Idealization in the liver transplant setting

Liver transplant patients in psychotherapy may often be relatively silent about their new organs but intensely preoccupied with their medical and psychosocial caregivers. An important challenge for the liver transplant recipient is to preserve positive relationships with caregivers, and to ward off frightening feelings of anger and mistrust that may threaten to emerge. Idealization of caregivers is common, and may be ego-enhancing. Any threat to the idealization may be hazardous. Three liver transplant cases from the author's psychotherapy practice are presented which illustrate this paradigm. The ideas developed are readily applicable to current problems involving both psychotherapy and selection of transplant recipients.