AIDS has humbled us. Thus observes editor Mark Blechner in introducing readers to this powerful collection of essays on psychodynamic approaches to AIDS. It is the disease, Blechner tells us, that "has forced us to rethink our relation to sickness and health, mortality, sexuality, drug use, and what we consider valuable in life." In the chapters that follow, experienced clinicians shatter myths about the inapplicability of psychoanalysis to work with AIDS patients.
In addition to setting forth general principles involved in working with patients with serious illness, Hope and Mortality explores the wide range of therapeutic issues that have arisen in the wake of AIDS. Among the topics of individual chapters: working with children whose parents have AIDS; working with AIDS patients in an inner-city hospital; disability, dementia, and other realities of late-stage AIDS; treating someone who becomes HIV-positive while in therapy; leading a support group for gay men with AIDS; confronting fears of HIV in the "worried well"; and coming out of the closet as a heterosexual while running a bereavement group for gay men.
Most poignant of all are chapters in which therapists examine how they have been transformed by treating people with AIDS. Here contributors candidly discuss how their attitudes toward death have shaped, and in turn been shaped by, their clinical work. They tell of recovering near-death memories, of questioning their reliance on traditional medicine, and of feeling the numbing effects of multiple loss with their patients.
The AIDS epidemic has become so widespread that every clinician must learn about the disease and the psychological issues it raises. Hope and Mortality provides an illuminating exploration of these issues and raises profound questions about the overall aims of psychotherapy. It will instruct and challenge all mental health professionals, and provide hope and enlightenment to anyone dealing with a life-threatening condition.
Table of Contents
Introduction - Mark J. Blechner
I. Principles of Treatment
Psychodynamic Approaches to AIDS and HIV - Mark J. Blechner
Modifying Psychotherapeutic Methods When Treating the HIV-Positive Patient -
Bertram H. Schaffner
Treatment of Children and Parents in Families with AIDS - Seth Aronson
"Gidget Goes to Sing-Sing": An Interpersonal Therapeutic Approach to HIV-Positive Substance Abusers - Susan Bodnar
II. Case Studies
There but for the Grace of . . . : Countertransference During the Psychotherapy of a Young HIV-Positive Woman - Sue A. Shapiro
Psychotherapy of an AIDS Patient with Dementia - Karen Marisak
"Playing with Fire": Transference-Countertransference Configurations in the Treatment of a Sexually Compulsive HIV-Positive Gay Man - Jean Petrucelli
Managing Chronic Loss and Grief: Contrapuntal Needs of an AIDS Patient and His Therapist - Richard B. Gartner
Disease, Death, and Group Process from a Psychodynamic Point of View - Barbara K. Eisold
When a Patient Becomes HIV-Positive During Psychotherapy - Ernesto Mujica
A Heterosexual Male Therapist's Journey of Self-Discovery: Wearing a "Straight"jacket in a Gay Men's Bereavement Group - John V. O'Leary
Dances with Men: The Impact of Multiple Losses in My Practice of Psychoanalytically Informed Psychotherapy - Susan Bodnar
Mark J. Blechner, Ph.D., is Training and Supervising Analyst and Teaching Faculty at the William Alanson White Institute and at the New York University Postdoctoral Program in Psychotherapy and Psychoanalysis. A member of the editorial board of Contemporary Psychoanalysis, Dr. Blechner also participates in the study group on neuropsychoanalysis at the New York Psychoanalytic Institute. He has written numerous articles on dreams and is the author of The Dream Frontier (Analytic Press, 2001).
"These essays are both moving and informative because their authors are willing to share with us not only their sophisticated clinical experiences but also their personal experiences of the mutually transforming relationship between therapist and the person with AIDS who seeks counseling. Hope and Mortality is wonderfully open to questioning assumptions, even as it demonstrates how interpersonal and relational psychoanalytic thinking can illuminate a difficult treatment journey. It is essential reading for clinicians of our time."
- Gillian Walker, ACSW, Author, In the Midst of Winter
“Hope and Mortality is a much needed, beautifully done book. The chapters on technique are wise; the case studies poignant and illuminating. Overall, the book is essential for those who work with AIDS patients, and extremely useful to anyone who practices psychodynamic psychotherapy."
- Jay Greenberg, Ph.D., Contemporary Psychoanalysis
"For anyone who might ask where generosity, humanity, and flexibility have gone in mental health care, the answer is that they are present every day in psychodynamic work with AIDS patients. The cutting edge of psychotherapy is here, in the pressure cooker" of engagement with people made inescapably aware of their mortality. This is a book for every psychotherapist. n particular, I cannot imagine a clinician reading Mark Blechner's wise and measured overview chapter without gaining a sense of renewal."
- Peter D. Kramer, M.D., Author, Listening to Prozac