The Sacred Arena: A Poem

The Space Between: Jesse Dice, LCSW
The Sacred Arena: Therapy As I See It. A picture analogy to the poem
Where curating hope is on the menu 
And being together is the venue 
Where our thoughts and hearts bleed through
And fiery red anger turns a deep well of blue
Where the unspoken can be shared
And all of our wounds can be bared 

Where we excavate the truth 
And take the file to being long in the tooth
Where we drop the struggle
And eagerly await challenge, like a team on the bubble
Where we listen to know 
And realize we are born to grow

In this arena we are at home amongst the brave
In this arena we bare the human soul from birth to the grave
Therapy + Poetry = Theroetry
Blue Ridge Behavioral Health

Communication: Holding Both – The Power of “And”

We can all acknowledge that there is an abundance of quotes out there. Often, we search for quotes to feel inspired or change how we are reflecting on something. The funny thing is that where you can find a quote to inspire in one way, there is another one equally inspiring that can almost communicate the exact opposite message. So do they negate each other? How are we supposed to integrate two seemingly conflicting, yet equally credible messages? Today, we will do just that with quotes on communication.

I find that there can be even more meaning in inspirational quotes when we look in between two seemingly opposite messages. Hence “Holding Both.” This theme just goes all too perfectly with “The Space Between” concept too! (Read here for that concept). What does it mean to hold both? It is a willingness to engage with two messages to find their individual value and collective values.

Holding Both: The Power of And 
Debating Influential Quotes and their Value

On Communication

I am going to make this “Holding Both” format an ongoing series that I dip back into throughout my blog posts. Also, this concept gives me a chance to show off more fun sub blog headers which I cannot resist.

Contradictions. We are all full of them. Humans, am I right? Health and balance comes from being able to hold life’s contradictions and find the truth somewhere in it all. 

In these “debate mash ups” between quotes that I will curate, I am going to find a variety of voices and backgrounds to compare, contrast, and hopefully marry. After all, variety is the spice of life (this statement too will be put on trial!).

For our first showcase, we are going to work with the theme of communication. What makes it healthy? What is important in communication? How do we communicate? I felt inspired to do this post after working some time with dissecting what makes for good communication with several couples that I am serving. The single biggest problem in communication is the illusion that it took place.

Quote the First

The difference between the right word and the almost right word is really a large matter. ‘Tis the difference between the lightening bug and lightning.

-Mark Twain

This is a bold statement from a bold person. Granted, he was likely referring to writing but this still applies to our analysis of communication. With social distancing, it feels that more and more of our communication is through some form of writing. It is hard not to agree with him, right? Words absolutely matter. This quote made me think about several times when I was working with clients and I chose a word that did not underscore the full intensity of their feeling. “This really sucks,” may be a true statement for someone who was recently diagnosed with cancer, but it can often be the lightening bug of “This is fucking bullshit.” Expect a post on swearing in therapy to come later.

This is a minor attunement issue for most therapeutic relationships, but these misattunements can definitely stack up if we are not paying attention. When we are referring to a romantic relationship and feel like our partner always misses the beat with naming what we are feeling this can lead many couples to turn to couples therapy. Even the way that someone uses certain words around us may be cause for relationship turmoil. While I agree that this statement is true, when applied to the therapeutic process, I can tell you that my education was not centered around choosing the best words.

Quote the Second

Conversation is king. Content is just something to talk about.

—Cory Doctorow

This quote seems almost contradictory to Mark Twain’s yet I can’t help but also agree. The act of conversation is ultimately way more important than what is said or what is talked about. That is my experience with therapy too. We get too hung up on the therapeutic plan and what interventions to use next. Outside of therapy, this may also come about as preparing to respond in the midst of the other person speaking. Paying attention to the conversation, tone, and message often speaks much louder than the content or advice itself. The need to be heard and understood is more important than “What advice do you have for me?” After all, there are hotlines and news columns that can cover the advice part if that is solely what someone is looking for.

During this time of the pandemic, I find this quote to carry even more weight as what we likely are all missing is conversation with one another. Being with one another, to me, is part of conversation. After all, the majority of the way we communicate is non-verbally and this makes a big difference in how conversation is steered. Content without conversation is just advertising or messaging. I would know, it is what I have been trying to accomplish here. So with that, I invite you to absolutely reach out to me or leave a comment replying to these posts! 

