Therapist Eric Stroo interviews Dr. Jeffrey Sung, our consulting psychiatrist, who is an experienced educator in the field of suicidality and suicide prevention.

Jeff, how did you become interested in the phenomenon of suicide as a focus for your professional work?

Sung: In our psychiatry residency training program at the University of Washington, we often worked with people with long histories of suicidality. And as can often happen in these settings, clinicians with the lowest level of training are often paired with the patients with the highest level of severity—people with very desperate and complicated circumstances. Like other psychiatry residents, I had patients who died by suicide. And it had some deep shock associated with it. In the face of it, the response from and work with my colleagues and supervisors was extremely helpful and supportive.
And so I became interested in this question of how we as clinicians understand our responses, knowing that someone might die by suicide or that someone has died by suicide. In particular, I wanted to understand how our responses influence our ability to persist in the clinical work and still find some sense of meaning and purpose.

Afterwards when I started working for UW through a Health Care for the Homeless Network program, I continued to encounter patients with complicated circumstances, often with high levels of suicide risk. And over time, I grew convinced that it’s possible to work with people who are suffering at that level if we are organized and structured with a framework in our minds so that we can sit comfortably and listen to a story with that level of pain.

Interviewer: Given this longstanding interest in suicide care, how have you seen the field evolve over the years?

Sung: Management of suicide risk has the goal of making sure people stay alive and can survive suicidal crises. An important shift in the field has been a move beyond a focus on assessment and immediate management, towards a focus on the treatment of suicide risk. Treatment of risk is working to develop a collaborative relationship so that patients can start to understand what contributes to their having suicidal thoughts and behaviors. Then they can recognize their own suicidality, intervene on their own behalf, and feel more confident in responding to their suicidal thoughts and urges with healthy coping strategies.

Interviewer: In your work as an educator in clinical suicidology, what messages do you believe to be the most important to convey?

Sung: Some of the best research in the field demonstrates the importance of connectedness as an intervention that can prevent suicide. By connectedness, I am talking about conveying general or specific messages of belonging, value, and hope. That might mean remaining quiet and reflective as someone tells the story of how they came to think about or attempt suicide. That’s a way of conveying belonging, value and hope.

Or it might mean simply saying directly, “I’m so glad we’re here. I’m glad we’re talking about this. You’re important to me, and I have hope that things will get better in your life. I want to work with you so that we have time to address the problems and pain in your life.”

Interviewer: You have thought a lot about the role of faith leaders in caregiving for people considering suicide. What do you see in that?

Sung: One entry point is simply that as a faith leader, some of the people you are speaking with might be thinking about suicide or might have attempted suicide. Frame your language and your thinking to be welcoming and open, so that someone in your community would consider confiding in you.  A great way to convey this openness is to have willingness to share your own personal experiences with mental health and mental health care, and those of others who have given permission to have their stories told. Are you seen to be open to talking about mental health conditions, about suffering, about suicidal thoughts and behavior?

As with clinicians, connectedness is critical. For faith leaders, that can mean acknowledging that you don’t necessarily have immediate solutions to someone’s problems.  Facilitating connectedness means that even without solutions, you can still commit to joining a person on their difficult pathway. This is actually a very important and unique role that faith leaders can play—finding connection or communion in suffering, instead of isolation. Finding a way to have meaning and purpose in suffering rather than believing that one’s pain is wasted. Finding a way to have hope versus despair, gratitude versus resentment. Faith leaders have these really amazing skills and a set of traditions to offer. When someone brings a problem that has no solution or no immediate solution, faith leaders can help grapple with suffering and enter into mysteries—to help find a viable pathway.

There is a resource that is supported by the National Action Alliance for Suicide

Prevention: the Faith, Hope, Life campaign for faith leaders. It details different suicide prevention competencies that faith leaders can develop for prevention, intervention, and postvention.

Interviewer: If you could change some aspects of our US culture that exacerbate the rate of suicidal behavior, what comes to mind?

Sung: It’s a great question. So many people in clinical and public health think about it, including the Surgeon General of the United States, Dr. Vivek Murthy. I recommend his recent reports about social media and youth mental health, and about social isolation and loneliness.

