ObjectivesIn two recent articles, we defined the notion of post-traumatic psycholinguistic syndrome from the standardized study of the speech of psychically wounded patients. This semiological novelty, based on the contributions of linguistics to psychiatry, fosters the ambition to overcome the diagnostic and therapeutic dead ends that too many psychotraumatized people still face. Either because this post-traumatic suffering is silenced, by the very fact of its clinical characteristics – a consequence of the structural indisputability of the psychological trauma – or because the healthcare system or certain networks of practitioners come up against impassable conceptions. Classical psychopathology, cognitive science, and neuroscience improve theories, but we also require knowledge useful for field practice. In order to go beyond the previous concepts, it is time to propose a new model in order to better : (i) identify people suffering from post-traumatic mental disorder, (ii) organize and evaluate their psychotherapeutic care, (iii) bring together practitioners around these first two objectives. The development of ideas is reaching a turning point where it becomes possible to unite around an original model embracing the precedents, a model based on linguistic and psycholinguistic references which are, on the whole, unknown to psychologists and psychiatrists alike. Admittedly, many psycholinguistic notions appear esoteric and therefore unapproachable. However, the analysis and production of language bind caregivers and people in mental distress. This appears all the more paradigmatic for the space of trauma, marked by unspeakability, which must be overcome by psychotherapy. In two coordinated voices, psycholinguistic and psychiatric, we present in this work the results of our final reflections on the syndrome recently called “Traumatic PsychoLinguistic Syndrome” (SPLIT for ‘Syndrome PsychoLinguistique Traumatique’ in French). Moreover, as it sheds light on psychotraumatic symptoms, the model that we propose might help to popularize different components of linguistics : lexicology, syntax, and pragmatics.MethodsWe carried out a qualitative exploratory study of the speech of French soldiers suffering from post-traumatic stress disorder. The investigator followed a semi-structured interview framework based on open questions with encouragement to relaunch the expression, a focused framework for the approach of different themes : the “recognition” of the disorder in its multiple aspects (medical, institutional, symbolic, etc.), its “reparation” (according to the legal terminology of compensation for bodily and psychological damage), and the “information” provided by society on the disorder. All solicited veterans agreed to participate in the study; data saturation was obtained by carrying out fifteen interviews transcribed manually in word processing software (corpus of 76,762 words for 351,453 characters, spaces not included). Centered on the societal notions of “recognition” and “reparation,” a first analysis was the subject of publications according to quantitative and then qualitative phenomenological interpretations. But above all, an unexpected result has emerged: the speech of psychically wounded people is intrinsic evidence, both in substance and in form, of the traumatic repetition syndrome. We then described the “post-Traumatic PsychoLinguistic Syndrome” characterized by three axioms: traumatic anomia, linguistic repetitions, and discursive disorganization. In order to limit the approximations inherent in the software approach, we performed an exhaustive manual analysis of the above-mentioned corpus, word by word, phrase by phrase, proposition by proposition, then sentence by sentence. In what follows, we present our first representations of the symptomatic manifestations of trauma in speech.ResultsThe results are presented using a heuristic model following the components of language construction from “bricks,” building “columns,” to the “unfinished temple:” the word opens up to lexical analysis, the sentence invites to the syntactic approach, and the discourse interests pragmatic considerations. For each of these three dimensions we present: (i) a brief definition of the related scientific concepts, (ii) their disturbances in psychically injured subjects, (iii) clinical examples, (iv) a brief discussion. Lexical marks of trauma: anomia, dysfluencies, emotional theme. Traumatic anomia manifests itself at the lexical level by the inability to express the trauma in words that could evoke it. Verbosity, that is to say the number of words and clauses, appears inferior to common language, as is evidenced by a lower lexical density, e.g. a drop in the ratio of the number of lexical words over that of grammatical words. Modifiers such as epithet adjectives and noun complements are rare. Circumlocutions, periphrases, comparisons, and antiphrases are over-represented. Lexical dysfluencies are expressed by silent and filled pauses, vocalic lengthenings, repetitions of determinants in front of a noun, of pronouns in front of a verb, and of adverbs in front of an adjective. This dimension can take on the caricatured aspect of producing snippets of words or phrases, or even of an obstinate stopping on grammatical words, which indicates a disruption of lexical access. Thematically, sensory and emotional expression appears to be much more developed than the verbalization of cognitions. Syntactic marks of trauma: repetition, fragmentation, passive form. The phrase and sentence analysis highlights linguistic repetitions on several levels. The historical present is used to the detriment of other verbal tenses. The repetition of utterances, especially syntagmatic, is an indicator of perseveration. Thus, dysfluencies characterized by silent or filled pauses located at non-natural syntactic boundaries result in fragmented speech. Even