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The Potential Role of Dependency in the Weaning Process: The Case of a 57-Year-Old Woman Connected to a Mechanical Ventilator

Bar Ilan University, Ramat Gan, Israel

Weaning from the mechanical ventilator is considered a difficult task, with the majority of patients remaining permanently connected to the machine. This case report demonstrates the role of dependency and denial as important factors in the weaning process from the mechanical ventilator. Supportive psychotherapy and relaxation training were provided to Rebecca (pseudonym), a 57-year-old woman connected to the mechanical ventilator. After numerous failures to wean, it was decided that Rebecca would leave the rehabilitation hospital to an assisted-living facility, connected to the mechanical ventilator. However, following a repeated discussion of Rebecca's prognosis and discharge plans, Rebecca weaned off the mechanical ventilation and made "a miraculous recovery" within days. This case study demonstrates the significant role that psychological factors play in the patient's ability to wean off the mechanical ventilator. Integrating psychology and medicine can result in better health care outcomes.

Key Words: dependent personality disorder • therapy • psychosomatic • denial • mind-body distinction • respiratory illness

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