The experience of transplantation as reflected in dream life: A case study illustrating the mental processing of a lung transplant

Goetzmann, Lutz; Benden, Christian; Ruettner, Barbara; Wutzler, Uwe; Boehler, Annette; Wittmann, Lutz

doi:10.1080/00207578.2019.1589378

Cited by 2 publications

(11 citation statements)

References 17 publications

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“…The aim of the present study was to provide a deeper understanding of how a lung transplant is processed psychologically. To this end, we investigated whether the findings of the single-case study such as the activation of early unconscious fantasies by the transplant [ 20 ] could be applied to the entire sample ( N = 38). We also examined whether the transplantation complex is represented directly, or at least indirectly, in the patients’ narratives.…”

Section: Discussionmentioning

confidence: 99%

“…In “condensation”, several representations merge into new imaginative content [ 34 , 35 ]. “Negation” can also be used, i.e., conflict-laden material becomes conscious only in the negated form [ 20 , 36 , 37 ]. The waking narrative can then “provide clues to the depth of meaning of a dream” [ 20 ] (p. 519).…”

Section: Methodsmentioning

confidence: 99%

“…As part of the present research project, the unconscious processing of lung transplantation was recently investigated in a qualitative single-case study [ 20 ]. In this study, the postoperative dream and waking narratives of a lung-transplant patient were analyzed using the Zurich Dream Process Coding System [ 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

“…Based on the different sources (waking narratives and dream reports), an unconscious transplantation complex was reconstructed. Unconscious complexes are stored in long-term memory and can be activated, for example, by transplantation [ 20 , 23 ]. They may include, among others, archaic oral sadistic fantasies.…”

Section: Introductionmentioning

confidence: 99%

“…Here too, the metaphor of pregnancy was used, which ultimately led, however, to a separation from the “baby” (The new organ (lung) can be expelled). The will to survive and the incorporation of the lung can thus be associated with fears of (organ) rejection [ 20 ]. Based on this qualitative data analysis, the dream and waking narratives were used to reconstruct a so-called psychological transplantation complex , composed of unconscious or preconscious fantasies around the transplant experience, and including the following aspects: 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 part of the recipient’s internal world, The (new) object is a member of the family of organs, The new organ (lung) can be expelled.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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

et al. 2021

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

Goetzmann,

Eichenlaub,

Siegel

et al. 2023

Brit J Psychotherapy

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An organ transplant involves complex psychodynamic processing that has been explored particularly in terms of object relationship theory. In the present study, we develop a model of transplantation based primarily on Lacan's explanations of the torus. In a prospective study, we examined 40 patients, 2 weeks, 3 months and 6 months post-transplant. Based on the analysis of a dream, we identified the so-called 'transplantation complex' in the form of earlier, for example, oral-sadistic fantasies. In a further step, we examined the extent to which direct and indirect indications of this complex were found in the interviews of the total sample. In the present paper, these results are related to Lacan's graph of the torus. Our results display the dialectic of a repetitive demand, especially on the lungs, and the desire for an object that is basically lost or Oedipally forbidden. This dialectic may explain both the different quality of life and the frequent occurrence of feelings of guilt reported by the patients. We also show the function of identification, for example, with a single trait of the donor. Overall, the model of the torus may be a way of understanding the processing of the transplant in a deeper and more coherent psychodynamic manner.

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The experience of transplantation as reflected in dream life: A case study illustrating the mental processing of a lung transplant

Cited by 2 publications

References 17 publications

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

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

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

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