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Rongting Hou

Self-restoration
of People Living
with HIV/AIDS
in China
Self-restoration of People Living with HIV/AIDS
in China
Rongting Hou

Self-restoration of People
Living with HIV/AIDS
in China

123
Rongting Hou
Inner Mongolia University
of Science and Technology
Baotou, China

Translated by
Hulin Zhao
Henan University of Chinese Medicine
Zhengzhou, China

ISBN 978-981-15-7412-2 ISBN 978-981-15-7413-9 (eBook)

https://doi.org/10.1007/978-981-15-7413-9
Jointly published with Huazhong University of Science and Technology Press
The print edition is not for sale in China (Mainland). Customers from China (Mainland) please order the
print book from: Huazhong University of Science and Technology Press.

© Huazhong University of Science and Technology Press 2020

This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part
of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations,
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The use of general descriptive names, registered names, trademarks, service marks, etc. in this
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The registered company address is: 152 Beach Road, #21-01/04 Gateway East, Singapore 189721,
Singapore
Foreword

The book is based on the Ph.D. thesis of Hou Rongting. This English version is
translated by Zhao Hulin from Henan University of Chinese Medicine.
In guiding graduate students to write theses, I hold a basic belief that students
must have something to say before they can write, and that writing must be sup-
ported by theoretical thinking before they can finish the writing. I want to explain
two important concepts in this belief: having something to say (i.e., having sub-
stance) and having theoretical framework (i.e., how to say).
Students who claim to follow the school system but have nothing other than their
courses and lessons are usually not chosen by our institute. In other words, the
chosen graduate students must have some life experiences worth discussing, for
instance, their own experiences, or their relationships with others. This is called
having something to say (i.e., having substance). What theories (how to say) to use
when he or she is going to start writing thesis next? I am a believer in the saying “to
believe everything in books is worse than to have no books at all”. If my students
believe everything in books and can’t discuss with me, it will be a nightmare for
me. “Can discuss” and “can debate” are the essence of “can say”. But at the
beginning of discussion and debate, we will suddenly fall into the historical flood of
thought, and we will enter the vast world of literature.
In the spring of 2013, I received a message that a Ph.D. candidate from Renmin
University of China was coming to the Department of Psychology at Fu Jen
Catholic University to study for a “double training doctoral degree”. I got a general
idea of his work before Remin University of China and his sociology studies after
he was enrolled. After a few letters between us and my careful evaluation, I decided
to let him have a try. Our Ph.D. students usually take 5 or 6 years to complete their
courses, and with the time to write their thesis, it is common for our Ph.D. can-
didates to study for seven or eight years. After the summer vacation, I met the
student mentioned above, Hou Rongting at the beginning of the 2013 school year.
He can only use two academic years to finish his study here.
In addition to taking courses, he also took all three courses I had opened in each
semester, including an elective course for undergraduates, as well as a master’s and
doctoral courses in my institute. In short, he took all the time to learn. The assigned

v
vi Foreword

readings I’ve given to each course do contain some very advanced theories, like
“relational psychoanalysis”, as well as some very classic (but never-obsolete)
subjects, like “spiritual life”. My students are required to read the profound works
of many scholars who emerged in the United States after the 1990s, without
Chinese translations, and works of philosophers in the Song Dynasty, without
modern Chinese versions. Many students’ learning attitude, compared with
Rongting, I must admit, is inadequate. So, I found out very quickly that he is a
student who has something to say and is willing to have theories. We took the time
to draw up a plan for the writing of the thesis.
The book includes social work, psychological intervention and the researcher’s
introspection. “Interdiscipline” is the general term for this kind of research, and the
researcher needs to break through any intellectual barriers between knowledge
rather than breaking down barriers between disciplines. The topic is how
HIV-infected people can firmly believe that they live because of certain interven-
tions or assistances, which is a “spiritual” issue. However, psychology may not be
able to deal with such issues face to face. The “psychoanalysis” we discuss must be
cross-examined by western scholarship from its origin and by the ancient and
present knowledge transmitted by Chinese.
In the year I began to supervise Rongting, my own research project (not to
follow someone else’s “project”) was to write a paper on philosophy and psy-
chology, “The Moment of Healing: A Multicultural Cross-Discussion of
Mindology and Healing”. There are no “discipline boundaries” in my question,
both in thinking and writing. I won’t ask students to imitate my research, but to a
certain extent, this academic attitude will manifest itself in the supervision
relationship. Young scholars who can’t use this as their ambition to learn will
certainly work very hard. On the other hand, the fully immersed study will soon
generate motivation for learning, so that thesis writing becomes a work of “can
discuss” and “can debate”.
After discussing with me, Rongting chose the essentials of Kohut’s
self-psychology (self-psychology, also known as autologous psychology) and
turned it into a method of psychological intervention, and practiced it in the objects
he wanted to assist, that is, some HIV-infected people. At the most fundamental
level, I explain the goal of this thesis writing: to enable infected people to gain a
new life through “psychological motivation” caused by “psychotherapy”. This
fundamental proposition forms a very directional discourse in the understanding of
Rongting, called “being-to-death” and “dying to live”.
Whether or not the language used in this proposition constitutes a “neologism”,
this is a challenging proposition for researchers themselves, for intervention, and for
the objects of intervention. Nevertheless, he finished his thesis writing with
something to say and with theoretical framework, but with no waste of a moment
and efficiency in the course of studying while discussing. Students in Taiwan will
neither do it nor can do it with this “time-consuming” way.
I don’t have to write a summary of the book. As long as I explain how the
unprecedented “double training doctoral degree” like this is done, the rest is for the
reader to read. If you’re a graduate student, how do you get started with topics like
Foreword vii

this? How do you write it down? How to combine the practice with theoretical
thinking? In the course of writing this book, there is an ice-breaking discussion,
which later appears in the first chapter of the book. Rongting shows his under-
standing in the tone of my explanation like this (not exactly the words in the book).
A brief explanation for “helping profession”: it’s a system of knowledge and
practice that encompasses a wide range of disciplines. In human civilization, it is
linked to the saying “God helps those who help themselves”. But in modern society,
the concept of “God help” has gradually been replaced by “social support”, and
“self-help” is “the ultimate purpose of all these social supports”. We can use the
word “self-help” to express the purpose of “social worker” for social support. It is
the same with a proverb, “to give a man a fish is inferior to teach him how to fish”.
However, in the academic “helping profession” needs to develop a system of
discourse like Kohu’s self-psychology. The key word Kohut needs to explain is his
own creation of “self-object”, which, with the joint effort of the helper and the
object in need, is nothing more than to form a “self-help relationship”. If this
process is further developed through sophisticated theoretical development, it may
form a complex set of knowledge/practice discourses that require hundreds of
thousands of words to be clarified.
When I saw an understanding like this in Rongting’s writing plan, I realized that
the power of knowledge had been generated in his thinking, and I knew that this
relationship between teachers and students would develop comfortably for a limited
time. I really just want to explain how to start. Also just want to say, like me, a good
scholar can let knowledge be produced “without external demands”. In the guiding
relationship of a doctoral thesis, the supervisor’s actual job is simply to “inject
impetus”, rather than pushing people into the thesis writing as if the ducks were
pressed on the shelf. I’m glad that in my coaching career, I met students like
Rongting in the fall of 2013 and completed this compact and unprecedented work
before the summer of 2015.

December 2017 Wei-Li Soong

Fu Jen Catholic University
Contents

1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.1 Rationale for Research on AIDS . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.2 Research Participants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
1.3 Research Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
1.3.1 Participant Selection . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
1.3.2 Data Collection and Analysis . . . . . . . . . . . . . . . . . . . . . . 9
1.4 Research Ethics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
1.4.1 Informed Consent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
1.4.2 No Harm but with Benefits . . . . . . . . . . . . . . . . . . . . . . . 12
1.4.3 Rigorous Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
1.5 Theoretical Perspective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
2 Governance of AIDS and Actions Taken . . . . . . . . . . . . . . . . . . . . . 19
2.1 Outbreak of AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
2.2 AIDS Governance in China . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
2.2.1 Status Quo of AIDS Population . . . . . . . . . . . . . . . . . . . . 22
2.2.2 Prevention and Treatment of AIDS . . . . . . . . . . . . . . . . . . 23
2.3 Policy Guarantees Related to AIDS . . . . . . . . . . . . . . . . . . . . . . . 31
2.3.1 The Successive Introduction of AIDS Prevention
and Treatment Measures . . . . . . . . . . . . . . . . . . . . ..... 31
2.3.2 Institutional Guarantee of AIDS Medical Service
System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..... 32
2.3.3 Funding Inputs for the Implementation of the AIDS
Policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..... 33
2.3.4 Project Configuration for AIDS Prevention,
Involvement and Intervention . . . . . . . . . . . . . . . . . ..... 33

