Psychic trauma, psychotrauma, or psychological trauma, is the set of psychological, neurobiological and physiological safeguard mechanisms that can be put in place following one or more events generating an uncontrolled emotional charge and exceeding the resources of the subject.
It is very often expressed by post-traumatic stress disorder but also by mood disorders, personality disorders, eating disorders, generalized anxiety disorders, dissociative symptoms, acute psychotic disorders, stress-related illnesses, etc.
The possible causes of trauma are diverse: loss of a loved one, rape or other sexual violence, accident with sometimes associated injury, moral harassment, domestic violence, indoctrination, victim of alcoholism, threat or witness of a traumatic event, particularly during childhood, early trauma. Events such as natural disasters (earthquakes and volcanic eruptions), wars or other aggravating violence can also contribute to psychological trauma. Long-term exposure to situations such as poverty or other forms of aggression, such as humiliation and verbal aggression, can be traumatic.
Not all individuals are susceptible to the same forms and intensity of trauma. Psychological vulnerability varies individually, being linked to the subject's personality, their personal history (including possible past traumas) but also to the context.
Since the end of the 19th century, this notion has first been referred to as traumatic neurosis or war neurosis. Today, the clinic of psychological trauma is recognized under the aspects of acute stress disorder and especially post-traumatic stress disorder since the third revision of the DSM in 1980.
To have a traumatic effect, the event(s) must represent a threat (real, potential or imagined) to the integrity of the person, exceed their capacity to react, occur suddenly and unexpectedly, and be accompanied by a feeling of helplessness, terror, distress, fright, loneliness, abandonment, etc. During this event, the person experiences, briefly or prolonged, a feeling where death is part of the realm of possibility (their own death or that of a third party).
According to Lenore Terr, there are two categories of trauma:
· Type I trauma refers to a single, isolated, time-limited event induced by an acute and non-abusive stressor (accident, natural disaster, physical assault, fire, etc.). It is also called "simple trauma";
· Type II trauma corresponds to a situation that repeats itself, when it has been present constantly or threatened to recur at any time over a long period of time. It is induced by a chronic or abusive stressor (domestic violence, political violence, acts of war, secondary trauma of aid professionals, etc.).
Initially, a trauma is always type I. The reactions presented by victims are identical to those following a type I stressor, but over time, increasingly pathological coping mechanisms will appear (development of type II trauma).
It is important not to confuse a person whose life is punctuated by numerous Type I traumas with one who suffers from Type II trauma. Trauma induced by sexual abuse or torture should be assimilated to Type II traumas, or even Type III traumas, even if the stressor has occurred only once in the person's life.
Eldra P. Solomon and Kathleen M. Heide. have differentiated a third category of traumas:
· Type III trauma refers to multiple, pervasive and violent events present over a long period of time. They are induced by a chronic or abusive stressor (prisoner of war and concentration camps, torture, sexual exploitation, violence and intrafamilial sexual violence, etc.).
Judith L. Herman, distinguished between complex trauma and simple trauma:
· Complex trauma is the result of chronic victimization of subjugation to a person or group of people. In these situations, the victim is usually captive for a period, even a short time, under the control of the perpetrator of the traumatic acts and unable to escape. Complex trauma is similar to the type III trauma defined by Solomon and Heide (concentration and prisoner of war camps, brothels, constant domestic violence, physical violence, etc.).
Direct and indirect trauma:
· we speak of direct trauma when the person has been the subject (underwent), actor (voluntarily or involuntarily provoked) or witness (saw) of the traumatic event;
· indirect trauma: a subject, child or adult, who has not suffered direct trauma may present psychotraumatic disorders following the contacts he has with a traumatized person or group of people. In this case, the traumatic event is the encounter with the traumatized person. We speak of vicarious trauma or secondary trauma (hosts, family and friends, taking in people affected by serious trauma, children returning to the family unit after their parents have suffered traumatic events, etc.).
It is therefore important to differentiate the type of trauma of a person in order to be able to adapt specific monitoring and treatment to the trauma experienced.
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