A Special Form of Survivor Syndrome
1972; Taylor & Francis; Volume: 41; Issue: 1 Linguagem: Inglês
10.1080/21674086.1972.11926588
ISSN2167-4086
Autores Tópico(s)Ethics and Legal Issues in Pediatric Healthcare
ResumoA woman was first seen several months after her husband had died following cardiac transplantation. She had gone into mourning and cried freely at the time, but was indignant about the failure of the surgery. She felt her husband should not have chosen surgery knowing that there was a chance he would not survive and would leave her widowed; she had cared for him 'devotedly' during his nine-year illness. While she admired his intelligence and bravery in deciding to undergo 'experimental' surgery, she expressed anger about his selfishness as he could have lived for many years without surgery. Her husband and the surgeon had insisted that she give her permission for the operation. When it proved unsuccessful, she felt like 'a failure in the eyes of the world'—guilty and worthless as though she had 'committed a great crime'. When first seen the patient was anxious and depressed; she cried constantly and spoke of suicide. After once-a-week treatment began, she brought out many past memories associated with feelings of guilt. An older sister, with whom she had migrated to the United States, died several years after they arrived; she had felt guilty at the time because she had not been close enough to her sister during the last years of her life. She also expressed feelings of guilt concerning the murder of her parents and younger sisters by the Nazis. When she discussed signing permission for her husband's surgery, she spoke of her sons whom she considered emotionally defective and incapable of separating from her, and blamed herself for the way they ————————————— The author wishes to thank Drs. William G. Niederland and Norman Margolis; both provided advice and assistance which brought clarity to the material presented in this paper. - 58 had developed. Because of her chronic, severe feelings of guilt, the patient's experience with her husband was unusually painful and after his death her belief in her own worthlessness became even stronger. A number of dreams revealed her ambivalent feelings toward her husband. In one dream a young girl plunged a knife into her husband's chest while the patient slept beside him in their bed. Her associations to this dream were that she wished he were alive, that he had survived the surgery. She went on to speak of longstanding resentment toward her husband and mother-in-law. As an immigrant girl she had longed for a close family and had missed her own mother, but instead of finding such closeness after her marriage, she was resented by her mother-in-law. In turn, she resented her husband's family and was angry that he did not provide the close relationship she needed. In another dream she found herself in an oceanside 'paradise', a lush countryside all around her. She felt lost. Her associations led to anger at her husband for leaving her; she felt she could not function on her own and needed him to take care of her. Further, because she had signed for the surgery she felt like a 'murderer'. Frequently as she dozed, awakened from a nap, or was just 'sitting around the house', she thought she 'saw' her husband standing by an open closet door. He had often expressed anger when she left doors ajar, and now in her vision he would repeat over and over again, 'You don't respect me … respect your husband!'. In this dissociated state she felt guilty but unafraid. She knew he was not there, but she could not understand how her mind could play such tricks on her. When her husband appeared in additional dreams, he was healthy and had not had surgery. Her associations to these dreams included happiness and she recalled that after he became ill, he needed her more and was more attentive to her. She enjoyed this attention and the new-found feeling of closeness in her marriage, and was able to feel pride in herself as a good nurse. But she then expressed - 59
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