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People seem to go through two separate periods in their reactions to having herpes. The first obviously comes right away; it starts as you sit in your clinicians office and hear the words, I think you may have herpes, and continues until you get your test results that confirm those suspicions. When the news first hits, your thinking may be scattered, so its hard to sit there, listen, and learn. Your own thoughts are racing: how long have I had this, who gave it to me, and what will I do now? You might have the best-informed, most compassionate clinician there is, but your inability to process anything but your emotions interferes with your ability to absorb what youre being told about herpes. You may have run out to a bookstore immediately and found this book, but youre still flipping randomly through the pages, trying to gather your thoughts. All of this, however, is perfectly normal and expected. Lets talk specifically about some of the reactions you may have had early on, right after you got the news.
+ SHOCK AND SURPRISE
When you were first diagnosed, you were probably shocked that something like this could ever happen to you and to discover that you now have a lifelong sexually transmitted infection. These realities may have caused you to cry and ask, Why me? especially since you thought you were careful and never saw it coming. Its completely okay to feel shock, surprise, and a sense of disbelief when youre diagnosed with herpes. Of course, if you knew that your partner had herpes beforehand and you understood the risk of getting infected, youre probably not as surprised. But even in that situation, you may have held the belief that youd be the one to dodge the bullet.
+ ANGER
Your anger couldve been directed at a number of people, but the first may have been your partner: How could you do this to me? How dare you give me genital herpes? You mustve been cheating on me!
But the cold and simple reality is that you couldve been the one who had herpes first. Or, if you really do have a new infection, your partner may not have known about being infected; remember that about 90
percent of those who have herpes dont know it (Leone et al. 2004). Its normal to wonder if your partner was unfaithful, particularly if youve been together for a long time, but remember that monogamous couples can be together for years before transmission occurs. Ive seen this many times in my practice, so if youre skeptical about this possibility, it really does happen. Playing the blame game wont change the fact that you have herpes; so whats the point in doing it? You may never be able to sort out who gave what to whom. You can either have herpes plus a contentious relationship with your partner over this issue, or you can simply have herpes. Its your choice.
You might be angry with your clinician. Youd always been diligent about asking for regular STI testing before entering a new sexual relationship, and now you find out that herpes screening was never included.
How could that be? you ask. How could I not have been tested for the most common STI in America when I specifically asked for a full STI screen? Or it could be that your herpes diagnostic visit was less than ideal. Perhaps your clinician didnt provide much information or education, or failed to address your emotional needs. Maybe you feel that you were rushed in and out of the appointment, or that your concerns were minimized. Perhaps the clinical staff even made you feel ashamed or embarrassed about getting herpes. Maybe a clinician had told your sex partner that herpes could be transmitted only during an outbreak, so you found out the hard way that this isnt true.
Your anger could be directed at society for having such a negative view of STIs and stigmatizing a common infection. But the person at whom youre most angry may be you. Either recently or long ago,
you put yourself in a position to be infected with genital herpes: you didnt have every sex partner tested for STIs before having sex, didnt use condoms with every encounter, had a casual encounter you regretted, or werent faithful to your regular partner and thus contracted herpes. Your sexual behavior was, in your view, less than perfect, so now youre beating yourself up emotionally for it.
Sometimes people say to me, I have a right to be angry about contracting herpes: I never had a choice! or I have a right to be angry: my partner cheated on me and gave me herpes! Maybe you really do have
a right to be angry, and for some amount of time, and to some degree, you will be. But after a while youll need to decide whether or not your anger is helping you in some way or if its just making you unhappy.
How, you ask, can anger help? If your partner has a history of having sex with other people, but youve both agreed to monogamy, your anger may propel you out of an unhealthy relationship, which might be a
good thing. But if youre mad at the person who gave you herpes and they didnt even know they had it, or if youre harboring hostile feelings toward someone who simply didnt tell you he or she was infected for one of several reasons that made sense to him or her at the time, youll need to ask yourself how long you want to keep that up. If you redirect the energy youre using to be angry into moving forward, I believe youll be far better off in the long run.
+ GUILT
Guilt is a form of anger at yourself that involves a troubled conscience about something youve done that creates a conflict between how you perceive right and wrong, and your actions. Having sex with someone other than your regular partner, and getting herpes in the process, is a situation that often elicits guilty feelings. Not only have you violated your promise to be monogamous, but now you also have an infection
that cant be cured and that can be passed to your partner through one of lifes most intimate expressions of love and affection. The resulting guilt can immobilize you and cause great sadness.
