When the body is defective: An object relations informed narrative analysis of the illness experience of people affected by pulmonary hypertension

Titolo Rivista RICERCHE DI PSICOLOGIA
Autori/Curatori Andrea Caputo
Anno di pubblicazione 2020 Fascicolo 2020/3 Lingua Inglese
Numero pagine 18 P. 817-834 Dimensione file 241 KB
DOI 10.3280/RIP2020-003002
Il DOI è il codice a barre della proprietà intellettuale: per saperne di più clicca qui

Qui sotto puoi vedere in anteprima la prima pagina di questo articolo.

Se questo articolo ti interessa, lo puoi acquistare (e scaricare in formato pdf) seguendo le facili indicazioni per acquistare il download credit. Acquista Download Credits per scaricare questo Articolo in formato PDF

Anteprima articolo

FrancoAngeli è membro della Publishers International Linking Association, Inc (PILA)associazione indipendente e non profit per facilitare (attraverso i servizi tecnologici implementati da CrossRef.org) l’accesso degli studiosi ai contenuti digitali nelle pubblicazioni professionali e scientifiche

Pulmonary Hypertension (PH) can be considered as a paradigmat-ic disease for the understanding of repairing processes enacted to re-store internal regulation when the body is defective. The present study aims at providing an object relations informed narrative analy-sis of the illness experience of people affected by PH through a qualitative phenomenological analysis of the illness narratives of 12 adult Italian patients with PH. Four thematic areas (each consisting of three subthemes) were identified that respectively deal with pro-gressive stages of illness story: coping with early symptoms (mean-inglessness, minimization, self-blame), searching for a diagnosis (helplessness, burden, refusal of medical advice), reacting to diagno-sis (shock, resignation, acceptance of limitations) and facing the fu-ture (medical benefits, faith in God, support from patients’ associa-tions). Findings make a significant contribution to the exploration of people with PH’s several subjective challenges in coping with a de-fective body from symptom onset to after diagnosis.

Keywords:Pulmonary hypertension, illness perception, narratives, qualitative phenomenological analysis, object relations theory.

