Post-Traumatic Feelings of Vulnerability, Psychological Disability, And Connection to Others in Victims of the 2016 Seka Train Derailment in Cameroon

The problem here is that of the restructuring of the link to the other of the psych traumatized person. The objective here is to apprehend the mechanism by which the feeling of vulnerability in the victim of a serious traffic accident, entered in a situation of disability, affects his or her link to the other. Following a qualitative approach, focused on the case study, the data were collected through semi-directive interviews with three victims of the 2016 Seka train accident. For this purpose, thematic content analysis was favoured. According to the results, the link to the other of the psych traumatized person (PP) is declined according to the instinctual unbinding, the attempt of the ego to restore the balance within the psychic spaces in humans. Also, they show that after a serious traffic accident, the organizers of the link are re-focused and can preserve their initial character just as they can be tainted by a feeling of pity. In this case, they plunge the victim into a fusional and/or conflictual relationship, generating a feeling of uselessness, a functional discomfort and a decrease or even a loss of self-esteem.

Traditionally, psychological trauma has been considered in terms of the individual consequences of various catastrophic events, without sufficiently considering the family, social and professional impact of such events and the possible circular effects between the suffering of a "traumatized" individual and their repercussions on the individual's socio-professional and family relationships (Delage, 2003). Similarly, until recently, little account was taken of the situation of incapacity, functional reduction and disadvantage in which the tremorgenic event consigns its victim (accident). However, recently, scientific advances have shown that "the clinic of psychological trauma, in its very extensive contemporary evolution, is not without a considerable body of knowledge, which is becoming increasingly elaborate" (Valet, 2009, p.165). Thus, we are nowadays witnessing questions that go far beyond the individual in a situation of psychological trauma and touch, so to speak, the interactional dimension of the individual in a situation that, moreover, is a problem situation (psychological trauma). But this is not our concern, because what concerns us goes well beyond the trauma. It is obviously about the feeling of vulnerability which results from it. It is important from this moment on to question the dimension of the link of the individual in situation. From there, we can ask ourselves what aspect the link takes on after a psychological trauma? To speak about the future of the link to the other also amounts to questioning the genesis of the said link.
Problem
The notion of attachment, which is widely used today when we think of the relationship between one person and another, was conceptualized by Bowlby in 1958. His first formulation of the theory of attachment is based on the fact that the attachment of the baby to its attachment figure is based on a behavioral equipment constituted by a determined number of "instinctive responses" that orient it towards the attachment figure (Teramo et al., 2007). Bowlby, based on this conception, identified five of these responses, which specifically contribute to the development of the child's ability to love: proximity behaviors and signaling behaviors. These behaviors are integrated and oriented by the child (and by ricochet the future adult) throughout its development towards the attachment figure, constituting what he designates as attachment behaviors. The attachment behavior, in this engrain age, is conceived as a form of behavior, simple or organized, whose outcome is more or less the search and the maintenance of the proximity of a differentiated and preferred third party. In the baby, when the attachment figure is available, its behavior may be limited to a visual or auditory verification directed towards it, and to an occasional exchange of glances. Although in certain circumstances, the child may seek out the attachment figure, or try to catch it, in order to receive care from the figure. In this logic, the notion of attachment is intimately linked to that of "emotional bonding" (Teramo & al., 2007, p.152). We can then conceive that the development of human attachment takes place through a matrix organized around the care system of the parental figure, expressed in the form of dyadic regulation patterns, in which the degree of participation of the child is progressively increased (Scrouge, 1990, quoted by Pallet, 2007). In this logic, if we take Goldbeter-Merinfeld (2005) as our starting point, we will see that the notion of attachment is useful when it is necessary to account for the behavior of an "individual who seeks to get closer to a particular person (his or her attachment figure) in potentially dangerous situations" (p.15). The attachment process thus has essentially an adaptive function (Pierre Humbert, 2003, p. 87-88). Depending on whether the child becomes an adult, these patterns become a determining factor in his or her mental stability and therefore in his or her mental health. Questioning the function of these patterns in the construction of bonds, Teramo & al. (2007), relying on Bowlby (1969/1982), distinguish two types of development likely to explain adult behavior: favorable and unfavorable development, and question the conditions that favor one or the other type of development. On this basis, they allege that: differences in the quality of care (attachment figure regulation) lead to differences in the quality of attachment (dyadic regulation); and that differences in attachment patterns will influence the individual's emotional self-regulation (p.157). In view of the above, we can say, following Pallet (2007), that inter-individual and individual interactions are always tainted by the dimensions of attachment and this, through the attachment patterns which, depending on adulthood and even the multiple dimensions of the experience, can be substituted as service colleagues, business partners or not, etc. Faced with the experience of a psychological trauma, the link to the other is declined according to whether the victim of the trauma has remained fixed and, because of the strong emotional charge that accompanies the said trauma, regressed to a level of early development with the sole aim of finding and coping with a mode of resolution or overcoming the situation experienced. In this wake, depending on whether the previous development would have been favorable (due to the adequacy of the care given by the attachment figure) or unfavorable (due to the inadequacy of the care given by the attachment figure), the link to the other will either take the form of a secure and positive interaction (love, attachment, security, etc.) or in the form of an impasse (conflicting interaction, hatred, insecurity, etc.) This is to say that the internal model that operates in each individual, whether he or she is in a situation of trauma-related disability or not, stems from the confident expectation or not of the availability of the attachment figure based on a sufficiently "reliable" representation of experience in the past. "These experience representations are encoded, remembered, and then retrieved in memory but not necessarily conscious" (Pallet, 2007, p.9). This could potentially explain why individuals specifically make one type of connection to each experienced situation.
Method
The present study took place in Yaoundé (Cameroon), specifically at the Centre National de Rehabilitation des Personness Handicappers (CNRPH). It is based on a qualitative research design, combining life stories and individual semi-directive interviews as data collection techniques. The study involved three (03) victims of the Seka railway accident (Cameroon) on October 26, 2016.
Participant Selection Procedure
The selection of participants for this study followed the following procedure: first, we administered the Davidson Trauma Scale (DTS) to a dozen victims of the said accident whom we met at the CNRPH who had come for rehabilitation and to follow certain socio-cultural programs (a set of activities designed to facilitate the socialization and social reintegration of the disabled person as much as possible). After this preliminary work, we selected 5 people with a high score (> 61) on the ETD. Among these subjects (respondent), we retained the 03 cases that were more available and willing to be interviewed. These participants are referred to in the text as Sybil, Drexler, and Camila to ensure anonymity as stipulated in the informed consent form.
Characteristics of the Participant
The participants are presented as follows
Sybil, who is a young adult aged 25. She is a Master 2 student at the University of Yaoundé 1 and obtained a score of 71 on the ETD. Drexler, age 32, is a young Cameroonian from the Beti tribe. He is a government employee and construction technician and scored 69 on the ETD. Camila is a 39-year-old woman from the Bailee tribe, married with three children, who scored 124 on the ETD.
Data Collection and Analysis Techniques
It should be noted that before beginning the actual interview, we obtained the participants' agreement to the recording. Thus, the interview began with an introduction of the participants. This was done in order to gather information about the socio-demographic characteristics of the respondents. The life stories coupled with individual semi-directive interviews made it possible to collect the victims' discourse on the context of the accident, the reality of the trauma, the realization of the feeling of vulnerability, the experience of the situation of disability and the experience of the link to the other: relationship between the feeling of vulnerability and the link to the other. Furthermore, the informed consent of the participants was obtained through a form established for this purpose. Each interview/story lasted 30 to 40 minutes and took place in one of the CNRPH listening rooms. The data collected for this purpose were subject to a thematic content analysis.

