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Cole, G.W. (2001). The HIV-Positive Analyst: Identifying the Other. Contemp. Psychoanal., 37(1):113-132.

(2001). Contemporary Psychoanalysis, 37(1):113-132

The HIV-Positive Analyst: Identifying the Other

Gilbert W. Cole, Ph.D.

IT HAS JUST happened again. Earlier this week, I had blood drawn for a T-cell test, in order to decide whether I should begin to take the recently (as of this writing) available protease inhibitors. In the ten years that I have had quarterly blood tests, the same sequence of psychic events occurs. I begin by asserting once again how ridiculous it is to allow numbers that measure a component of my blood determine how I experience myself. Then the familiar fantasy begins, that suddenly this dreadful, decade-long mistake will be over. In my fantasy, I telephone the doctor's office for the result of the blood test and an alarmed and excited nurse tells me that the reading is well within the normal range and that, in fact, there has been a terrible mistake: I am not HIV positive at all. Then comes the bargaining period, in which I attempt to end my reliance on this kind of denial by assessing the “realistic” aspects of the situation. I take into consideration all the clinical facts of my physical state, as well as the (by now) significant progress in treating the virus. And then, after firmly telling myself to calm down, I call the doctor's office and receive the news.

I tested positive for HIV before I began my psychoanalytic training, but after beginning my analysis, and after deciding to become an analyst. The possibility of testing positive did not seem unrealistic even as I was deciding to become an analyst, and so a cognitive dissonance emerged that had to be negotiated: did it make sense to begin a protracted training period in order to engage in a protracted, intimate process with other people while I harbored a potentially devastating virus in my body? The intimation that such a negotiation was necessary I now regard as a prescient sign of the potential constructions of myself that seemed latent along with the effects of the virus. Perhaps it is an indication of the wish to dissociate any of these multiple and new constructions that have been inevitable that I considered only for a moment what it would be like to tell anyone I may be involved with professionally about my serostatus.

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