Le développement du discours des personnes blessées psychiques : de l’indicible à la métaphore

Abstract

BackgroundDespite a growing societal interest and a progressive enrichment of the semiological description of post-traumatic psychic disorders in the contemporary English and French-speaking literatures, under-diagnosis and late diagnosis, at the stage of intense suffering, remain numerous. Indeed, the post-traumatic origins of the disorders are most often kept silent, due to their clinical characteristics which are often understood as “unspeakable” as the literature says. How to talk about one's trauma? Is it really possible? Objectives, materials and methodsAfter clarifying the linguistic data of interest concerning normal verbal production, we study the accounts of traumatic events produced by survivors of the Paris attacks (Bataclan attack) and by military personnel suffering from post-traumatic stress disorder (war in Afghanistan) in order to authenticate their language dysfluencies (pauses, repetitions, incomplete utterances) compared to a control group.We specify the strategies spontaneously used by the patients to overcome the difficulties in describing their traumatic experience (use of periphrases, metaphors, generic words). ResultsRegarding dysfluencies, our hypothesis was partially verified: the traumatic narratives contained significantly more repetitions and incomplete utterances than the control narratives, but no difference was observed with respect to silent or filled pauses. Regarding adaptive strategies, the trauma narratives contained more periphrases and metaphors, while the use of generic words was not greater than in the control narratives. DiscussionThe non-significance of the data concerning pauses could be consequential to the size of our corpus because an increase in the number of occurrences of each dysfluency studied is gradually sensitized from control to psychically injured people of attacks, then of war, following gradually: incomplete statements, repetitions, silent pauses, and finally filled pauses. This increase can be explained by the chronicisation of the symptoms of the acute stress disorder corresponding to the “Bataclan” corpus, up to a chronic post-traumatic psychic disorder present for several years as in the military interviewed. We can therefore hypothesize a typology of dysfluencies according to the degree of chronicity of the traumatic repetitive syndrome. With regard to palliative strategies, many metaphors used by psychically injured patients remain metaphors in the linguistic sense of the term, without necessarily becoming metaphors in the psychological sense of full access to the second degree, to symbolization, to the association of dimensions initially dissociated by the trauma. However, in the discourse of certain patients, a gradient of metaphorization, from the literal traumatic image to the symbolic construction, seems to exist, as a path towards healing. Metaphorization appears to be a tool for overcoming trauma re-experiencing. It is not so much the theme of the metaphor that is psychotherapeutically important but the process itself of its formation. ConclusionFrom defusing to debriefing to subsequent care when necessary, the principles classically promoted by the psychotherapies work towards a common goal: the symbolization of the trauma. The psycholinguistic study appears here as a heuristic research space in order to clarify the etiopathogeny, the clinical forms and the efficient care offered to patients suffering from post-traumatic psychic disorders. While the traumatic psycholinguistic syndrome (SPLIT) reflects the damage to language that is constitutive of the trauma, conversely, it is language rebuilt during psychotherapy that allows one to escape from the intrusions. At a time when different “schools” of psychotherapy (behavioral and cognitive protocols, hypnosis treatments, eye movement therapies, narrative therapies, etc.) are competing with each other, the analysis of language restoration could unify a specific conception of the alleviation of traumatic consequences while defining linguistic markers that would allow us to evaluate the effectiveness of the recommended treatments.