"When It Hurts to Ask for Help"

"Up Until Now I've Done Pretty Well on My Own With No One Else's Help"

January/February 2003

I'm a person who has been living with HIV for the last 10 years. Up until now I've done pretty well on my own with no one else's help. In fact it used to really brother me that there were HIV-positive people out there who would who "bleed the system dry."

Now I guess I'm about to become one of those people who is dependent on the system. I don't like becoming needy but I want to keep living in my own home. This takes bucks, though, and I will have to have additional medical and emotional help!

Right now, I feel like a failure. I have an appointment with a case manager next week, but how do I start with an attitude like mine?

A Response to This Case Study

First off, your outlook has been, for whatever reasons, you seem to view all people who accept social services as taking advantage of the system. It is true that some people may get used to the idea of receiving services and that this inhibits them from redirecting back towards a life of independence. But most people want what you want, a sense of their own independence and freedom from ill health concerns and from the need for services provided.

There will always be some people who may grow too dependent on social services and, but if you must place blame, direct some of your criticism to social service agencies who may view the client as a source of government funds and even encourage the very dependence you speak of. But I am hopeful that most people and agencies have a common goal to get clients to live their life as independently as possible.

Although it is difficult for you to see yourself as someone who may need assistance at this time, I would not look at this as "forever" or even necessarily for the long term. Right now, you need additional help that will hopefully enable you to continue to function as independently as possible. That's probably the best way to look at this: realize that your need may be short term and that a return to a life of total independence will be very possible in the near future. Nothing is set in stone when it comes to your physical and mental health and your own personal motivation for independence.

Now let's take a closer look at the thought processes that may be creating your negative feelings about receiving assistance. This may help you to realize you have choices and hopefully this may give you more of a sense of power and control over your current situation.

Reduce Negative Thoughts

Try to change your negative thoughts and the way you view yourself as a failure. When you think that you have failed to live up to your own expectations or to those of others, or you have become the very kind of person that you have put down in the past, you must always remember you do have a choice in your perception.

Attempt to let go of the thoughts that weigh you down and affect your physical and emotional health. You can choose to turn around those negative thoughts by realizing that you are not failing but rather redirecting yourself towards positive influences such as the medical and emotional services that you need. If in any way you can learn from this situation by placing a positive spin on it, you will increase your chances of being happier and healthier. Ask yourself, "what can I learn from this event?" -- then move on to better times.

It may help if you explore and challenge the negative assumptions of your general outlook in individual or group psychotherapy sessions. I would discuss this with your case manager, who may be a good resource for connecting you to a therapist. Cost and commitment to the therapist and long or short-term interventions should also be discussed. I believe therapy should be goal-directed and reasonable in cost and time. You should also have choices in what therapist or group you finally select; don't feel pressured to go with only one choice. Therapy is a joint process, so please request information on the therapist's educational and clinical background -- your emotional health should be enhanced by therapy and not damaged! So take care and work with your case manager on this process.

Value Yourself

Change the way you treat yourself and others in your interactions. Some people view themselves as damaged from having HIV and thus don't treat themselves well, such as by not seeking out the needed services for HIV treatment! Try to view yourself as every bit as valuable as you would a loved one. Would you let a loved one with HIV, go around smoking, drinking, using drugs, or doing other things that might compromise their health? Of course not! If there were services out there to enable your loved one to get their medical and emotional needs met, I doubt you would hesitate. In addition resolve to eat a healthy diet and get plenty of exercise and rest, not only because you should but because you value, love and care enough about yourself to do it!

Always also attempt to keep your appointments with your case manager. If you are going to be late or can't make the appointment, please call as your case manager has many other clients. Your "no show" is disruptive and inconsiderate not only to your case manager but also to his/her other clients. As your case manager sets up additional appointments for you, attempt to keep those also.

If you have any hesitation about any medical or emotional health appointments, discuss your concerns directly with your case manager before the appointment. Always clarify with your case manager what your medical and emotional needs are, so you can feel confident that all your appointments are needed and useful. The bottom line is that your case manager is there to connect you with the services that you need. In order for your case manager to do his or her job, you must be direct and honest in what your medical and emotional needs are.

Consider Volunteer Work

Psychologically speaking, people with HIV who help others often live longer and more emotionally healthy lives. When they volunteer to help others in need, most people feel better emotionally and physically. Here is the time that you then can pay back society for the services you have received. Regardless of your current disability or your physical health, you can volunteer on some level to work within the agencies that are helping you or another agency that is helping others. Attempt to volunteer in activities that you enjoy, because when you enjoy what you are doing it is often reflected in your attitude. People around you will benefit from your positive mood. Your case manager should have good insights into what volunteer programs maybe right for you.

Develop Your Sense of Humor

Life isn't fair and the world isn't balanced. Right now you need help and what is really great is that there are agencies out there with case managers just waiting to help you! The problem is that some people with medical and emotional concerns, who need help the most, sometimes retreat and hide from the actual services that can assist them. You need to push yourself to make the calls, leave your home, stand in those lines, and sit in the waiting rooms and, above all, attempt to do this with a smile on your face and to keep your sense of humor!

Research continues to point this out time and time again that if you keep your sense of humor, you will do much better both physically and emotionally. If you know you are going to be standing in a line or sitting in a waiting room come prepared! Bring humor with you in the form of a book, an audiotape or a journal full of jokes. If you meet with your case manager in a good, positive mood, chances are it will be more productive and a pleasure for the both of you. Remember your case manager may have as many as fifty more clients to see and could use a good laugh!

In conclusion one way to look at the services you maybe receiving is that these services will enable you to get back on your feet and remain in your home. Hopefully, with time, you can pay back society by your own personal productivity and contributions. If you have in the past judged others' behaviors due to their use of public assistance -- let go of that. You have your own goals now and your physical and mental health concerns should be number one! Good Luck!

Benefits to Discuss With Your Case Manager
  • Medical benefits, including Medicare eligibility

  • Financial aid, including S.S.I. eligibility

  • Medical needs, including a medical and psychiatric evaluation

  • Housing needs, including eligibility for selective housing

  • Educational needs, including GED and college

  • Vocational services, including direct training for future employment

  • Psychotherapy, including individual and group psychotherapy

  • Support groups, including HIV-specific groups and social outings

J. Buzz von Ornsteiner"Psychologically Speaking" columnist J. Buzz von Ornsteiner, Ph.D. is a New York State-licensed psychologist working as a psychotherapist, educator, and behavioral consultant.

This article was provided by Body Positive. It is a part of the publication Body Positive.


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