ix
x Contents

2.4 Development of AIDS NGOS in China . . . . . . . . . . . ......... 34

2.4.1 The Development of AIDS NGOS in China . . ......... 34
2.4.2 Actions Taken by AIDS NGOs . . . . . . . . . . . ......... 36
2.4.3 Criticism and Reflection on AIDS Governance
and In-Place Action . . . . . . . . . . . . . . . . . . . . ......... 37
Reference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... 39
3 The Relational Psychoanalysis: The Way of Relationship
Construction and Deepening Treatment . . . . . . . . . . . . . . . . . . . . .. 41
3.1 The Classical Spiritual Analysis Represented
by the Drive-Conflict Model . . . . . . . . . . . . . . . . . . . . . . . . . . .. 43
3.2 A Paradigm Shift Characterized by the Development-Inhibition
Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
3.3 Integration Model with Relational Theory as the Core . . . . . . . . . 48
3.4 Special Insights of Self-psychology in Psychological Therapy . . . . 54
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
4 Mutual Influence of the Infected . . . . . . . . . . . . . . . . . . . . . . ...... 67
4.1 The Course of “Dying to Live” . . . . . . . . . . . . . . . . . . . . ...... 67
4.2 The Psychological Dynamic Analysis from Disintegrating
to Restoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
4.2.1 Fracture of Self Development . . . . . . . . . . . . . . . . . . . . . . 74
4.2.2 Pursuit of the Self-Object Demands . . . . . . . . . . . . . . . . . 79
4.2.3 Restoration of Self Structure . . . . . . . . . . . . . . . . . . . . . . . 86
4.3 Way to Involve and Intervene in the Journey . . . . . . . . . . . . . . . . 87
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
5 Crossing the River with a Stone: The Exploration of Infecting
Love with Love . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .... 91
5.1 Support and Cure by Empathy . . . . . . . . . . . . . . . . . . . . . . . . . . 101
5.1.1 Understanding the Dynamics of Therapy . . . . . . . . . . . . . . 103
5.2 The Interpretation of the Healing of the Occurrence
of Reconstruction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
5.3 Effects of Moderate Response . . . . . . . . . . . . . . . . . . . . . . . . . . . 119
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
6 Self-restoration in Relationship Co-construction . . . . . . . . . . . . . . . . 125
6.1 Subjective Feeling of Helping Themselves and Others . . . . . . . . . 125
6.2 Self-restoration Under the Co-construction of the Relationship . . . 132
6.2.1 The “Cocktail Intervention Therapy” Under
the Relationship Co-construction . . . . . . . . . . . . . . . . . . . 134
6.2.2 New Experience of Helping Others Help Themselves . . . . 141
Reference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144
Contents xi

7 Re-Exploration of Self-restoration and Intervention Mechanism . . . 145

7.1 The Mechanism Exploration of Self-restoration . . . . . . . . . . . . . . 145
7.1.1 The Stage of Self Ignorance: The Fracture
of the Self-object Bond . . . . . . . . . . . . . . . . . . . . . . . . . . 147
7.1.2 The Stage of Spontaneous Action: The Repair
of Self-object Bond . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148
7.1.3 The Stage of Self Disintegrating: The Disintegrating
of Self Structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
7.1.4 The Stage of Active Repair: The Pursuit of the Self-object
Needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
7.1.5 The Stage of the Self Stability: The Reconstruction
of Self Structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150
7.2 The Intervention Mechanism of “Dying to Live” . . . . . . . . . . . . . 152
7.2.1 Mature Self: The Appropriate Intervention Object
and the Final Intervention Target . . . . . . . . . . . . . . . . . . . 153
7.2.2 Self Disintegration: Poor Adaptation and Internal
and External Conflicts . . . . . . . . . . . . . . . . . . . . . . . . . . . 154
7.2.3 Self Repair: The Organic Combination of Empathy
and Moderate Response . . . . . . . . . . . . . . . . . . . . . . . . . . 155
7.2.4 Self Restoration: Focus on the Satisfaction
of the Self-object Needs and the Formation
of Compensation Structure . . . . . . . . . . . . . . . . . . . . . . . . 158

Afterwords . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169
Chapter 1
Introduction

1.1 Rationale for Research on AIDS

When it came to the topic of AIDS, two deep impressions were left upon the author.
First, AIDS was a formidable, infectious and fatal disease; second, I only knew one
of the facts that AIDS was transmitted by blood. It was not until the second year of
my college life that AIDS caught my attention when a public event occurred. In 2003,
the epidemiological investigation by anti-epidemic workers in Hohhot City of the
Inner Mongolia Autonomous Region in China revealed that 13 people were infected
with HIV (Human Immunodeficiency Virus) due to blood transfusion. The blood
was illegally drawn by one county hospital of Hohhot City during October, 1998
and September, 2000. This had been the first domestic major medical accident of
HIV infection ever since the implementation of Blood Donation Act of the People’s
Republic of China in 1st, October, 1998.
In China, the initial transmission of AIDS was not through sexual behaviors,
different from that in other countries of the world. The earliest outbreak of AIDS
was caused by intravenous drug users in China’s southwest border areas. Later, major
adjustments were made on the AIDS policy, such as the publicity of the prevention of
AIDS and the implementation of the “Four Frees and One Care” policy. Specifically,
the “Four Frees and One Care” policy refers to the implementation of free antiviral
treatment for AIDS-infected peasants and people with financial difficulties in towns
and cities, the implementation of free and anonymous blood tests in key areas of the
AIDS epidemic and free access to schooling of AIDS orphans, the implementation
of free AIDS counseling, screening and antiviral treatment for pregnant women in
the demonstration area of comprehensive AIDS prevention and control in hope of
reducing mother-to-child transmission. The policy also includes people living with
AIDS who are in financial difficulty into government assistance to give necessary
life relief and actively support them to participate in production activities.
The author’s bond with AIDS research dated back to 2007. In that year, the
author participated in qualitative and quantitative survey of the AIDS prevention
project sponsored by research institutes under International Labor Organization and

© Huazhong University of Science and Technology Press 2020 1

R. Hou, Self-restoration of People Living with HIV/AIDS in China,
https://doi.org/10.1007/978-981-15-7413-9_1
2 1 Introduction

Ministry of Human Resources and Social Security of the People’s Republic of China,
and met with so-called high-risk groups, such as female sex workers and male objects
(mainly miners in the southwest of China and truck drivers). Because at that time the
mainstream idea of AIDS prevention and treatment was individual practice showed
a significantly positive correlation with individual knowledge, attitude, and belief,
the author’s understanding of AIDS prevention remained at the level of improving
condom use and clearly distinguishing the infection pathways of AIDS. In 2009, when
the author participated in a survey of the survival status of infected persons initiated
by an organization for the infected, it was the first time that the author had met with
infected persons, including those infected through blood transfusion when having
an operation, children transmitted by their mothers, men or women infected through
sex. It was the first time that the author had known the presence of homosexuals
and the possible transmission through sex between them. At that time, there was a
general debate in society about the “nocence” and “innocence” of infected people.
Those who were infected with HIV through blood transfusion and mother were
often considered innocent; while those through improper sexual behaviors, drugs
injection or homosexuality were nocent, especially those through homosexuality
more discriminated against. The living conditions of infected people were much
worse in the past than they are now. There are still many difficulties in testing,
diagnosing, dispensing, treatment of opportunistic infections and other complicating
diseases, and medical insurance. Therefore, under the impetus of the international
community, domestic and foreign funds, and social forces, a large number of social
organizations has been set up dedicated to the involvement and intervention in the
treatment of infected people.
The reason why the author’s research can be started lies in strong assistance of
these non-governmental organizations. It is like key mediators, making the author
successfully find the infected and gain their trust in convenience of completing the
survey. At that time, the domestic academic circles showed enthusiasm about the
research on AIDS, but the focus was the prevention and treatment of AIDS. The
psychological problems of the infected have always been a phenomenon of almost
any discipline, including clinical medicine, public health, epidemiology, psychology,
sociology, social work and other disciplines, nevertheless it has never been a research
question, but a common sense. Compared with the severe AIDS epidemic, anxiety,
fear and worry for AIDS is ignored.
In 2013, when China’s economy continued to develop at a high speed, it was also
the last year of financial support to China by the international community and inter-
national non-governmental AIDS organizations. The final round of capital invest-
ment in China by The Global Fund to Fight Aids, Tuberculosis and Malaria and
China-Gates AIDS Project marked the end of the financial support. Worse, China’s
private organizations for the infected were facing many new problems. As one of
the evaluations of the China-Gates AIDS Project, we undertook a research project
on the support and care of infected people, and explored how relevant organizations,
including non-governmental organizations, can work together to care and help them.
It was based on this survey, jokingly called “eating, living and laboring together”,
that the author had a deeper understanding of infected people. Before getting along
1.1 Rationale for research on AIDS 3

with them, the author assumed that infected people in organization A should be
worried about the disease, be pessimistic, disappointed, and unwilling to contact
with others, and perhaps some of them would resent society. However, it could be
found in the process that they are far more optimistic than imagined, and full of
confidence in life. The author can always hear their exhortation: “Keep healthy. Now
many young people overwork to death, because they don’t care staying up. Instead,
we are now more concerned about our health than ever before.”
Once the organization has any activities, the infected people actively provide
mutual assistance and perform their respective roles to keep activities orderly. The
apartment provided by organization A for them looks like a warm home. Organiza-
tion A has a long history in city B and has been involved in the support and care
of infected people since its inception, but it belongs to non-governmental organiza-
tions, also known as grassroots organization. What makes the author most curious is
how such an organization, formed spontaneously by infected persons, survives for so
many years and obtains an excellent reputation. Most importantly, Special Hospital
for Infectious Diseases and Centers for Disease Prevention and Control at all levels
(hereinafter referred to as CDPC) are also very dependent on and trust the organiza-
tion. It improves not only the use of condoms among local AIDS population, but also
the initial screening rate, flow rate, detection rate and other epidemiological testing
data. It is because of its presence that the infected individual is no longer dispersed.
Many infected no longer need to solely bear the panic and helplessness caused by
infection. In their words, “we found a sense of belonging in the organization, which
can really bring us hope and change.” Their comment contains a high degree of
recognition of organization A by the infected.
A quantitative survey of the project demonstrates that the recognition of organi-
zations for the infected is stronger than that of medical staff CDPC workers. First
of all, because of the existence of organizations for the infected, everything has
changed from helping and supporting the infected, guiding them to see the doctor
to how to survive and live better. Members of these organizations, in addition to
several formal full-time staff, are mostly volunteers. They are far less professional
than medical workers in terms of the medical level; they are also inferior to profes-
sional social workers in terms of helping others. However, they play an important
role. China’s current social work is in the development period, so medical and mental
social workers, especially those involved in the AIDS population, are few. Further,
it is often difficult for professional social workers to have a comprehensive under-
standing of the infected person when they are engaged in matters related to the
infected person. Just as an infected person once pointed out: “In fact, you do not
understand my fear!” Such an assessment is a challenge to a professional social
worker in terms of its professionalism. Nevertheless, these infected people, with the
assistance of organizations, not only can face the fact of their own infection, but also
provide support and care for other newly diagnosed infected people to improve their
living and life status quo.
The author can’t help but ask, can a few talks, some medical information, a few
words of comfort, and empathy like “everyone is so”, “I understand your feelings”
work?
4 1 Introduction

