Notes on Resilience
Conversations about trauma, resilience, and compassion.
How do we genuinely support individuals who have experienced trauma and build inclusive and safe environments? Trauma significantly affects the mental and physical health of those who experience it, and personal resiliency is only part of the solution. The rest lies in addressing organizational, systemic, and social determinants of health and wellness, and making the effort to genuinely understand the impact of trauma.
Here, we ask and answer the tough questions about how wellness is framed in an organizational context, what supports are available and why, what the barriers are to supporting trauma survivors, and what best practices contribute to mental wellness. These conversations provide a framework to identify areas for change and actionable steps to reshape organizations to be truly trauma sensitive.
Notes on Resilience
90: Understanding Suicide: Building Connection and Reducing Stigma, with Dr. Liz Clark
We are each irreplaceable.
Join us for the third episode in our four-part series for suicide prevention awareness month, for a conversation with Dr. Liz Clark, Director of the Defense Suicide Prevention Office. We discuss the topic of suicide prevention from an ecosystem perspective.
Dr. Clark discusses the essential role of belongingness and connectedness, especially in our post-pandemic hybrid work environment, the severe health consequences of social isolation, and the importance of human connection. We also tackle the stigma surrounding mental health and suicide, advocating for direct communication and empathy. We explore a comprehensive approach to suicide prevention, emphasizing the importance of national policies, effective crisis response systems, and community-based support programs.
Resources
- Call or text 988, a 24/7, free, and confidential support for people in distress.
- FindSupport.gov
Dr. Liz Clark serves as the Director of the Defense Suicide Prevention Office (DSPO) in the Office of the Under Secretary of Defense for Personnel and Readiness. She is responsible for policy, oversight, and advocacy of U.S. Department of Defense (DoD) suicide prevention programs, which include non-clinical suicide prevention, intervention, and postvention efforts including policy, program development and evaluation, data surveillance, research, and outreach and engagement in support of more than 2M service members and over 2.5M military family members worldwide.
Prior to her current assignment, Dr. Clark was the Deputy Director of DSPO. Dr. Clark also previously served as the Deputy Executive Director for the PREVENTS Task Force, and charged with developing the first federally coordinated national public health strategy and roadmap to address Veteran suicide. From 2015 to 2020, Dr. Clark served as the Director and Assistant Director of the DSPO Policy and Plans Directorate. Dr. Clark brings an array of suicide prevention experience to the Department through her previous work as a volunteer hotline crisis worker answering the National Suicide Prevention Lifeline, as well as established and co-led a suicide bereavement support group in the Washington Metropolitan area.
Dr. Clark served as an Army Officer for over nine years in the Ordnance Corps and Adjutant General Corps and had a variety of assignments at the installation level, Army Staff, and National Guard Bureau.
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Producer / Editor: Neel Panji
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Really not just focus in on preventing death but actually, from an ecosystem perspective, making life worth living. You know how do we make sure that, when we're speaking through this, that we have this opportunity to have policies that reduce human suffering.
Manya Chylinski:Hello and welcome to Notes on Resilience. I'm your host, manya Chyilinski. Today, my guest is Dr Liz Clark. She is the Director of the Defense Suicide Prevention Office within the Department of Defense, and we talked about the costs of suicide stigma and how words matter and that policy really can make a difference in this area. I think you're going to learn a lot in this episode, liz. I'm so excited that we finally are together having this conversation. Thank you for being here.
Dr. Liz Clark:Thank you so much for the opportunity to be here. Really excited to talk with you today.
Manya Chylinski:Excellent, and before we dig into the topic Excellent. And before we dig into the topic. The question I ask everyone is if you could have dinner with any historical figure, who would it be and why?
Dr. Liz Clark:This is such a powerful question and thanks for just one prepping me for this ahead of time, and I spent a lot of time thinking through this and I will tell you, there are hundreds of folks that I could have named. But then, when I really thought about this and when we think about it, our historical figures, especially with how they contributed to what we're working on right now the one person that I would actually want to meet with is more forward-facing. I would actually I wish I could move into the future. I wish I could look at two years from now, meeting with Liz Clark, and I would love to be able to sit down with Liz Clark to say, hey, all the things that you're building and working on right now, how did that work out? Because while I can go in the past and I can look at historical figures and we can learn from them, and we have brilliant, amazing people that do biographies and autobiographies on these amazing figures, I would really love to be able to move forward to the future and say, hey, how?
