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

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 pati...

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Bibliographic Details
Published in:	British journal of psychotherapy Vol. 39; no. 3; pp. 466 - 485
Main Authors:	Goetzmann, Lutz, Eichenlaub, Marie, Siegel, Adrian M., Benden, Christian, Boehler, Annette, Jenewein, Josef, Seiler, Annina, Grytska, Olga, Hesse, Konstantin, Wutzler, Uwe, Ruettner, Barbara
Format:	Journal Article
Language:	English
Published:	Hoboken, USA John Wiley & Sons, Inc 01-08-2023 Wiley Subscription Services, Inc
Subjects:	DEMAND DESIRE Dialectics Guilt IDENTIFICATION LUNG TRANSPLANTATION Lung transplants Lungs QUALITY OF LIFE Sadistic personality disorder TORUS TRANSPLANTATION COMPLEX Transplants Transplants & implants
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Summary:	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.
ISSN:	0265-9883 1752-0118
DOI:	10.1111/bjp.12846