Trauma & Acute Care Open Access

Editorial

I would like to share some milestones about Trauma, Psychological Traumatism and Catastrophe. It is important to specify precisely and distinguish these notions.

A trauma is usually defined as a whole of perturbations resulting from a violent emotional shock, and more precisely, as a situation triggering in the person an influx of excitations exceeding the threshold of tolerance of the psychic capacities. This corresponds to the first definition given by Sigmund Freud.

For him, a psychic trauma refers to an event in the subject's life that is defined by its intensity, the inability to respond adequately, and the upheaval and long-lasting pathogenic effects it causes in its psychic organisation.

Thus, according to Freud, a trauma is characterised by an influx of excitations, which is excessive, relative to the tolerance of the subject and his ability to master and psychically elaborate these excitations. Sigmund Freud employs the term “trauma”, from its meaning in ancient Greek, by transposing on the psychic field the three meanings implied in it: a violent shock, a break-in and the consequences on the whole organisation [1].

In Greek, trauma means injury, disaster or devastation. In the psychic register, it indicates a shock caused by an external or internal factor causing disturbances or damage more or less deep and lasting. The moral wound corresponds to a blow, a pain or an offence. The person feels affected, tested or crumpled. Disaster is a stronger word: it concerns a fatal event, a very serious misfortune, in particular a calamity, a cataclysm or a plague. A devastation indicates the occurrence of a massive destruction or a ruin. For these last two levels of definition, trauma reaches the dimension of catastrophe. In the great majority of cases, the occurrence of the disruptive incident is corresponding to an accident, or of a fortuitous event, a sudden manifestation of chance, a mishap, a reversal, and therefore of unexpected and surprising phenomena, impossible to foresee.

Therefore, a traumatised person is wounded. Then, a psychological traumatism follows the shock. In fact, the trauma produces personal consequences, as deep anxiety, breakdown and repetitive nightmares [2]. The persons are upset by the trauma. They must deal with the accident or the drama they lived, take it into account, understand it, overcome it, if possible, and live differently after it happened to them. So, a traumatism encompasses all these consequences and corresponds to a specific story one can, or could, tell about the drama [3].

With the development of natural disasters as well as human disasters, we also need to differentiate a trauma from a catastrophe. A disaster leads to several traumas and grieves altogether. The individuals are stricken, as much as their families and communities. Thus, a catastrophe induces several disorders at the same time and for the same person. Of course, these calamities produce severe traumatisms but, moreover, they break the relationship with time. The past disappears completely. The world, as it was before, does not exist anymore. The future seems impossible, and the present looks like a perpetual disaster as if the tragedy were still happening [4]. Knowing these specificities is particularly significant to conduct the best treatments. With a traumatised person, therapists would better forget the theories they learned at school, and really take care of the human being in front of them. This person is unique. His or her story is also a unique one. They need to be carefully listened to, with great empathy and sincere goodwill. Healing oneself from a trauma or a disaster takes time. Great patience is necessary and, above all, finding again one’s own profound resources, a strong desire for life and vivid creativity [5].

References

1. Freud S (1893) Studies in Hysteria (1893-1895), with Breuer J. London: Penguin Classics 2004.
2. Ferenczi S (1931) Trauma and anxiety. In: Ferenczi London: Hogart 1955: 249-250.
3. Tomasella S (2015) Renaître après un traumatisme. Paris: Eyrolles.
4. Tomasella S (2017) Desubjectivation, Resubjectivation and Collective Resilience in Disasters Situation: The Exile of European and Jewish Populations of the Maghreb. Trauma Acute Care 2: 34.
5. Tomasella S (2016) Trauma, deuil et principed’intégrité. L'Évolution psychiatrique 81: 641-652.