In the AIDS prevention and control system, it has long been in the era of medical
hegemony, especially for AIDS people. They sincerely hope that the development
of medical technology can completely cure AIDS. However, this is bound to be a
long and arduous task. Because of this, we step into a de-medical way for AIDS
prevention and care from the perspective of social science. Although it has only just
started, much relevant research has emerged, such as supplying care for the infected
from aspects of social capital, social support, and social policy. Necessarily, there is
no shortage of attention to the psychology of infected people. But there is little deeper
understanding of it, just regarding it as anxiety, stress, fear and so on. It is the result
of disease and social factors, but there is often a lack of the voice of psychology,
especially psychoanalysis.
Even in case of psychoanalysis, previous research often emphasizes an outdated
libido theory, which is indeed a century-old misunderstanding of Freud and psycho-
analysis. Just as Mao Zedong thought was not the thought of Mao Zedong alone,
psychoanalysis was not created by Freud alone. As the chief architect of psycho-
analysis, Freud planned the blueprint for psychoanalysis. Since his creation, he had
experienced schools such as self-psychology, the psychology of object relations, the
psychoanalysis of self-psychology and relational psychoanalysis, and continued to
develop. In particular, the emergence of the relational psychoanalysis broadened our
vision of relation research. Although sociology and social work have never given up
on the study of relation, they have focused more on the macro aspects. Looking glass
self or generalized others are good cases in point.
Under the influence of the relational psychoanalysis, some questions are always
flashing in the author’s mind: whether the success of organization A is simply because
it provides some support and services, and a place to get together to communicate
with each other, Or is it due to the personal charisma of X (the head of organization
A)? These facilities and social support are easy to be provided, why in B City, with
the help of infected people, other organizations, including hospitals and CDC, can
not obtain such trust of infected people? More importantly, what allows infected
people to be so open to and optimistic about the severe AIDS?
It turned out to be “psychological motivation” and “psychotherapy” that allowed
infected people to gain a new life. Generally, HIV infection often means being on
the brink of death, and death goes hand in hand, a situation that coexists with death.
As many infected people believe, HIV infection is like being sentenced to death,
and perhaps the next stop is death. However, the intervention of organization A has
changed the passive situation of infected people in response to HIV, and infected
people have thus gained survival support and life care, gained psychological motiva-
tion to combat HIV. Consequently, negative emotions such as fear of HIV have been
soothed to achieve a self transition from disintegrating to restoration. In the process,
the intervention of organization A has played an important role in helping self-help
function, putting infected people on a healing path of “dying to live”.
This happens to be the basic connotation of the concept “helping profession”.
It is a system of knowledge and practice that contains a wide range of disciplines.
In human civilization, it is roughly similar to the proverb “God helps those who
help themselves”; while in modern society, it has gradually been replaced by social
1.1 Rationale for research on AIDS 5

support. “Self-help” is the ultimate goal of all these social support. We can use it
to express social workers’ understanding of the purpose of support. However, the
helping profession can even develop a system of discourse that requires the use of
hundreds of thousands of words to be clarified, such as the self psychology theory
of Kohut discussed in this book. In a word, “self-object” by Kohut, under the joint
treatment of helping professionals and objects, will not only form the synonym of the
concept of “self-help relationship”, but it will inevitably form a set of complicated
knowledge and practice.

1.2 Research Participants

Since the birth of mankind, disease has been like a shadow following a form. Health
and disease are a set of corresponding concepts that have not yet been fully and clearly
defined. In the authoritative teaching materials familiar to medical students in China,
disease refers to a regular process of injury and anti-injury caused by the interaction
between etiology and body under certain conditions. In cases of falling ill, a series of
changes of function, metabolism and morphological structure occur in the body, and
the coordination between the body and internal and external environment goes wrong.
Finally, different symptoms appear in the clinical performance, so that the body’s
mechanism to labor and adapt to environment reduces or loses. In short, disease is an
abnormal process of life activity in which the body is affected by etiological damage
under certain conditions and is disturbed by homeostasis. This concept attempts to
generalize the nature of the disease, and it changes with the increasing level of human
awareness of the disease and the development of the disease itself.
Diseases can be divided into infectious and non-infectious diseases, sudden
seizures of acute conditions that can be cured and chronic conditions that require
long-term medication, curable and incurable diseases, and so on. AIDS, for example,
is one of the more terrible conditions in human history. It is both an infectious and
currently incurable disease that requires lifelong medication due to autoimmune
dysfunction that can occur at any time with opportunistic infections. Those infected
do not die of AIDS per se, but from other diseases or complications caused by
opportunistic infections. We cannot equate its treatment with conventional diseases
in general from the outset. For people living with AIDS, we have no intention to
explore their pathology, because in any case, they are physically patients. People
turn pale at the mere mention of the incurable AIDS. In this situation, it is whimsical
to make the infected psychologically healthy and sound.
In the participation of the interview and the author’s observation, many people
lose sleep, have nightmares, find food tasteless and feel like dying when they get
the result of positive HIV test. They experience what all other diseases share, but
they also have an experience that other diseases have never had. However, they can
survive in such an environment, live well, and even take AIDS as a gift of life. Many
of them are gay, and there is such a strange presence in them. It is not discrimination
against them, but praise for them, who can combine so many stigma and illness,
6 1 Introduction

and live bravely and engage in all kinds of work. So, the author thinks that it is of
more significance to analyze their spirit and life. They are ordinary people, but so
strong to live, and live better. The most important part is to find mechanisms for their
active survival and life, especially from the psychological dynamics, to serve so many
people who are plagued by HIV. After all, there are too few people who can face
it frankly. The current AIDS prevention and control policy in China has provided a
certain guarantee for the medical treatment of AIDS people. Besides, various groups
of infected people all over the country are exploring the intervention. Nevertheless,
there are few theoretical studies on intervention and treatment to help them achieve
their self-restoration from the perspective of psychological dynamics, especially the
application of psychoanalysis. The folk intervention and the intervention practice
is a kind of personal experience, and often need theory guidance and experience
enhancement. Therefore, it is helpful exploring the psychological and self-restoration
mechanism of infected people to expand the application of theoretical research,
enhance the ability of intervention and support of civil organizations, enrich the
practical guidance for infected people, improve their life quality and survival status.
Unlike traditional professional psychoanalysis, this study does not focus on the
entire life experience of infected people, much less on the identity of their homosex-
uals, but on the changes brought about by HIV, as is the case with psychoanalysis clin-
ical work. Therefore, this study should be a psychoanalytically-informed research.
There is no doubt that the course of their lives has changed as a result of HIV infec-
tion. So, what makes them face this “gift of God”? What kind of psychological
motivation supports them and guides them? How do they go on to find, deconstruct,
and reconstruct themselves in this situation? These are the questions that need to be
solved in this study.
They acknowledge the medical “authenticity” of the disease, and also believe
that it has a richer spiritual meaning. For infected people, HIV is a powerful owner,
living in them, but also a loyal slave, which is a dialectical existence. The disease
destroys their immune system, thus making it impossible to resist the invasion of
other viruses and causing disease, which is medically referred to as opportunistic
infections. In particular, ordinary people rarely become ill due to diseases such as
Kaposi’s sarcoma, but it has a chilling manifestation of their complications. The
defects of the autoimmune system make the infected people often become ill, and
the effect of their treatment is not obvious. Therefore, they first have to face the fact
of HIV infection. Second, the infection of the disease is an infection through a “rela-
tionship”. In other words, the real impact of HIV is on the individual’s significant
other, who are most likely to be their loved ones or sexual partners and children.
Furthermore, after the infection, the first group to suffer from the disease is those
having the most intimate relationship with the infected person. Later, the most inti-
mate relationship gradually breaks out, accompanied by the discrimination and fear
of the common, and they gradually lose their various connections. They have to bear
the fear, worry and sadness caused by the virus alone.
Therefore, every infected person has the unconscious use of the disease. Its central
purpose is to solve the conflicting internal relations caused by AIDS, and to achieve
their own aspirations in an alternative form. Whenever and wherever they are, they
1.2 Research Participants 7

must face this truth and be encouraged to bear what they have done and all the
consequences.
This book focuses on the restoration of the AIDS population from the perspective
of relational theory. The reason why it is called self-restoration is somewhat hollow
for us to talk about life and death. This is not the case for people living with AIDS,
and since the diagnosis of the infection, death has followed them like a shadow. “You
may never know, the next stop is Death” (infected X). In the days near death, however,
many of them were reborn. The reason why it is called a relational perspective is that
every disease and every growth of an infected person means dealing with conflicts
with self and others (including HIV, doctors and case managers, etc.), especially with
the therapist in the interactive treatment, to obtain a perception of life and the self.
All must be based on a true understanding of AIDS. In the coexistence with HIV,
they experience the physical and mental development brought about by changes in
relations, and this will ultimately be beneficial.
This book attempts to analyze their “dying to live” intervention mechanisms,
to explore what kind of deconstruction and construction their hearts have really
experienced after they have been informed of the diagnosis, what is supporting them
to go down, to come out, and to go further; to try to discover and explain the healing, to
expect them to be able to reduce psychological stress. The book is more an attempt
to boost their lives and promote their positive optimism to “live to the successful
development of antiviral drugs” (infected X).

