The Language of Life and Death: How the Drives are Expressed in the Treatment of a Terminally III Patient

Mr. L is a young adult male with HIV disease who can't decide if he wants to live or die. That is how he frames his problem. It is not an intellectual debate. He may, in fact, die soon. In his intial interview, he stated his dilemma bluntly:

If I don't get in touch with my emotions I will surely die. I might die anyway but my feelings will kill me if I don't understand them better.

This was a patient who had spent the past ten years drug-addicted and promiscuous. He felt that being HIV positive was just punishment for his lifestyle. He condemned himself just as his strict religious upbringing had condemned him. This is how he understood his experience.

His struggle jolted me right from the start because it frightened me. I was not at all certain that I wanted to treat a terminally ill man who might die while he was in treatment. My grandiosity that I would cure him frightened me even more. I knew intellectually that analysis might not effect remission in such a dramatic somatic symptom as AIDS, but I wanted to believe that it could, that it could arrest any deterioration. If my patient could be saved, then I, too, could