Fantasized recipient–donor relationships following lung transplantations: A qualitative case analysis based on patient narratives

Abstract

The present study examines the relationships between lung transplant recipients and their unknown, deceased donors. Out of 20 semi‐structured interviews, eight narratives, by three female and three male recipients respectively, were identified in which the figure of the donor played a role. These narratives were examined using JAKOB, a qualitative research tool that analyses relational configurations and diagnoses psychodynamic conflicts. Analysis revealed a broad range of varying themes and relationships with equally varying wish and fear themes. All the narrators dealt either explicitly or implicitly with whether and how they are connected to their donors. In five narratives, specific personality traits were attributed to the figure of the donor; in four narratives, latent feelings of guilt concerning the donor’s death were expressed. Indeed, the figure of the donor was not always perceived as an independent person, separate from the narrator’s self: in two cases, the donor appears as part of the recipient’s self, while in another case, the donor is presented as a transitional object for the recipient. The findings of the narrative analysis are discussed within a theoretical model of psychical organ integration.

Key words:

• fantasy formation
• lung transplantation
• narrative analysis
• organ integration
• recipient–donor relationship

1. Translated by Keith Westerfield (New York) and Mark Kyburz (Zürich).

1. Translated by Keith Westerfield (New York) and Mark Kyburz (Zürich).

Notes

1. Translated by Keith Westerfield (New York) and Mark Kyburz (Zürich).

17. This modification of the body image via identification with another person is described in the literature as ‘appersonization’ (cf. Schilder, 1935; Schafer, 1968).

18. Translator’s note: Because the acronym JAKOB is derived from the German words Objekte and Aktionen, i.e. objects and actions, the misspelling of actions with a ‘k’ is retained.

19. Translator’s note: ‘Trauerfeier’ is a compound comprising the two words ‘mourning’ and ‘celebration’.

20. This has to do with the filler words used in Swiss German, which are often coupled with making eye contact. In terms of maintaining undisturbed communication at these moments, the listener is obliged to nod.

21. Translator’s note: The ‘OPD’, which has been published in Germany since 1995, is similar in conception to the Psychodynamic Diagnostic Manual (PDM) published more recently in the United States. See http://www.opd‐online.net andhttp://www.pdm1.org for more information.