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HIV and AIDS are still with us, and unfortunately seem likely to continue to be so for an unbearably long time ahead. We are fully aware of the extent and seriousness of these illnesses and the way they ravage the quality of life of those infected. These diseases have probably killed more than 50,000 individuals in the United States alone in 1995, and profoundly disturbed the mental health of every infected person, as well as those who love them.
We are here because we care about the lives of HIV patients and because we have volunteered to take professional responsibility toward them. Implicitly, we are also examining the question “Can psychoanalysis be helpful to the HIV or AIDS patient?” In my opinion the answer is “yes.” In the past, psychoanalysis has been a fairly defined and structured system, however. The nature of HIV does not fit well into any system.
This article concerns itself with various methodological changes that are quite challenging to the analyst's usual conception of his role and functioning with a patient. In passing, let me state that my patients have been largely HIV + gay men, with only a small number of women and substance abusers. Naturally, this is reflected in the article.
Twelve years ago when I first mentioned to a friend that I was treating an AIDS patient, I was met with the discouraging question, “What is the use of treating such a patient? You can't cure him anyway!” This kind of comment was typical from people living in a culture imbued with simple standards of success or