1.3 Research Methods

This study uses the in-depth interview method and the participation observation
method in the qualitative research so that the researcher can understand things from
a specific position, and can explore the so-called reality presented by the interaction
and construction between the individual and society. This study explores the “dying
to live” process of the AIDS population. It is the journey of the heart in the face of HIV
infection, it is also the existence and presentation of self and disease, relationship
between self and surrounding. It is the comprehensive performance of emotion,
cognition and behavior by a person in the very subjective situation. It is a subjective
experience and phenomenon that the individual and members of the organization for
the infected interact with and construct under the social context. It emphasizes the
communication between each other, and as a creative discovery of inter-subjectivity,
emphasizes subjective construction of the two parties.
Qualitative research has included ground theory, ethnography, narrative,
phenomenology, hermeneutics, action research and so on. Among them,
phenomenology is the basis of qualitative research, is also an important cornerstone
of the psychoanalysis of relational theory. It attaches importance to the existence
of human subjectivity and inter-subjectivity, and pay attention to the structure and
nature of the real experience of individuals. Therefore, the author, as a subjective
participant, understand the subjective intention of the survey participants in the joint
8 1 Introduction

construction with the researcher and constant self-reflection, and with a participatory,
equal interaction.
The author’s research content is the “dying to live” self-restoration mechanism
of AIDS population, so it will inevitably involve the infected person and the related
staff. Because of the discrimination brought about by AIDS, the infected people have
a certain degree of concealment and particularity. If there is no important insider’s
leadership and reference, it will be extremely difficult to find them. At the same
time, they distrust and reject “outsiders”, including doctors. The author must first
gain their trust if they are asked to cooperate. The author with the help of the founder
of A organization, X, contacts the organization of infected people. The author’s
help with the corresponding paperwork of A and some other help for A and infected
individuals make him obtain the trust of infected people. This is precisely in line with
the requirements of qualitative research and guarantees obtaining real and detailed
information.

1.3.1 Participant Selection

First, choose a successful organization. Since 2002, a large number of grassroots

organizations has been set up in China to combat AIDS, but their development and
their way of intervention are different. That organization A is chosen is because it
is the largest grassroots organization in City B, with a long time of establishment.
It has experienced two transformations, its ability to intervene infected people is
stronger, and the head of the organization is keen on relevant research. In addition,
the author has many good cooperation experiences with the organization, so it is
easy to make acquaintance and carry out work. Secondly, the author adopts a simple
and easy way to avoid causing unnecessary trouble to organization A and infected
individuals. Meanwhile, the author chooses the interviewee in line with the principle
of no harm but with benefits.
Based on this, the first chosen participant is X, the head of organization A. He had
been combating HIV for more than 10 years, during which he had been evicted from
his home by his parents for HIV infection. He had experienced three months of death
next to the morgue in YD hospital; and had experienced the physical and mental
suffering as a result of opportunistic infections; and had formed drug dependence
caused by worry and fear of trembling hands. With the support and care of health
workers, a trainer Y and many infected people, he eventually went from disintegrating
to restoring. He is still as healthy as ever, more frankly saying “to live to the successful
development of antiviral drugs”. X, from his own experience, puts forward the life
concept of “dying to live”, Together with Y, he establishes A organization, and puts
forward the intervention model of life support and survival care for the infected
people. In the struggle against AIDS, he not only changed his own destiny, but also
influenced the lives of others.
1.3 Research Methods 9

The second chosen participant is trainer, Y, who has many years of work experi-
ence in organization A. He is not the infected himself, but joins the care and inter-
vention of infected people from the very start. His first care object is X. Perhaps it
is on the basis of such an experience, more based on the identity of a non-infected
person, he has more time and energy to provide services to infected people. It also
breaks the cycle that non-infected people can’t really understand or support infected
people, and truly realize the way of support and care for infected people. Y has more
than 40 infected people to supply support and care. Different infected people have
different experiences, but Y has a considerable amount of work experience. They
have jointly explored a set of intervention model and personal perception accepted
by infected people.
The last interviewee selected was an infected Z. Z showed a positive reaction
in the initial sieve of organization A in March 2012, after which it was once out
of contact with X and A because of fear of AIDS. It was also because unbearable
physical and mental torture brought by AIDS, he chooses to suicide. After rescued,
he recognized the fact of his own HIV infection, but was pushbacked and refused to
have surgery. Eventually, under the guidance of X, the operation was successfully
carried out at YD Hospital. A professional relationship was established with X, and
the support and care of X was re-accepted. His current value of CD4, an important
immune cell in the body’s immune system, is maintained at around 540. He has
become a volunteer for organization A, supporting the care of five infected persons.
Additionally, the author observes as participants the daily work of organization A,
listening to their words and feeling their inner world in the participation.

1.3.2 Data Collection and Analysis

This study mainly uses two methods of interview and participant observation,
because they are more suitable for the interview object of this study (infected
person/organization leader). As mentioned earlier, because of the particularity of
the interviewees, only when trust and bond is established between the author and
them, can they reduce their defensive mind and open their hearts to talk about their
real situation and ideas. Interviews are semi-structured, and the outline of interviews
lists only the main aspects and scope of the survey. Interview is a process of discus-
sion, with the narration of interviewees as the center, accompanied by the author’s
inquiry. Because of the privacy involved in the interviewees, the author explains his
identity and the purpose of the investigation in detail to the interviewees, obtains
their orally informed consent and recording permission, and conducts interviews in
a separate enclosed room. After the interview, in order to express the gratitude to
the interviewees and compensation for the time taken, the author gave the gift as a
reward.
The participant observation refers to a method that the researcher direct observe
the subjects in the natural state and the organizational environment in which they are
located. It produces the most direct, specific and vivid perceptual cognition. In this
10 1 Introduction

study, the author conducted internship in A organization for one and half months,
and participates in their daily work, including many meetings, daily work assistance,
draft of relevant files, business in the street office and related departments and so
on. The observation and experience make me obtain detailed records of their living
conditions, organizational environment and their interaction, access to perceptual
information. And through listening, chatting and other ways, the author left a favor-
able impression on the interviewees in the organization. After returning to the place
of residence, the author quickly recorded the observed phenomena and personal
feelings, and collated the recordings.
Data are collected in a variety of ways, ranging from information obtained on
site through observation, records obtained through interviews, as well as some essay
thoughts and diaries, and other relevant information obtained on site. This requires the
classification, induction, comparison, collation, especially the individual collation of
their original words, and the establishment of archives for qualitative analysis. After
that, it is necessary to split many cases into different parts according to the needs of
research design, form concepts, make codes, and then find their internal relations,
sum up the corresponding common problems.
This study adopts QSR NVivo 8.0 to carry on the data analysis of the interview
data. NVivo is a qualitative analysis software developed by QSR and is currently
a generic version of 8.0. The full name of the software is NUDIST Vivo, of which
NUDIST is an abbreviation for Non-numerical Unstructured Data by Techniques of
Indexing Searching and Theorizing, meaning that it can be used as a non-numerical,
non-structural data indexing search system and auxiliary tools to assist shaping
theory. It is the international mainstream qualitative analysis software. The appli-
cation of auxiliary software can greatly shorten the research cycle of qualitative
research that needs to deal with a large number of raw materials, and help researchers
rapidly screen information and have effective thinking in the vast text.
This study uses in-depth interview and participant observation as research
methods, record a large number of interview content and feeling and thinking of
the field survey. Besides, the NVivo software can be used to organize the original
data, encode, decode and annotate the interview data and field notes on the basis of
the careful study of the interview data. Because the software combines the computer’s
powerful index search and assists in shaping theory, the author can at any time extract
and reorganize the data on demand, assist in the analysis of the hidden theoretical
model and the relationship between the data. Furthermore, NVivo combines many of
today’s emerging functions like hyper text, can integrate data such as Excel, Word,
and Adobe’s PDF into the system, making the data more diverse in how it behaves.
In addition, NVivo is also used in the literature review of this book. The coding of
different literature content can bring a unified extraction of similarities and differ-
ences between these documents, and can effectively improve the ability and efficiency
of induction and summary.
1.4 Research Ethics 11

1.4 Research Ethics

Internationally, the focus on research ethics in social surveys began in the mid-
twentieth century, with the “Tuskegee Syphilis Study” as a key event. Since 1932,
funded by the U.S. government, the Study has been tested, but not treated in black
people for more than 40 years of research. The experiment has made the US govern-
ment notorious and become a negative example in the history of medical ethics. Since
then, international attention has been paid to the study of ethical issues, in which
respect, benefit and fairness have been defined as three basic principles of research
ethics.
This is especially true of AIDS research. Regardless of the public’s fear of AIDS,
infected people often hide their true identity because of the stigma and infectivity of
AIDS. Many of them are at the bottom or margin of society. Their marginal status
and moral discrimination put them in a vulnerable position not only in society, but
also in the research. Therefore, in order to “protect themselves”, they show obvious
resistance to and perfunctory attitude towards any “survey”. This situation prompts
the author to keep an eye on and reflect on the research methods and the related
problems of research ethics when doing research.
This study focuses on the illness and emotional representation of the subjects after
infection, often involving many personal information of them. Although the name
of the infected person and other characteristics can be hidden in the writing of the
book, the infected people in the inner circle may often infer and speculate based on
their illness and personal performance, This can cause the infected person to worry
about the real statement. This also prompted the author to always think about how to
let infected people open their mouths in the process of interviewing, how to obtain
more real information, how to let infected people reduce the psychological burden,
how to implement confidentiality guidelines, and how to try to defuse the “privacy
barrier” in sociological survey.
These special factors also prompted the author to rely on his own strength, and
maintain interpersonal relationship through equal interaction and exchange with the
infected people. The introduction of key people helps the author enter the organi-
zation for the infected, and the process of eating, living, and working together wins
their trust. On the basis of equal exchange, the author relies on empathy to feel, to
understand the living conditions and emotional fluctuation of infected people, and
finally completes the collection of interview data, collation and analysis.