Manya Chylinski:did that work out?
Dr. Liz Clark:How did that go and how do we contribute differently to our system? So not really answering your question, but excited to be able to. It definitely generated a lot of thoughts.
Manya Chylinski:Well, I love that as an answer to the question and I bet our listeners can absolutely feel the same thing, right so many of us and I read something recently and I'm not going to get the quote right, but it's something like you know, the me of today is where the me of two or three or five years ago wanted to be, and so you're flipping that of. Let's see if I get to that place two years from now.
Dr. Liz Clark:Oh my gosh, wouldn't that be amazing. And even when we think about all the things in the past, we are the people that we are right now because of what we've learned from amazing sprint campaigns in our past. But oh my goodness, how amazing would it be. I would love to have dinner with two years from now, Liz, to be like, hey, how did that work out? How was that decision that you made? So yeah, thank you for the opportunity for that question.
Manya Chylinski:Oh, absolutely, and, like I say for all of them, I wish I could make it happen. You would know many things that I think all of us would want to know too if we could jettison you a couple years into the future. But let's get to the topic at hand today. We are recording this to air in September, which is Suicide Prevention Month, and I would like to get started if you could just elaborate on what are the costs to us as individuals or family members or society as a whole, to suicide.
Dr. Liz Clark:So one thank you for the opportunity of talking about this. And in September, which is Suicide Prevention Awareness Month, but not only is it just during September. We really take suicide prevention as an everyday event and it's not just one time in September. While we get to have the privilege of recognizing suicide prevention in September, know that we do take an all-year approach, that every single day we have an opportunity to save lives.
Dr. Liz Clark:And so I love this question about the cost, like what is the cost of suicide on individuals, on families, but really to society as a whole?
Dr. Liz Clark:And what I would really like to talk about is almost reframing that and rephrasing that to assessing the cost and talk about the impact that it has on not only our service members, our family members, but every person in our world.
Dr. Liz Clark:Because when we think about individuals, we matter right, like every one of us is contributing to society.
Dr. Liz Clark:We have a unique skill, we have a strength that we're giving to our families, to our community, to our nation, to our society at large, and just the impact on one person and the ripple effect that that has across our society.
Dr. Liz Clark:And when we think about those personally, that we may have lost somebody in our family, one of our friends, one of our colleagues, and just that internal cost that it has to us. But then, when we think about what that person was contributing to our world and the loss of that and how do you like put a monetary amount to it, and so I think to me that's what makes this particular month such an impactful time is that we can make a difference, we can touch lives, we can save lives, and I'm really excited to be able to talk with you about, about resiliency and how and how we get there. Excited to be able to talk with you about resiliency and how we get there. To me, every single person absolutely matters, and it's not just that monetary cost, it truly is, and we think about that ripple effect that then happens across our world and what we could be doing to make life worth living Right.
Manya Chylinski:And I think about the added grief for family and friends when losing a loved one to suicide. You've got the regular grief of the death and then, I imagine, all sorts of questions about what happened and did.
Dr. Liz Clark:I play a role in it.
Dr. Liz Clark:Oh, absolutely the trauma and the catastrophe that just happens systematically when we draw somebody to suicide If it's somebody in your family, somebody in your workplace, just in your community and the impact that that has on like what did I do and how did I contribute? Important and critical amount of work that we can do is what we call. That is, postvention, and so basically responding to either a suicide death and also, I think, expanding and thinking about those that have had suicide-related behaviors, and so those that have had thoughts of suicide, those that have had a suicide-related behavior and then who seek help.
Dr. Liz Clark:But also unfortunately, those who have died by suicide, and I think that's the one thing in the suicide prevention community that we look at is suicide is non-discriminatory. Every person is at risk and every person we have an opportunity to then save somebody from suicide and to really save their lives. When I think about it, I think about it from an ecosystem. It's not just one thing, and I think it's a combination of a lot of things. It's a combination of it's not just this one thing now happened and now this has made me have thoughts of suicide. It's a combination of a lot of different things and we can talk about this throughout our conversation here, and I think that's why many organizations us within the Department of Defense we take this comprehensive public health approach to suicide prevention. And so it's not just one thing, it's many things, and I think that goes back to your.
