In its psychoanalytical sense, trauma denotes an event of such violence and suddenness that it occasions an inflow of excitation sufficiently strong to defeat normally successful defense mechanisms; as a general rule trauma stuns the subject and, sooner or later, brings about a disorganization of the psychic economy.
Trauma (a wound), a term borrowed from ancient Greek, was at first used in surgery to denote a violent injury from an external cause that breached the body's integrity. (Traumatism is used occasionally as a synonym, and occasionally to refer to any condition resulting from trauma.) The term eventually made its way into common usage, its psychological sense coming to the fore as its employment spread from medicine to psychoanalysis.
In the context of late-nineteenth-century causation, the notion of trauma was inseparably linked to the ideas of shock and physical breach, and it was regularly invoked to explain a variety of syndromes, among them traumatic neurosis. Freud was part of this current of thought, and, following Charcot, assigned trauma a determining role in the etiology of hysteria; then, along with Breuer (1893a), he moved from the idea of real, physical trauma to that of a "psychical trauma" (pp. 5-6), with the stress laid no longer on the reality of the event but rather on its mental representation, experienced as an internal "foreign body," which is the source of the excitation. This was a radical shift relative to the theories of the time, and an epistemological leap of great import, for it was the foundation stone of psychoanalysis.
What made an experience traumatic for Freud was indeed the incapacity of the psychical apparatus to discharge the excessive excitation in accordance with the principle of constancy, whether that excitation arose from the pathogenic action of a single brutal event or of a series of incidents having a cumulative effect. This economic view of things was part of psychoanalysis from the beginning, and it is crucial to the understanding of the psychoanalytical notion of trauma. Even at this early period, Freud distinguished two models: the first, evidenced by hysteria, involved the absence of discharge, whereas in the second, operative in the actual neuroses, discharge took place but did so at the wrong time and place, and independently of the object. The economic perspective provided the connection and continuity between the successive theories proposed by Freud as he considered trauma in terms of a causal relationship: the first of these theories was modeled on Charcot's hystero-trauma, but this traumatic theory was very soon replaced by the theory of seduction. Founded on clinical observation, this theory led Freud to assert that the trauma was always of a sexual nature and that it had two moments: the first, the moment of fright, confronted the child prematurely with the sexual conduct of an adult seducer; this the child experienced uncomprehendingly, and its meaning and traumatic effect came into play only after puberty, on the occasion of a second scene that served to reactualize the repressed memory of the earlier one. When the frequency with which his patients produced accounts of such early events obliged Freud to question their reality and treat them instead as products of fantasy, the theory of seduction lost a good deal of its interest; at the same time, its temporal aspect—the process of "deferred action" (après coup) of which the case of Emma provided the archetypal instance—remained essential to Freud's explanation of the trauma, whose importance in the triggering of neuroses, however, he now qualified by taking into account such factors as individual predisposition, the trauma's place in the subject's history and mental organization, and the circumstances of the event.
The thinking sparked by the war neuroses gave the notion of trauma a new lease on life, while so reinforcing the energetic point of view that in 1916 Freud did not hesitate to say that "the term 'traumatic' has no other sense than an economic one" (1916-17a [1915-17], p. 275). Thus a trauma, by its simple intensity, could produce an instinctual hypercathexis capable of breaching the protective shield against stimuli. In order to stem this influx, which the ego, not having been prepared by anxiety to confront the danger, was all the more incapable of neutralizing, the psychical apparatus would mobilize all available energy and establish countervailing charges. Should these defensive strategies be insufficient, the apparatus would have to bind the excitation compulsively, "beyond the pleasure principle," so as to lower it gradually to a tolerable threshold (1920g, p. 31).
In Beyond the Pleasure Principle, where the importance assigned to the compulsion to repeat led Freud into speculation about the death instinct, the question arose of what principle governed repetition. Was it Thanatos, striving for absolute discharge, as in certain behaviors analogous to the traumatophilia described by Karl Abraham in 1907? Or Eros, aiming to attain mastery through the gradual resolution of tension and thence accede to the power of symbolization, as well illustrated by repetitive dreams recounted in the analytic session and by reproductions in the transference? In fact, where the work of analysis made it possible for the subject to recover and work through repressed material, the binding function could triumph over death-oriented repetition. In that case, deferred effects, by making reorganizations possible, would have been the motor of change.
Finally, in the context of Freud's revised theory of anxiety (1926d), the stress fell on the state of helplessness: what the baby experiences, subjected without recourse to a state of tension in the absence of its mother, was taken as the prototype of all traumatic situations. In this instance with the signal function of anxiety as yet not developed, the ego is overwhelmed by an eruption of instinctual forces it is powerless to contain.
Freud's reflections of 1926 have given rise to the present-day notion of narcissistic trauma, which refers to the ego's inability to bind excitation resulting from a loss, whether the loss of an object or a loss of a narcissistic kind. This classification is justified in terms of the symptomatology often presented by patients (rumination, repetitive dreams), who may thus be thought to be expressing a pathological mourning under the influence of deferred effects (après coup).
This category has led to a questionable broadening of the concept, for it tends to water down the specificity assigned to trauma in Freud's early works: Systematically treating all and every physical or psychic injury as a trauma runs counter to the psychoanalytic view, for which a trauma cannot be reduced to the level of events alone; at the same time, this level should always be taken into account, precisely because not to do so is to court the danger of further pathological development in a traumatic mode.
Bibliography
Abraham, Karl. (1979). The experiencing of sexual traumas as a form of sexual activity. In Selected papers on psychoanalysis. New York: Brunner/Mazel. (Original work published 1907)
Brette, Françoise. (1988). Le traumatisme et ses théories. Revue française de psychanalyse, 52 (6), 1259-84.
Freud, Sigmund. (1916-17a [1915-17]). Introductory lectures on psycho-analysis. SE, 15-16.
——. (1920g). Beyond the pleasure principle. SE, 18: 1-64.
——. (1926d). Inhibitions, symptoms and anxiety. SE, 20: 87-172.
Freud, Sigmund, and Breuer, Josef. (1893a). On the psychical mechanism of hysterical phenomena: Preliminary communication. SE, 2: 1-17.
——. (1895d). Studies on hysteria. SE,2.
Further Reading
Levine, Howard (Ed.). (1990). Adult analysis and childhood sexual abuse. Hillsdale, NJ: Analytic Press.
Sandler, Joseph, et al. (1991). Conceptual research in psychoanalysis: Psychic trauma. International Review of Psychoanalysis, 18, 133-142.
Terr, Lenore. (1990). Too scared to cry: Psychic trauma in childhood. New York: Harper and Row.
Van Der Kolk, Bessel, et al. (1996). Traumatic stress: The effects of overwhelming experience on mind, body, and society. New York: Guilford.
—FRANÇOISE BRETTE