The Extremes of Contemporary Violence: From a State of Paralysis to the Transformation of Trauma.

Abstract

Psychoanalysis is today faced, clinically and conceptually, with extremes of violence and forced exile, creating a need to rethink clinical work with patients whose life has been marked by disaster. In work with foreign patients, difficulty in speaking about trauma is sometimes attributed to a linguistic barrier; however, the experience of terror can in any situation whatever be expressed only with difficulty. Cultural differences must not be ignored, but the clinician must find a way to facilitate speech in a subject experiencing a state of dread. Speaking cannot be forced. Offering a presence in which the analyst accepts being the recipient of what is unbearable and recognizes the subject's current state of chaos is essential in establishing or mobilizing transference in work with patients subject to unlinking. This can initiate a transformation of the trauma, as is shown in two clinical vignettes of refugee patients in France who were victims of terror in their countries of origin. The approach discussed here differs from the earlier ethnopsychiatric method, which would reduce these others to exotic envelopes of their culture, independent of their subjectivity.