These reports bring us back to connection, the importance of relationships with people, family, friends, and the importance of social connection between individuals in

different community settings. It fits together with the role of healthy faith communities as places where people have an organizational level of connection, where a person can form relationships with other people and then develop internal connections and beliefs.

Interviewer: Finally, Jeff, what sustains you personally and professionally, given this challenging choice of focus in your life’s work?

Sung: Clearly, I think that the work is extremely meaningful—confronting these existential questions around finding a reason to go on when one feels that one has lost everything. Important, meaningful questions that need an answer at some point. In my own work, I’ve lost patients to suicide and I’ve had patients make amazing recoveries. And that actually helps me stay in the work, knowing that we need answers not only for patients to get better, but also for the people who survive the suicide of their friends and family members. Answers that can help all of us find community, meaning, purpose, hope, and courage in the face of profound pain and loss.

Sources referenced in this article can be found here.

In February, we spoke with Jim Furrow, who has worked closely with our clinical staff over the last five years as a trainer and consultant. Jim is an internationally recognized leader and contributor to the practice of Emotionally Focused Therapy with couples and families. Together with EFT originator Susan Johnson, he coauthored seminal works on EFT as it is practiced for couples and families. Jim maintains an active research program examining the process and effectiveness of the model.

Interviewer: What was it that drew you to psychotherapy and particularly to therapy with couples and families?

Furrow: I’ve always been a bit of a curious person. I grew up in a family of scientists—a biologist and chemist who were often pursuing a deeper understanding of the nature of things?

Relationship stood out to me in this regard in particular how important relationships are in shaping people’s lives. I found people intriguing. While relationships are significant in shaping our experience of the world, they are also complicated—whether that’s a parent-child relationship or a romantic relationship. People in relationships are often seeking something more and often finding it challenging to get what they most need.

All these factors sort of pushed me in the direction of seeing what I could do to be helpful for others in the relationships that mattered in life.

Interviewer: We appreciate that you’ve engaged your work in a variety of ways: teaching, consulting, clinical practice, research, publishing books and papers. I wonder if you see a certain thread that ties together all those ways of working?

Furrow: Yes, I love the question because the work I do is truly multifaceted. There is a core however and for me that is discovery, whether I am thinking about my teaching, writing, research, or practice I am curious how to foster discovery learning It’s one thing to tell somebody some helpful information. It’s a whole different experience when you can help them find it for themselves.

When they see something new about their relationship, or something new about their partner or about themselves—it’s like a light bulb moment. Whether it’s with a student or a client or another professional, what I find most energizing and what I’m passionate about is this idea that through experience we find new understanding. We see ourselves more clearly, we see the world more vividly, we see those we love more endearingly.

It requires some amount of what I know, but also being invited into what I don’t know, and finding discovery there. This is where the curiosity comes in—I’m always learning. It’s a huge privilege, whether it’s a student in a classroom or a couple in my office, or even a research subject: Somebody shares from their experience, and I see the world in a new way. Those moments are a gift and opportunity.

Interviewer: What has made EFT so central to your work and to your career?

Furrow: What’s been interesting to me, especially in my 30 plus years in the field, is to see emotion move from the background to the foreground. And the more that we learn about the neuroscience , the more we understand that emotion provides an important integrating element between cognition and behavior.

As a model, EFT sees emotion as a resource for change and also as a target to focus on. It gives me a map for the work that I’m doing, but also a means for change– which is a powerful combination. It’s enabled me to be effective in moving toward both transformation and reconciliation in relationships: transformation—how people grow, how they become; and reconciliation—how people are brought together, which is about belonging.

Interviewer: At Samaritan Center, we have a commitment to spirituality as a dimension of therapy. And in working with you, we’ve found that to be a shared commitment. Could you say a bit about how that also informs your work?

Furrow: Absolutely. One way to think about spiritual integration is to talk about soul care, the care for people’s sense of meaning and purpose in the world. For a lot of folks, that has a spiritual or religious expression.