Dr. Liz Clark:This happened in that ripple effect and how did we contribute to suicide? How could we have contributed to saving their lives? And so, when we think about that, what a great opportunity to kind of take a step back and look at this bundled approach of what we can do to make sure we have a comprehensive approach of looking at how do we make sure that we're increasing health seeking? How do we make sure that we actually have effective care and treatment and the appropriate level of care and treatment? Yes, how do we make sure that we're connected? I mean connection. We can talk a lot about connection. Connection, really, my goodness, is such an opportunity to make lives worth living and we also, I think, have an opportunity to respond to those in crisis and to respond with what the appropriate need is for the appropriate issue that is occurring. So excited to continue this part of the conversation.
Manya Chylinski:You mentioned connections, social connections, and we know that in so many areas of our lives, social connections can be really protective against a lot of things, including suicide. So what is the importance of having that strong social support and that sense of belonging?
Dr. Liz Clark:is the importance of having that strong social support and that sense of belonging. I could spend probably a couple of hours talking about foundational theories and research and all the things we have, but I will tell you, to the core of all of that, we are human beings, right? We like connection, we like to feel that we belong, and so when we think about just some foundational theories on suicide, some of those that you're going to hear about is belonging making sure you belong to a community, make sure you don't have sort of belonging there are many times that people could be within a family unit within their community and, while they're around, a lot of people but they don't actually feel like they belong there.
Dr. Liz Clark:I think there's a really good opportunity to really think about that belongingness, but also going to the connectedness. You know, as human beings we want to feel connected. And what does that now look like? What does that look like coming out of the pandemic? What does that look like many times when we're all operating in this hybrid work environment? How do we build different types of connection and how do we actually feel connected? You know, many times we can be around a whole bunch of people but despite that we don't feel connected with one another. So how do we purposely and deliberately create that connected tissue? And so we do feel that alarmingness. We do feel that connection.
Dr. Liz Clark:And actually, if you look back there, the Surgeon General published a report about connectedness. When, actually, when you're looking at that, we know that if somebody feels connected and somebody feels that they belong, it is actually, it adds years to their life actual, just physical. You know that belongingness, that connectedness, that feeling like you're part of the community or part of a mission, part of something, actually saves your life and adds to your life. And the opposite of that is, if you're not feeling connected, you don't feel that you belong. It actually significantly reduces your life. And then the Surgeon General's report talked about the effect of that versus smoking.
Dr. Liz Clark:When you don't feel that you're connected. It's actually as bad as smoking. You know X amount of packs of smoking a day. It's so hard to conceptualize that.
Manya Chylinski:I believe the studies, I believe it, but it's very difficult to conceptualize that. I think about this topic and suicide is very difficult to talk about. People don't want to say the word. I know in preparation for this series, I was searching on Google and Google even interrupts and says if you need help, here's how to get help, like it is, which I actually think is amazing. But I had to keep saying no, I just actually am looking for information about this, I'm okay.
Manya Chylinski:But, there's also a stigma about talking about suicide and I will share with you. I wasn't sure if I was going to do this, but at the beginning of the pandemic, things shut down. Social lives were different. I had suicidal ideation and it was very clear in my own mind that these were merely thoughts. This was not something I was going to follow through on, but it was very distressing and I didn't feel I could share that with people because that's a scary thing to share with someone.
Manya Chylinski:So what I did is put the phone number for the suicide hotline in my phone, so if I needed to, if I needed help and I needed to talk to somebody. But then I also set up daily phone calls with some family members and some friends, without really saying why, and that created that connection. But it was so scary to think about what if I said those words to somebody that will scare them and it's even thinking that that thought just floated through my head is scary to me.
Dr. Liz Clark:One. Thank you for your vulnerability and sharing your experience. You're not alone with that. I mean. So many of us have thoughts of suicide, have passing thoughts of suicide. People have constant thoughts of suicide. And just kind of taking a step back to what you said, which I think is really impactful and powerful is you're really scared to say something and when we think about stigma, and stigma on so many different levels, stigma with your family, friends, community, reacting in a way that's not going to feel supportive right, I think that even pulls in.
