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How to cope with partner's anger/suicide threats?

Jul 27, 1998

thanks again for this service. you folks are awesome! I'm living with my parter of 15+ years who has aids. he was just diagnosed with aids 9 months ago, has moderate dementia, and has had a mild stroke in the past year; we didn't even know that he was hiv+ until he went into the hospital. Right now, he's refusing to take his antiviral meds, hasn't taken them for >2 weeks and is telling me that he will start taking them again only if I see a different therapist that the one I've been seeing for many years (eg, my therapist hasn't been able to make me want to have sex with my partner over the past 6 months since he's been home because of our history together, so I need a new one). He refuses my suggestions for couples' counseling. Everything right now is my fault: I haven't met his needs ever, I haven't cared for him properly and so forth. Now is enraged, enraged, enraged and is even threatening to hit me if I come home and he's insisting on me living somewhere else. Although I love him, this is a really hard situation. I'm not concerned about my safety, just the quality of my life and his state of mind. I really don't know what to do, but I do know that his behavior is driving me farther and farther away. And with each suicide threat, with each statement that our marriage is a sham, with each mean comment, another piece of my heart shrivels up. This kind of situation has been on and off for months now, and I am exhausted. I'm getting so I care more about my well being than his and I just want to have him out of my life. he's seeing a psychiatrist right now and is on Zoloft, but the sheer amount of rage is really hard to take on an ongoing basis. I know he's trying to manipulate me and that it is a tough situation, but I need some practical advice at this point. Any suggestions, please?

Response from Mr. Shernoff

You are obviously in the midst of a terrible situation for a variety of reasons. I wonder if he wasn't controlling and manipulative even prior to this illness? HIV related neuro-psychiatric involvement does at times cause a person's personality to change, but more often it only exacerbates the way they were before they got ill. All you can do is to tell him that his threats and raging at you is only driving you away. You must be prepared to tell him if he threatens to hit you again that if he does ever strike you, you will leave the relationship. You do not have to put up with that kind of abuse from any one even if he has AIDS. Part of the reason that he is striking out at you in hateful ways is that you are probably the only person he is close enough to to be a target of his frustration and rage. I am not saying that you have to take this kind of treatment. One thing you can do is to call his psychiatrist and let him know how your partner is behaving. Do not expect him to do anything other than listen to your report since he can not legally or ethically really talk to you about your partner unless your partner gives him permission to do so. You could ask your partner if he would be willing to allow you to come with him for a session to his psychiatrist.

For me as both a clinician and as someone who lived with a demented partner with AIDS (luckily, my partner never became hostile, angry or abusive to me), the bottom line is that you do not have to accept the tyranny of his behavior and I think it would be very helpful to you, to him and to the relationship to tell him this. But you can only tell him once you have decided upon what your bottom line will be if he does not shape up. Are you willing to move out in order to preserve your own sanity? You do have to consider this option. Please explore this and all others with your therapist. Never make any idle threats to your partner, but you must determine what your limits are and then stick to them. Once you have reached an understanding for your self of when enough will be enough then this needs to be communicated clearly to him without any anger.

Remember that you can not engage in a power struggle with him around whether or not he takes his medication. Tell him that whether he takes them or not is his decision and one that you have no power or control over. It really stinks that he is pushing you away at this time in his life. But you still have an obligation to take good care of yourself too. Part of that is not allowing yourself to be abused.

Michael Shernoff, MSW

Serodiscordance: Can our love last?

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