The psychodynamic impact of coronary bypass surgery

Twenty-one individuals underwent extensive psychological evaluation before, and four months after, coronary bypass surgery, that examined: defensive mechanisms; fantasies and distortions; subjective meaning of the procedure; and transference and projections. Patients showed a significant improvement in their physical condition and indicated vigorous psychodynamic activity. Both before and after surgery many patients: a) used denial; b) misconceived the procedure; c) developed a subjective explanation of etiology; d) mourned; and e) revered their surgeon. Following surgery, many patients: a) rationalized their decision; b) reviewed their life and changed priorities (valuing human closeness, devaluing work); and c) recognized their mortality (engendering a renewed interest in life and/or rage).