What is the break down of all of this? How do we hold both? Check it out in a section I am going to call Quotable Quotient, a quote that splits the difference between the two.

Quotable Quotient 

Every act of communication is a miracle of translation.

-Ken Liu 

There really isn’t much to elaborate on here. I love this quote because it is absolutely true. It is a wonder that any of us are able to communicate with one another, have the other person process that, and respond in kind with the chance of feeling fully on the same page. The importance of this can absolutely be seen and felt during critical conversations and also within therapy and writing. Those moments where we might be a little more vigilant in attending to communication really make this quote stand out to me as being the overarching observation that ties the above to points together. 

We are stronger when we listen, and smarter when we share.

-Rania Al-Abdullah 

This quote also gives credence to the wonder and power of conversation. Rania argues that it is not necessarily the choice of words, but the strength within listening to people’s words and communications that is the most important. Choosing the right word is a part of this, but listening to truly hear what the other person is trying to share is another part of the equation. The “smarter when we share,” part of this quote sounds very intentional. It is not “stronger when we talk.” Sharing is a mutual process that includes truly hearing another person’s experience. The sentiment in this quote suggests that finding the lightning can actually be a shared process rather than just up to the one talking. 

Two people engaged in communication

If nothing else, I hope that this exploration sheds light on why communication can be so powerful, and also why it is so complex and sticky. Again, if this exploration didn’t hit true for you, please feel free to chime in, collaborate and converse. We will find truth together.

The single biggest problem in communication is the illusion that it took place.

—George Bernard Shaw

Psychodynamic Therapy: The Concept of “The Space Between”

The Space Between
What Even Is Therapy?

My experience with practicing from a psychodynamic perspective started very early on in my psychotherapy career. I was provided with a world class education in psychodynamic therapy from Smith College. I didn’t know Smith’s reputation for training clinicians in psychodynamic therapy, nor how to practice from that lens. Eight years post graduation and I have found a deep appreciation for this therapeutic process. So much so, that it is precisely what the title of my blog is about. I hope that this post translates well to those seeking therapy services and to providers alike. 

What is psychodynamic therapy? 

Psychodynamic therapy is a byproduct of psychoanalysis, (think Freud and Jung) and has wide applications for therapy today. Psychodynamic therapy embraces a client-centered approach allowing the client to explore anything they are experiencing in the moment. We can touch on family dynamics or discuss past experiences all within the same session. Those who interview with a psychodynamic approach embrace flexibility. The goal of this type of therapy is to process areas of internal conflict and repressed or subconscious emotions. Expect a lot of Socratic questions. 

Analyzing past experiences and shedding light on behavioral patterns allow for clients to better understand and adapt their current relationships, behavior patterns, and emotional experience. This way of interviewing allows the therapist to better understand the person they are working with, not just their symptoms. Additionally, it allows the therapist to reflect on their own work and monitor their experiences to attune to the client. 

How Does It Work? 

The psychodynamic approach means that we treat the person as a whole and try to understand someone’s way of “being” in the world. This is done through processing transference and counter-transference within the relationship. Very simply put, transference is the way the client responds to the therapist’s support and attunement. The quality of their prior relationships and attachments in their life influences this. Counter-transference captures the therapist’s own way of being with a client based on past attachments and experiences.

Therapy is very much a two-way process because everyone brings into relationships the way that they have learned to be in the world. Recognizing that the therapeutic relationship is much like any other relationship, where two people co-create their own “space between” them, the therapist is called to attend to the relationship as being of primary importance in itself. The therapist is their own tool in this fashion, not just a facilitator of a manualized way of doing treatment.

Psychodynamic At Heart

Psychodynamic Treatment Vs. The Medical Model

Much of psychotherapeutic treatment has been perverted to just treating client’s symptoms rather than treating the person. This is partially due to pressures from health insurance and evidence-based research pressures. Purely treating symptoms would be akin to me seeing a physician for treatment for tennis elbow and the physician only taught me methods to not move that elbow so that I can cope with the pain.

Me: “It hurts when I go like this.” *extends arm* MD: “So stop going like that.” 

I absolutely find a lot of value in many evidence-based approaches, but know to my clinical core that those are only useful tools if psychodynamic practice is woven into treatment. When treating someone for depression or anxiety, I first need to know who they are and why they are. I got into this profession to understand the “why?” Of human behavior, not the “what?” Of course, appropriately assessing a client’s goals and hopes in treatment will dictate the depth and use of these reflective practices.

