Trauma & Acute Care Open Access

Editorial

“Psychic trauma is not magazines everyday bad news”, says Nachin [1]. It stems from a discrepancy between an event and the psychic possibilities of overcoming it by an interior redevelopment. On one hand, tragedies like war shatter everyone, even the most balanced person. On the other hand, trivial events in themselves may become traumatic, in particular:

-When one of the protagonists disappears without the incidents being the object of a communion of language between them.

-When a dangerous situation, which tends to split the unconscious, brings to light the image of “insufficiently good” relative or an absent parent, either depressed, ill or hiding a secret [1].

All theories present the trauma as a breaking in that overwhelms the subject and creates a radical cut between the now and the after, accompanied by a more or less lasting disorganization [2].

Douville insists on the importance of not confusing shock and trauma. An overly explicit psychoanalytic theory agrees that trauma is structurally an encounter with an excess, with something impossible to understand. Moreover, the notion of “shock” and “stress” both have the effect of greatly diluting the term trauma, which would then cover any physical or moral injury or damage. It is true that this amalgam between shock and trauma facilitates the promotion of “victimary” ideologies [3]. These ideologies also stem from demands to eliminate uncertainty and surprise. Thus, life would be “guaranteed” against any accident.

Barrois asserts that psychoanalysis, born at the same time as the notion of traumatic neurosis, found with psychic trauma one of its models, but also a genuine irritating thorn, an “internal foreign body”, as Freud used to say of pathogenic memory [4]. One of the causes of the present disarray is the refusal of the accident, induced by the project of an increasingly sophisticated and rational world organization.

It is impossible to draw up a list of singular events that may have psychic traumatic value for a subject, and this is only evident during each cure. However, apart from wars and major natural disasters, the loss of a relative by sudden death (accident or illness), violent death or disappearance, sexual assaults and abuse are examples of actual difficult situations for everyone. Some temporal elements are very important such as the proximity between the birth of a child and the death of another child or one of the grandparents. The same is true of the rapid death of one of his parents when a young man (or a young woman) leaves the original home, marries or conceives a child.

The accidents (and incidents) of human life are not necessarily important events seen from the outside. In her last book, Torok reports the story of a child treated for a phimosis, who finds himself in hospital after having undergone surgery without having been informed. He feels betrayed by his mother who did not warn him. His trauma stems from a loss of confidence in her. Loss of trust is accompanied by a divestment, a loss of identity, which is defined in relation to the trust the child had in the mother before [5].

An accident causes a break-in, which constitutes the possible origin of a psychological traumatism, its entry. Some accidents do not cause traumatisms and some traumatisms happen without any apparent accident: the psychic break-in is then caused by the repetition of disturbing situations.

References

1. Nachin C (2004) La méthodepsychanalytique, Paris, Armand Colin.
2. Waintrater R (2003) Sortir du génocide. Témoignage et survivance, Paris, Payot, 2011.
3. Douville O (2003) Du choc au trauma, il y a plus d’un temps, Figures de la Psychanalyse. Logos 8: 83-96.
4. Barrois C (1988) Les névrosestraumatiques, Paris, Dunod.
5. Torok M (2002). Une vie avec la psychanalyse, Paris, Aubier.