Dr. Liz Clark:How do we train individuals? How do we have individuals that are aware of? What do you do if somebody has thoughts of suicide? Or what do you do if you're worried about something, if somebody and you don't know how to ask about suicide? I think it's like what you just said. It opens up so many opportunities to me, but I really wanted to talk just a little bit about I had the opportunity for about a decade of being on a crisis line.
Dr. Liz Clark:So now you can call the it's 988. Yes, you call the 988 Suicide Crisis Line. At the time it was the National Suicide Prevention Lifeline. But I had the opportunity of being a crisis worker and I will tell you the honor and the privilege that I had when somebody reached out many times their worst day of their entire life. I had the honor and the privilege to answer the phone call and to be with them and many times when their hardest days and yet they reached out and I got that honor and privilege to be on the other line, on the other side of the text or the other side of the chat, and the impact that that had on me as a human, and so I think that connection and that stigma. So there are lots of opportunities and avenues to be able to find that connection and find that help in nonjudgmental ways.
Manya Chylinski:I think one of those is the 988 suicide crisis line.
Dr. Liz Clark:But I think when we kind of peel that back a little bit and we think about stigma, stigma is real. I mean.
Dr. Liz Clark:It is absolutely real how people are going to react and interact with you and I think that, from a societal perspective, is an opportunity that we can look at it, being able to respond empathetically, compassionately, and not just solutions driven. Many times, I think, something you know. When we think about somebody that might be struggling, I think one of the things to help reduce stigma is to actually ask them are you having thoughts of suicide? Are you thinking about killing yourself? I mean, and not asking things of. Are you thinking of killing yourself? I mean, and not asking things of. Are you thinking of harming yourself? Because asking directly about suicide hits them.
Dr. Liz Clark:If you say harming yourself, that can mean a lot of things. If you can directly ask somebody, hey, are you having thoughts of suicide? Very powerful. Those that are not thinking of that will say no. Many times. Those thinking about it will say yes. So how do we then train folks that like what do you then do with that? How do you then hold that? And I think there's also a part when we think about stigma is will that affect in the Department of Defense? Will that affect my career? What will then happen if I say yes, I am having thoughts of suicide?
Manya Chylinski:What does?
Dr. Liz Clark:help look like and what does support look like? And that's our opportunity to really train our community at large on how to ask about and respond to suicide.
Manya Chylinski:Yes, and you said something about asking somebody very directly are you thinking about suicide, or are you thinking about committing suicide, thinking about killing yourself? Those are very scary questions to ask someone for a variety of reasons, but I think one of the things that many of us might be afraid of is if I say that that will put the idea in their head.
Dr. Liz Clark:Oh, I'm so glad you mentioned that, which is such a myth, right? Even so, let's think back to just using you as an example right now and again, thank you for sharing your vulnerability. But when you have thoughts of suicide, if somebody were to say, hey, I'm really concerned about you. I'm noticing these types of things. I'm noticing that you're not as connected anymore. I'm noticing that we asked if you wanted to go out and you're not willing to, or you're not excited to, or just you notice some of those changes?
Dr. Liz Clark:And if somebody were to say, hey, are you having thoughts of suicide? And the relief that that might've been of like wow, somebody is noticing me. That didn't put the thought in your head, but the power behind, yes, and I don't have to hold it by myself anymore, and there's a lot of power behind, yes, and I don't have to hold it by myself anymore, and there's a lot of power behind that. And so it's actually not true. Just having asking somebody directly about suicide will not put the thought into their head.
Dr. Liz Clark:It's just like us talking about it right now is not going to make somebody else have thoughts of suicide, but it might help somebody who is having thoughts of suicide have an opportunity to reach out for help and the appropriate level of help.
Manya Chylinski:Right, and I think about that. When you were going through that scenario as a trauma survivor, somebody actually asked me about the trauma in a way that was empathetic and caring, made me feel validated and listened to, and so it it's essentially you're saying it's the same.
Dr. Liz Clark:by asking that question, you're not putting the idea into someone's head, but you are validating them and you are seeing them what I think is part of it too is that saying like you can get a name at the payment right, and like when you kind of think about that, like if somebody is just saying I'm noticing you, I care about you and I'm asking you about suicide. I'm asking you this because I care, I, I care about you as a human being and I care about you and I'm worried about you because of everything that's leading up to the reasons of of asking that question. But I think there's also a part of it, like when we it's like we're all safety officers, right, you see something, say something. If you see somebody might be struggling, then ask them like hey, everything going okay. And then if you're getting that and I think intuition is- such an amazing gift that we all have.