The questions that come up routinely in therapy, whether they relate to parenting or to marriage and couple relationships, are at their heart questions about purpose, about direction. What are we doing here and why are we doing it and what’s the value here? Is it just satisfaction? Is that all I’m looking for, or is there some deeper meaning? I think it’s essential that we have a way to talk about these existential questions in the client’s language and from their perspective—honoring the importance of communities, religious communities, for example.

And for me, there is something more, something that comes from my core, from my own Christian understanding. And that is that there is a promise. It’s not just purpose, it’s not just a direction, but there’s a promise that gives hope.

Of course, one thing I’m quick to say in a conversation around faith is that it can be a resource, but it can also be a risk. There are ways that it’s been hurtful in people’s lives, ways that it’s been constraining. And yet where it brings freedom and hope, I do believe that it can lead to transformation and reconciliation.

Interviewer: Finally, Jim, on this subject of hope, I wonder if you would share a bit more about what gives you hope, professionally and personally?

Furrow: Well, I think it’s twofold. One way is very much from the ground up: The people that I work with give me hope because I see the efforts that they bring to seek something better in their lives, to seek understanding, to seek compassion, to seek caring, to seek repairing, to seek growing. I see courage every day and the work that I do. The risk to be vulnerable in a relationship with another person in marriage, in family life, in friendship. You see and find courage, and you see the human spirit.

And I think you often see the presence of Christ in the midst of these moments, which is a second source of promise and hope that is vitally important, at least for me. It’s not a generic hope, like “hopefully” this is going to get better; there is a confidence that comes in knowing that we’re in this together and ultimately held in the love and mercy of God.

The critical question is, are we alone in our suffering, or can we find others who can walk that journey with us with a sense of hope and promise? That’s where I would like to show up—to provide a sense of presence, holding on to a hope that for me is based in God’s promise.

Remarkably Bright Creatures, by Shelby Van Pelt, surprised me with its charming characterizations, implausible interspecies relationships and healing connections.

Tova Sullivan, the main character, lost her son, Eric, years ago when he was just 18, and she was recently widowed at the age of 70. Facing an unknown future, she copes with her loneliness by staying busy at her night job cleaning the local aquarium, purposefully performing her daily duties “in the right way.” Unwelcome interruptions to her regular routines create unexpected opportunities for change. But can she open to the possibilities they might offer?

Van Pelt sensitively attends to the experience of each of four characters as they seek to understand and find some resolution to their grief. Tova’s quietly painful reflections about her lost son. Cameron, a misfit soul who comes to this small seaside town searching for the father who abandoned him 30 years ago. Ethan, the local music-loving grocer burned in his youth by love lost. Marcellus, the 60-pound octopus who muses on his “end of days,” adding a humorous, magical realism to the mix.

The story centers on a mystery, but it was the relationships between the four characters that captured my heart. Watching as each of them seeks answers to the questions that will shape their next steps forward. Will Tova stay in the house she loves or move to a retirement home? Will Cameron find a way to take on the personal responsibility of adulthood? Will Ethan create more meaningful connections than those of local gossip? Will Marcellus remain a captive in the aquarium?

The relationships that develop between the four of them support the possibility of the opening of new doors and of resolving their losses. As a therapist, this beautifully told story speaks to me about the important aspects of human development that are present in each of life’s stages. For example, the challenges that aging presents, the unending process of grief, and the healing power of relationships- even those that are unexpected and imperfect. It reminds us that anyone – the young folks and the elderly – can learn new ways of making meaning in life, creating and engaging in their preferred pathways.

There is renewed hope every new year as the struggles of the previous year give way to a fresh start. As January 1st strikes, people all over the world join on a journey of change as they make their resolutions for 2024. It is the day gyms are most crowded and the most promises are made. Well, we’re now into February. How are we doing, folks?

Did you know that the second Friday of January is referred to as Quitters’ Day, and that Ditch New Year’s Resolution Day falls on January 17th. We know that the vast majority of people will not keep their resolutions: in fact, a study from Sundried.com found that 43% of people begin the year already anticipating that they will give up by the end of the month. Many people decide to give up altogether, resigned that things cannot and will never change.

