Trauma & Acute Care Open Access

Editorial

The requirement of clarity and precision in the approach of psychic trauma favours its clinical identification. If trauma does not resolve itself in terms of shock or stress assessment, psychic traumatism may be named a fate of constraint to repetition that does not end in the symptomatic compromise but takes shape in a relentless death drive over the psyche itself [1]. Especially since the representations of death have changed profoundly during the 20^th century.

From a clinical point of view, we could define trauma as an experience of surprise or unusual violence in which the integrity of a person is threatened. The suddenness of the event overwhelms their ability to cope with it and plunges them into distress or dread.

Here is the testimony of 50 years old woman, who expresses a traumatic experience of her childhood, long remained for her impossible to tell. This experience corresponds to repeated incestuous sexual assaults from her maternal grandfather, whom she has long idealized.

“The shock has the violence of a volcanic explosion, with the burning lava flowing into every part of my being. Afterward, the memory of the shock is more insidious, but equally violent. It causes a halt on picture, a momentum cut that will not return. Imagine a child running in a field. He runs, almost flies, carried away by his joy, his innocence, his desire to live. Suddenly he stops and collapses. The body is like folded on itself, stiffened. Besides, I must remain silent, so as not to awaken anything of this abominable, unspeakable moment; above all, not to awaken that monstrosity which has filled every fibre of my being. This shock has created a gap in the being that allows residues to sink through the days. My soul wanders, wild, blue, bloodless, broken. Time, a lot of time was necessary to say the words that could repel this killing.”

It should be noted that the trauma does not only correspond to what a subject undergoes on the part of another or its environment, but also to what they can inflict on others.

The massacre of Saint Bartholomew, ordered by Charles IX, despite himself, lasted from 22 to 24 August 1572. Shortly afterwards, the 22-year-old king expressed to his doctor, Ambroise Paré, the deep trouble that assailed him.

“I do not know what has happened to me for the last two or three days, but I find my mind and body just as excited as if I had a fever. It seems to me at every moment, both as watchful and asleep, that these massacred bodies present themselves to me, their faces hideous and covered with blood” [2]. Two years later, the young king, who had fallen into madness, died, gnawed by remorse.

All the elements of these narratives characterize precisely what is a psychic trauma. Its dynamics is based on the unpredictable suddenness with which the catastrophe occurs. In these situations, the environment in which the subject had confidence until then suddenly loses its reliability and reassuring benchmarks. Even when the subject believes that they will to do something prepares them to endure the shock, as in the extreme case of attacks, wars and massacres; he is overwhelmed by the emergence of horror [3]. Whether it is a car accident, the announcement of a very bad news, a violent humiliation, and the like, the trauma brutally confronts the subject with the naked reality, the fading away of identity, and even the disappearance of human benchmarks, and sometimes the radical denial of humanity in situations of socio-political catastrophes that can also be called humanitarian catastrophes.

References

1. Douville O (2003) Du choc au trauma, il y a plus d’un temps. Figures de la Psychanalyse, Logos, Ananké, 83-96.
2. Vaudoyer JL (1936) Ambroise Paré et les Valois, Lyon, Ciba, 52-54.
3. Tomasella S (2016) Trauma, deuil et principe d’intégrité. Evolution psychiatrique, 82.