Dr. Liz Clark:We know when something is off, we know when we're feeling, oh, the vibe is not right. So then ask, and I think directly saying hey, I think that's our challenge, anybody listening to this right now. Our challenge is how do I comfortably ask somebody have you ever thought of suicide, are you having thoughts of taking your life? But directly asking about that and then being able to come back to say, and here's a resource for you, you know, I care about you, I hear you, what's going on? Can you tell me more about that? And I think there are ways to not ask about suicide.
Manya Chylinski:We don't want to add in judgment.
Dr. Liz Clark:We don't want to add in. Why would you be thinking about that? That's a very judgmental type of question and I think even things like asking it what not to do with you're not thinking of doing anything stupid, are you Like?
Manya Chylinski:oh my gosh.
Dr. Liz Clark:Yes, Right, Like words matter, Language matters and I think there's purposeful and deliberate type of questions is getting comfortable with? Hey, I'm really worried about you and I'm noticing this. You know people, you know when they, and it can even be if you're a layman, you're not a clinician, et cetera. I'm like, hey, you know, I've read about suicide prevention and some of the things that you're mentioning right now really concern me and I care about you and I wanted to ask you, you know, are you having thoughts of suicide? And stop talking and listen?
Manya Chylinski:Yes, the listening piece we all work. That's something we all work on. You know you said something that is one of my favorite phrases, which is that words matter, the words we use when we talk about this matter, and I'm curious about when we get news of a celebrity, for example, who has died by suicide. I feel like there can sometimes be this sensationalism about what has happened, and how do we use language around suicide that's accurate and respectful and maybe shares the information without sensationalizing it?
Dr. Liz Clark:It's such a powerful question and I really appreciate you asking about that one, because, especially in our day and age that we are today, social media, news travels extremely fast. Yes, and I think that's something that when we are on social media, we are talking publicly, we're reporting of, not glorifying suicide. I think there's a lot of this. Just do no harm. And doing no harm is how do we appropriately and responsibly report on suicide, how do we not glorify that and how do we make sure that we're adding in messages of hope, not just distress. And so, with that, I think you know as reporters, as engagers in this system, you know as people, when we talk publicly about suicide, how do we make sure that we do that in a safe and responsible way? But I think little actions that we can all individually take is even changing our language around things like commit suicide.
Dr. Liz Clark:You know when you commit a crime, you commit murder, but committing suicide is extremely judgmental, right? So when we think about how do you change that language and flip the script to having thoughts of suicide, died by suicide and that, oh my goodness, what a powerful way of changing that message. So you're not having that judgment on somebody. You know somebody didn't commit suicide, somebody died by suicide, and like what a difference that even makes too, and especially when we think about the amount of individuals who have, who have felt the suicide, that don't feel safe, they don't feel connected to be able to say something to somebody. And our, when we think about our words matter and the impact that our words have on individuals. It's how do we make sure that we're also contributing to making life worth living, not just having that judgmental and responding to Right, right, okay, thank you for that.
Manya Chylinski:Well, you know, in your position as director of the department, you're looking at this at a 30,000 foot level. Right, you're looking at policy and advocacy and prevention, and all of this from from where you sit, what is giving you hope right now and how we are addressing the issue of suicide.
Dr. Liz Clark:One. I'm a policy guru. Policy is my background and with that I also will say that. I will say policy is the forgotten intervention. I think the impact that we can have to policy and through our national ecosystem, it just can create so much good. There's so many things we could do and this one you talked to me about this question. I was like, oh my goodness, I could speak hours about the potential for policy and what are we currently doing on it? What can we do to enhance our system? I mean, I think there are a few different things.
Dr. Liz Clark:But, I think part of it is and I've mentioned this a few times throughout our conversation here is how do we not just focus in on preventing death but actually, from an ecosystem perspective, making life worth living? You know, how do we make sure that when we're, when we're thinking through this, that we have this opportunity to have policies that reduce the human suffering, and I think that that can be impactful. I mean, I would absolutely say, how do we promote a culture of legal and safety and like, what is legal need? Safety? It's not just having time and space with a firearm, it's also making sure that we lock up our medications, that we have bridge barriers being at our households and we're making them safer from suicide.
