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Thesis

French

ID: <

10670/1.s809we

>

Where these data come from
Pain as an affect of trauma : a study of algic, antalgic and tranference processes in a clinical survey of chronic pain in locomotor apparatus pathology

Abstract

The research to be read in this thesis, is refered to pain, especially chronical pain, as an affect. When patients concerned with backache or locomotor disorders express their pain, they always refer to parts of their social and inner life.After a large survey of the pain phenomenon in the light of anthropology and history which emphasizes a dependance to representations and creeds, and then with the results of biology, medecine and neurosciences, a particular attention is paid to the knowledge of the patient as a subject, enabbled by the practice of psychoanalysis.S. Freud, from his first discoveries about pain as a neurologist, until his last writings reflecting his own experience, is taken as a guide, then the disciples are studied, particularly « psychosomatic medecine » followers. Studying the cases of five patients consulting for the first time in a pain unit, and the cases of two persons with more than ten years follow up in the same hospital, leads to know the affect of their pain, after a genuine sharing of it. First recognized in posture, behaviours, ways of speaking, and indeed in the very words of the patients, the affect of pain is experienced as transference-countertransference. This, both in the consulting head to head and in long run hospitalization, when the patient connects himself with the care device, conceived as the whole institution and as the staff of persons competent for his treatment, according to his proper life rhythm. The nurses, physiotherapists, occupational therapists, thermal agents act this large cycle of communication that needs to be ruled carefully.This research leads to avoid considering pain exclusively as a deficital sign of. Pain appears mostly as protective sensoriality and appeal to relationship ; obviously a narcissistic problem would stress its weight ;The trauma, ordinarily considered as the initial point of pain, appears as a retort of previous facts, repressed or denied. Pain also appears as an attempt to symbolise a mainly somatic sensorial affect. The therapists’ challenge is to support the affect reconstruction with symbolizing cares.

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