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

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Presentation on theme: "The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii."— Presentation transcript:

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

51 Ways to Deal with Anger Changing your environment Easing up on yourself Assertive rather than aggressive

52 Hatred paralyzes life; love releases it. Hatred confuses life; love harmonizes it. Hatred darkens life; love illumines it. -- Martin Luther King, Jr.

53 In Conclusion You can’t eliminate anger In spite of all your efforts, things will happen that will cause you anger Life is filled with frustration, pain, loss, and the unpredictable actions of others and events You cannot change that; but you CAN change the way you let such events affect you.

54

55 Thank you


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