By Howard Gluss —

Recently a patient of mine was newly diagnosed with HIV. After the initial shock of the diagnosis the patient appeared to handle the reality of the diagnosis quite well. He immediately received all the necessary medical treatment and began a medication regimen.

All seemed to be going well until he reported that he was having great difficulty remembering to take his medication. What we discovered in therapy was that he had attached a lot of negative psychological meaning and symbolism to the medication. He stated that every time he took his meds it reminded him of his HIV positive status which he felt ashamed of. In addition he believed that his dating days were over and that he would remain single and alone. By forgetting to take his medication he really wanted to stay in a state of denial and not deal with what he was really feeling about his diagnosis.

Through his treatment he was able to accept that the negative stigma of being HIV positive was really self imposed. He had to forgive himself for not practicing safe sex and make the commitment that his days of self destructive behavior were over.

Ultimately, he realized that HIV could be a very manageable condition and that shame really had no place in his recovery. Eventually he discovered that there was a whole community of well informed people both HIV positive and negative that would be very willing to accept him for who he was without judgment. It was this deep accepting of himself that allowed for his medication compliance to become an ongoing reality. In fact he went so far as to call his medication his vitamins because they kept him alive and were now being associated with forgiveness and acceptance of self. In the end he made peace with his diagnosis in a very personal and individualized manner. As he let go of his judgments about himself and ignored those of others he realized being HIV positive did not mean the end to his happiness but rather a beginning to living a fuller more accepting life.