It’s not hard to see how other people create the meaning of events in their lives (although it is not quite so easy to see how we ourselves do this). For example, the loss of a job can mean a number of things:
1. A defeat or a sign of failure.
2. A challenge.
3. A chance to start out fresh.
4. A sign that life is unfair.
Which of these meanings people attach to the experience is dependent on other beliefs they have:
1. Perceived opportunities to get other jobs.
2. The degree to which the job was a symbol of personal worth.
3. Beliefs about being in charge of one’s life.
4. Their ability to create a positive new situation.
The principle that you create the meaning of events applies to all the stresses typically identified as occurring prior to the onset of cancer. As painful as some of these experiences can be—loss of a loved one or of an important role, for example— the amount of stress and particularly the degree to which these events make you feel hopeless and helpless are the result of the meaning you attach to the experience. You determine the significance of events.
By exploring the beliefs that limit your responses, by considering alternative interpretations of life’s events and alternative ways of responding, it is possible for you to create positive meanings where negative ones existed before. When the crucial beliefs that have created the blockage in a healthy, forward flow to life are discovered and dislodged, the full energy of life can flow smoothly once again. And with that flow can come the vital force that will restore the body’s natural defenses to normal potency.
Although the exact form this freeing up will take varies from person to person, it almost always involves giving oneself permission to experience life differently. Some people may participate in their health by saying no to others’ expectations, others by saying yes to experiences and parts of themselves they have denied. When the energy begins to flow again, while there will still be problems and stresses to face, they will be faced with the belief that the problems can be solved or at the least coped with—with the belief that one has the power to make decisions that will contribute to getting well again.
Vaillant, in examining the course of recovery from alcoholism, found that quite commonly those who recovered “acquired a new love object.” Basically, those who recovered found someone to love and be loved by, someone who had not been part of the active alcoholism. This cannot be used as evidence that family treatment is not warranted because there has been too much water over the dam, too much pain, and too much guilt. The sample he studied were those who were treated prior to the time in which family involvement in treatment was commonplace. So who knows what the outcome would have been had attention been directed to family members as well. Early intervention was not the rule then either. His sample consisted of long-established cases of alcoholism. However, it does serve to remind us of an important fact. Not all families will come through alcoholism treatment intact. Divorce is not uncommon in our society. Even if alcoholics had a divorce rate similar to that for nonalcoholics, it would still mean a substantial number of divorces. Therefore, for some families, the work of family counseling will be to achieve a separation, with the least pain possible and in the least destructive manner for both partners and their children.
Issues of family relationships are not important just for the alcoholic whose family is intact. For the alcoholic who enters treatment divorced and/or estranged from the family, the task during the early treatment phase will be to help him make it without family supports. Other family members may well have come to the conclusion long ago that cutting off contacts with the alcoholic was necessary for their welfare. Even if contacted when the alcoholic enters treatment, they may refuse to have anything to do with him or his treatment. However, with many months or years of sobriety, the issue of broken family ties may emerge. The recovering alcoholic may desire a restoration of family contacts and have the emotional and personal stability to attempt it, be it with parents, siblings, or the alcoholic’s own children.
If the alcoholic remains in follow-up treatment with a counselor, the counselor ought to be alert to this. If the alcoholic is successful, it will still involve stress; very likely many old wounds will be opened. If the attempt is unsuccessful, the counselor will be able to provide support and help the person find a new adjustment in the face of those unfulfilled hopes. As family treatment becomes an integral part of treatment for alcoholism, the hope is that fewer families will experience a total disruption of communications in the face of alcoholism. It is hoped that a more widespread knowledge of the symptoms of alcoholism may facilitate reconciliation of previously estranged families.
Productive cough, shortness of breath, and fever are symptoms of tuberculosis and pneumonia caused by certain common types of bacteria; these symptoms may also be caused by PCP, certain viruses, Kaposi’s sarcoma in the lung, and several other unusual conditions.
Bacterial pneumonias-Bacteria have always been a major cause of serious pneumonias. Before penicillin became available in the 1940s, bacterial pneumonias were the most common cause of death in the United States.
The symptoms of bacterial pneumonias are fever, shortness of breath, and a cough that produces thick yellow or green sputum. For some people, the major symptom is chest pain, especially when they breathe. Unlike PCP and TB, bacterial pneumonias usually begin rather abruptly, and people see physicians within days, rather than weeks or months.
Bacterial pneumonias can occur relatively early in the course of HIV infection. Unlike PCP, bacterial pneumonias do not necessarily indicate a severely weakened immune system. One common bacterial pneumonia is caused by a microbe called pneumococcus; people with HIV infection seem especially prone to pneumococcal pneumonia.
The diagnosis of bacterial pneumonias is usually established with a chest x-ray and sputum tests. Treatment with antibiotics is highly effective when begun early in the infection. Furthermore, a vaccine can now help prevent pneumococcal pneumonia.
Trimethoprim-sulfamethoxazole, which prevents PCP, will prevent pneumococcal pneumonia as well. Bacteria other than pneumococcus cause pneumonias as well, but the symptoms, diagnostic tests, and treatment are all similar.