HIV testing and dealing with guilt feeling

[Guest guest]

Dear Friends

I am working in the field of HIV/AIDS counselling. I am learning to develop my

practice. I m interested to share a case with you all, regarding a male client

who was in a vicious cycle of geting tested for HIV again and again inspite of

he being diagnosed as negative each time.

The patient is 40 year old, married, have 2 kids. From good Socio-economic

status. He had an 'outside marriage sexual exposure' -not with a CSW- about 8-9

months ago. He began experiencing very serious `Guilt'.

He is a very successful person and has a very high self esteem about his overall

achievements in his life. He lossed his self confidence on controlling his

sexual drive. Started thinking that it was the only big and unforgivable crime

he commited in his life. He went to a private practioner complaining burning

sensations to his penis and disclosed his exposure. The doctor misguided him and

told him that he might have been infected with AIDS.

The client became phobic of being infected with HIV and he got tested, came out

as negative. But he was not convinced with this report. He then disclosed this

event to his family. Then his wife and kids also got tested and came out

negative. His self esteem was damaged, he startd feeling very low in his eyes.

The `guilt feeling' reached to an extent that he started to secure his family

financially, considering the period after his death. He took help of

psychologist whose opinion was that the client has become obsessive about the

fear.

He got tested again and agin. Moreover, he requested to the lady who he had sex

with, to get tested for HIV. She also came out negative.

His family members kept praying the god to save thie breadwinner. For last eight

months he is inactive in his business and has a huge business loss. He along

with his wife referred to us for psychological help. The client was found not

able to cope with his `guilt feelings'. We are dealing with the client and

hopeful of getting good results.

The intesion of sharing this case to inform that how much a `guilt feeling' can

make the life misrable of a vulnearble.

Thanks. Your suggestions are welcomed.

Pawan Khatawane

E-mail: <pawanpeacemaker@...>

[Guest guest]

Dear Pawan,

Your posting regarding the client is interesting. However, giving some

more information might help to give more appropriate response.

For example, " geting tested for HIV again and again inspite of he being

diagnosed as negative each time " . Is he getting tested repeatedly on his own or

his consulting physicians are asking him to get tested?.

From the description it is very difficult to make out whether he is anxious

about his status like the " worried wells " or he is depressed. His excessive

guilt, and loss of initiative in work and business loss could be a mnifestation

of a biological depression. If you are familiar with mood disorder or affective

disorder, you may evaluate him or else refer him to a trained clinical

psychologist or a psychiatrist for evaluation.

Meanwhile you may also assess his religious/faith orientation. A person with

good faith in God when has significant degree of depression may express

hostility to God with the feeling that God has abandoned him. If he is not

intensely depressed and has good religious orientation, you may work with his

spiritual dimension to get him out of the guilt. Depending on his spiritual

orientation, there are several methods in every religion to atone guilt.

But this has to be done carefully since, a very intensely depressed person may

also increase his guilt feelings as result of his cognitive distortions.

Kindly assess his extent of depression before you proceed further. You may back

channel for further help if you would like to.

Dr. L.Sam S. Manickam, Ph.D.

Director & Chief Consultant Clinical Psychologist

Centre for Applied Psychological Studies

Thirupuram, 695 133

Thiruvananthapuram , India

(H) 91-471-2260148, (W) 91-471-2430029.

E-mail: sammanickam@...

[Guest guest]

Dear Forum,

In the USA this scenario, of a patient who tests negative repeatedly but

who has psychological problems related to fear of hiv, is often referred to as

the " worried well " phenomenon, or can be found in searching for the term " hiv

repeat testers. " Public health sites have a particular financial concern to

control this phenomenon, to ensure that tests and staff time are directed to

high risk individuals, and not misdirected.

See:

http://www.thebody.com/sowadsky/worried.html

http://www.cdc.gov/hiv/conferences/hiv99/abstracts/532.pdf

Boston, Massachusetts, USA

E-mail: jamesmichaelboston@...