Again, the “Space Between” refers to this rich relationship that the therapist and client both lean into together in the murkiness of their transferential relationship. This co-creation is what carries the therapeutic weight and speaks to higher truths of what it means to be human. Every human I have ever worked with suffering from depression, anxiety, life limiting diseases, or relationship issues have all been unique experiences. This is because the space in between us (our relationship) will always be a unique melting pot of both our emotional and behavioral DNA. 

Who Does Your Mind Sublease To?: Naming The Unwanted Internal Roomate

Those who realize their folly are not true fools.”

Zhuangzi

If you are reading this, you are likely afflicted with the human condition (unless you are some sort of super computer who has achieved sentience…in which case, I assure you, I am pro-singularity!). Generally, the human condition is a pretty sweet deal, but it does come with a lot of baggage. One of those pieces of baggage is that voice, radio station, shoulder angel vs. demon, fear, self-doubt, however you experience it, that hooks you away from who you want to be. These hooks can be present all the way throughout a day, for entire weeks, or more sporadically. Some clinicians might refer to this part of ourselves as the superego, internalized self, or conscience. Maybe at times you might experience that it is punitive, overactive, or rigid. Maybe you are one of the lucky few who has a superego that encourages you to keep doing you (you healthy, or unhealthy narcissist you!). If you are a healthy narcissist, please read on out of amusement. If you are a toxic narcissist, then this post will assuredly be super boring.

We are in a relationship with this roommate in our mind. It is just a part of us, but sometimes because of how noisy it might be, we experience it as all of us. I can prove that your harsh inner critic is not your consciousness simply by the fact that you are able to be aware of and think about it (think about that). You’re welcome.

What does your relationship with your superego or that roommate in your mind look like? I encourage you to notice how you communicate with that part of yourself, and what the characteristics of that part of your are. Is that part of you occupying a lot of real estate in your head? Is it unruly and unpredictable? Does it kick you when you are down, or lift you up? I have a quick tip on how to deal with this unwelcome roommate for you, so read on!

Name your internal roommate! I’ve been more and more appreciating the therapy of asking my clients to come up with their own creative name for that part of themselves. There have been some pretty stellar responses that have allowed them to drop the ongoing struggle with trying to evict, or try to negotiate boundaries with their unruly roommates. Naming them has been able to bring that part of themselves to light, and destigmatized it with levity, honesty and creativity. The name I have come up with for that part of myself is “Homer J,” because much like The Simpsons character, it is self absorbed, doesn’t respect my boundaries, is over indulgent, and is not even apologetic for “having enormous character flaws that [it] doesn’t work on.” Ultimately though, I know he is trying in his own way to look out for me and care for me (just like Homer does for his kids). 

Even while writing this post, “Homer J.” is chiming in. I already struggle with wondering how my writing will be received or if it will even be viewed as helpful or even viewed for that matter. Prime time for “Homer J.” to offer up his classic advice, “You tried your best and you failed miserably. The lesson is, never try.” Thanks, “Homer J.”! Super helpful right now. While I jest, there really is an element of this that sticks with me and makes me question myself.

You know what would give me more pause though? If all of the sudden, I wasn’t aware that “Homer J.” was that roommate of mine doing that chiming in and it just felt like “I” was having all of those thoughts. Now “I” become the failure, and I then listen to myself and give up, and you don’t see this post.

The power of naming our internal roommate can be pretty immediate because it gives us distance and ways to observe that part of ourselves. This can be where the rest of our work comes in with building a relationship with ourselves that we would like to have through thick and thin. 

On Fatherhood and Grief: What My Four Fathers Taught

My father didn’t tell me how to live. He lived and let me watch him do it.” -Clarence Budington Kelland

I grew up with one father, but received fatherly life lessons from three additional male adults in my life:my godfather, step-father, and father-in-law. These are of whom I speak in this post. 

As Father’s Day is upon us, I was a little struck with how down I was feeling entering into the weekend. Grief has a funny way of always catching me by surprise. It took me some time to even identify I was feeling hooked inward by grief. With the non-stop cloudiness and rain, I figured I was feeling a seasonal affective slump.