In many ways, the phenomenon of New Year’s resolutions reflects the larger process of change we experience as humans. Even though we have a desire to grow, change is hard. It’s hard to begin, and it’s hard to sustain. Sometimes, the pressure and overwhelm associated with stepping out of a comfort zone keeps a person from even thinking about it. But the New Year is upon us.. well, the lunar one that is. Perhaps it’s as good of a reason as any to make some new resolutions. Are you willing try again? If so, here are some tips that may help:

1. Keep it simple. It can be tempting to try to change everything all at once or to engage goals with full abandon, but that often leads to taking actions without the underlying structures to sustain them. It’s like a runner who starts off the block too quickly and begins to fade because they do not have the energy left to finish strong. Instead, focus on smaller increments of change that will challenge you to grow but are still manageable. Gradual steps can build towards greater growth. Bruce Lee once said, “I fear not the man who has practiced 10,000 kicks once, but I fear the man who has practiced one kick 10,000 times.” Building depth and not breadth by simplifying goals is a good way to build long-term and sustainable change.

2. Find your meaning. According to Angela Duckworth, a leading expert on grit, one important ingredient for follow-through and perseverance is to identify and focus on your passions. The more an individual action is attached to a larger meaning and desire, the greater the motivation to complete that action. We see this play out all the time. Students grind to achieve a grade at the end of the year. Athletes run wind sprints because every rep gets them closer to the championship. What might be your larger reason to work out, stop drinking, or try something new? Focusing on that can provide continued direction when you run into the dog days of summer.

3. Don’t do it alone. Reaching out to another person can be an incredibly important resource when it comes to follow through. Someone who gives consistent encouragement and accountability can provide a secondary, external source of motivation when internal willpower falters. Furthermore, working with another person offers an opportunity for feedback and reflection that is vital to learning and growth. Not only are there external benefits to reaching out, research has also found sharing goals with another person–particularly someone we hold in high esteem–can actually increase internal motivation as well.

4. Try again… again. Unfortunately, we will all face failure. Research from the University of Scranton found that a whopping 92% of people do not keep their New Year’s resolutions. Just as telling, however, is a study by Norcross and Vangarelli which found that those who successfully kept their resolutions still averaged 14 setbacks over a two-year period. A big part of success is learning what to do with failure. Failure is often thought of as the end of the story and is connected with feelings of incompetence, embarrassment, or rejection. One effective way of overcoming that mindset about failure is to see it as part of the growth process rather than the end result. As Thomas Edison famously said, “I have not failed 10,000 times, I’ve successfully found 10,000 ways that will not work.”

Regardless of where you are with your resolutions, whether you are still going strong, have crashed and burned, or never started to begin with, we hope that this message can be a little bit of encouragement to continue, restart, or begin your journey of change. There is always the next opportunity to try again. There is always a new chance to grow. As the scriptures say, “His mercies are new every morning.” Have at it once more!

This writing was originally posted in an email sent to our mailing list on February 9th, 2024. Please enter your email at the bottom of the page if you would like to sign up to be part of our mailing list.

One of the strengths of Samaritan is that we are available to help people in an ongoing way with the problems that inevitably arise in life. Created in 1960, with therapists who stay with us for 10, 20, and 30 years, we serve families in a variety of ways—often beginning with individual or couples therapy, sometimes including additional family members, and when it’s indicated, referring them to another therapist with specific expertise. Clients sometimes come with a specific issue that is resolved in a few sessions, but frequently they find that the issues are more complicated and they engage in deeper, longer-term work.

An example of Samaritan as an ongoing family resource is a couple in their mid-40s who came to Samaritan for the first time 10 years ago. The problem was the “out of control” behavior of their two teenagers. They wanted to know how to set limits and provide support for their adolescents, both of whom were taking risks that could have serious long-range consequences. Their therapist helped them examine and make changes in how they were parenting and, at the same time, focused on protecting and strengthening their marital relationship.