  1. Matura, L. A., McDonough, A., Aglietti, L., Herzog, J., & Gallant, K. (2012). A virtual community: Concerns of patients with pulmonary hypertension. Clinical Nursing Research, 22(2), 155-171. DOI: 10.1177/1054773812462867
  2. Mitchell, V., & Helson, R. (1988). Object relations and social interaction in short stories. Poetics, 17(4-5), 367-384. DOI: 10.1016/0304-422X(88)90041-1
  3. Olsson, K. M., & Palazzini, M. (2015). Challenges in pulmonary hypertension: managing the unexpected. European Respiratory Review, 24(138), 674-81. DOI: 10.1183/16000617.0060-2015
  4. Pennebaker, J. W. (1993). Putting stress into words: Health, linguistic, and therapeutic implications. Behaviour Research and Therapy, 31(6), 539-548.  DOI: 10.1016/0005-7967(93)90105-4
  5. Ricoeur, P. (1991). From text to action essays in hermeneutics, II. Evanston, IL, USA: North-Western University Press.
  6. Schattner, E., Shahar, G., & Abu-Shakra, M. (2008). “I used to dream of lupus as some sort of creature”: Chronic illness as an internal object. American Journal of Orthopsychiatry, 78(4), 466-472.
  7. Shahar, G., & Lerman, S. F. (2013). The personification of chronic physical illness: Its role inadjustment and implications for psychotherapy integration. Journal of Psychotherapy Integration, 23(1), 49-58.
  8. Simonneau, G., Robbins, I. M., Beghetti, M., Channick, R. N., Delcroix, M., Denton, C. P., & Souza, R. (2009). Updated Clinical Classification of Pulmonary Hypertension. Journal of the American College of Cardiology, 54(Suppl. 1), S43-54.
  9. Somaini, G., Hasler, E. D., Saxer, S., Huber, L. C., Lichtblau, M., Speich, R., Ulrich, S. (2016). Prevalence of anxiety and depression in pulmonary hypertension and changes during therapy. Respiration, 91(5), 359-366. DOI: 10.1159/000445805
  10. Taylor, G. J. (1993). Clinical application of a dysregulation model of illness and disease: A case of spasmodic torticollis. International Journal of Psychoanalysis, 74, 581-595.
  11. Teising, M. (1997). The nurse, the patient, and the illness: An object-relations approach to nursing. Perspectives in Psychiatric Care, 33(4), 19-24.
  12. Thenappan, T., Shah, S. J., Rich, S., Tian, L., Archer, S. L., & Gomberg-Maitland, M. (2010). Survival in pulmonary arterial hypertension: A reappraisal of the NIH risk stratification equation. European Respiratory Journal, 35, 1079-1087. DOI: 10.1183/09031936.00072709
  13. Tomai, M., & Lauriola, M., & Caputo, A. (2019). Are social support and coping styles differently associated with adjustment to cancer in early and advanced stages?. Mediterranean Journal of Clinical Psychology, 7(1), 1-24. DOI: 10.6092/2282-1619/2019.7.19831981
  14. US Food and Drug Administration (FDA) (2014, 13 May). The voice of the patient: Pulmonary arterial hypertension [A series of reports]. Retrieved from https://www.fda.gov/downloads/ForIndustry/UserFees/PrescriptionDrugUserFee/UCM429382.pdf.
  15. Vanhoof, J., Delcroix, M., Vandevelde, E., Denhaerynck, K., Wuyts, W., Belge, C., & Dobbels, F. (2014). Emotional symptoms and quality of life in patients with pulmonary arterial hypertension. Journal of Heart and Lung Transplantation, 33(8), 800-808.
  16. Ville, I., & Khlat, M. (2007). Meaning and coherence of self and health. An approach based on narratives of life events. Social Science & Medicine, 64, 1001-1014.
  17. Von Visger, T. T., Kuntz, K. K., Phillips, G. S., Yildiz, V. O., & Sood, N. (2018). Quality of life and psychological symptoms in patients with pulmonary hypertension. Heart & Lung 47(2), 115-121.
  18. Wryobeck, J. M., Lippo, G., McLaughlin, V., Riba, M., & Rubenfire, M. (2007). Psychosocial aspects of pulmonary hypertension: A review. Psychosomatics, 48(6), 467-475.
  19. Armstrong, I., Rochnia, N. K., Harries, C., Bundock, S., & Yorke, J. (2012). The trajectory to diagnosis with pulmonary arterial hypertension: a qualitative study. BMJ Open, 2(2), e000806.
  20. Badesch, D. B., Raskob, G. E., Elliott, C. G., Krichman, A. M., Farber, H. W., Frost, A. E., & McGoon, M. D. (2010). Pulmonary arterial hypertension. Chest, 137, 376-387.
  21. Blatt, S. J. (1998). Contributions of psychoanalysis to the understanding and treatment of depression. Journal of the American Psychoanalytic Association, 46, 724-752.
  22. Bury, M. (2001). Illness Narratives Fact or Fiction. Sociology of Health & Illness, 23(3), 263-285. DOI: 10.1111/1467-9566.00252
  23. Caputo, A. (2013). Health demand in primary care context: What do people think about physicians?. Psychology, Health & Medicine, 18(2), 145-154. DOI: 10.1080/13548506.2012.687828
  24. Caputo, A. (2014). Exploring quality of life in Italian patients with rare disease: A computer-aided content analysis of illness stories. Psychology, Health & Medicine, 19(2), 211-221. DOI: 10.1080/13548506.2013.793372
  25. Caputo, A. (2015a). Sharing problem gamblers’ experiences: A text analysis of gambling stories via online forum. Mediterranean Journal of Clinical Psychology, 3(1), 1-26. DOI: 10.6092/2282-1619/2015.3.1051
  26. Caputo, A. (2015b). Trends of psychology-related research on euthanasia: a qualitative software-based thematic analysis of journal abstracts. Psychology, Health & Medicine, 20(7), 858-869. DOI: 10.1080/13548506.2014.993405
