Place du traumatisme psychique en clinique de la douleur

Abstract

The psychological trauma in pain management can be considered as two manners. The first one considers that chronic pain can mask an older trauma, which occupies an important dimension in the way the pain is experienced. The second is to consider that the chronic pain, because of the rehearsal of the painful episodes, can constitute a trauma in itself. This article develops these two aspects, to envisage the consequences of a non-identification of the traumatic dimension associated with pain. This "second trauma" explains in particular some patients' reaction. They express some anger, the feeling of not being listened or supported, up to a real-life experience of rejection, an impression of non-gratitude, requests of ceaseless investigations. © 2014 Springer-Verlag.