Dear Valued Patient,

You may be aware of a story that may be published by the Orlando Sentinel and which impacts myself and Two Spirit. The issue involves a former employee who has chosen to take advantage of the current climate of publicizing sexual harassment accusations by making false and defamatory statements in retaliation against me and the clinic.

This individual has taken an incident that involved poor judgment on my part and which was immediately addressed by our HR director. The matter was resolved through standard and proper human resource practices and in accordance with the law as it relates to these issues. I participated fully in the correction process and to this individual’s documented satisfaction.

However, sometime after resolution of this matter, this same individual made new demands related to this issue and which were rejected. He then walked off the job in such a manner that we were forced to involve law enforcement in his departure. Additionally, we received a call from someone representing this individual and making another demand on his behalf, which was also rejected.

He has chosen to retaliate using social media for posting a variety of lies about my conduct and our workplace. This issue is attracting media attention.

I have acknowledged and am sorry for my mistake which was limited solely to inappropriate communication. I participated in corrective action. A thorough internal review was conducted to the satisfaction of our Board of Directors. No legal or regulatory actions have been activated.

The aggressive news media climate blended with the social media landscape has made it shockingly easy for an individual to paint a distasteful and patently false scenario with untruths and misinformation. And there is nothing we can do to stop such activity.

We have retained a communications professional to assist us in factual outreach to the community, our partners and you, our valued patients, to be transparent and to protect Two Spirit. We have also retained legal counsel and am in the process of reviewing my options for legal action against this individual.

I value you as a patient to Two Spirit and the important work we do. I ask for your patience, understanding and friendship.


David Baker-Hargrove, Ph.D., LMHC, DAPA



Community Trauma:

Community Trauma:

How the Historical Trauma in your Community affects your Mental Health.

History teaches us about our origins. It gives us the opportunity to understand that we come from somewhere. Our communities of origin gives us a road map to understand who we are. In connection to this, it may also reveal information to better understand our mental health. Indeed, we learn dysfunctional behaviors at home, and then we pass them from one generation to another. Most of these behaviors stem from traumatic experiences that happened to our ancestors in response to events that took place in our communities of origin. Indeed, there is a form of transgenerational trauma called Historical Trauma. This refers to the cumulative emotional wound that an individual or a community as a whole endures in response to a traumatic event. Indeed, there are communities that endured events such as natural disasters, war, slavery, terrorism, persecution, discrimination, or genocide. In response to this type of events, a whole generation can develop a trauma. Later, that affected generations becomes responsible to raise the following generation. Hence, many of us might be affected by Historical Trauma even if we did not experience the event ourselves. For this reason, it can be very helpful for us to understand our origins, and the traumas that our whole community experiences to better understand our mental health. There is a more complex layer to this related to intersectionality of identities. This refers to the study of overlapping or intersecting social identities and related systems of oppression, domination, or discrimination. Indeed, a person who is simultaneously a member of the LGBTQ+ community and a member of an ethnic minority might have a significant accumulation of historical trauma to address. Intersectionality of identities can encompass race, culture, gender, social class, sexual orientation, religion, physical disability, mental disability, mental illness, and migratory status, just to mention some of them.

Today, it is important to reflect about community trauma because of the social cost that represents. Indeed, abuse, neglect, and household dysfunction stem from trauma. This type of untreated trauma lead to outcomes such as inability build healthy relationships, poor stress management, substance abuse, poverty and homelessness. Poor support at home, leads to lower ability to be resilient.

A year ago, the city of Orlando suffered of a traumatic event that can have effects that can last for generations. Indeed, the tragedy at Pulse affected several communities, and several individuals with intersectional identities. Furthermore, many of the survivors and affected from the tragedy come from communities that already accumulated historical trauma prior to the event. An event of this nature, not only traumatized the LGBTQ+ community, the Latin community, or the LatinX community. It re-traumatized them. As we raise future generations, we are at risk of passing the Historical Trauma to them. Therefore, it is vital to heal as a community. Those who address and treat this trauma, will not only help themselves, but they will protect the future of those who follow.