This feels like a special Father’s Day this year. I am the proud father of an almost three and a half year old. My wife built me a wonderful desk and office space for my shift into the private practice world. I am reclaiming more “work/life” balance.  This is a start of a brand new journey for my career that has already been super exciting. Why the grief tidal wave?

I have spent the past eight years of my career as a medical social worker helping to usher countless people into the after-life and grieve with their families throughout the process. I have formal grief and bereavement training and have co-facilitiated a grief support group for caregivers of cancer patients. Shouldn’t I be a little less surprised with how grief shows up and be a little more versed in identifying it? That’s grief for you. Always humbling. 

I have lost two of the four fathers mentioned, and I am recognizing how much I am missing being able to connect with the other two in this world of COVID. You just can’t replace sharing meals and sharing space. In honor of my four-fathers and my grief I am going to lay out what I have learned from them and what I have internalized: 

  1. Showing our next generation how to live is infinitely more important than telling them. 

I have been fortunate enough to have very gentle voiced fathers in my life. I have received explicit life lessons throughout my upbringing, and had my fair share of difficult conversations on manhood, love, life, politics, spirituality, and how to be an adult and father. However, my four-fathers gentle voices are what resonate with me the most. I know I have internalized this and it comes out in my practice. My dad’s mother even tells me I have the same voice as my father, which I love that I am able to carry on. My dad was definitely on the quiet side and it was only when I starting entering my young adult life that I recognized how the way he carried himself made me pay that much more attention to what he was doing, not just what he was saying. 

  1. We Must Strive To Share in the Emotional Labor. 

If you are unfamiliar with what emotional labor means, please check out this article on the topic.

While I actually credit my wife with furthering my growth in this respect, I also noticed my willingness to be able to show up in this capacity started with my upbringing. My father would cook, grocery shop, be involved with talking finances in the household and would partner in decision making. I grew up seeing both of my parents as wielding equal power and voice in many things. I have no doubt that I found the partner I have had for almost 13 years because I saw attraction in partnering with a powerful woman, which was mirrored to me my whole life. 

  1. Laugh. A lot!

This one is pretty self explanatory, but definitely one of the most important things I have internalized. You know those kitschy “Live, Laugh, Love” pictures (Sorry if you are someone that has one, but I think we both know that it is kitschy.)? I actually don’t see those words as being separate. I grew up learning that to live and love, you must be able to laugh. At yourself, at each other, at humanity, and a lot of the absurdities in life. I mean honestly, platypuses?? A duck that is actually a semi-aquatic mammal that has venom and lays eggs?? Pick a lane, you real life Pokémon. 

  1. Show emotions, name them, and normalize them.

My fathers haven’t been afraid to show me the full range of emotion while rearing me. I remember seeing my dad cry multiple times throughout my life and back then it would always rattle me. Looking back though, I feel that he was the strongest when he was willing to show me his emotions. I never grew up thinking that emotions were bad or to be controlled. I never grew up thinking it wasn’t okay to be and feel however I was feeling. I grew up knowing that even men weep and do so because there are things that matter that much in life. I grew up knowing that this is what true connection is all about. Connection and love isn’t necessarily knowing someone. It is what they are willing to show you. 

  1. Be curious 

All of my fathers greatly encouraged and embodied curiosity. Two of my four-fathers were scientists (Microbiologist and Paleontologist) and the other two were teachers. Inherent in their makeup is encouraging and living a life filled with curiosity and wonderment. For the longest time, I figured I would fall into a science field. I guess I eventually did, I just didn’t realize it would be the social sciences. Let’s face it though, what makes a human’s psychology tick is infinitely more interesting and curious! Curiosity breeds openness, openness breeds understanding, understanding breeds knowledge, and knowledge breeds love. I am very indebted to my fathers for having ignited this passion inside of me and I hope that if anything, I can pass this same passion on to my daughter.

Happy Father’s Day everyone. If today you find yourself in the throes of grief, my advice is don’t fight it and try to push on without acknowledging it. There is a reason why grief shows up. It is an invitation to connect with your past, no matter how painful. It is not something to overcome or live despite it. It is something that reminds us how to live and what is most valuable to us. It is an enormous privilege being a grief counselor. There is pain, sadness, regret and loss that comes with this territory, but there is also life, love, and meaning. 

If you are in the state of Virginia and find yourself having difficulty managing waves of grief please feel free to reach out to me on my about page. I would be happy to get you connected to resources, or offer my own services.