As the old year rolls over it's natural to review how well our lives have functioned during the past 12 months. Many of us take the opportunity to make resolutions about changing our behavior. These often concern diet, getting to the gym, or cutting back on other things that might not contribute to our health. This well-intentioned exercise often collapses, falling away within weeks (or even days) as our resolve and the routines of daily living once again intrude into our hope that this year will be different.

Any successful change that truly improves and nurtures our lives needs to be integrated into new routines. For example, it's not enough to go on an extreme diet and lose a few pounds. Eventually our bodies will surely scream and draw us back into our old eating patterns. The same is true for budgeting, meditation, exercise, or any other new year's resolution. We need to be able to create goals that are manageable, realistic and, in the long run, worth the effort.

I have found that this is best accomplished by sitting down and creating a vision for ourselves rather than designating new resolutions. Sometimes at the beginning of a year we have moments of clarity and realize we are walking through each day without truly having a plan. Weeks and months can slip by as we move through our lives largely unconscious, that is, without direction. I believe that living with the HIV virus makes us particularly susceptible. It is easy to become consumed by taking (or even acquiring) our medications, doctor visits, and managing the health care system. Add to this the emotional effects of living with the virus, from depression to a sense of hopelessness ("why bother?"), and it's easy to see how months and even years can pass while we just tread water, hopefully not falling behind, but rarely moving forward.

One way to approach this, particularly as we begin a new year, is to make an annual review. We can ask ourselves what went well this last year, and conversely, what didn't go well? Like any self inventory, honesty pays great benefits in this process. If we can truly examine those areas where we could have done a little (or a lot) better, we will be able to map out ways in which we can change our behavior and reap the benefits.

Once we have this important information, it can be converted into a vision, a very real idea of how one's life might look and feel if certain changes were made. I encourage my clients to follow this process by creating a vision for themselves in several life areas, including the creation of measurable goals.

This vision process can focus on any number of categories. One might concern friends and family. For example, one could ask "was I a good friend this year?" Maybe calls and messages went unreturned for days and consequently people that might be important in one's life drifted away. This year one might work on being a better friend, including returning calls the same day.

Perhaps the vision concerns one's career. A client of mine has been feeling frustrated for several years. Her health is stable and she is bothered by feeling unproductive. Her plan for 2012 is to look into nursing education programs and complete any prerequisites she needs before she can enroll. It's a long-range plan and she certainly won't be a nurse in 2012, but she will be well on her way.

Other people utilize this process to focus on creativity. One acquaintance who makes jewelry wants to create a website and really take a shot at getting his beautiful pieces out into the world. Another is creating a vision where she can incorporate meditation time into her day to improve her health. Yet another, tired of emotional pain, has committed to taking steps to address and heal old hurts.

In every one of these cases, the commitment is not a quick fix, nor is it unmanageable or impossible. Each person has committed energy toward taking realistic steps that will make truly meaningful changes in their lives. Remember that nothing can happen if we can't imagine it, and the spark of this imagination begins by creating a vision for yourself. There are many things in life that we cannot control, but there are many more over which we can assert influence. This may be the perfect time to take charge of a troublesome area in your life.

There is one final piece that I believe is useful in this process. That is to create a theme for the year. This concept is familiar from Chinese cosmology. 2012, for example, is the year of the dragon. In our own lives, it could be the "Year of Transition," or the "Year of Emotional Healing," or even the "Year of Giving Back." Give yourself some quiet space, allow your vision to become clear, and take action. What will your theme be this year?

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Riding the Tiger: Life Lessons From an HIV-Positive Therapist

David Fawcett, Ph.D., L.C.S.W., is a social worker, certified sex therapist and clinical hypnotherapist. He has worked in the areas of mental health and substance abuse for more than 25 years.

Diagnosed with HIV in 1988, David is dedicated to promoting physical and emotional resilience in his own life and in the lives of his psychotherapy clients. Like the Hindu goddess Durga, he strives to live fearlessly and patiently, never losing his sense of humor even in battles of epic proportions.

David's blog entries have appeared on LifeLube and The Bilerico Project, Florida. He's also a contributor to TheBodyPRO.com's blog for health care providers, HIV Care Today. He answers questions about Mental Health and Substance Use in two separate "Ask the Experts" forums on TheBody.com. David resides in Ft. Lauderdale, Fla., with his partner.

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