The Substance Abuse and Mental Health Service Administration (SAMHSA) regards community trauma and violence as a preventable issue. In this respect, they provide a series of recommendations:

-An emergency-room based violence interruption and retaliatory prevention program.

-A city mural arts programs to bring residents together to simultaneously transform physical space and mindsets and attitudes regarding connecting people across race, age, and neighborhood.

-Law enforcement training on crisis intervention and trauma; districts creating trauma-informed schools and identifying the impact of uneven discipline practices across diverse populations;

-An entire county public health department training their workforce in trauma-informed care;

-Neighborhood and faith-based leadership providing better supports for people re-entering the community from incarceration.

-The use of media and public events to highlight the power of peer support.

As we reached the one year mark of Pulse, Orlando has been seeking to heal as a community, and that is reflected in the events that took place recently in the History Center, outside of Pulse, in Lake Eola, and other locations. However, treating community trauma starts with the individual. We can help our community through our actions, and voluntarisms. Nonetheless, we have to make sure that we are taking care of ourselves first. Please, assess your level of functioning and symptoms before helping. We can only be effective helpers if we take care of our wellness first.






The impact of trauma on the brain

According to the American Psychological Association (APA), trauma is defined as the emotional response someone has to an extremely negative event. In short, trauma is a normal reaction to an abnormal situation and can interfere with an individual’s ability to live a normal life. Trauma is frequently associated with being physically present at the site of a traumatic experience, but it is also possible to experience trauma after hearing accounts of a traumatic event from survivors, watching videos, or news reports of a traumatic event.

The effects of a traumatic event can last weeks, months or years because trauma changes the way our brain sees the world.

Common symptoms of trauma include night terrors, edginess, irritability, poor concentration, mood swings, anger outbursts, panic attacks, difficulty concentrating, and depression. People who are experiencing a traumatic reaction often behave in ways that appear unpredictable, oppositional, volatile, or extreme.

During a traumatic event, our brain analyzes the surroundings and goes into one of three survival modes: Fight, Flight or Freeze. The choice of going into one of these modes is as involuntary as the choice to make your heart beat.

While in one of these survival modes, the brain will become fixated solely on survival above all else; meaning that it uses fear to activate your superpowers. These superpowers cause your heart to beat faster, bringing more oxygenated blood to your muscles, ensuring that you can run faster, jump higher, and lift more weight than you ever have.  This increased blood flow also makes you hyper-aware of your surroundings; people often describe this as a feeling that time slows down.

Disassociation, or mentally separating oneself from an experience, is a coping strategy that our brain can use to protect us during a traumatic event. Disassociation can lead to a perception that a person is detached from their body, floating above it or somewhere else in the room observing the action of their body without being emotionally able to participate in the experience. They may feel like they are in a dream or some alternate reality or as if the experience is simply happening to someone else. In some cases, memory loss can occur due to disassociation; leading to gaps in a person’s memory timeline.

One of the common misunderstandings about trauma is that our brain can turn off “survival mode” the very moment that we are out of the mitigating experience. That is not true because our brain can remain in survival mode for weeks, months, or even years until it determines that we are experiencing safety consistently and therefore, no longer facing perceived threats. In order to experience safety, we must have all of our basic physiological needs met including eating regularly, sleeping soundly enough to rest our body, and generally feeling personal safety by limiting triggers. We also require our emotional needs to be met; feeling we are loved, cared for and needed. The last necessity is to experience moments where we are emotionally present in our bodies and experiencing joy.

For many trauma survivors, the healing process is best summarized by this quote from Mary Anna Radmacher “Courage doesn’t always roar. Sometimes courage is the little voice at the end of the day that says I’ll try again tomorrow.”  As a community, we must recognize their courage, appreciate their journey, help them when they struggle and celebrate their victories.


