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Affiliation
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Service Psychiatrique d'Accueil et d'Orientation, Coordination Régionale (Bretagne) Cellule d'Urgence Médico-Psychologique, Centre Hospitalier Spécialisé, Rennes, France. |
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Abstract
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OBJECTIVE: Group debriefing has been a topic of controversy regarding its temporal dimension. What is the opportune time for using this communication device and when is it the most effective? In practice, group debriefing is generally used after the fact, in post-event interventions. What is the rationale for delaying the debriefing process? Debriefing follows a logical progression that goes from evocation of the event to the expression of a possible future. How should one view this progression in relation to the subject's logical temporality? Finally, are the temporalities of the subjects and the group compatible? The objective of this paper is to show that one of the particularities of group debriefing is that it associates group temporality and subjective logical time.
METHODOLOGY: This study describes the temporal modalities of group debriefing practiced at the Emergency Medical-Psychological Unit of the Ille-et-Vilaine Department of France, based on the analysis of a clinical case. The debriefing situation presented here took place in a firm following a suicide. Four female employees of the firm saw the body of a person committing suicide as it fell from the higher floors of the building. The psychoanalytic research on subjective time, used as a basis for this study, points out two dimensions of time, prograde and retrograde. Retrograde time produces a feedback effect via which the subject reorganizes his/her past. Psychoanalysis also describes a logical time specific to each subject, which can be broken down into three time frames: seeing, understanding, and concluding. In group debriefing, the time course is group-specific.
RESULTS: We show that the subjects' temporality is interconnected with the temporal progression of the group during debriefing. We present some elements showing how subjective and group positioning evolved in relation to the shared temporal unfolding of the debriefing. The debriefing consisted of three time frames. The first involved evoking the tragic experience of the event; it brought out the common points in the women's experience of the event, and a solution of "withdrawal" as a protection mechanism. Individual experiences, such as the desire to avoid or see the scene, or the ability or inability to call for help, were also present. The second time frame pertained to the symptomatology and subsequent experience of the event; here, we observed evocation of similar symptoms among some of the participants but also after the event, depending on individual subjectivity. The relationship to the event was also addressed in terms of the ability or inability of each individual to cope with the event and overcome it. The third time frame involved projection into the future; a sense of relief became manifest as the debriefing progressed. This third time frame permitted evocation of a possible way of "breaking away" from the event, linked to each person's history and connected in particular to the relationship with death evoked during the second time frame. The debriefing also helped in acknowledging the pain brought about by the traumatic event, a beneficial factor in psychic processing.
CONCLUSION: Group debriefing articulates subjective time and group time. In practice, debriefing follows chronological time, at the same time as it mobilizes logical time. It brings to bear a double temporality that must be taken into account during both the implementation and unfolding phases of the debriefing process, but also in the objectives set for this device. The clinician-debriefer must consider this double temporality in order to direct the debriefing in a way suited to the clinical implications that justify its use, and must do so with tact and moderation, without imposition on the subjects'individual temporalities and defenses.
Language: fr |