The Psychoanalytic Defence Mechanisms in the Context of Chronic Kidney Disease and Living Kidney Organ Donation Occuring in Children and their Parents

This review deals with the psychoanalytic defence mechanisms, an important aspect of kidney transplantation from parents to their child. The different modes of defence, appearing in this process will be discussed. There is evidence that the psychodynamic defence behaviour of physically disabled persons and people with chronic diseases is significantly enhanced. Children and adolescents with chronic or end-stage renal failure or kidney transplantation and their parents have to deal with problems like adherence, infections, rejection and – most important – graft survival next to the conscious and unconscious coping. Unconscious behaviour of defence exerts a decisive influence on coping even in intra-family relationships. To which extent and in which specific form do these defence mechanisms occur in infant and adolescent patients and their families, coping with end stage renal diseases or living kidney donation? This question will be discussed exemplarily.