Did ever occur to you that at some point in your lives your self-respect and sense of responsibility have been put aside? That you have forgotten your awareness, so to speak, in exchange for a few seconds of pleasure, mixed perhaps with some guilt and a good dose of adrenaline?
For a moment, a few seconds really, but the consequences could have changed the course of your life forever. You know what I mean.
This happened to my patient. And to many more for sure. It has taken her years to decide to talk about it.
Because of this and many other issues related to sexuality, pleasure and its consequences, not always pleasant, nobody speaks. A radio program here, a brochure there, some friend in crisis at best. We know that few have had the great fortune of listening to our educators -parents, teachers- bringing up topics as uncomfortable as relevant.
She did it with me just a week ago, starting with a delicate and intimate subject itself, but avoiding the point she was most concerned of.
Next chapter: she made an appointment with a gynecologist for the first time in her life. Feeling fear, anxiety, but having a new impulse that motivates her not stop. Not even when she sudden suffered from the loss of a family member, happened a couple of days later.
She comes to therapy right after the consultation with her physician, with plenty of anxiety. It is when she uncovers the subject, by admitting she wanted to get tested for HIV. She says she did it, that at times of her life she had lost her head, but above all the respect for herself, her sense of responsibility. “I’ve had unprotected sex,” she reveals almost trembling.
Me, I watch, listen, encourage her. She is very willing to talk about it, still in tears and with nervous giggles, and I realize that much of her distress arises from ignorance.
A few minutes after some education about HIV, the current possibility of living with the virus having a healthy, normal life eventually changes her expression.
I invite her to consider being accompanied by her partner or a friend for the study, the ELISA test, and she becomes even lighter. She then leaves the office after many sighs and equal determination.
The few days that follow represent for me a great lesson of life from a great woman: my patient.
She says she is terrified, but does not change her mind before it. She says she cannot follow the pattern of avoidance that has accompanied most of her life. Not anymore. She adds that here in therapy she has learned to get to know herself openly, to love herself without indulgences, to demand to herself to be happy, without skimping on the mistakes as great companions of this joy.
She says she cannot fake blindness on so many experiences, and even invaded by fear she can’t roll back, she declares.
Then decides who will accompany her. And asked me to be with her once she gets the test result. I am honored and happy, and proud that at each step, and -boy!- there were several in just a few days, she has shown great ability to deal with commitment under considerably stressful situations, as well as the ability to surround herself with people who can serve her purpose: her partner and friend for moral support, her therapist for emotional and practical support.
And even more: she also shared with her father her intention to get tested, getting from him deep understanding and support.
She finally risked and faced the consequences of her actions, and got much more than expected.
I was advised that today will be the results, so I made an appropriate time for the session at lunchtime. I’m a little nervous and worried, but I know what is for me to do, and I feel no worry.
To emotionally prepare a person to face a diagnosis result is something that I had not yet done in therapy. It seems my personal experiences served me well, and I felt very comfortable doing it.
It is a job that requires relevant information regarding the diagnosis and prognosis. Moreover, there must be emotional balance from the clinician in order to transfer it to the other, without falling into optimism but not the opposite extreme either. It is very important to work with the patient’s fears and take him/her by the hand through a journey of imagination: what if the test is positive (for HIV, in this case) but also what if not, measuring the patient’s sense of reality and providing very appropriate, sensible and practical information in the event that her/his ideas were unrealistic.
It was very special to share with her as her therapist this preparatory work and open an envelope that wasn’t in my name to inform her of the result, as she asked me.
It turned HIV negative. My heart lightened together with hers.
I expected most of her following reactions she showed: her joy, her distress because of the whole experience, anguish, guilt, anger.
What I did not expect is that the first thing she thought next was to educate. Now she wants not just to keep handing out advice to her nieces and friends when they’ll ask; she has the firm intention to share this adventure with them, including her fears and failures, and to show them that same page she asked me to open for her, the one showing the great self-love that she has learned along the way and practicing better everyday.
Educate to self-esteem and self-care is one of the most difficult and important tasks for the lives of your children. And it doesn’t happen by telling them what they should not do, but through other methods involving a daily work in which they are taught to love, to respect, to value and not negotiate anything, absolutely anything that may jeopardize their health and life.
HIV is not a disease, it’s a virus that, while having it on our body, involves a non-reversible but not deadly condition comparable to diabetes. When tested positive for HIV, it necessarily involves making some changes in your lifestyle and probably taking antiretroviral drugs, which will allow you to live a healthy, stable and long life.
The parenthood plan involves new learning for the potential parents. The knowledge, seeking of support and guidance to achieve the children’s self-esteem and self-care to protect them from this and many other risk situations is a must.
Educating to self-love is a matter of life or death.