Violences sexuelles, traumatismes et mentalisation : étude de la dynamique psychique à partir du cas Hélène

Abstract

Objectives

Experiences of sexual violence lead to a wide range of psychopathologies, often associated with post-traumatic stress disorder. Mentalization abilities, developed in relation to attachment figures, play a significant role in the development of psychological trauma. We explore the notion that low mentalization capacities, coupled with fearful attachment, hinder the psychological processing of trauma. This article aims to identify the psychological mechanisms at play in our participant and to clinically refine the exploration of our hypothesis, while isolating the relevant role of clinical tools (AAI, RSQ, RFQ, and Rorschach) in shaping the management of patients who have experienced sexual violence.

Method

Theoretical-clinical links are proposed to align the use of these tools with the psychological issues faced by the participant.

Results

The participant exhibits psychological trauma following childhood experiences of sexual violence, a disorganized attachment profile, and a failure in mentalization with a stiffening of mentalization processes.

Discussion

Impairment in mentalization abilities is evident in the Rorschach test, characterized by rigid thinking, difficulties in symbolization, intrusive early childhood experiences, and significant relational avoidance. Due to the risk posed by establishing a new relationship, establishing the therapeutic relationship should be the focus of initial psychotherapeutic work. Subsequently, the work can address experiences of violence and trauma.

Conclusion

This case sheds light on trauma management through the reactivation of mentalization and symbolization processes in an individual with an insecure/fearful attachment profile. In the psychotherapeutic treatment of patients with similar metapsychological characteristics, these elements can inform the development of an appropriate care pathway.