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The Anger of HIV

The Anger of HIV. The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii. Anger is only one letter short of danger. -- Unknown. Why Talk About Anger?. Common complaint Not a isolated emotion Inward Outward Blocking good numbers

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The Anger of HIV

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  1. The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii

  2. Anger is only one letter short of danger.-- Unknown

  3. Why Talk About Anger? • Common complaint • Not a isolated emotion • Inward • Outward • Blocking good numbers • Blocking good life • What can be done about it?

  4. Anger in HIV • Anger at Diagnosis • Anger at Disclosure • Anger at Symptoms • Anger at the Disease • Anger at Disability • Anger at Behavioral Problems • Anger at God • Anger at Anyone and Everyone • Anger at Self

  5. Anger at Diagnosis • Directed inward • Directed outward • At getting the HIV diagnosis • At who I got HIV from • Not knowing I had HIV • Who is to blame?

  6. John’s Story

  7. If you are patient in one moment of anger, you will escape a hundred days of sorrow.-- Chinese Proverb

  8. Anger at Disclosure • Who do you tell? • How do you tell? • What is their reaction? • Judgment “just under the surface” • Relationships • Past • Present • Future • Isolation

  9. How much more grievous are the consequences of anger than the causes of it.-- Marcus Aurelius

  10. Anger at Symptoms • Fatigue and decreased energy • Lipodystrophy • Lipoatrophy • Fat accumulation • Lipid disorders • Wasting syndrome • Neuropathy • Gastrointestinal symptoms • Neuro-Cognitive changes

  11. Anger is a wind which blows out the lamp of the mind.-- Robert G. Ingersoll

  12. Anger at the Disease • Medications • Labs • Trips to the clinic/hospital • Long term effects of the medications • Long term effects of the disease • Access to medical care • Cost of medical care

  13. Speak when you're angry, and you'll make the best speech you'll ever regret.-- Lawrence J. Peter

  14. Anger at Disability • Food • Clothing • Housing • Medical care • Being the disabled person

  15. The continuance of anger is hatred.-- Unknown

  16. Anger at Behavioral Problems • Anxiety • Depression • Substance abuse • Cognitive disorders

  17. There is no passion so much transports the sincerity of judgment as doth anger.-- Michel de Montaigne

  18. Anger at God • Why me? • What did I do to deserve this? • Judgment • Loss of faith • Falling away from organized religions • Isolation

  19. Heat and animosity, contest and conflict, may sharpen the wits, although they rarely do; they never strengthen the understanding, clear the perspicacity, guide the judgment, or improve the heart.-- Walter Savage Landor

  20. Anger at Anyone and Everyone • Lashing out • Loosing control • Can’t contain the anger • Innocent bystander

  21. Anger: an acid that can do more harm to the vessel in which it is stored than on anything on which it is poured.-- Seneca

  22. Anger at Self • Acknowledge • Forgive

  23. Resentment is like drinking poison and waiting for the other person to die.-- Cindy Clabough

  24. Anger and CD4 Count • 130 sexually active gay and bisexual men • 75 were HIV+ • Given a battery of psychosocial questionnaires (including Anger Expression Scale, Hardiness Test, and Profile of Mood States) and had blood drawn for CD4 counts Levy E, Knapp P, Linde R, Mayer K, Stoddard A, McCusker J; Boston University School of Medicine, Boston, MA, USA Int Conf AIDS 1989 Jun 4-9; 5:810 (abstract no. D.713)

  25. Anger and CD4 Counts • Both anger-in and anger-out were associated with fewer CD4 cells in the HIV+ groups Levy E, Knapp P, Linde R, Mayer K, Stoddard A, McCusker J; Boston University School of Medicine, Boston, MA, USA Int Conf AIDS 1989 Jun 4-9; 5:810 (abstract no. D.713)

  26. Hurt leads to bitterness, bitterness to anger, travel too far that road, and the way is lost.-- Terry Brooks

  27. Emergency Measures • A,B,C of Anger control • D,E,F of Anger control • Other suggestions

  28. A,B,C of Anger Control • A = Avoid loud speech. • B = Breathe. Take a series of deep breaths. • C = Curtail swearing.

  29. D, E, F of Anger Control • D = Drink a glass of cold water. • E = Exercise. Burn off the anger. Run, walk, swim, bike, dance, etc. • F = Find a friend and talk it out.

  30. Other Measures • Sit quietly and collect your thoughts • Practice “buying time” • Lie down until the anger passes • Look in the mirror • Beat on a pillow • Roll up the windows and go for a “drive-and-scream”

  31. Anger Toolkit • How am I feeling right now? • What happened to make you angry? • Who are you angry at? • How did the situation make me feel besides angry? • What about this angers me the most? • Now, what about this angers me the MOST?

  32. Blowing out another's candle will not make yours shine brighter.-- Unknown

  33. How am I Feeling Right Now? • Anxious • Worthless • Hostile • Depressed • Mean/Evil • Revengeful • Bitchy

  34. How am I Feeling Right Now? • Bitter • Rebellious • Paranoid • Victimized • Numb • Sarcastic • Resentful

  35. Sticks and stones may break your bones when there's anger to inpart. Spiteful words can hurt your feelings but silence breaks your heart.-- Unknown

  36. How am I Feeling Right Now? • Frustrated • Destructive • These are some of the names we give to feelings of anger. • There is no cure for any of them • First step is to identify is as anger

  37. The thought manifests as the word. The word manifests as the deed. The deed develops into habit. And the habit hardens into character. So watch the thought and its ways with care. And let it spring from love, born out of concern for all beings.-- Buddha

  38. What Happened to Make you Angry • If we can focus on the specific incidents which triggered the anger, it becomes more understandable and easier to manage

  39. Who am I Angry At? • My self? • My partner/spouse? • My boss? • The kids? • God? • The Human Race? • My life?

  40. No one can make you feel inferior without your consent.-- Eleanor Roosevelt

  41. Who am I Angry At? • All men? • All women? • Other races? • Miscellaneous?

  42. Not respecting yourself, is the same as committing suicide at a slow rate.-- Unknown

  43. Anger Involves 5 General Areas • Our anger at others • Others anger at us • Our anger at ourselves • Residual anger from the past • Abstract anger

  44. How did the situation make me feel besides angry? • Sad? • Stupid? • Unappreciated? • Unworthy? • Powerless? • Guilty? • Inadequate? • Many others…fill in the blank

  45. The world is too dangerous for anything but truth and too small for anything but love.-- William Sloan Coffin

  46. What about this angers me the most? • Peel down to the next layer • Put your anger in clearer perspective

  47. Now, What about this angers me the MOST? • Down to the bedrock; one word • The fundamental issue which underlies all of the others • It often turns out to be a feeling: stupid, worthless, helpless, inadequate, powerless • We lose our self respect and hold ourselves in contempt

  48. Replacing the “Feeling” • Replacing the feeling of worthlessness • Even unworthy of our own respect with the antidote • The only antidote for self contempt is self respect

  49. Ways to Deal with Anger • Talk about your feelings with others, such as people in a support group, or with a counselor, friend, pastor or social worker. • Try to get some exercise--like working out, walking, or dancing--to relieve some of the tension and angry feelings you may be experiencing. • Avoid situations-- involving certain people, places, and events--that cause you to feel angry or stressed out.

  50. Ways to Deal with Anger • Why are some people more angry than others? • Is it good to “let it all hang out?” • Relaxation • Cognitive restructuring • Problem solving • Better communication • Using humor

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