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One year ago, I felt emotionally detached from the tragedy of AIDS.1 For me, AIDS was a terrible problem that happened to someone else. My experience changed in the spring of 1987 when Peter, a 40-year-old man who I am treating, was diagnosed as having AIDS-related complex,2 better known as ARC. Peter responded to this crisis by expressing a great deal of anxiety, anger, resistance, and denial. He felt alone and stoically idealized his isolation as “unbound” self-sufficiency. The disease called into question his resigned solution. Here was the possibility of death, the ultimate freedom from the world. He wondered whether that was what he truly wanted. He struggled with the possible alternative, being alive.
Both Peter and I tried to absorb the rapid transformation that unfolded in his life. The language in the therapeutic hour changed. New words came into his conversation: T-cells, skin cancer, thrush, pneumonia, fungal infections, boils, AL721, dapsone, AZT, DTC, nausea, fatigue, blood tests, doctors, money, health insurance, death. I felt overwhelmed and had difficulty opening to the changes in the therapeutic relationship. In an effort to clarify and understand my resistance, I consulted a supervisor. Through that exchange I realized that exploring my own fears in a nonjudgmental way was the key to both cultivating openness in the therapeutic relationship and increasing Peter's opportunity for growth in the face of this crisis.
Peter began treatment in November 1984 three times a week. He described feeling “empty.” Peter was disillusioned with the “gay scene” he had been a part of for 20 years. His promiscuity and obsession with the male body left him, as he stated, “without human contact.” Peter had never experienced a mutually satisfying relationship, and he was lonely. During our initial interview he said:
I'm standing in my own way. I have difficulty being aggressive. I have no desire for the female sex. Maybe I need to explore that. I've never had a long-term r