Another emotion you might feel is regret. Regret is similar to guilt or remorse but without the bothered conscience: you feel bad for a behavior and vow to try to avoid making a similar error again in the future.
Regret may be more useful than guilt, because it lets you move yourself into areas where you can act differently, whereas guilt often just weighs you down with negative feelings about yourself and sometimes makes you unable to move ahead and do better.
+ CONFUSION
If youre like most people diagnosed with genital herpes, you knew very little about the disease. Oh sure, you may have heard about it in a high-school health class. Maybe you even have a friend with herpes,
but you never paid any serious attention to this particular infection. But now, youre scrambling to learn all you can in a short period of time. However, depending upon how much information you received
from your clinician when you were diagnosed, you may find yourself struggling to set this all straight in your head. HSV 1, HSV 2, mouths, genitals, shedding, blood tests, swab tests, old infection, new infection, suppression, outbreak treatmentno wonder youre confused! And believe me, too many clinicians are just as confused as you are about the details of genital herpes. Unless you have the time and interest to focus on this topic for a while, itll be difficult to keep things straight.
You can clear up a lot of confusion through self-education and by asking your clinician a few questions about how your diagnosis was made. Get as much information as you can in writing so you can refer back to it more than just once. Identify reliable websites and reading materials; several are included in this book. And keep asking questions until you feel confident that you have a good grasp of everything you need to understand your condition. Remember, there are no stupid questions, and no one can expect you to know all there is to know about herpes.
+ FEAR
Are you afraid that no one will ever want you as a sexual partner now that you have herpes? You may fear that after you tell them about your herpes, potential partners will reject you in favor of someone whos uninfected. You fear the unknown: what will future outbreaks be like, how will you know when youre infectious, will you be able to identify herpes outbreaks when they happen, or will you infect family members through normal household living? Some people even fear that herpes will shorten their lives, but herpes doesnt affect life span, so you can take that particular concern off your list right away.
Others fear that theyll be outed: that theyll tell someone wholl say something to others, and soon everyone will know. This is a reasonable concern but one over which you do have some degree of control; remember the previous chapter on telling others? If youre careful about whom you tell and ask those individuals to protect your privacy, you may manage to keep this matter to yourself and to those you want to know about it.
You may have irrational fears about infecting others through nonsexual means. Some of the most poignant letters I receive on the WebMD site are from parents who fear infecting their children through normal day-to-day activities of household living. For them, herpes is perceived as something awful that might befall their children through physical contact. But children dont get infected from parents who have genital herpes by typical household living experiences or by normal gestures of affection.
Finding out more about herpes lessens the fear. The unknown can be very scary, so instead of avoiding thinking or learning about herpes, dive right in. Immerse yourself in knowledge from accurate sources. If youre staying home alone feeling stunned after finding out that you have herpes, use the time out to your advantage by educating yourself. You can also decrease your fear by trying out positive behaviors, like telling a potential partner that you have herpes. Yes, you might get rejected (thats certainly a possibility), but youll at least know how it feels to tell someone. Youll discover that even if youre rejected, youll survive the experience and the world wont come to an end, and perhaps youll learn how to tell someone else a bit differently next time.
+ EMBARRASSMENT
Okay, I agree that your herpes diagnosis isnt something youll want to post in your hometown paper. Having herpes can be embarrassing. But what is embarrassment, really? In this case, its probably concern about having attention called to private matters that you believe involve flaws in yourself. Embarrassment is related to shame but is felt on a much more superficial level.
Maybe youre embarrassed because the clinician youre seeing for this diagnosis delivered your child or has taken care of you since you started getting physical exams for Little League. You believe this particular problem just isnt one your clinician would expect to happen to you. But remember our discussion of how common genital herpes is? Your clinician sees it all the time, and your infection, though embarrassing to you, is routine for medical professionals. Instead of judging you as you might suspect, most sincerely care more about your emotional pain and how to minimize it. So dont give in to your discomfort and avoid discussing herpes with your health care provider. Push through, and ask for help to get you through this difficult time.
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Excerpt from The Good News About the Bad News: Herpes: Everything You Need to Know (New Harbinger Publications)
