Litoff. Camera (color, HD): Daniel B. Gold. Editor: Toby Shimin. Music: T. Griffin.
  • With: Hope Litoff, Todd Hagopian, Charlie Hagopian, Caroline Hagopian, Jane Wagman, Renee Rubin, Sarah Brokaw, Susanna Green, Alan Danneels, Jonathan Hayes, Beth Levison, Thomas Safian, Gregory P. Mink.