Dr. Liz Clark:But I think there's also when we think about if somebody needs to get help. What does the appropriate level of help look like? And so when we think about this, I think there's an opportunity for policy, and where our nation is moving towards is this crisis response, continuum of care, and so when we think about that and we think about, like what we talked about with reach out you need help, call 988.
Dr. Liz Clark:What does that look like if you're having thoughts of suicide and you need help? So it's making sure that we are outreach and engaging with people at risk. We're making sure that we're able to see those early stages of crisis. But then we're also having these crisis hubs so you can call in and then it's going to divert you to the appropriate level of help.
Manya Chylinski:And.
Dr. Liz Clark:I will say this widely somebody that has thoughts of suicide may not need to always go to the emergency department. They might need something else. So how do we make sure that we have that appropriate level of care? But I think it's also, if you do end up going to the emergency department, what does that look like? How do we make sure that we have crisis stabilization, that you're not there treated as if you're a criminal right? You're going in there and you have an empathetic, compassionate environment that you're going to?
Dr. Liz Clark:and you have an opportunity for that crisis stabilization. And then I think kind of the other thing with thinking through policy is what can we do, not just the federal sector, but down at the state and then the local and the community level, to make sure that we have community-based support programs and that we are able to help reduce those crises from happening?
Manya Chylinski:Yes, yes and again. We could have this phone call to be for, I'm sure, last all day. But I asked somebody else about the social determinants of health and how that relates to suicide, and the answer was essentially everything we need to be reducing everything. I see so many benefits to addressing some of these other societal challenges that we face, and one of them is reducing the number of people who die by suicide. Them is reducing the number of people who die by suicide.
Dr. Liz Clark:And I think part of that is when we think back to this. It truly is how do you make life worth living? How do we make sure that our underrepresented populations are getting the care and the appropriate care that they need? When we talk about health care, we think about human basic rights, and I think that there are so many opportunities for us to not just somebody that crisis immediately send them to a hospital. It's actually training from an ecological system from just universally. What are we doing?
Dr. Liz Clark:What are we doing for these populations? What are we doing for the individual into strengthening those policies to strengthen the system, because it really is not just. It's not just one thing that's going to have somebody think about suicide, right, it's not going to be one thing that is leading somebody to to die by suicide.
Dr. Liz Clark:It truly is a combination of a complicated, many different factors that heighten that risk. So I think that's where it goes back to how do we make sure, from a from an ecosystem perspective, we are taking this comprehensive approach to suicide prevention, this comprehensive approach to just making life worth living?
Manya Chylinski:Yeah, I like framing it that way. So thank you. Well, Liz, we are at the end of our time. Do you have any final thoughts to leave with our listeners?
Dr. Liz Clark:I just I'm so grateful for the opportunity to talk through this. Thank you for your time and I would just say for those. Listening right now is like kind of one action that you can do, especially when we're thinking about suicide prevention laws is. We talk a lot about connection today. We talk a lot about words matter and when you think about that and you hear all of this think through, is there one person in your life that you want to connect with and just say, hey, I was thinking about you today.
Dr. Liz Clark:I just wanted to check in to let you know that you matter to me, you matter in this world and I'm grateful and I appreciate you in my life and I will tell you that, my goodness, the power that that has, just as human beings.
Manya Chylinski:Oh, thank you. That is the perfect thought to end on. Thank you so much.
Dr. Liz Clark:I appreciate you.
Manya Chylinski:Thank you for listening. I hope you got as much out of this conversation as I did. So if you'd like to learn more about me, manya Chylinski, I work with organizations to help understand how to create environments where people can thrive after difficult life experiences, and I do this through talks and consulting. I'm a survivor of mass violence and I use my experience to help leaders learn of resiliency, compassion and trauma-sensitive leadership To build strategies to enable teams to thrive and be engaged amidst difficulty and turmoil. If this is something you want to learn more about, visit my website, www. manyachylinski. com, or email me at manya at manyachylinski. com, or stop by my social media on LinkedIn and Twitter. Thanks so much.