Post Transition Blues

Yes, it’s a thing. I see it often. In fact, I can expect to see a client who’s “done with transition” about 6 months later, usually after Gender Corrective Surgery (GCS), and most of the time it’s in my MTF (male to female) clients.

If you’ve ever known someone going through a gender transition then you’ve probably witnessed what I refer to as “trans glow.. It’s like a state of euphoria. The person is elated because they finally see the changes they want, reaffirming that they’ve made the right decision. They’re excited because they are finally taking action on an issue that they’ve been hiding behind for years.

This is where the person becomes like a horse in a race with blinders on, seeing nothing but the finish line. This metaphorical “race” lasts about a year. There’s a lot to do within that year: coming out – to family, friends, partners, work, and school. There’s HRT, surgeries, getting surgeries scheduled, figuring out how to pay for them. A transition takes up a lot of time and energy.

Once the person has been “just living” as male or female, “real life” sets in and the person realizes that the transition was never going to solve all the problems of life and make everything look like rainbows and kittens in top hats. The excitement of the transition has turned into complacency which often turns into a whole new type of depression.

I liken it to the “post party blues.” You’ve had a great time with all your friends in one place, listening to music, playing board games, having a few drinks. Then the next morning everyone’s gone and there’s a lot of mess to clean up. This is what the person “done with transition” often feels like.

Usually people come in under the guise of something else, not realizing what’s going on. The client might report that she’s just not been herself lately, or her partner noticed she wasn’t herself and wanted her to come back in to see me.

I’ll do my usual assessment on depression: changes in sleeping patterns, changes in appetite, feeling lethargic or hopeless, lack of motivation, sadness, etc. The symptoms will be there but the client can’t pinpoint what the trigger was. It started occurring to me a few years ago that the “post transition blues” was actually a thing.

When I mention it to the client, at first they seem puzzled. Then when I explain it, I can almost see the lightbulb go off over their head. Then it all comes together. It’s not that the client’s life is worse, it’s just normal, boring, everyday life.

Dr. David gives a whole presentation on this very topic. He compares the experience to when he was getting his PhD. For years and years, he ate, slept, and breathed his work on the PhD. When he finished his final presentation to the panel of professors, left and made his way down the hall, one of the professors popped out and addressed him as “Doctor Baker-Hargrove” and he realized he had done it. And he explains feeling super elated for about a day and then experiencing months of depression.

He realized he needed to take on some other big projects that he felt passionate about to consume his time and energy.

I don’t even look at it as “depression” as much as it’s a weird kind of “boredom.” The person still has all this energy but now has to find somewhere to direct it. I let clients know early on in transition to make sure that they have other goals in their lives to work on besides transition.

Hope this helps!


The Importance of Play

Last summer, the world was overwhelmed by the phenomena of Pokémon Go. For those of you unfamiliar, Pokémon Go is a free location-based cell phone game that invites users to collect digital monsters.  It has become commonplace to witness multitudes of people walking around metropolitan areas and parks staring at their phones, while playing Pokémon Go. Then, reports began to pour in with people attributing physical and mental health benefits to playing the game. This raises the question of whether the game designers are secret life coaching geniuses or if these users are experiencing a placebo effect.

The main advantages of Pokémon Go are magnificent in their simplicity, which is that the game is able to keep adults and children alike, engaged in the fundamental tasks of play. This simplicity leads people to open up to one another around a common interest and may cause them to interact more with others when they otherwise may not have.

Everyone knows that play is important in childhood, because play is how children process and make sense of their world.

Which begs the question, is play necessary in adulthood?  In short Yes!

What is play?

Philosopher and author Bernard Suit describes play as “a voluntary attempt to overcome unnecessary obstacles.”

The online Oxford dictionary defines play as “engage in activity for enjoyment and recreation rather than a serious or practical purpose.”

I believe Jill Vailet best describes how to identify what play means in her 2012 Ted Talk; “Play is like pornography. You know it when you see it.”

Why should we play?