1.4.1 Informed Consent

Informed consent refers to the need for researchers to obtain the consent of the subject
or participant in any field of scientific research with human beings as subjects.
Specifically, when a potential subject or participant obtains all the necessary infor-
mation about the study and fully understands it, he or she voluntarily makes a decision
12 1 Introduction

on whether to participate in scientific research or whether to withdraw in the course

of scientific research without coercion, undue pressure and inducement.
In this study, at the beginning of the survey, the author explains in detail to the
subjects the main purpose and research methods of this study, so that they clearly
know the presentation of interview data in the book, as well as the right to request
changes in the way of research and withdrawal from research. In addition, the author
also presents to the infected person the research he has carried out and the ethics
education he has received and the observance of the research ethics, in order to
obtain the trust and attention of the infected person, so as to ensure the authenticity
of the data and the possible return visit. Because of the personal privacy involved
in infected persons, the study did not sign formal informed consent with them, but
took the form of orally informed consent, and stressed that infected persons could
interrupt interviews at any time.

1.4.2 No Harm but with Benefits

Because this study involves the personal experience and emotional changes of
infected people, it will not only occupy much time and energy of them, but also
may cause the infected people’s fear of exposure to identity. Therefore, the first and
fundamental “no harm” in this study is to keep confidential, that is, not to disclose the
information of the interviewees, including text description and recording materials.
In terms of text description, the author will not ask the name of the infected person
or illustrate the interviewee’s personal information, only in the form of DCYJ** on
behalf of the sequence of their interview. Because the interview needs to be recorded,
the author makes a recording with the permission of the infected person, and promises
that the recording material will only be used by the researcher and destroyed in time
after use (has now been destroyed).
In addition, the interview involves the personal life and emotional expression of
the infected person, and occupies a certain amount of time, therefore, this study also
embodies the principle of allowing the infected person to benefit from the survey.
In the course of interview, the author uses empathy to understand the emotional
experience of infected people, so that they feel the support and care of the author.
Apart from that, the author tries to exchange information and emotion with the
infected people, not only talking about “their world”, but also talking about “my
world”. It is the most basic interpersonal interaction guidelines instead of purely
asking infected people to cooperate. And after the interview, the author gives the
infected person a gift as a token of gratitude. The above principle of no harm but
with benefits can make infected people really feel the author’s concern for their lives
and respect for the value of life, and can also bring them a certain degree of return.
1.4 Research Ethics 13

1.4.3 Rigorous Survey

The study of social sciences should be accountable not only to the research partici-
pants surveyed, but also to other social science researchers. This study attaches great
importance to this principle in the course of interview, and strives to verify the accu-
racy of the data through various channels in case of discrepancy of information. The
data survey and analysis strictly abides by relevant norms. The personal informa-
tion of the infected person is blurred in the book, in order to prevent others’ guess
and speculation. The necessary technical treatment has been done for some of the
interview content and materials that have to be cited, and efforts have been made to
present the most complete and accurate information to the peers in the presentation
of the content of the study. In the author’s view, the accurate and true presentation of
survey data is not only the embodiment of the professional level of researchers, but
also the observance of academic norms and research ethics, moreover the expression
of the most sincere thanks to the infected people.

1.5 Theoretical Perspective

The above mentioned “communication between each other is also a kind of creative
discovery of inter-subjectivity, emphasizing the construction of the subject and his
counterpart”, is also called psychotherapy. It refers to psychological and physical
treatment methods with professional assistance. It usually requires the therapist to
interact with the client in a cooperative manner rather than in a general doctor-patient
relationship. This psychotherapy is intended for people with mental illness, mental
dysfunction and all those who feel psychologically painful and troubled. It is also
the connotation of psychotherapy in this book. The establishment of a unique inter-
personal relationship assists therapists to deal with psychological problems, reduce
subjective painful experience, cure mental illness and thus promote the individual’s
mental health and its growth and development.
Psychotherapy generally means the establishment of a treatment system based
on psychotherapy theory and related clinical research (mainly psychological coun-
seling, clinical psychology and psychiatry). It aims to establish relationship, dialogue,
communication, deep self-exploration, behavioural change and other skills to achieve
treatment goals, such as improving the mental health of recipients or reducing symp-
toms of mental illness. So far, psychotherapy has many different schools in contin-
uous development. Generally speaking, the mainstream hundreds of psychotherapy
methods have psychoanalysis (including Jung’s analytical psychology, Adler psycho-
analysis, dynamic orientation psychotherapy, psychoanalysis of object relation-
ship, psychoanalysis of self-psychological orientation, etc.), behavioral therapy,
cognitive behavior therapy, client-center treatment, group psychotherapy, Gestalt
therapy, psychological drama, language therapy, family therapy, sexual therapy and
art therapy. There is ambiguity about the division of methods between different
14 1 Introduction

schools, and even experienced therapists are unable to understand the treatment of
all schools. There is also no consistent classification in the famous psychiatric clas-
sics of the United States (Synopsis of Psychiatry) and the psychiatric textbooks of
Oxford Press in the UK. Therefore, this book also needs to make specific choices
about the psychotherapy that must be involved in the research action.
As mentioned above, psychotherapy used in this book is Kohut’s self-psychology
and its subsequent development, and it can be summarized as relational psychoana-
lytic therapy.
In this book, the psychological treatment of infected persons by organization A
is included in the intervention. It is one of the main actions of organization A. The
head of his organization, X, after contracting HIV, was once unable to work and
live properly because of stress and fear, and suffered severe anxiety, inability to fall
asleep, hands trembling and other symptoms, but also received medication from a
psychiatrist, thus formed a drug dependence. X later found that other infected people
are also faced with similar psychological conditions. In this case, the psychological
state of infected people should not be underestimated. Therefore, at the beginning
of its establishment, the organization has made it one of the main goals to improve
the psychological state of infected persons. X’s psychotherapy is a kind of trial and
test based on his own experience. Though lack of certain theoretical guidance, it
has achieved a certain therapeutic effect. In the intervention of organization A, most
infected people often have the same or similar experience, and are more spontaneous
in the use of empathy and emotional experience for treatment. By sharing their
experiences of seeking medical advice, they support each other and are treated with
each other. There is an interactive relationship between a trainer and an infected
person that is closely linked by infection. This approach is different from the common
abuse and misuse of empathy, is also indeed different from the traditional authoritative
treatment and the doctor-patient relationship.
The psychotherapy method in this study originated from Kohut, a famous Amer-
ican psychoanalyst, and followed the classical psychoanalysis. It was a unique
psychoanalysis study developed in the 1950s and the 1960s. Kohut was long been
engaged in the clinical treatment and research of narcissistic personality disorder,
and has systematically constructed his self psychology system on the basis of tradi-
tional psychoanalysis theory before his death. After his death, scholars has devel-
oped contemporary psychoanalysis schools on the basis of the original single theory,
internally including a variety of orientations. Over the past more than 30 years, self-
psychology has gone far beyond the single theoretical framework of Khut’s self-
psychology in theory, forming the main theoretical characteristics of pluralism, rela-
tionship and postmodernism. Therefore, it has converged with other similar schools,
forming relational psychoanalytic therapy.
In theory, the book still focuses on the new exploration of psychoanalysis method-
ology by self-psychology, puts forward a new interpretation of self and his or her own
experience, and introduces a moderately new point of view in the research practice.
In practice, the treatment will be more directed to mental illness and mental health,
hoping to expand the treatment scope and treatment content of self-psychology. This
treatment practice is mainly embodied in: Based on the inter-subjectivity of analyst
1.5 Theoretical Perspective 15

and patient, the analyst carries out the treatment with analytical interpretation. In the
treatment of sexual psychological problems, this book discusses the key concepts of
Kohut’s theory, that is, the relationship between the failure of self-object and gender
identity, the problem of libido, gender trauma and self-pathology, and the influence of
analyst’s gender on treatment through psychoanalysis. In the case of gay therapy, this
book probes into the gender identity of homosexuality, the significance of gender to
homosexuality, the problem of lesbian homosexuality, and the twinship transference
of homosexuality. In the treatment of addiction problem, the author puts forward
the unique treatment concept and method by using the theory of inter-subjectivity.
In the treatment of suicide, this book puts forward a new concept of narcissistic
suicide, probes into the relationship between suicide and traumatic idealization, the
relationship between efficacy and suicide treatment. In the aspect of grief treatment,
the author puts forward a brand-new theoretical model of clinical grief treatment. In
psychiatric treatment, the book probes into the relationship between psychosis and
the failure of individual cognitive development, and puts forward the basic framework
of mutual psychiatric treatment, and so on.
So far, however, few theories of self-psychology have been applied to the practical
guidance of infected people, so this book attempts to expand its application areas in
order to better guide practice.
Whether the academic community or the public first consider the cure of the AIDS
population medicine, then comes its way of infection. Academia may pay attention
to the social relations of infected people, such as discrimination, social support and
social capital. Besides, the public’s understanding of the psychology of infected
people is based on common sense, only knowing that they will have concerns about
disease, fear of death, anxiety about treatment and so on. The existing psychology
related research is more focused on the living conditions of AIDS people.
Due to psychological problems, AIDS people’s quality of life is significantly
lower than ordinary people. They are often worried about the onset of disease, fear
of exposure, medical rejection, afraid to seek employment, no money to see a doctor,
family do not accept, dare not inform their partner, do not know when to start taking
medication, because side effects are too big and self-stop, There is no place to live,
be ostracized by neighborhood friends and relatives, look down on themselves, self-
isolation, do not know where the future, want to commit suicide can not find a way,
want to live and can not find a reason, want to cooperate with the treatment but can
not swallow pills and other predicament.
For their concerns and psychological problems caused by HIV infection, the
corresponding intervention measures are nothing more than providing some psycho-
logical support and psychological counseling. In serious cases, they will take some
drugs for treatment prescribed by psychiatrists. Few research focuses on the process
from knowing being infected to facing the fact and the changing course of their own
experience from the perspective of psychoanalysis. Among many current theories
of psychotherapy and psychological counseling, this book, from the perspective of
relational theory, guided by self-psychology and its development, attempts to analyze
the process of infected people facing HIV from their own disintegration to their own
reconstruction, and gain the confidence and courage to stand up again. “Although
16 1 Introduction

