HIV Diagnosis and The Process of Adjustment

This incredible story of Luke Alexander, who’s been HIV positive for just a year, shows us all how brave and well adjusted a person can be when responding to such devastating news.

BBC Newsbeat: Luke has been HIV+ for a yearThere are so many layers and levels to deal with.  There’s the initial ‘oh shit’ to deal with, there’s the ‘am I going to die’ and there’s the ‘who do I tell?’.  There’s guilt, remorse, regret, anger towards the self and the other person involved, it goes on.  These are not simple points to deal with and require an emotional maturity that you don’t often see in an 19 year old.

In some ways Luke is lucky to be young, there’s a big difference between Luke’s generation, my generation, and my parents’ generation – each of which has its own stereotypes about HIV and AIDS.  Luke lives at a time when HIV is a manageable disease akin to diabetes which can be managed by regular medication.  Nonetheless, it can be truly isolating for some.  Luke’s decision to be public and fearless about his condition means that the people he meets will ‘self-sort’ into those that can see past the disease and those that can’t.  There are enough HIV dating sites and social and support groups to ensure that he’ll be able to find loving, caring HIV+ people to surround himself with, even if he can’t find it in the general population.  His attitude is truly heroic.  His attitude is rare.  Even in gay circles, it’s rare for people to be so open about their HIV status.  There’s still a stigma attached.   There’s still fear about ‘people at work’ finding out, losing friends, or parents that might be devastated. And if you’re heterosexual or black the stigma can be much worse and much more isolating.

I don’t know how Luke managed in the period immediately following his diagnosis but, for most people, there is a lot of adjustments to make.  There is a process to go through.  It can be similar to what goes on when a person grieves: Denial, Anger, Bargaining, Depression and finally Acceptance.  There are similar processes for people who go through other traumas, such as assault.  There is no time limit for the brain to make these adjustments but in my experience most can do it within a year.  It depends on the person, it depends upon their belief system and resilience and there are other factors we don’t understand yet.  And, there are some people who can’t.

Some people get lost.  Actually, some people get stuck.  I don’t know if there is a technical name for a person that can’t get over a bad diagnosis but for regular trauma cases, the analogue is Post Traumatic Stress Disorder (PTSD), for grief, it’s ‘Prolonged Grief Disorder’!  Just to set the context, in the case of PTSD, it is not a disorder to have nightmares, insomnia, hyper-vigilance, anxiety, etc.  It only becomes a ‘disorder’ when we don’t return to normal after a reasonable time.  We are supposed to be impacted, shocked, stressed, vigilant, etc. we are supposed to learn lessons, and then we are supposed to move on, that’s how it works.  And, some people can’t because they don’t know how.

This is when it becomes an issue for therapy.  Thankfully chronic trauma, in its many forms, is a treatable condition.  The symptoms are many, isolation, anger, guilt, addiction, etc.  If this applies to you or somebody you care about then it may be time to talk.

Author: Simon Bates, Freedom Hypnosis
Cognitive Hypnotherapist working with London’s YMCA Positve Health Programme.

 

Suicide and Young Gay Men

There’s a disproportionate number of young gay men committing suicide. Very disproportionate. If the figures from Stonewall’s 2011 study of gay and bisexual men is to be believed 27% of gay and 38% of bisexual men said they had considered taking their own life in the previous year – this compares to just 4% of heterosexual men. And this was a big survey – 6,861 respondents from Britain. It gets worse.

Of the respondents, 3% of gay men and 5% of bisexual men had actually taken steps to take their own life in the previous year. Apparently the comparable rate is 0.4% of all men. It gets worse.

What if we look at just the young men? 10% of gay and bisexual men aged between 16 and 19 actually took steps to take their own life in the last year. 1 in 10. If you go to a gay bar with lots of young gay men, look over into one corner – proportionally – all the gay men in that corner took action to kill themselves last year. If that doesn’t shock you, there’s something wrong.

We could spend hours debating the real reason for this: coming out early, coming out late, permissive society, disapproving society, too many rules, not enough rules, too much drugs/alcohol, not enough, too much internet use, not enough, freedom to be gay, not enough freedom to be gay, too many gay role models, not enough,  too selfish, too selfless, being able to marry, not being able to marry, too much coddling, too little, too much religion, not enough. I hope that clears things up.  Certainly, I’ve heard arguments for all the above.

We could ask those young men what’s wrong but most people aren’t good at giving you reasons when they’re an emotional mess.  Frankly, it could be your phone running out of charge that can push a vulnerable person over the edge.

Here’s what I think.  Think about the changes that most of these men are going through in their teenage/early adult years (most of which only apply to young gay men):

  • they are coming out (to mixed reviews!)
  • they are going through the difficult years that follow from puberty
  • they will likely have their most emotionally charged relationships and break-ups in this period
  • they are becoming independent and usually separated from their usual unconditional emotional support
  • they are more likely to have moved from home (young gay men move to the cities, actually they run…)
  • they are experiencing drugs and alcohol for the first time.
  • HIV infection, or constant fear of infection

It’s a lot to deal with for people without enough life experience.  These young men haven’t learnt yet about how to be emotionally resilient. The people they are attached to emotionally and provide emotional support (friends, parents, teachers, lovers) can, and do, suddenly remove that emotional support and even reject them.

Drugs and alcohol are huge problems for young gay men.  They lead to risky behaviour that leads to guilt and regret.  But worse, they lead to huge ups and downs, often days later.  So a normal day might feel like an unbearable weight, for no apparent ‘reason’.

Generally, we all learn to be emotionally resilient over the years – at least to some extent.  The question is whether we manage to do this in time and without too much damage along the way.  Thankfully this emotional resilience can be learnt through CBT and/or Cognitive Hypnotherapy. These are also good ways of dealing with excessive drug or alcohol use, as can issues of identity and self-worth.

And sometimes, people just need somebody to talk to.