  27. Caputo, A. (2017). The Contribution of Psychology to Research on Congenital Anomalies (CAs): Computer-Aided Thematic Analysis of International Scientific Literature. In W. Ramirez (Ed.), Rare Diseases: Prevalence, Treatment Options and Research Insights (pp. 91-110). New York: Nova Science Publishers.
  28. Caputo, A. (2019a). Psychodynamic insights from narratives of people with amyotrophic lateral sclerosis: A qualitative phenomenological study. Mediterranean Journal of Clinical Psychology, 7(2), 1-15. DOI: 10.6092/2282-1619/2019.7.2009
  29. Caputo, A. (2019b). The experience of therapeutic community: emotional and motivational dynamics of people with drug addiction following rehabilitation. International Journal of Mental Health and Addiction, 17(1), 151-165.
  30. Caputo, A. (2019c). Deceptive dynamics in drug addiction and their role in control beliefs and health status reporting: A study on people with substance use disorder in treatment. Journal of Drug Issues, 49(4), 575-592. DOI: 10.1177/0022042619853299
  31. Cepeda, M. S., Chapman, C. R., Miranda, N., Sanchez, R., Rodriguez, C. H., Restrepo, A. E. & Carr, D. B. (2008). Emotional disclosure through patient narrative may improve pain and well-being: results of a randomized controlled trial in patients with cancer pain. Journal of pain and symptom management, 35(6), 623-631.
  32. Charon, R. (2006). Narrative medicine: Honoring the stories of illness. New York, NY: Oxford University Press.
  33. DʼAlberton, F., Nardi, L., & Zucchini, S. (2012). The onset of a chronic disease as a traumatic psychic experience: A psychodynamic survey on type 1 diabetes in young patients. Psychoanalytic Psychotherapy, 26(4), 294-307.
  34. Delcroix, M., & Howard, L. (2015). Pulmonary arterial hypertension: The burden of disease and impact on quality of life. European Respiratory Review, 24, 621-629. DOI: 10.1183/16000617.0063-2015
  35. Flattery, M. P., Pinson, J. M., Savage, L., & Salyer, J. (2005). Living with pulmonary artery hypertension: Patients’ experiences. Heart & Lung, 34(2), 99-107.
  36. Garrett, C., & Weisman, M. G. (2001). A self-psychological perspective on chronic illness. Clinical Social Work Journal, 29(2), 119-132. DOI: 10.1023/A:1010321918435
  37. Giorgi, A. (1975). An application of phenomenological method in psychology. In A. Giorgi, C. Fischer, & E. Murray (Eds.), Duquesne studies in phenomenological psychology (Vol. 2, pp. 82-103). Pittsburgh, PA: Duquesne University Press.
  38. Goddard, J., Armstrong, I., Kiely, D., Elliot, C., Charalampopoulos, A., Condliffe, R., Sabroe, I. (2017). Combining creative writing and narrative analysis to deliver new insights into the impact of pulmonary hypertension. BMJ Open Respiratory Research, 4(1), e000184.
  39. Goldstein, E. G. (2001). Object relations theory and self psychology in social work practice. New York: The Free Press.
  40. Greenhalgh, T., & Hurwitz, B. (1999). Why study narrative? BMJ: British Medical Journal, 318, 48-50.
  41. Guillevin, L., Armstrong, I., Aldrighetti, R., Howard, L., Ryftenius, H., Fischer, A.,…Ferrari, P. (2013). Understanding the impact of pulmonary arterial hypertension on patients’ and carers’ lives. European Respiratory Review, 22(130), 535–542. DOI: 10.1183/09059180.00005713
  42. Hurwitz, B. (Ed.) (2004). Narrative research in health and illness. London: BMJ Books, Blackwell.
  43. Iannello, P., Biassoni, F., Bertola, L., Antonietti, A., Caserta, V. A., & Panella, L. (2018). The role of autobiographical story-telling during rehabilitation among hip-fracture geriatric patients. Europeʼs journal of psychology, 14(2), 424-443.
  44. Kingman, M., Hinzmann, B., Sweet, O., & Vachiéry, J-Luc. (2014). Living with pulmonary hypertension: Unique insights from an international ethnographic study. BMJ Open, 4(5), e004735.
  45. Klein, M. (1935). A contribution to the psychogenesis of manic-depressive states. International Journal of Psychoanalysis, 16, 145-174.
  46. Langher, V., Caputo, A., & Martino, G. (2017). What happened to the clinical approach to case study in psychological research? A clinical psychological analysis of scientific articles in high impact-factor journals. Mediterranean Journal of Clinical Psychology, 5(3). DOI: 10.6092/2282-1619/2017.5.1670
  47. Langher, V., Fedele, F., Caputo, A., Marchini, F., & Aragona, C. (2019). Extreme desire for motherhood: Analysis of narratives from women undergoing Assisted Reproductive Technology (ART). Europeʼs Journal of Psychology, 15(2), 292-311.
  48. Löwe, B., Gräfe, K., Ufer, C., Kroenke, K., Grünig, E., Herzog, W., & Borst, M. M. (2004). Anxiety and depression in patients with pulmonary hypertension. Psychosomatic Medicine, 66(6), 831-836.
  49. Marchini, F., Caputo, A., Napoli, A., Tan Balonan, J., Martino, G., Nannini, V., & Langher, V. (2018). Chronic Illness as Loss of Good Self: Underlying Mechanisms Affecting Diabetes Adaptation. Mediterranean Journal of Clinical Psychology, 6(3), 1-25. DOI: 10.6092/2282-1619/2018.6.1981

Andrea Caputo, When the body is defective: An object relations informed narrative analysis of the illness experience of people affected by pulmonary hypertension in "RICERCHE DI PSICOLOGIA " 3/2020, pp 817-834, DOI: 10.3280/RIP2020-003002