After living on the west coast for a number of years, the ritual of “spring cleaning” practiced by many in the Midwest and the East is a faded memory. But for many people in the country, warmer weather in the spring means opening the doors and windows that were shut all winter to keep out the cold. Once open, it’s time for things to move in and out more easily – sweeping the dust out the door and letting the new warm fragrant breeze in. It can also be a good time for home maintenance like re-painting walls, bringing in new furnishings, or cleaning out things to give away to charity.
In the earliest years of the HIV/AIDS epidemic, many people were distressed by the appearance of nickel-sized purple lesions on their bodies and faces that were a visible sign of living with Kaposi’s Sarcoma, an AIDS-related opportunistic infection. The lesions involuntarily “outed” them as having the highly stigmatized disease of AIDS. Society’s reaction to patients with these visible symptoms often caused additional psychological distress to people who were already fighting a host of medical challenges in the days with almost no treatment options.
Most of these columns have focused on advice or suggestions for how someone living with HIV/AIDS can improve their own mental health for a variety of topics. Recently, I had a request for a column on how family and friends can help. Too often, friends and family want to help out or react to a person’s HIV disclosure the “right” way, but they’re not sure how.
As a mental health professional and licensed clinical social worker, one of things I do with a new patient is to take a thorough “psychosocial assessment” – basically, his or her life story in one hour or less. I ask about family history, history of current symptoms (depression, anxiety), current medications, work history, health experiences, education, social support, hobbies, and cultural background. But I also ask about his or her current and past socio-economic status; what “class” did he or she grow up? I ask this because I think the issue of money in American society is one of the most emotionally-laden, and can shape – positively or negatively – a person’s experience of the world.
Recently my friends, colleagues and I have debated the idea of “magnetic” or “sero-discordant” romantic relationships, where one partner is HIV-positive and the other is HIV-negative. It seems opinions for and against can be adamant. My predecessor writing this column, Dr. Tony Zimbardi, is also a psychotherapist living with HIV, and he and I are friends and colleagues in Los Angeles. He has written about this topic before, but we disagree on this issue.
It seems like everyone in HIV care recently uses the word “adherence” as often as a transcendental meditationist uses the word “om”: over and over again. But isn’t that what “adherence” is? Taking your colorful collection of pills “over and over” again? Millions of people worldwide now toast themselves once or more times daily with a “cocktail” of antiretroviral medications.
I love Halloween. Maybe it’s because of the theatricality of it, with costumes and props, or maybe it’s because of my addiction to chocolate. Author Peg Aloi, an expert on Pagan holidays, explains that Halloween, or “Samhain” as it is sometimes called (which means “summer’s end”), is observed as a celebration of the last harvest of the year before winter.
As we approach the anniversary of the September 11 terrorist attacks which affected all of us, people in the country and around the world will be reflecting on that trauma. Trauma is a negative event of loss that overwhelms us, that sails past our best defenses and leaves us feeling victimized and temporarily helpless. It is usually sudden, taking us by surprise even if on some level we might have been expecting it. It damages us in a way that leaves us wondering if we’ll ever be the same.
It seems everybody is a therapist these days — or at least calling themselves that. Our society is so much in need of support in these fast-paced, overworked, multiply-stressed days that we’re seeking help anywhere we can find it. Maybe I’m biased because I live in Los Angeles and I’m used to seeing all kinds of new-age “practitioners” – people who offer “professional services” to change your life if only you had your chakras balanced, your high colon cleaned out, your aura adjusted, your astrological chart analyzed, or a thorough assessment (on the phone, no less) with Miss Cleo and her associates at the Psychic Friends Network.