Background: The child psychiatry unit of the Cochin Hospital in Paris is specialized in a transcultural clinical approach and treatment of psychotraumatism. The clinical demands addressed to the service often combine several levels of vulnerability: recent migration, repeated and intentional traumas, isolation and breach in family bonds sometimes precarious living conditions. Mastering how to approach trauma content adapting to the person’s temporality while taking into account the individual, family and collective dimensions, is a key driver to the clinical intervention (of our approach). Objective and method: We describe a paradigmatic clinical situation articulating its multidimensional complexity: the case of Céline, a 16-year-old Mozambique teenager, unaccompanied minor (UM), who arrived in France three years ago with her 4-year-old child born out of rape. They are both cared for by Paris Child Welfare Bureau. The authors used the CARE guidelines for a rigorous approach to clinical case writing. Results and discussion: In the clinical discussion, we highlight the pertinence of transcultural abilities for the treatment of a complex PTSD (post-traumatic stress disorder). We describe the measures taken to adapt the clinical interview framework to the mother’s psychic temporality, while negotiating what can be said in attendance of the child. The idea of tranquility is primordial—whether she decides to tell or not tell the child. Removing the pressure to have to tell is an element of treatment. Conclusion: Working through a progressive narrative construction, the therapeutical process allowed for the restoration of multiple levels of continuity between times prior to the trauma and following it, as well as prior to migration and following it, to create a continuum from adolescence to adulthood. Restoring narrativity favors the process of becoming a mother and the one of negotiating this new identity. The therapeutic axes also focused on improving the well-being of the UM-mother and preventing the impacts of transgenerational trauma transmission to the child. For women with similar experiences, , sharing their emotions and their stories with us makes their choice about telling their child legitimate and comfortable, regardless of the decision they make.

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Revue européenne des migrations internationales vol. 34 -n°2 et 3 | 2018 La santé mentale en migrations internationalesÉtude du lien entre deuil, dépression et troubles somatiques auprès d'une population d'immigrés ouest-africains en Europe

Background Disclosing traumatic events experienced by parents to their children is a central issue in the intergenerational trauma transmission. However, little is known about this question among migrant population. The main objective of this study was to examine the choice to disclose the traumatic experiences of migrant women in France to their children. Methods This pilot study examined fourteen mother–child dyads in which migrant mothers (M = 30 years; range = 19–42 years) were exposed to traumatic events. A sequential mixed method design was used. In addition to the completion of the Impact Event Scale-Revised, qualitative data were collected through semi-structured interviews. These data were analyzed using thematic and cross-cultural methods. The survey took place from May 2019 to July 2020. Results Our study revealed three profiles of mothers with regard to the choice to disclose the traumatic story to the child: one group of mothers opted for silence (n = 4), the other for disclosure (n = 7) and the last group who were hesitant (n = 3). The modalities of choice were statistically associated with the severity of the post-traumatic stress symptoms, F (2, 11) = 4,62, p < .05. Specifically, women who made the choice of silence (M = 72.75, SD = 4.99) and those hesitated on the choice to disclosure (M = 71.33, SD = 7.51) reported higher scores on IES-R than those who made the choice to disclosure (M = 59.86, SD = 12.44). Six main themes emerged from the thematic and cross-cultural analysis of participants’ narratives: (1) the personalization of the traumatic experience, (2) the child seen as a weapon against collapse, (3) the fear of the child's personal reactions, (4) the possible partial disclosure, (5) the trauma narrative according to the child's age, and (6) the trap of the in-between two cultures. Conclusion Our results suggest that the recovery of these mothers from their trauma, through culturally appropriate therapeutic care, can effectively contribute to the choice to disclose their traumatic experiences to their children. This treatment can support them in developing open and healthy communication strategies to prevent the transmission of traumatic effects to their children.

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