though incomplete utterances (also called false starts) persist, some primers can be completed or repaired, but the continuous flow of speech is disturbed by snatches and accidents. In addition, passive forms and the use of gerund and infinitive participial clauses are used, which are structures eclipsing the expression of the agent (who performs the action expressed by the verb). Pragmatic marks of trauma: disorganization and depersonalization. The disorganization of discourse is reflected by a decrease in discursive cohesion as evidenced by the processing of anaphors by distancing the anaphoric pronoun from its antecedent, and the presence of numerous ambiguous anaphoric references. Note also the decrease in the efficiency of the use of temporal and logical connectors. There are also many digressions, disrupting the chronological progression of the events described. Depersonalization is characterized by an underuse of first-person pronouns (I, one) compared to generic-valued impersonal pronouns (one, you). The frequency of use of third-person singular pronouns as well as semantically empty words (he, she, that, thing, something, someone, etc.) is increased.DiscussionTraumatic psycholinguistic syndrome turns out to be the verbal counterpart to the cardinal semiological symptoms of trauma. The anomia reflects the unspeakable contemporary moment of fear, and persistent linguistic repetitions refer to flashbacks, while discursive disturbances correspond to the dissociation of language. The capacities of verbal expression are constrained by the avoidance; the psychic interference creates ecmnesias. The preeminence of indefinite and impersonal forms points to depersonalization and even to desubjectivation. We can also note the overrepresentation of negative, infinitive forms and of passive constructions reflecting the subject constrained by the experience of trauma, as if he remained the object of traumatic flashbacks, without the possibility of action. The present tense is overused, as a symptom of derealization, related to the recurrent memories of the traumatic event, always repeating identically…. to the detriment of the future. If SPLIT expresses the classic understanding of trauma, this section cannot be strictly superimposed on the American nosography. Our identification of the psycholinguistic footprints of trauma referenced in SPLIT enriches the existing clinical descriptions in order to help with diagnostic identification. However, would these signs alone make it possible to differentiate the psychotraumatic consequences from other anatomoclinical profiles? So far, in the field of psychological disorders, only schizophrenia has a linguistic diagnostic criterion in the DSM, a specificity that is probably historical since language disorders were considered fundamental in the original semiological descriptions of diseases in the schizophrenia group. The language disorders identified in subjects suffering from traumatic repetition syndrome or schizophrenia are quite different even if they present similar dimensions – at least in appearance. This corroborates the etiopathogenic divergences of these two pathogenic frameworks: primary neurobiological impairment for schizophrenia, more reactive disorder for traumatic repetition syndrome. It also accounts for the usual dead ends of psychiatric semiology and perhaps, even more difficult to overcome, for the transcription of human perception considering various objects (things of the world, medical signs, attitude and the words of others, etc.). Rümke and Minkowski (1942, 1949) were the first to recognize the establishment of a psychiatric diagnosis as a rapid intuition, which immediately embraces the overall clinical context of the patient, an impression that is very difficult to translate into semiological terms. As the first phenomenological clinicians had foreseen before several scientific studies validated this intuition, the almost instantaneous precocity of certain psychiatric diagnoses leads to the qualification of concordant symptoms. What is called clinical diagnosis in psychiatry is often only a tautology in the sense that this diagnosis refers to nothing but itself, and not to a meaning that would provide an etiopathogenic value. Whatever their etiopathogenic origins and their semiological characteristics, certain psycholinguistic markers seem to be found in various pathological expressions such as mood disorders, non-fluent aphasias (of the Broca type), or even dementia (especially Alzheimer's disease). More judicious than the categorical approach, the transnosographic dimensional analysis, of the normal or the pathological, could be favored in order to cross the borders of semiology towards the analysis of cognitive processes responsible for language disturbances.ConclusionsPsycholinguistic analysis opens up a considerable field of investigation in the realm of psychotraumatology. If we postulate the linguistic phenomenon as a surface phenomenon accounting for prior cognitive processes, the expression of language abnormalities would allow us to go back to normal or pathological neurocognitive mechanisms. We have described SPLIT based on the identification of new clinical signs, aimed at better identifying post-traumatic mental disorders and also at proposing linguo-markers allowing the effects of recommended psychotherapies to be evaluated in real conditions. But, as already mentioned for previous theories, care should be taken to ensure that innovative modeling does not constitute an expression of the symptom, of dissociation. Indeed, the traumatic nucleus appears to protect itself, insinuating itself even into methods and systems that have the ambition to explore it, to circumscribe it. The new clinical entity called SPLIT represents a paradigmatic change in our conception of psychic trauma, called by semantics. This is another story we will tell soon.