Play can change how we engage in an experience and how easily we are able to engage with other people. The benefits of play as an adult include relief of stress, increased creativity, feelings of well-being, problem solving, and a sense of connections with others in the world around us.

In terms of stress relief, play is fun and triggers our body to release endorphins, the body’s natural feel-good chemicals. Endorphins encourage an overall sense of comfort and have also been known to temporarily relieve pain.

Play assists with the developing and improving social skills. As adults, we continually refine verbal communication, body language, boundaries, cooperation, and teamwork skills through play and playful communication. Play also allows adults to break down barriers and improve relationships with others. There are many adults that utilize games, such as, Words with Friends, Mario Run Ruzzle, Candy Crush, 2048, and Two Dots to maintain loose daily social contacts with friends.

Play can heal emotional wounds. As adults, playing together, engages us in the same patterns of behavior that shape our brains as children. If an emotionally-insecure individual plays with a secure partner, for example, it can help replace negative beliefs and behaviors with positive assumptions and actions.

How to play?

You can play on your own, with a pet, but for the greater benefits, play should involve at least one other person. You can play puzzles, word games, trivia, card games, board games, or any other kind of game that encourages social engagement.

There are also games, such as Superbetter, which are designed to help achieve reduction in depression, anxiety and with weight loss by helping to gather a support system and creating small measurable quests leading to your success in your mission.

The most import thing is just to try and make sure you follow your joy.

Gaslighting: The Stockholm Syndrome of Emotional Abuse and Manipulation

Gaslighting is a traumatic form of abuse by a psychopath, sociopath, or narcissist initially disguising themselves as a dear friend, a doting partner, a loving family member, or a supportive co-worker or supervisor. The main goals are to take away your power (usually with the hope of gaining it for themselves) and to deflect from their own issues and project them onto you.

The gaslighter might be a supervisor that thinks you’re gunning for their job, a partner or parent who wants to exhibit control over you, a friend who’s jealous of you, or a co-worker who thinks s/he’s in competition with you. They feel insecure and powerless and divert others’ attention from their own problems by focusing on, and exacerbating, yours.

Oftentimes, this makes them look like “the hero” because they “saved” you or have to “put up” with you and, over time, this gives the abuser more power and control. They’ll say things like, “It’s a good thing you’ve got me around looking out for you” or “What would you do without me?” It starts out seeming supportive and caring and the criticisms are very subtle.

The subtlety and impression of caring are what remind me of Stockholm Syndrome, because the victim not only doesn’t see it for the longest time, but can’t bring him/herself to think for a minute that the abuser would ever do anything to hurt them – let alone go to the extremes that they do. In fact, in most cases, the victim can’t imagine their lives without that person.

The abuser then begins to drop little hints here and there, saying, “Hmm…your partner has been running late an awful lot lately. I wonder why that is.” Or maybe something along the lines of, “Well, that presentation for work might not have gone that well but you’ll do better next time.” Only, you weren’t actually complaining (or noticing) that your partner was running late recently and you had felt your presentation was amazing.

Concern for you becomes the main focus, only the concern is imagined, or more likely created, by the other person to make you doubt yourself. The abuser will use a series of orchestrations to turn their allegations into “truths” to make the victim feel that s/he is the one imagining things, and that they’re “misinformed”, not remembering things correctly, not that bright, or even paranoid, delusional, or crazy.

So how do you know if this is happening to you?

1) You constantly second-guess yourself.
2) You find wedges between yourself and others you used to be really close to, yet you have no idea why.
3) You know that something is definitely wrong, but can’t pinpoint what or why.
4) You feel confused, hopeless, and joyless all the time.
5) You feel as though you can never do anything right.
6) You start to suspect the abuser is intentionally hurting you and are told by him/her that you are “imagining things” that are very clear and obvious.

If you think this is happening to you, it’s helpful to document the behaviors and activities. Keep a log of the things they say that seem degrading or dismissive or just don’t make sense. Look at the frequency and significance of the events and in what areas of your life they seem to be targeting, such as your relationship, your friendships, or your job.

