Trauma between neuroscience and psychoanalysis

Objective. - We propose to make Psychoanalysis and Neuroscience enter into dialogue among psychic traumatism in order to enlarge and precise our understanding of trauma. Materials and methods. - Prisms of these two fields are used among five major characteristics of trauma; its memory trace, its disrupting effect, its double temporality, its narcissistic damages, its inscription in psychic reality. Each characteristic was treated by a review of both psychoanalytic and neuroscientific literatures. Results. - Psychoanalytic and neuroscientific theories meet up and complement one another about that traumatic phenomenon. (1) Procedural and declarative memories and their neuro-anatomical and functional basis (reverberant circuits according to the Hebbian's theory) are consistent with Janet's concept of "fixed idea" or Freud's concept of "reminiscence". (2) The interruption of representative and symbolic processes according to neuroscience, underpinned by disconnection of speech areas and hippocampal alterations, echoes and specifies the "disrupting effect" of trauma described by psychoanalysis (Freudian's concepts of living vesicle model, Hilfosigkeit s). (3) The diachronic conception of trauma and the psychoanalytic concept of "afterwardness" could be linked with neuroscientific works on memory discontinuity, reconsolidation and reassociation. (4) Cognitive and neurobiological understanding of "continuing sense of self" through the concept of extended consciousness and autobiographical memory emphasizes psychoanalytic notions of narcissistic damages and assaults of the Ego by trauma. (5) The psychodynamic approach of psychoanalysis emphasizes the importance of individual psychic reality and can balance the ordinary conception of neuroscience's trauma (stress due to rape, aggressions, natural disasters...). Conclusions. - The neuropsychoanalytic approach permits to construct a trans-theorical story of trauma. (C) 2018 Elsevier Masson SAS. All rights reserved.