The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser...
-
Upload
perla-seeney -
Category
Documents
-
view
220 -
download
1
Transcript of The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser...
![Page 1: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/1.jpg)
The Anger of HIV
The Very Rev. Father Drew A. Kovach, MD, MDiv.,
Director of HIV Services
Kaiser Permanente Hawaii
![Page 2: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/2.jpg)
Anger is only one letter short of danger.
-- Unknown
![Page 3: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/3.jpg)
Why Talk About Anger?
• Common complaint
• Not a isolated emotion
• Inward
• Outward
• Blocking good numbers
• Blocking good life
• What can be done about it?
![Page 4: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/4.jpg)
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
![Page 5: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/5.jpg)
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?
![Page 6: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/6.jpg)
John’s Story
![Page 7: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/7.jpg)
If you are patient in one moment of anger, you will escape a hundred
days of sorrow.-- Chinese Proverb
![Page 8: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/8.jpg)
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
![Page 9: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/9.jpg)
How much more grievous are
the consequences of anger than the causes of it.
-- Marcus Aurelius
![Page 10: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/10.jpg)
Anger at Symptoms
• Fatigue and decreased energy• Lipodystrophy
– Lipoatrophy– Fat accumulation– Lipid disorders
• Wasting syndrome• Neuropathy• Gastrointestinal symptoms• Neuro-Cognitive changes
![Page 11: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/11.jpg)
Anger is a wind which blows out
the lamp of the mind.-- Robert G. Ingersoll
![Page 12: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/12.jpg)
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
![Page 13: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/13.jpg)
Speak when you're angry,
and you'll make the best speech
you'll ever regret.-- Lawrence J. Peter
![Page 14: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/14.jpg)
Anger at Disability
• Food
• Clothing
• Housing
• Medical care
• Being the disabled person
![Page 15: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/15.jpg)
The continuance of anger is hatred.
-- Unknown
![Page 16: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/16.jpg)
Anger at Behavioral Problems
• Anxiety
• Depression
• Substance abuse
• Cognitive disorders
![Page 17: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/17.jpg)
There is no passion so much
transports the sincerity of judgment
as doth anger.-- Michel de Montaigne
![Page 18: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/18.jpg)
Anger at God
• Why me?
• What did I do to deserve this?
• Judgment
• Loss of faith
• Falling away from organized religions
• Isolation
![Page 19: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/19.jpg)
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
![Page 20: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/20.jpg)
Anger at Anyone and Everyone
• Lashing out
• Loosing control
• Can’t contain the anger
• Innocent bystander
![Page 21: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/21.jpg)
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
![Page 22: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/22.jpg)
Anger at Self
• Acknowledge
• Forgive
![Page 23: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/23.jpg)
Resentment is like drinking poison
and waiting for the other person to die.
-- Cindy Clabough
![Page 24: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/24.jpg)
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)
![Page 25: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/25.jpg)
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)
![Page 26: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/26.jpg)
Hurt leads to bitterness, bitterness to anger, travel too far that road, and the way
is lost.-- Terry Brooks
![Page 27: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/27.jpg)
Emergency Measures
• A,B,C of Anger control
• D,E,F of Anger control
• Other suggestions
![Page 28: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/28.jpg)
A,B,C of Anger Control
• A = Avoid loud speech.
• B = Breathe. Take a series of deep breaths.
• C = Curtail swearing.
![Page 29: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/29.jpg)
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.
![Page 30: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/30.jpg)
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”
![Page 31: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/31.jpg)
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?
![Page 32: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/32.jpg)
Blowing out another's candle
will not make yours shine
brighter.-- Unknown
![Page 33: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/33.jpg)
How am I Feeling Right Now?
• Anxious
• Worthless
• Hostile
• Depressed
• Mean/Evil
• Revengeful
• Bitchy
![Page 34: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/34.jpg)
How am I Feeling Right Now?
• Bitter
• Rebellious
• Paranoid
• Victimized
• Numb
• Sarcastic
• Resentful
![Page 35: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/35.jpg)
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
![Page 36: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/36.jpg)
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
![Page 37: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/37.jpg)
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
![Page 38: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/38.jpg)
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
![Page 39: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/39.jpg)
Who am I Angry At?
• My self?
• My partner/spouse?
• My boss?
• The kids?
• God?
• The Human Race?
• My life?
![Page 40: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/40.jpg)
No one can make you feel inferior without your consent.
-- Eleanor Roosevelt
![Page 41: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/41.jpg)
Who am I Angry At?
• All men?
• All women?
• Other races?
• Miscellaneous?
![Page 42: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/42.jpg)
Not respecting yourself, is the same as committing suicide
at a slow rate.-- Unknown
![Page 43: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/43.jpg)
Anger Involves 5 General Areas
• Our anger at others
• Others anger at us
• Our anger at ourselves
• Residual anger from the past
• Abstract anger
![Page 44: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/44.jpg)
How did the situation make me feel besides angry?
• Sad?• Stupid?• Unappreciated?• Unworthy?• Powerless?• Guilty?• Inadequate?• Many others…fill in the blank
![Page 45: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/45.jpg)
The world is too dangerous for
anything but truth and too small
for anything but love.-- William Sloan Coffin
![Page 46: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/46.jpg)
What about this angers me the most?
• Peel down to the next layer
• Put your anger in clearer perspective
![Page 47: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/47.jpg)
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
![Page 48: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/48.jpg)
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
![Page 49: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/49.jpg)
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.
![Page 50: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/50.jpg)
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
![Page 51: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/51.jpg)
Ways to Deal with Anger
• Changing your environment
• Easing up on yourself
• Assertive rather than aggressive
![Page 52: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/52.jpg)
Hatred paralyzes life; love releases it.
Hatred confuses life; love harmonizes it.
Hatred darkens life; love illumines it.
-- Martin Luther King, Jr.
![Page 53: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/53.jpg)
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.
![Page 54: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/54.jpg)
![Page 55: The Anger of HIV The Very Rev. Father Drew A. Kovach, MD, MDiv., Director of HIV Services Kaiser Permanente Hawaii.](https://reader036.fdocuments.net/reader036/viewer/2022062423/56649c9e5503460f9495e394/html5/thumbnails/55.jpg)
Thank you