De la réparation à la reconnaissance du traumatisme psychique : une nécessaire prise en compte de la temporalité subjective - 07/03/23
From repair to recognition of psychic trauma: A necessary consideration of subjective temporality
Résumé |
La dimension de la reconnaissance et de la réparation du trouble est consubstantielle à la conception moderne de traumatisme psychique. Ainsi, dans les suites des attentats survenus à Paris en 2015 s’est rapidement déployée une importante machine médicale, juridique et sociale, afin de soutenir les impliqués et de faire valoir leurs droits en tant que victimes. Cette volonté collective de réparation peut initialement étayer un individu bien souvent à l’arrêt suite à l’horreur vécue. Cependant, le cheminement subjectif de reconstruction au décours d’une rencontre traumatique relève d’une grande variabilité interindividuelle. Cette temporalité singulière et subjective n’est pas forcément superposable à la temporalité des démarches administratives et juridiques de réparation. Les processus de reconnaissance peuvent servir d’étayage pour certains dans la phase qui suit le trauma. Pour d’autres, en revanche, l’identification au statut de victime peut renforcer la passivité et l’impossibilité de reprendre le cours de leur existence. Les temps d’expertise peuvent scander utilement le parcours de reconstruction, pour peu qu’ils soient préparés avec le patient et surviennent dans le respect de sa temporalité psychique. Le thérapeute se doit de conseiller son patient afin qu’il soit en mesure de faire valoir ses droits et doit être aussi vigilant aux mouvements subjectifs en jeu afin que ces démarches ne viennent pas déstabiliser un individu déjà fragilisé, mais qu’elles puissent, au contraire, produire un effet de reconnaissance par leur valeur signifiante.
Le texte complet de cet article est disponible en PDF.Abstract |
Nowadays, the dimension of recognition and repair of the disorder is inseparable from the conception of psychic trauma. Thus, in the aftermath of the attacks in Paris in 2015, a major medical, legal and social machine quickly deployed to support those involved and assert their rights as victims. This collective desire for reparation, carried by society, can initially support an individual in a state of shock. However, the subjective journey of reconstruction following a traumatic encounter is subject to great interindividual variability. This singular and subjective temporality cannot necessarily be superimposed on the temporality of the administrative and legal procedures for reparation. The recognition process, provided it occurs at the right time, can be a tremendous therapeutic lever. It can serve as support for some in the phase following the trauma. For others, it can redouble the passivity experienced during the traumatic encounter and freeze the individual in his victim status. Different things are played out in the immediate time during the traumatic encounter, the post-immediate time, and the longer time. How can the different times that mark out the social course of repair of the psychically injured be articulated with psychiatric care to help the individual to appropriate his experience? Two proposed clinical vignettes show that reparation rights can serve individuals differently. For some, the steps initiated in the post-immediate time can match, for a time at least, a lack of personal subjectivation; they also made it possible to establish a therapeutic link necessary for commitment to care. For another, these steps only made sense in retrospect. The psychiatrist then had to hear the patient's need to detach himself from the status of victim. He informed the patient of his rights, but without forcing him to use them because that would have been against the patient's subjective path of reconstruction. The time of compensation for the consequences is another aspect of reparation, which can also destabilize the individual, or fuel endless quarrel. The challenge for the psychiatrist is then that this request be put into words: this stage must have been prepared with the patient and the various interlocutors in the legal and social field. This is how recognition effects can occur for the individual. It is the same for the function that the testimony can have during the trial of the accused. It is about creating for the subject the conditions of possibility of putting speech into function, even though the process has a general and social function. The times of expertise can usefully punctuate the course of reconstruction, as long as they are prepared with the patient and occur in respect of his psychic temporality. Consequently, the therapist must advise his patient so that he is able to assert his rights and must also be vigilant to the subjective movements involved so that these steps do not come to destabilize an already weakened individual but that they can on the contrary, produce an effect of recognition through their signifying value.
Le texte complet de cet article est disponible en PDF.Mots clés : Attentat, Cas clinique, Réparation, Stress post traumatique, Temps, Traumatisme psychique, Victime
Keywords : Attack, Clinical case, Repair, Post-traumatic stress, Time, Psychic trauma, Victim
Plan
Vol 181 - N° 3
P. 246-250 - mars 2023 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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