the HIV virus can not be killed by drugs at this time, I can obtain a new life in the
symbiosis with HIV, and wait for the good news of medical cure in the process of
helping others and self-help” (infected X), to achieve the self-restoration of the AIDS
population.
However, the existing research at home and abroad does not specifically include
the psychological problems of infected people in the treatment scope of self-
psychology. Analyzing the infected person himself or herself from the angle of
self-psychology is still in a relatively blank state at present. It is proved that self-
psychology broke through the so-called “non-analytical” possibility at the beginning.
The initial treatment of narcissistic patients is extended to the current various fields.
In particular, George Hagman’s theoretical model on grief divides the grief process
into five stages of the shock stage, the search stage, the psychological disintegration,
the psychological reorganization and the new identity. It provides guidance for the
self-restoration of the AIDS population.
AIDS is currently incurable and infectious. After diagnosis, the infected person
is faced with a confrontation with the disease (virus) and the loss of the relationship
caused by its infection, including, of course, psychological relations. Since 2007, the
author has been in contact with infected people. Whenever mentioning the first time
to know HIV infection, they are often in a state of shock, suspicion and numbness.
The first thing that an infected person thinks about is that AIDS is incurable, that he
will soon die, and that he will die in pain. Even by taking antiviral drugs, their life
can only be extended for a period of time, unable to achieve the effect of a complete
cure. They will be burdened with all kinds of stress. At this stage, these thoughts
flashed quickly through my mind: “I was like thunderbolt, my mind is blank about
how I can be infected, how I can be contracted, who passed it to me, I am about to
die, and will die badly?” (infected X). They experience a sense of helplessness that
is dominated by anxiety, worry, and fear. AIDS patients often show doubts about
the test results and “Why me” questions, can not calmly face and accept the reality,
but have a little fluke, such as whether it is the hospital testing went wrong. “I’ve
looked at the test sheet several times, including the name and the positive reaction,
and you know, it’s not a joke,” he thought. Later, I went to the provincial CDC (then
called Epidemic Prevention Station) to re-examine” (infected X). In general, many
infected people have not yet become ill at this time, only the carriers of HIV. They
often have an illusion to rely on their own efforts to deal with HIV. They understand
that AIDS is an disease resulting from immune dysfunction, and look forward to
combating HIV by their own efforts, such as strengthening exercise, taking health
care drugs to improve immunity, go on dieting. Of course, because the HIV virus
also has self incubation period, plus the efforts of infected people, they have received
a certain level. However, when the number of CD4 in an infected person drops to
a certain extent, opportunistic infections are often concurrent. At this time, infected
people not only bear the inner fear, but also experience the impact of failure of
their own efforts and unsatisfaction of self-object needs. Coupled with the pain of
opportunistic infection, it often leads to the instability of their own experience and
eventually fragmentation.
1.5 Theoretical Perspective 17

Self fragmentation refers to the feeling of “I’m going to fall apart” that everyone
experiences at some point in their lives. In his writings and published articles (1959,
1966, 1971, 1977, 1984), Kohut clarified the anxiety, shock, and immobile fragmen-
tation that can occur to individuals in any situation based on the clinical experience.
Although Kohut’s self and self-object are mainly used for people with psychological
defects, Kohut has also suggested that they accompany the individual a whole life.
Here, the author does not think that all people living with AIDS have psychological
pathology, admittedly, many of them have some anxiety about HIV infection. As
Kohut points out, the specific experience of personality is falling on a spectrum,
and anxiety and worry, a point in the spectrum, will change with a variety of stress
situations. Self and self-object will also change in this process, thus affecting the
development of the individual. Therefore, this book tries to use self-psychology and
the development of its successors as the theoretical focus, the orientation of rela-
tional theory as the therapeutic framework, self and self-object as the explanatory
items of psychological motivation, in the relationship between analyst and analysand,
paying attention to how infected people with the help of infected organizations face
difficulties together, solve problems, get rid of troubles, complete their own process
from fragmentation to restoration, and realize the cure of “relational theory” and
“self-psychology”, after facing their own fragmentation.
Chapter 2
Governance of AIDS and Actions Taken

2.1 Outbreak of AIDS

AIDS, known as the most serious public health problem in the twentieth century,
is also named the “Black Death of the twentieth century”, because of its infectious
and high fatality rate. The epidemic has been extended to the twenty-first century,
and there is no trend of slowing down. AIDS, short for Acquired Immune Deficiency
Syndrome, is caused by retrovirus infection of human immunodeficiency virus (HIV).
It infects human immune system cells, destroying or damaging its function. There are
no symptoms in the early stages of infection. But, as infections develop, the immune
system begins to weaken, and infected people are more likely to suffer from so-
called opportunistic infections. It shows a comprehensive condition that contributes
to a variety of clinical symptoms, rather than a mere disease.
Because the HIV virus itself is very small, the existing testing methods do not
determine the presence of HIV. Only after the human body is infected with HIV for a
period of time, the blood will produce the corresponding HIV antibody. At this time
the test will show what we call a positive reaction. However, the time at which individ-
uals produce antibodies varies from person to person and is generally considered to
be 6–12 weeks after infection, with the longest clinical report being 12 months. This
period is often referred to as the window period. But as the test approach progresses,
the window period has now been shortened to 1–2 weeks. Unlike other viruses, HIV
infection does not immediately lead to a clinically symptomatic response. On the
contrary, it has an incubation period in the human body, as fast as half a year and as
slow as more than 10 years.
When an individual is still in its incubation period, it is traditionally referred to
as an infected person or a carrier living with HIV. In the event of an opportunistic
infection, or according to medical diagnostic criteria, such as the CD4 (an important
immune cell in the body’s immune system) of an infected person less than 350, it is
recommended to take antiviral drugs.
The vitality of HIV virus is relatively fragile, so it will die when exposed to air
for a few minutes. Its transmission pathway is mainly through direct contact with

© Huazhong University of Science and Technology Press 2020 19

R. Hou, Self-restoration of People Living with HIV/AIDS in China,
https://doi.org/10.1007/978-981-15-7413-9_2
20 2 Governance of AIDS and Actions Taken

mucosal tissue of the mouth, genitals, anus, etc. or with the virus of blood, semen,
vaginal secretion, breast milk. Therefore, all kinds of sexual behavior, blood trans-
fusion, shared needles, drug intravenous injection are known routes of transmission.
In addition, there is a risk of cross-infection of the virus, if the medical device is not
thoroughly disinfected in all traumatic medical examinations, such as colonoscopy
and gastroscopy, tooth washing and fillings.
The world’s first report on AIDS appeared in the United States. In June 1981,
the U.S. Center for Disease Control and Prevention reported the world’s first case of
HIV infection. Because the infected person is a gay man, AIDS has been regarded
as a disease of homosexuals, especially gay men, in the many years that followed.
Homosexuality is even equated with AIDS. Since the discovery of AIDS, human
beings have begun to fight against AIDS. However, early medicine is often helpless
to AIDS, so that many infected people suffer from pain and death. AIDS has been
overshadowed by a layer of terror. It was not until 1996, when Dr. David Ho, a Chinese
American scientist, pioneered cocktail therapy to effectively control the replication
of HIV in the body, delaying the onset of most infected people and beginning to
significantly reduce their mortality rate. But today, scientists around the world are
still conducting much research and many clinical experiments, hoping to find a cure
as soon as possible.
However, since its diagnosis, AIDS has not only been a disease problem. In the
past more than 30 years, it has killed tens of millions of people. According to a 2016
report by the United Nations Programme on HIV/AIDS, UNAIDS, the number of
people living with HIV worldwide was 36.7 million (30.8–42.90 million), of which
34.5 million (28.8–40.2 million) adults and 2.1 million (1.7–2.6 million) children
(younger than 15 years of age). Only in 2016, 1.8 million (1.6–2.1 million) of new
infections were added. Today, AIDS has become a worldwide problem, not only
bringing pain, fear and even death for the infected themselves, but also seriously
affecting the stability of the country and economic and social development. What is
more, nearly half of the infected people do not know they are ill or refuse to check
because of their own window period, incubation period and social stigmatization.
All exacerbates the risk of HIV transmission. In addition, HIV is spreading to the
general population through sexual transmission by people with high-risk behaviours
(gay men, co-needles, sex workers and clients), and the rate of sexually transmitted
infections between the same gender is increasing at a significant rate.
Unlike ordinary diseases, AIDS cannot be cured only through research in the
field of medicine or biology. Because of the spread of HIV through blood, sex and
other means and the stigma associated with it since its birth, AIDS has been more
manifested as a serious social problem. Today, the spread of AIDS in China has been
spread from high-risk groups to the general population. People become jittery at the
mere mention of AIDS in society. This is not because AIDS is incurable, and it alone
is not fatal, and effective control of HIV can be achieved through the continuous use
of antiviral drugs. In terms of its infectivity alone, HIV will die in the air for a few
seconds to a few minutes, and its transmission pathway is limited to few transmission
methods, such as blood and body fluids, which are simply less contagious than SARS
virus, hepatitis virus, tuberculosis virus and many other viruses. However, AIDS has
Another random document with
no related content on Scribd:
Henry Hotspur, in whose behalfe this may be sayd as followeth.”]
[556]
 How Henry Percy Earle of
Northumberland, was for his couetous
and trayterous attempt put to death at
Yorke, Anno 1407.[557]
1.

O morall Senec, true finde I thy saying,

That neither kinne,[558] riches, strength, or fauour,
Are free from fortune, but are aye decaying:
No worldly welth is ought saue doubtfull labour,
Man’s life in earth is like vnto a tabour,
Which nowe to myrth doth mildly men prouoke
And straight to warre, with a more sturdy stroke.

2.

