This thesis explores the psychological experiences relating to two types of potentially traumatic cardiac treatments: heart transplantation and implantable cardioverter defibrillators (ICD). It was hoped that such an endeavour would yield novel insights into these treatments that might facilitate the development of pertinent theory and psychotherapeutic approaches designed to alleviate the psychological distress that often results from them.
The literature review comprises a metasynthesis of 19 papers derived from 13 different studies on the posttransplant psychological experiences of cardiac patients. This yielded four themes: 1. ‘The ambiguous presence of the donor’; 2. ‘Reborn but still not in control’; 3. ‘Striving for autonomy and normality’; and 4. ‘The search for acceptance and new meaning’. The chief novel finding from the synthesis was that successful psychological recovery from the myriad traumas associated with heart transplantation might best be characterised as a form of posttraumatic growth.
The empirical paper comprises a qualitative exploration of the psychological experiences of six ICD-patients who have received ‘electrical storms’ from their devices i.e., episodes of multiple ostensibly therapeutic ‘shocks’. The use of interpretative phenomenological analysis enabled the exploration of divergences and convergences across the accounts, culminating in the identification of five themes: 1. ‘Fear of imminent death’; 2. ‘Living with a sense of dread’; 3. ‘Problematic attempts to regain control’; 4. ‘Beliefs about what constitutes acceptable support’; and 5. ‘The ongoing struggle to accept the device and its implications’. The analysis revealed that shocks may be triply traumatic, not least because they can make recipients fear that their lives are in imminent danger. Long-term post-storm adjustment may be influenced by the recipients’ locus of control orientation and by the degree to which they inhibit their emotions. The clinical, theoretical and research implications of both papers’ findings were explored.