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A close friend of mine is HIV-negative. Or at least until recently he thought he was. After developing symptoms suspiciously resembling syphilis, he went to a local clinic, where they decided to do an HIV test. A rapid test. He thought it was a good idea. After waiting 15 minutes, his counselor entered the room and said, 'Congratulations, you're HIV-negative.' My friend (we'll call him Shawn) thought 15 minutes was terribly quick but let it go. The counselor (we'll call him Greg) left the room to get the nurse to draw blood for the syphilis test, leaving Shawn alone in the room with the test. Minutes passed, and since there was nothing else to do, Shawn shifted his attention to the test itself. He picked it up, glanced at it, and to his astonishment noticed that, where there was no line just moments before, a faint one was beginning to appear. His heart quickened and he began to worry. When Greg returned, Shawn showed him the test, and Greg's face developed a grave expression. The nurse also looked at the result and couldn't hide her similar concern. They apologized, said the results were inconclusive, and ordered a blood test. That was Thursday. Results might be in Tuesday, nearly a week later and punctuated by a long weekend. We have all been in similar positions, yes? Getting a test result, worrying about it being positive. And perhaps even some of us have received inconclusive results requiring follow-up. But I wonder how many of us have been left alone in an exam room, watching the result unfold before our very eyes. Anxiety. Fear of the unknown. Shawn's world changed during those moments, a seismic shift knowing that quite possibly his world would never be the same. In times past Shawn dealt with stress--any type of stress--in a fairly consistent fashion: with substances. Regardless of the stressor or perceived difficult emotion--boredom, disappointment, restlessness, fatigue, excitement--Shawn would use substances either to escape from a negative emotion or enhance a positive one. But after a series of consequences and humiliations, he is trying something different. He realized that to continue would be disaster. Continuing on the same path was destruction. So back to Thursday, weekend approaching. Before he would have partied over a plethora of relatively benign issues; now he was now trying to avoid substances altogether while feeling enormous fear and discomfort. How could he accomplish this? Well, I spoke with him several times over the weekend, and he fared as well as anyone could. Over the past months he has made a number of new friends in trying to remain clean, and he chose to spend a good deal of time with them over the weekend. It was no cakewalk. Navigating treacherous terrain, dogged with doubt, he felt vulnerable and confused. However, he spoke frequently and honestly about his fears and sadness. He spoke about how he wanted to use drugs. He avoided isolation. He managed to laugh a bit. He avoided self-medication. He avoided self-destruction. Psychological literature consistently mentions the importance of having a support network. Throughout my life, I dismissed this notion--perhaps more out of fear--sensing that there were few who I could trust or who would understand. Little did I know and little did Shawn know that the supposed stance of invulnerability is precisely what leads to being vulnerable and that being vulnerable is precisely what leads to strength. Fransen is a licensed clinical social worker who is in private practice in Chicago. E-mail him at stillpoint4003@yahoo.com.
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