The Actualization of the Transplantation Complex on the Axis of Psychosomatic Totality—Results of a Qualitative Study

Abstract

Although transplantation medicine is not new, there is a clinically justified gap in the existing literature with respect to the psychological processing of lung transplants. The present study aims to examine whether lung transplantation leads to an actualization of psychological, e.g., oral-sadistic fantasies. Following a qualitative approach, 38 lung transplant patients were interviewed three times within the first six months after transplantation. Data analysis focused on identifying unconscious and conscious material. The inter-rater reliability for all codes was calculated using Krippendorff’s Alpha (c-α-binary = 0.94). Direct and implicit evidence of a so-called transplantation complex was detected e.g., regarding the “incorporation” of the dead donor and his lungs. These processes occur predominantly at an imaginary level and are related to the body. Our findings emphasize that such psychological aspects should be borne in mind in the psychological treatment of lung-transplant patients in order to improve the processing of lung transplants, and that this might have a positive effect on patient adherence.

Torus, Demand and Desire: Towards a Psychosomatic Structure of Lung Transplantation

“…All patients gave their written consent to participate in the study and to have the anonymous results published. Previous results were published by Seiler et al (2015Seiler et al ( , 2016, Goetzmann et al (2018Goetzmann et al ( , 2019 and Eichenlaub et al (2021).…”

“…I dreamed that my caregiver came into my room and tore out my central venous catheter’. The motifs or aspects of an actualization of the transplantation complex can be summarized as follows (Goetzmann et al ., 2019; Eichenlaub et al ., 2021): The donor is killed. The body is broken open. Objects penetrate into the body/are devoured (incorporation). The donor is the recipient (identification). The donor is a part of the recipient's internal world. The (new) object is a member of the family of organs that can be expelled. …”

“…Once the medical situation has settled down, the fourth ring can be discarded. As we observed in the prospective course of the interview study (Eichenlaub et al ., 2021), the transplantation complex will then recede into the background. We could on one hand imagine that the torus with the dynamics of demand/desire regarding the life‐saving lungs and the identification with the donor has fulfilled its prominent integrative function.…”

“…It is this surface of the body that becomes eroticized in contact with the other, for example with the mother, and in this sense, the bodily surface is projected into the mental or psychological dimension: the surface of the body is transformed into a mental object (Dejours, 2021), and in this way, the unconscious bodily image becomes the structure of the subject (Dolto, 1984; Hamad, 2021). We could say that this psychosomatic surface has both a material (physical) and an ideal (mental) side (Eichenlaub et al ., 2021). In this sense, the psychosomatic torus, in its capacity as a Möbius strip, develops two dimensions, namely the physical (material) and the mental (ideal).…”

“…I dreamed that my caregiver came into my room and tore out my central venous catheter'. The motifs or aspects of an actualization of the transplantation complex can be summarized as follows (Goetzmann et al, 2019;Eichenlaub et al, 2021):…”