All this full true I Percy finde by proofe,

Which whilom was earle of Northumberland:
And therefore, Baldwine, for my pier’s[559] behoofe,
To note men’s falles sith thou hast tane in hand,
I would thou should my state well vnderstand:
For fewe kinges were more than I redouted,[560]
Whom double fortune lifted vp and louted.

3.

As for my kinne their noblenesse is knowen,

My valiaunt acts were[561] folly for to prayse,
Where through the Scots[562] so oft were ouerthrowen,
That who but I was doubted in my dayes:
And that king Richarde found at all assayes,
For neuer Scots[563] rebelled in his raigne,
But through my force were eyther caught or slayne.

4.

A brother I had was earle of Worcester,

Alwayes in office and fauour[564] with the king,
And by my wife dame Elinor Mortimer,
A sonne I had[565] which so the Scots[566] did sting,
That being yong, and but a very spring,
Henry Hotspur they gaue him vnto name,[567]
And though I say it, hee did deserue the same.

5.

Wee three triumphed in king Richard’s time,

Till fortune ought both him and vs a spite:
But chiefly mee, whome clerely from[568] any crime,
My king did banishe from his fauour quite,
Proclayming mee a trayterous knight:[569]
Where through false slaunder forced mee to bee,
That which before I did most deadly flee.

6.

Let men beware how they true folke defame,

Or threaten on them the blame of vices nought,
For infamy breedeth wrath, wreke followeth shame:
Eke open slannder often times hath brought
That to effect, that erst was neuer thought:
To bee misdeemed men suffer in a sort,
But none can beare the griefe of misreport.

7.
Because my king did shame mee wrongfully,
I hated him and in deede[570] became his foe:
And while hee did at warre in Ireland lye,
I did conspire to turne his weale to woe:
And through the duke of Yorke and other moe,
All royall power from him wee quickely tooke,
And gaue the same to Henry Bolenbroke.

8.

Neither did wee this onely[571] for this cause,

But to say truth, force draue vs to the same:
For hee despising God and all his lawes,
Slewe whome hee would, made sinne a very game:
And seeing neyther age[572] nor counsaile could him
tame,
Wee thought it well done for the kingdome’s sake,
To leaue his rule, that did all rule forsake.

9.

But when sir Henry had attaynde his place,

Hee strayght became in all poynts worse then hee,
Destroyed the peeres, and slewe king Richard’s grace,
Against his othe made to the lordes and mee:
And seeking quarels how to disagree,
Hee shamelesly required mee and my sonne,
To yeelde hym Scots[573] which wee in fielde had
wonne.

10.

My nephue also Edmund Mortimer,

The very heyre apparant to the crowne,
Whome Owen Glendour held as prisoner,
Vilely bound[574] in dungeon deepe cast downe,
Hee would not raunsome, but did felly frowne
 Against my brother and mee,[575] which[576] for him
spake,
And him proclaymed traytour for our sake.

11.

This foule despite did cause vs to conspire,

To put him downe as wee did Richard erst,
And that wee might this matter set on fire,
From Owen’s jaile, our coosin wee remerst,
And vnto Glendour all our griefes reherst,
Who made a bond with Mortimer and mee,
To priue the king and part the realme in three.

12.

But when king Henry heard of this deuise,

Toward[577] Owen Glendour hee sped him very quicke,
Mynding by force to stop hur[578] enterprise:
And as the deuill would, than fell I sicke,
Howbeit my brother, and sonne, more polliticke
Than prosperous, with an hoast from Scotland brought,
Encountred him at Shrewesbury, where they fought.

13.

The one was tane and kild, the other slayne,

And shortly after was Owen put to flight,
By meanes whereof I forced was to fayne,
That I knewe nothing of the former fight:
Fraude oft auayles more then doth sturdy might,
For by my faining I brought him in beliefe,
I knewe not that wherein my part was chiefe.

14.

And while the king thus tooke mee for his frend,
I sought all meane my former wrong to wreake,
Which that I might bring to the sooner end,
To the bishop of Yorke I did the matter breake,
And to th’earle marshall likewise did I speake,
Whose father was through Henrie’s cause exiled,
The bishop’s brother with trayterous death defiled.

15.

These strayt assented to doe what they could,

So did the lord Hastings and lord Fauconbridge:
Which altogether promised they would
Set all their power the king’s dayes to abridge:
But see the spite, before the byrdes were flydge
The king had word and seasoned[579] on the nest,
Whereby, alas, my freendes were all opprest.

16.

The bloudy tyrant brought them all to end

Excepted mee, which into Scotland scapt,[580]
To George of Dunbar th’earle of March, my frend,
Who in my cause all that hee could ey scrapt:
And when I had for greater succour gapt,[581]
Both at the Frenchmen and the Fleming’s hand,
And could get none, I tooke such as I fand.

17.

And with the helpe of George my very frend,

I did enuade Northumberland full bolde,
Whereas the folke drewe to mee still on end,[582]
Bent to death my party to vpholde:
Through helpe of these, full many a fort and holde,
The which the king right manfully had mand,
I easely wonne, and seised in my hand.

18.
Not so content (for vengeaunce draue mee on)
I entred Yorkeshire, there to wast and spoile:
But ere I had far in the countrye gone,
The shiriffe thereof, Rafe Rokesby did assoyle
My trobled hoast of much part of our toyle:
For hee assaulting freshly tooke through power,
Mee and lord Bardolph both, at Bramham More.

19.

And thence conueyed vs to the towne of Yorke,

Untill hee knewe what was the kinge’s entent:[583]
There loe lord Bardolph kinder than the storke,
Did lose his head, which was to London sent,
With whome for friendship mine in like case went,
This was my hap my fortune or my faute,
This life I led and thus I came to naught.

20.

Wherefore, good Baldwine, will the peeres take heede,

Of slaunder, malice, and conspiracy,
Of couetise, whence all the rest proceede,
For couetise ioynt with contumacy,
Doth cause all mischiefe in men’s hartes to breede:
And therefore this to esperance my word,
Who causeth bloudshed shall not escape[584] the
sword.[585]
 [By that this was ended, I had found out the story of Richard earle
of Cambridge: and because it contained matter in it, though not very
notable, yet for the better vnderstanding of the rest, I thought it
meete to touch it, and therefore saide as followeth: “You haue saide
well of the Percies and fauourably; for in deede, as it should
appeare, the chiefe cause of their conspiracy against king Henry,
was for Edmund Mortimer their cousin’s sake, whome the king very
maliciously proclaymed to haue yeelded him selfe to Owen
coulourably, when, as in deede, hee was taken forcibly against his
will and very cruelly ordered in prison. And seeing wee are in hand
with Mortimer’s matter, I will take vpon mee the person of Richard
Plantagenet, earle of Cambridge, who for his sake likewise died. And
therefore I let passe Edmund Holland, earle of Kent, whome Henry
the fourth made admirall to scoure the seas, because the Britayns
were abroad. Which earle (as many thinges happen in war) was
slaine with an arrowe at the assaulte of Briacke:[586] shortly after
whose death this king died, and his sonne Henry the fift of that
name, succeded in his place. In the beginning of this Henry the fifte’s
raigne, died this Richard, and with him Henry the lord Scrope and
other, in whose behalfe this may bee saide.”]
How Richard Plantagenet[587] Earle of
Cambridge entending the king’s
destruction, was put to death at
Southamton, Anno Dom. 1415.[588]
1.

Haste maketh waste, hath commonly ben sayd,

And secrete mischiefe seelde hath lucky speede:
A murdering minde with proper poyze is wayd,
All this is[589] true, I finde it in[590] my creede:
And therefore, Baldwine, warne all states take heede,
How they conspire any other to betrappe,
Least mischiefe ment, light in the miner’s lappe.[591]

2.

For I lord Richard, heyre Plantagenet,

Was earle of Cambridge and right fortunate,
If I had had the grace my wit to set,
To haue content mee with mine owne estate:
But, O, false honours, breeders of debate,
The loue of you our lewde hartes doth[592] allure,
To leese our selues by seeking you vnsure.

3.

Because my brother Edmund Mortimer,

Whose eldest sister was my wedded wife,
I meane that Edmund that was prisoner
In Walles so long, through Owen’s busie strife,
Because I say that after Edmunde’s life,
His rightes and titles must by lawe bee mine,
For hee ne had, nor could encrease his line.

4.

Because the right of realme and crowne was ours,

I searched meanes to helpe him thereunto:
And where the Henries held it by theyr powres,
I sought a shift their tenures to vndoe,
Which being force, sith force or sleight must doe,
I voide of might, because their powre was strong,
Set priuy sleight against their open wrong.

5.

But sith the death of most part of my kin

Did dashe my hope, through out the father’s dayes
I let it slip, and thought it best begin,
Whan as the sonne should dred least such assaies:
For force through spede, sleight speedeth through
delayes,
And seeld doth treason time so fitly finde,
As whan all daungers most bee out of minde.

6.

Wherefore while Henry, of that name the fifte,

Prepard his army to goe conquere Fraunce,
Lord Scroope and I thought to attempt a drift
To put him downe, my brother to auaunce:
But were it[593] God’s will, my lucke, or his good chaunce
The king wist wholly where about wee went
The night before to shipward hee him bent.

7.

Then were wee straight as traytours apprehended,

Our purpose spied, the cause thereof was hid,
And therefore, loe a false cause wee pretended,
Where through my brother was fro daunger rid:
Wee sayd, for hire of[594] French kinge’s coyne wee did
Behight to kill the king: and thus with shame
Wee staind our selues, to saue our frend fro blame.
[595]

8.

