Ernie’s Blog

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.