A second round of therapy occurred when one of their aging parents needed to move from home to an assisted living facility.  The loss of independence was devastating for the parent and put our clients in the position of making hard but necessary decisions while being viewed as “the bad guys.” The therapy setting created space for them to voice their grief and frustration without appearing weak or unfeeling.

Later, health issues for each of the couple coincided with the husband’s planned retirement.  It brought them face to face with questions of their own mortality and an urgent need to re-think their financial expectations.  Again, having a therapist who could listen deeply to their fears, bringing both her history with the family and her training in life transitions, helped them move forward.  The couple pulled together their considerable resources—among them their love for each other, their strong Christian faith, their experience of meeting adversity with determination, and a soul-saving sense of humor.

The belief that both the couple and the therapist held as they worked together, once again, to find a way through very difficult circumstances is what Samaritan has always offered our community. A belief in our ability to care for one another and to create positive change.

Life isn’t always easy to navigate or easy to understand. Samaritan Center exists to help people cope, rebound, and heal from the unexpected difficulties life can bring.

In the third year of pandemic-driven change, we are determined to continue to live vibrantly into that mission. No matter their ages or their circumstances, our clients tell us they are weary, worn thin by the stress of isolation, unpredictability, and the incessant troubling news. For example, there is the woman in her 70s who meets with her therapist every other week. She lives alone in low-income housing, is largely estranged from her adult children, and worries continually about her health, her finances, and the uncertainty of the future. She talks about her faith and experience of decline: ‘You’re the only one I have to talk to,” she says. “I don’t know what I would do without being able to meet with you.’

Those of you who so generously support this ministry make it possible for us to continue to be a healing presence for people who are in need of care. Without these donations from our spiritual partners – church congregations and individuals – helping those in need simply can’t be done. We pray that you will stand beside us in this difficult time. We thank you.”

Review by Peggy Hansen

In the preface, Robin Wall Kimmerer writes: “I could hand you a braid of sweetgrass, as thick and shining as the plait that hung down my grandmother’s back. But it is not mine to give, nor yours to take. Wiingaashk belongs to herself. So I offer, in its place, a braid of stories meant to heal our relationship with
the world. This braid is woven from three strands: Indigenous ways of knowing, scientific knowledge, and the story of an Anishinabekwe scientist trying to bring them together in service to what matters most.”

In this beautifully written book, Kimmerer moves back and forth between stories of relationships with her family and her students, very detailed and scholarly descriptions of the plants she loves and their (and our) endangered environment, and the beloved traditions and wisdom of her elders. She describes the ceremonial giveaway, the minidewak, one of her peoples’ oldest teachings.” Generosity is simultaneously a moral and a material imperative, especially among people who live close to the land and know its waves of plenty and scarcity. Where the well-being of one is linked to the well-being of all. Wealth among traditional people is measured by having enough to give away…. In a culture of gratitude, everyone knows that gifts will follow the circle of reciprocity and flow back to you again. This time you give and next time you receive. Both the honor of giving and humility of receiving are necessary halves of the equation.”

She introduces us to the Thanksgiving Address, which embodies the Onondaga relationship with the world. ”Each part of Creation is thanked in turn for fulfilling its Creator-given duty to the others. It reminds you every day that you have enough,” she writes, drawing on the words of Freida Jacques, a teacher at the Onondaga Nation School. “Gratitude,” says Kimmerer, “doesn’t send you out shopping to find satisfaction, it comes as a gift rather than a commodity, subverting the foundation of the whole economy. That’s good medicine for land and people alike.” The recognition of loss is also a theme of her book, as she recounts the taking of children from their tribe and families, isolating them in boarding schools and forbidding them to speak their native language. She mourns the ecological destruction that has changed her beloved Onondaga Lake into “the most chemically contaminated lake in the United States.” But she says: “Despair is paralysis. It robs us of agency. It blinds us to our own power and the power of the earth. Environmental despair is a poison every bit as destructive as the methylated mercury in the bottom of Onondaga Lake…. Restoration is a powerful antidote to despair. Restoration offers concrete means by which humans can once again enter into positive, creative relationship with the more-than-human world, meeting responsibilities that are simultaneously material and spiritual.”