When wee had thus confest so foule a treason,

That wee deserued, wee suffered by the lawe:
See, Baldwine, see, and note (as it is reason)
How wicked deedes to woefull endes doe drawe:
All force doth faile, no craft is worth a strawe
To attayne thinges lost, and therefore let them goe,
For might ruleth[596] right, and will though truth[597] say
no.[598]
 [Whan stout Richarde had stoutely sayd his minde: “Belike,”
sayd[599] one, “this Richard was but a litle man, or els litle fauoured
of the[600] writers, for our cronicles speake very litle of him. But
seeing wee be come nowe to king Henrie’s voyage into Fraunce, we
cannot lacke valiaunt men to speake of, for among so many as were
led and sent by the king out of this realme thyther, it cannot be
chosen but some, and that a great somme were slayne among them:
wherefore to speake of them all, I thinke not needefull. And therefore
to let passe Edwarde duke of Yorke, and the earle of Suffolke,
slayne both at the battayl of Agïncourt, as were also many other, let
vs end the time of Henry the fift, and come to his sonne Henry the
sixt: whose nonage brought Fraunce and Normandy out of bondage,
and was cause that so[601] few of our noble men died aged: of
whome to let passe the nombre, I will take vpon mee the person of
Thomas Montague, earle of Salisbury, whose name was not so good
at home (and yet hee was called the good earle) as it was dreadful
abroade: who exclayming vpon the mutability of fortune may iustly
say[602] in maner as followeth.”]
 How Thomas Montague Earle[603] of
Salisbury in the middest of his glory,
was chaunceably slayne at
Orleaunce[604] with a piece of
ordinaunce, the 3. of Nouember, Anno
1428.[605]
1.

What fooles bee we to trust vnto our strength,

Our wit, our courage, or our noble fame,
Which time it selfe must nedes deuour at length,
Though froward fortune could not foile the same:
But seeing this goddesse guideth all the game,
Which still to chaunge doth set her onely lust,
Why toyle wee so for thinges so harde to trust?

2.

A goodly thing it is, surely, good report,[606]

Which noble hartes doe seeke by course of kinde:
But seeing[607] the date so doubtfull and so short,
The way so rough whereby wee doe it finde,
I cannot choose but prayse the princely minde
That preaseth for it, though wee finde opprest,
By foule defame, those that deserue it best.

3.
Concerning whome, marke, Baldwine, what I say,
I meane the vertuous, hindred of their brute,
Among which nombre reckon well I may
My valiaunt father Iohn lord Montacute,
Who lost his life I iudge through[608] iust pursute:
I say the cause and not the casuall speede
Is to be wayed, in euery kinde of deede.

4.

This rule obserued, how many shall wee finde

For vertue’s sake with infamy opprest?
How many[609] againe, through helpe of fortune blinde,
For ill attemptes atchieued, with honour blest?
Successe is worst oftimes whan cause is best:
Therefore, say I, God send them sory haps,
That iudge the causes by their afterclaps.

5.

The end in deede is iudge of euery thing,

Which is the cause or latter poynt of time:
The first true verdict at the first may bring,
The last is slow, or slipper as the slime,
Oft chaunging names of innocence and crime:
Duke Thomas’ death was justice two yeares long,
And euer since, sore tyranny and wrong.

6.

Wherefore, I pray thee, Baldwine, way the cause,

And prayse my father as hee doth deserue?
Because earle Henry, king agaynst all lawes,
Endeuoured king Richard for to starue
In iayle, whereby the regall crowne might swarue
Out of the line to which it than was due,
(Whereby God knowes what euill might ensue.)
 7.

My lord Iohn Holland, duke of Excester,

Which was deare cosin to this wretched king,
Did moue my father, and the earle[610] of Glocester,
With other lordes to ponder well the thing:
Who seeing the mischiefe that began to spring,
Did all consent this Henry to depose,
And to restore king Richard to the rose.

8.

And while they did deuise a prety trayne,

Whereby to bring their purpose better[611] about,
Which was in maske this Henry to haue slaine,
The duke of Aumerle blew their counsaile out:
Yet was their purpose good there is no doubt:
What cause can bee more worthy for a knight,
Than saue his king, and helpe true heyres to right?

9.

For this with them my father was destroyde,

And buried in the dunghill of defame:
Thus euill chaunce their glory did auoide,
Whereas theyr cause doth claime eternall fame:
Whan deedes therefore vnluckely doe frame,
Men ought not iudge the aucthors to bee naught,
For right through might is often oueraught.

10.

And God doth suffer that it should bee so,

But why, my wit is feeble to decise,
Except it bee to heape vp wrath[612] and wo
On wicked heades that iniuries deuise:
The cause why mischiefes many times arise,
 And light on them that would men’s wronges redresse,
Is for the rancour that they beare, I gesse.

11.

God hates[613] rigour though it furder right,

For sinne is sinne, how euer it bee vsed:
And therefore suffereth shame and death to light,
To punishe vice, though it bee well abused:
Who furdereth right is not thereby excused,
If through the same hee doe some other wrong:
To euery vice due guerdon doth belong.

12.

What preach I now, I am a man of warre,

And that my body[614] I dare say doth professe,
Of cured woundes beset with many a skarre,
My broken jaw vnheald can say no lesse:
O fortune, fortune, cause of all distresse,
My father had great cause thy fraud to curse
But much more I, abused ten times worse.

13.

Thou neuer flatteredst him in all thy[615] life,

But mee thou dandledst like thy[616] darling deare:
Thy giftes I found in euery corner rife,
Where euer[617] I went I met thy smiling cheare:
Which was not for a day or for a yeare,
But through the raygne of three right worthy kinges,
I found thee forward in all kinde of thinges.

14.

The while king Henry conquered in Fraunce

I sued the warres and still found victory,
In all assaultes, so happy was my chaunce,
Holdes yeelde or won did make my enemies sory:
Dame Prudence eke augmented so my glory,
That in all treaties euer I was one,
Whan weyghty matters were agreed vpon.

15.

But when this king this mighty conquerour,

Through death vnripe was both his realmes bereft,
His seely infant did receiue his power,
Poore litle babe full yong in cradell left,
Where crowne and scepter hurt him with the heft,
Whose worthy vncles had the gouernaunce,
The one at home, the other abroad in Fraunce.

16.

And I which was in peace and warre well skilled,[618]

With both these rulers greately was esteemed:
Bare rule at home as often as they willed,
And fought in Fraunce whan they it needefull deemed,
And euery where so good my seruice seemed,
That English men to mee great loue did beare,
Our foes the French, my force fulfilled with feare.

17.

I alwayes thought it fitly for a prince,

And such as haue the regiment of realmes,
His subiecte’s hartes with mildnes to conuince,
With justice mixt, auoyding all extreames:
For like as Phœbus with his cherefull beames,
Doth freshly force the fragrant flowres to florish,
So ruler’s mildnes subiect’s loue doth norish.[619]

18.
This found I true: for through my milde behauiour,
Their hartes I had with mee to liue and die,
And in their speach bewrayer of[620] theyr fauour,
They cald mee still good earle of Salisbury,[621]
The lordes confest the[622] commons did not lye:
For vertuous life, free hart, and lowly minde,
With high and lowe shall alwayes fauour finde.

19.

Which vertues chiefe become a man of warre,

Whereof in Fraunce I found experience:
For in assautes due mildnes passeth farre
All rigour, force, and sturdy violence:
For men will stoutly sticke to their defence,
When cruell captaines couet after spoile,[623]
And so enforst, oft geue theyr foes the foile.

20.

But when they knowe they shal be frendly vsed,

They hazard not their heades but rather yeelde:
For this my offers neuer were refused
Of any towne, or surely very seelde:
But force and furies fyt bee for the fielde,
And there in deede I vsed so the same,
My foes would flye if they but[624] heard my name.

21.

For whan lord Steward and earle Vantadore

Had cruelly besieged Crauant towne,
Which we[625] had wonne, and kept long time before
Which lieth in Awxer on the riuer Youne,
To raise the siege the regent sent mee downe:[626]
Where, as I vsed all rigour that I might,
I killed all that were not saued by flight.
 22.

When th’erle of Bedford, then in Fraunce lord regent,

Knewe in what sort I had remoued the siege,[627]
In Brye and Champayne hee made mee vicegerent,
And lieutenaunt for him and for my liege:
Which caused mee to goe[628] to Brye, and there besiege
Mountaguillon with twenty weekes assaut,
Which at the last was yeelded mee for naught.[629]

23.

And for the duke of Britayne’s brother, Arthur,

Both earle of Richmond and of Yuery,
Against his oth from vs had made departure,
To Charles the Dolphin our chiefe enemy,
I with the regent went to Normandy,
To take his towne of Yuery which of spight,
Did to vs daily all the harme they might.

24.

They at the first compounded by a day

To yeelde, if rescues did not come before,
And while in hope to fight, wee at it lay,
The dolphin gathered men two thousand score,
With earles, lordes,[630] and captaynes ioly store:
Of which the duke of Alanson was guide,
And sent them downe to see if wee would bide.

25.

But they left vs, and downe to Vernoyle went,

And made their vaunt they had our army slayne,
And through that lye, that towne from vs they hent,
Which shortly after turned to their payne:
For there both armies met vpon the plaine:
 And wee eight thousand, whom they [flew, not] slew
before,
Did kill of them, ten thousand men and more.

26.

When wee had taken Vernoyle thus againe,

To driue the Dolphin vtterly out of Fraunce,[631]
The regent sent mee to Aniovy[632] and to Mayne,
Where I besieged the warlike towne of Mawns:
There lord of Toyser’s, Baldwin’s valiaunce
Did well appeare, which would not yeelde the towne,
Till all the towres and walles were battered downe.

27.

But here now, Baldwine, take it in good part,

Though that I brought this Baldwine there to yeelde,
The lyon fearce for all his noble hart,
Being ouer matched, is forst to flye the fielde:[633]
If Mars himselfe there had ben with his shielde,
And in my stormes had stoutly mee withstood,
Hee should haue yeeld, or els haue shed my bloud.

28.

This worthy knight both hardy, stout, and wise,

Wrought well his feat: as time and place require,
When fortune failes, it is the best aduise
To strike the sayle, least all lye in the mire:
This haue I sayd to th’end thou take no ire,
For though no cause bee found, so nature frames,
Men haue a zeale to such as beare theyr names.

29.

But to retourne, in Mayne wan I at length,