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negotiate safe sex practices and so on and
so forth.
“You don’t want to get away from all
the nurturing,” she notes, “but how do you
take care of other people and take care of
yourself as well? There has to be some balance.
Hopefully, counseling helps women
achieve greater balance. It’s about feeling
empowered enough to be themselves and
to pursue things that they’re worthy of
having in their lives,” says Burch.
Instead, she finds that many women
settle for less than they deserve, which can
begin a cycle of more unhappiness in their
lives. Others have problems establishing
healthy relationships and may have negative
coping skills, experiencing difficulty
with attachment (including having many
sexual partners) and figuring out who is
worthy of being with them. These women
often feel that they have to accept bad
behavior in order to be in a relationship or
are confused about what they have to do
to be in one.
“There are also issues around disclosure
and that relates back to self-esteem and
self-worth. It’s important for them to communicate
with partners for their own health
and also so that they can be truly known
and accepted and loved,” she said. “This is
similar to the things that other people are
dealing with, being true to themselves.”
Once a woman has a healthier relationship
with herself, her other relationships
are healthier too. Burch cites support
groups and support buddies as being
important for positive women, along with
caring friends, family members, and supportive
partners.
“We were created to be in relationships
with each other. It’s not just about
romantic relationships, but about learning
how to be a good parent and how
to have a healthy friendship…all kinds of
relationships that are essential to human
existence,” she says. “Everyone needs a
support system, and the healthier your
support system, the better off you are.
It’s about the people in your life who
are for you and support you. That helps
anybody’s mental health and physiological
health as well. It helps anybody to become
more resilient and do better.”
What’s different for people living with a
chronic illness like HIV, she says, is that the
same skills they use for creating healthy
relationships also work in managing their
health care.
“Sometimes negative issues can seep
into their attitudes towards their health,
their health care, and their provider.
When I talk to them about using skills in a
relationship, I recognize that those assertiveness
skills can help them ask for what
they need from their medical provider so
they don’t just think that they go to their
doctor and are told what to do, but report
things that are of concern to them and
ask, can we check into this?” Burch said.
“Sometimes I rehearse with them. ‘What
would you like to say when you go to the
doctor?’ I had a client who felt that her
doctor wasn’t listening to her. There were
some things that she thought needed to
be addressed, but she was complaining
about it to other people and not taking it
back to the doctor to say ‘this really worries
me’ or ‘I wish that at my last appointment
we could have talked about this.’
“So I helped her narrow down her complaints
and her concerns to three things
per visit, because there’s some reality
there too. The doctor cannot spend 90
minutes on a visit. The alternative was for
her to feel consistently frustrated with her
experience with the doctor,” Burch said.
“She didn’t realize she could ask for what
she wants. For the first item on her list, she
was able to get a referral to a specialist.
That also then reduced her anxiety and
worry about what was going on with her.”
She notes that not being able to communicate
with a provider or understand
what was being asked of them could lead
some people to not take their medication
correctly.
Burch pointed to other practical things
people can do to support their self-worth
and value. “It could be as simple as putting
on make-up. It could be signing up to take
a class or to stop talking to someone who
is not doing right by them—any behavioral
steps that reinforce the message that
they’re of value.”
Going for counseling, she believes, is
one big step towards self-care.
“When you show up to therapy, that’s
just in and of itself an affirmation that
you’re worthy of a better life and this is
part of what you are going to do about it,”
Burch says. “There’s always some kind of
spark I see that pulls women in, something
I can’t describe that gives them just a little
bit of hope that things could be different.
Especially for the women who are dealing
with addiction, it’s that little piece of
themselves that helps to pull them out,
to show up on the doorstep of a detox or
drug treatment program. There’s a ton
of internal strength and resiliency there,
and that’s something that I reflect back to
them sometimes. ‘Look at all that you’ve
been through to get to this point.’
“When you see that spark, that’s the
essence of who that person really is,” says
Burch. “The trick is to get them to see it,
despite their circumstances.”
She sometimes suggests that people
make positive affirmations, keep a journal,
and read certain books or authors. While
she can help weed out negative beliefs
people have about themselves that they
may not even be aware of, these activities
can keep people focused on messages
that are the opposite of the negative
beliefs and feelings. “It’s about changing
that message,” she said.
She sometimes has clients take time
to just relax and sit silently. Many people
are often too busy running around doing
everything they have to do to give themselves
time for reflection and hearing
what’s inside them, she said.
Perhaps the most important part of
her work, she believes, is treating people
with kindness and respect. “That’s really
at the core of the Chicago Women’s AIDS
Project,” she notes. “The mission statement
is about empowering women, seeing
the value in each and every woman.”
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