"I used to dream of lupus as some sort of creature": Chronic illness as an internal object.

Abstract

This study examines the place occupied by chronic illness in the inner lives of 15 women suffering from Systemic Lupus Erythematosus (SLE). A phenomenological analysis of illness narratives demonstrates that sufferers construe their illness as a protagonist or, using an object-relations informed perspective, as an internal object. That is, with time sufferers constituted a mental representation of SLE that in itself has the power to influence the sufferers' affective states and behaviors. An insight into these "illness relations" is conducive to a better understanding of the "lived experience" of SLE for disabled, economically disadvantaged women. Through their experience, the study of risk and resilience in chronic illness may be advanced.

Experiences and Perspectives of Adults Living With Systemic Lupus Erythematosus: Thematic Synthesis of Qualitative Studies

“…Participants in 21 studies felt that SLE had “wrecked the entire course” () of their life, and were pessimistic about the future. They believed that there was no hope for remission or recovery.…”

Depression in Systemic Lupus Erythematosus: The Key Role of Illness Intrusiveness and Concealment of Symptoms

“…Explaining the SLE-depression comorbidity in terms of CNS disorder or plain reaction to physical stress and disability overlooks the key role played by individuals' view of their illness as interfering with their lives in bringing about depression. Indeed, depressive symptoms may be only one facet, albeit a prominent one, in a wider disruption of sufferers' internal lives, brought about by the internalization of the illness (Schattner, Shahar, & Abu Shakra, 2008). A possible application of this finding to a clinical setting entails using the IIRS or a comparable brief structured interview to detect an approaching onset of depression well before depressive symptoms are evident.…”

“…Of the various chronic illnesses, Systemic Lupus Erythematosus (SLE) seems particularly suited to such an investigation, since several of its characteristics are arguably highly conducive to depressive symptoms. For individuals with SLE, the disorder presents a daunting challenge to psychological coping, as it has a highly variable pattern in terms of both symptoms and severity, has no known cause, lacks curative treatment, and follows an unpredictable course (Schattner, Shahar, & Abu Shakra, 2008). However, as Seawell and Danoff-Burg (2004) have shown, despite the critical importance of psychosocial factors to understanding the illness experience of people with SLE, there is a lack of longitudinal research in this field.…”

Defensive Projection, Superimposed On Simplistic Object Relations, Erodes Patient-Provider Relationships in High-Risk Pregnancy: an Empirical Investigation

“…In particular, psychoanalysis's unique attention to unconscious, intra-and interpersonal processes, defensive operations, and mental representations of self and others has the potential to shed light on (a) the role of stress in immunological deficiencies, (b) coping with the social and functional consequences of chronic illness, (c) managing pain, (d) recovering from injuries and physical accidents, (e) engaging in productive health behaviors and reducing deleterious ones, and (f) improving doctor-patient relationships and health care utilization. The present study is an initial attempt to bridge the two worlds, of psychoanalysis and behavioral medicine, by espousing an object relations perspective (see Schattner, Shahar, and Abu-Shakra 2008). We hope that our findings will encourage future studies, thereby forming bridges not only between theory, science, and practice, but also between patients and providers.…”