Should you discover that you are a victim, immediately begin to break off ties. People who gaslight are either not aware that they’re doing it or have been doing it for so long, it’s become “normal” behavior to them. Most of the time, they don’t care and cannot be reasoned with. Don’t engage with them any longer and, when in doubt, review the documentation to reassure yourself that you are not going mad and that you are now back in control and aware of the situation.

Healing from abuse takes time. You can’t beat yourself up over it or take it personally. When this person is done with you, they will happily move onto someone else. You can’t blame yourself; they’ve done it before you came along. Therapy can help. Try your best to surround yourself with people who love and support you 100% unconditionally and activities that bring you joy.

Confidence and Body Positivity

I get asked occasionally how I came by the confidence I have about myself and my body. This kind of question is rather insulting. I’m not a small person. I am what society calls “overweight” or “fat,” and in many ways, society shames those of us with non-supermodel bodies into thinking that we don’t deserve to be confident, or feel beautiful, or really be seen at all until we “get healthy” or lose weight.

I spent the majority of the first three decades of my life trying to come to terms with my body type, and failing miserably. I rarely felt attractive. I never felt confident. I felt I needed to be invisible, because I offended people with my body simply by existing. Even when I was at my smallest size or lowest weight, it wasn’t enough, because I still didn’t fit in the clothes at the stores my friends shopped.  I still had to shop “plus-size” stores or be relegated to the plus-size section of department stores, which by the way, usually means matching pant and sweater sets that did not at all fit in with my age or my style.

Then there are the ways that I would shame myself. Whenever I would eat out, before I would order my food I would go through a litany of reasoning as to why it was okay for me to order what I wanted, regardless of what other people were “clearly” thinking about an overweight woman ordering a double cheeseburger. I would compare myself to my friends, who were always smaller than me, and therefore more worthy, desirable, and attractive than I could ever be. If I shopped with them, I imagined that I could feel the employees in the stores looking at me and thinking, “She doesn’t belong here, nothing will fit her.” I even went so far as to make excuses for the people I dated regarding how they treated me or what I had a right to expect from them, because they were “compromising” by being with me, an overweight person who no one could possibly want simply because I was awesome.

I don’t feel that way anymore. I’m not sure when the switch flipped, or if there was a defining moment or a series of them, but I know several things for certain now:

  1. I’m beautiful. Not beautiful “for a fat person;” just beautiful. Period.
  2. I can order whatever food I damn well please, and chances are, no one really cares enough to think twice about it. And if they do, they have the problem, not me.
  3. My body is not a compromise. My body may not be everyone’s “type,” but not everyone is my “type” either. That’s okay. I have an amazing husband who loves every curve, squishy part and fat roll that I have, unequivocally.
  4. I am worthy of the same love everyone else is.

My confidence comes from somewhere deeper. It didn’t come from anyone else telling me how worthy or beautiful I am, it came from me recognizing all of the awesome things about myself that have nothing to do with my weight. I am confident because I know I am a good person. I treat others the way I want to be treated. I don’t judge people, and I have dedicated my life to helping people heal and grow. I know I’m smart: I’m resourceful, intelligent and driven to keep learning every day of my life.  I’m a good friend, daughter, sister, and wife. I’m the most beautiful woman in the world to the one person whose opinion actually matters to me: my husband. I’ve learned to appreciate my body in ways I never have before, by figuring out my own sense of style, what works for me and what doesn’t, and what makes me feel good and comfortable and stylish. I’ve learned to accept not being perfect and not aspiring to be, and that no one else is perfect either. Everyone has their insecurities, no matter how they may look to the outside world. And I’ve learned to operate by this principle: “What other people think of you (and if they’re thinking of you at all) is none of your business!”

