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摘要
Objectives. Group psychological debriefings belong to the various ways of treating mental trauma. Methodological and temporal structuring of group psychological debriefings is likely to highlight subjective impacts along with the evolution of the psychodynamic functioning which has been damaged by the tragic event. This contribution presents the clinical and psychopathological analysis of twenty group psychological debriefings made by the medical and psychological emergency unit of Ile-et-Vilaine (Bretagne region, France) following sudden deaths. Method. This study goes by the 20 "intervention reports" which have been systematically written by the unit workers after each debriefing. These documents mention: the nature of the request, the number of the group psychological debriefings made for each event, the number of persons taking part of the group, the themes brought up during the debriefing development, the presence of symptoms following the event, the offer of individual consultations to some participants, the debriefing length and its subsequently possible continuation. The twenty analysed debriefings have been put in place following fourteen different events (10 suicides, three sudden deaths, an accident on the public highway), considering that several debriefings might have been organized for one same situation. The results show: 1/ the effects on the mental functioning of the event in regard to the inventory of thoughts - or the lack of them -, affects, body manifestations, appearing at the moment of the event or its announcement; 2/ the symptomatology and psychopathological reactions that have occured since the event; 3/ the limited or lasting effects of the event on the psychodynamic functioning and the resumption of mental work that can be noticed from the evocation of perceptions about the future. Results. - Results hightlight mental upheavals linked to the trauma from initial disruption to the subsequent mental reorganization, depending on their limited or lasting evolution since the event till the debriefing and its regression phase. The research lists the adapted stress reaction signs and the trauma syndrom signs brought up during the debriefing, as well as the evolutive mental movements likely to avoid the fixation of the traumatic event. Results shows that, while some reveal real trauma syndroms requiring an individual psychotherapeutic treatment, trauma trivialization shall not hide the fact that not all sudden events are automatically traumatic but generally trigger an adapted stress reaction. Suicide cases, particularly at the workplace, imply a narcissistic imaginary breach, whether direct or linked to the image of the firm depending on its function to the subject involved, which is propitius for traumatic breach. Adapted stress reaction is generally noted, probably because of the nature of the events studied in this research: the-announcement of someone's sudden death - whose corpse was not discovered by those persons - without any threat against their own lives, which some call "secondarytraumatization". Hence a rather favourable and more or less rapid evolution of symptomatology, even if only a long-term epidemiological study could assess the presence of postponed, or even chronicized, symptoms. Conclusion. - At a scientific level, group debriefings throw light on clinical and psychopathological impacts on many people confronted with a same event which can be potentially traumatic. They also confirm the subjective dimension of the trauma. The study allows to assert that a debriefing contributes to relieve early distress and initiates, if need be, a psychotherapeutic treatment.
- 出版日期2013-7
