"Repair", "information" and "recognition" of psychological war disorders. Content analysis of the speech of fifteen psychological war wounded

Background. - Even though the psychological war disorders led to many epidemiological, clinical and therapeutic studies, we have not found any referenced studies evaluating the perception of the medical and social actions by soldiers themselves. The main objective of this study is to explore the subjective perception of French soldiers suffering from post-traumatic stress disorder attributable to service in order to evaluate how their condition is recognized and supported by society. Material and methods. - Using semi-structured interviews, we conducted a qualitative content analysis of the speech of psychic war-wounded patients. We relate the speech of the patients following the themes of psychological trauma and its consequences, and of the "repair", the "recognition" and the "information" received in relation to post-traumatic stress disorder caused by war. Results. - Ineffability of the event and its consequences, repetitions of signifiers juxtaposed without articulation phrase, marked guilt ... The study of the speech of the fifteen included subjects owns, on the form and substance, the traumatic clinical consequences which result in subjective thoughts. Essentially descriptive and encrypted notion, the term of legal "repair" of the damage little suited to patients who substituted the signifier of "reconstruction". The wounded asserted the primacy of their care, in the military environment, far ahead numerical compensation. Secondly, to improve information strategies, several wounded proposed to use their testimonials on the model of feedback. Note that these soldiers, despite their psycho-trauma, do not regret their commitment. Their speech reveals an attachment to their army and to those who represent it, particularly to their leaders. Discussion. - And the recognition? A mutual ambivalence has been suspected between war wounded and the society. On the side of the wounded, a restraint or even reluctance, understandable psychopathological determinants, may be at work. On the side of the society, a doubt, or an incomprehension towards the psychic war wounded could have been returned. A sort of tacit agreement seems sometimes to be structured: the society cannot hear; the subject cannot evoke. How to fill in, even partially, the empty signifier left by the trauma of both sides? The dimension of recognition appeared essential to us, therapeutical in itself. The interviewed wounded claimed with one voice their need to be heard and understood, evidence that emerged as a vital necessity of recognition. Conclusion. - This content analysis showed that the progress of each clinical situation is different. Medical and psychological cares, just like any other type of care, must be adapted or tailored to meet the requirements that each case presents. Each case is unique and different patients can require different kinds of help, depending on their career and yearnings. The society must continue to reach out to the wounded. (C) 2017 Elsevier Masson SAS. All rights reserved.