Couples in Transition…

As a specialist in relationships, I know that the dynamic which exists in couplehoods is complex and dynamic. Couples who experience satisfaction and contentment in their relationships know that maintaining commitment, intimacy and passion in their relationship takes work. Some people enter relationships thinking that since they have found that special person and that they love each other to the moon and back, it will be enough to maintain the relationship over time. However, that’s usually not the case. A couple must learn that each person brings a suitcase full of their “stuff” into the relationship. Frequently, when a couple experiences stress, conflict or discontentment in their relationship, it is because one (or both) of the partner’s stuff is being unpacked and dumped into the couplehood. Couples who are in tune with each other and who continue to seek growth in their relationship will already possess or be able to develop the tools to recognize what is happening. They learn to lean in and help their partner navigate whatever is going on. They will also be able to see how the “stuff” is affecting their relationship, and thus have the opportunity to grow stronger and deepen their bond as a couple. There are times, too, when something happens in a relationship that turns everything upside down. There may be injuries to the couple’s trust. There may be a death. There may be a secret that is revealed. It may also be something that makes one or both members of the partnership question whether the relationship can survive.

Here at Two Spirit, we work with couples who seek support when one of the partners in a relationship comes out as a person who is transgender. When someone in a couple transitions, both individuals AND the relationship experience a transition of sorts as well. Because we are all unique and our relationships are unique, not all that I describe here applies to all couples who are in transition. When one partner decides to come out as transgender, it may or may not be surprising to their partner. Sometimes the partner experiences a feeling of “now this all makes sense” because there have long been signs or their partner has shared some of their feelings about their gender dysphoria. Sometimes it is a shock. Often a partner experiences grief and goes through a process of letting go of the relationship and their partner as they once knew them. The partner can be left with many questions and concerns. Sometimes there needs to be a decision made concerning whether a couple will remain together.

Many couples do remain together after a partner transitions. Familiar dynamics in the relationship often change or are altered. It is common for the partner of the person who is transitioning to experience a temporary change in their role in the relationship. Some partners have reported feeling that they become more of a friend or “expert” advisor on such topics as dressing, clothes, hair, makeup, etc. They find themselves feeling a bit confused, but find that as the transition occurs and their partner experiences comfort and security in their transition, the relationship becomes more stable again. Every couple must navigate and explore the new dynamic and nature of their relationship. The couple must come to terms with a new sexual dynamic in their relationship. Hormone treatment can affect physical sex drive and may interfere with their usual way of sexually satisfying each other. Surgical procedures may alter body parts that were integral to the couple’s lovemaking. Couples may need to explore new or alternative ways to reach climax or sexual satisfaction. These conversations may be difficult or uncomfortable. It is very important for couples who remain together to develop ways to dialogue about all aspects of their partner’s transition, their relationship and themselves. Couples counseling is a great way for a couple to navigate these challenging times. We are here to help. Two Spirit Health Services also offers a group for partners of transgender people. Our next group is scheduled for Saturday, April 29th from 10:30am to Noon. Partners will be welcome to join us afterwards for lunch at a location to be determined. For more information or if you would like to join us, please email me at

Texting: The De-Evolution of Human Communication

With many of the couples that I work with, one of the primary themes is miscommunication. Couples will often come to therapy for that very purpose: to learn how to better communicate. And while I definitely have some higher-level tricks up my sleeve to deal with conflict, decision making, and parenting (among other things) there is one very basic rule that I often ask couples to start using: stop having important conversations via text. In fact, stop using texting to do anything more than the simplest of things: last minute grocery items, checking in during the day, the occasional dirty text to keep the flame alive- you get my drift.

So many of the essential pieces of human communication are completely lost in text. Tone, intonation, emphasis, and often little mistakes (like grammar or punctuation errors) can change the entire message behind a text. For example, you could interpret the following sentence seven different ways depending on which word you emphasize:

I never said she stole my money.

I never said she stole my money.

I never said she stole my money.

I never said she stole my money.

I never said she stole my money.

I never said she stole my money.

I never said she stole my money.

