[Psychic trauma in catastrophes. Views and reviews]

A review of literature on the subject reveals a great diversity of views but can nevertheless serve as a guideline for concrete interventions. A recent survey of the psychological state of the traumatised armenian population serves as a background for the theorisation of the trauma. Under the shock, the splitting of the ego and of the primitive self leads to a contradictory symptomatology. The ego level is mainly caracterised by repetition whereas the reactivation of the primitive self leads to avoidance of contact. Confusional states result from the gap between these two instances. Priority is given to group therapy when the ego fails to play its part. When the ego is reestablished, but must face certain losses, among which the loss of its own continuity, individual therapy is at place. Understanding the psychic trauma leads to a model of change.