Cancer as intrusion: some psychopathological patterns of reactions in post-trauma period following diagnosis

In the traumatic atmosphere of announcement, the word cancerbreaks into the psyche under the brutal form of the advent of reality. Standing aloof from the announcement, this article aims at analyzing, beyond the anguish that overwhelms the patient, how this affect will be the subject of a mental work to put it into representations. We will describe three distinct modes: First mode: the patient, shattered by the announcement of cancer, cannot manage to think, because he faces the impossible, a stop: it is a matter of something private, remarkable in front of any encounter with the reality. Second possible mode: some patients will build up proto-representations. They essentially appeal to psychogenic theories giving a great place to think themself as a responsible agent. The anguish is revealed inseparable from the emergence of infantile fantasies, of an ontological (in the anthropological meaning) view of cancer. Third mode: in front of the announcement, some patients seem unable to regress. It is even sometimes observed that the announcement of cancer and its medical follow-up lead to a new mode of social inclusion.These cancer-stricken patients then merge with almost too much complacency into societal stereotypes. To sum up, the traumatized patient uses two ways to divide up the massive affect of anguish, inaugural of the announcement: a cultural way, which borrows from retentions of supernatural historic representations of the illness and/or from societal attributes; and also an idiosyncratic way, resulting from the individual system of reference which has founded its means of defenses. The idiosyncrasic experience induced by trauma would stage the early construction of the self-orthopaedics in its relation with anguish, with the reality of the body, and with social living. The failure of this orthopaedics makes the patient refer to the first cultural way, because it serves as a cold room where the affect can be stored while waiting for the time to subjectify it.