I don’t know about your phone, but as smart as my phone is, it still can’t underline, italicize or embolden my texts, and if it could… well, that sounds like a lot of work, and still misses the point. If one brief sentence can be interpreted seven different ways, imagine how much room for misinterpretation there is in all of the texts we send each other on a daily basis. Many of the arguments I hear couples get into involve at least one or more misinterpreted text messages. This goes back to a topic I’ve discussed in my earlier blogs: assumption and ascribing intention. If you shouldn’t make assumptions about your partner’s feelings or intentions from what they say verbally, then you absolutely should not be doing it with what they say in text.

I’m guessing that each of us can probably think of at least one (or many) time(s) when something that we have said in text has been taken completely differently from how we intended it, and we had no idea how that happened. And I bet that at least a few times, that’s led to an argument- probably not about the thing we were actually texting about, but about our “attitude” or “tone.” Some of my more high-conflict couples will actually whip out their phones in session to prove to their partner (or to me, but this is rather irrelevant and will result in me redirecting the conversation) what was said. When it’s in text, all bets are off; you don’t get to win an argument based on your assumption of what was meant in a text message that to anyone else in the world might look completely benign.

I understand that texting is a convenient and quick way to communicate with one another, but we live in a society where texting has replaced the art of verbal human conversation, and that’s a problem, especially in long-term relationships where there are more important things going on that deserve more time and energy than texting. Take the time to have those important conversations in person. Agree as a couple what issues should never be discussed via text, and if you’re in a particularly rocky place in your relationship, maybe take texting off the table altogether for a while. Focus on rebuilding communication through genuine human connection, rather than technology.

And no, just because you use emojis doesn’t mean you are conveying your message effectively 🙂

Acceptance and Commitment: Self-Discovery for Those Living with HIV

Although there are many different theories and approaches to counseling and psychotherapy, a common theme across them is a focus on creating change in a client’s life. This change can take as many forms as there are individuals and problems they may face.  We all have things we would like to see become different in our lives, and through a process of self-discovery, we go about making those changes in our own way.

However, as much as we may wish it were otherwise, there are some things in life that we do not have the power to change. With some imagination, steps can be taken to shift the trajectory of one’s life in truly unexpected ways, but there are some things that we may find do not seem to budge. While this outcome may be found in an assortment of challenges, I’m reminded of the stories I’ve heard while working with clients who recently learned they are living with HIV. While building their support and realizing that there is a future, there is still the feeling of “why did this happen?” and “Why are we not yet able to cure HIV?” While advances are being made every day, it is true, as of this writing, that a diagnosis of HIV is not something we can change or remove.

The hope is in finding ways to change our lives in response to those things that we can’t change. One approach for achieving this in the counseling setting is Acceptance and Commitment Therapy (ACT). While there are many components of this therapy, its value can be demonstrated with the terms within its name: acceptance, and commitment.

Acceptance is achieved through an exploration of what experiences or conditions in life are causing us distress. The idea is to be mindful of these feelings, without attempting to avoid them. Avoidance may seem beneficial, but those feelings catch up to us, and they may be all the more intense if we don’t face them.1 Instead, ACT calls for exploring these feelings through mindfulness, or being able to view them from the perspective of an outsider. After this intensely powerful viewpoint, ACT then involves considering what we value in our lives and what we would like to pursue. In a sense: what do we want to do with ourselves, despite of the thing or things that we can’t change or control? For those who may be struggling with negative feelings in response to HIV, I wonder what opportunities there may be for finding goals and meaning, especially when considering the values these people hold dear to them.
Pursuing the goals that arise from this process of self-awareness is commitment. What values do we continue to uphold, or newly discover, in response to the things we cannot change? Once these are uncovered, we can make a commitment to change what we can.

Thinking of the people living with HIV that I know in my life, I recognize that many of them appear to have gone through something like the processes that ACT describes. Where their diagnosis once made them question what life could have left for them, there is now meaning and purpose that for some, may have never been there before. This is where we can find hope. People can continue pursuing dreams, despite the things we cannot change.