The results of this study show that the psychological trauma occurred in the three participants after the Seka train accident of October 21, 2016, while they were traveling to Douala for various reasons. Also, they show that the context in which the trip that led to the accident was thought, prepared and realized is determining in the traumatic experience. The problematic situation was amplified by the number of deaths, the state of the corpses, the physical condition of the living victims and the loss of loved ones. The traumatic event that founded the psychological trauma in Sybil, Drexler and Camila occurred suddenly, intensely, frighteningly, side rally, unpredictably, indescribably and uncontrollably; thus, generating in the psych traumatized people the feeling of powerlessness, the feeling of incomprehension (nonsense), the feeling of vulnerability; plunging them into a situation of disability where incapacity, functional decrease and disadvantage are indicators. The participants also felt sadness, guilt, despair (difficulty in envisioning or planning the future), hence the feeling of a blocked future; preventing them, at first, from projecting themselves into the future and admitting a positive evolution of things for them. And in a second time to lead to the modification of the links of the victim. We also witness a real reconstruction of the past, which through the "filter" of the trauma will take another aspect.
The Reality of Feeling Vulnerable
A person who faces or is confronted with the reality of death very often feels fragile. He or she has the impression of being permanently in danger: this is called the feeling of vulnerability. This feeling of vulnerability is due to the fact that the situation experienced, which in this case is the traffic accident, has left a wound in the victim; a wound that defines his behavior or explains his propensity for a very specific type of behavior. This feeling is mostly perceived through avoidance and hypervigilance.
Avoidance
According to Crummier & Lauren (2005, p.179), the clinic of psych traumatic syndromes is specific and the psych traumatic manifestations only explode after a latency period, which varies according to the individual. According to the participants' accounts, the avoidance syndrome is present after an accident and varies from one subject to another in terms of time, latency and intensity. The subject who experiences it is constantly on the lookout for danger. Speaking about the avoidance of situations that may remind one of the accidents experienced, Sybil states: it is true that during this period, I avoided moving around, whether by car or motorcycle, not to mention the train. I couldn't even take the train at that time. 
In the same light, Drexler says
It made me want to take better care of myself. If I have to travel, I will take the best possible way to travel [...] I had to take the road several times, no more train, that is completely excluded from my diet. Camila also knows the feeling of vulnerability. She lives it and exposes it through her avoidance behavior.
She testifies in these terms
Since I came back from this trip, the big carrier, the bus that is called big carrier, for me it is like that train, because, when it enters a ravine, I see again the same situation during which the train had tilted (accompanying with a gesture going from the left to the right) to the point where I am obliged to cling to people, to shout even, sometimes even I am asked what's wrong, up to the small car of my husband, when he takes the turn, I am shouting [... ... for me, if I had to cancel the trips... I had to, but until today I don't know if I can travel... I can't travel, I don't even know if I can take the bus anymore.Often, the victim tries not to think or talk about the event, and tries to cut himself off from the painful emotions caused by the situations associated with the memories of the traumatic event. This may be during a bus trip, for example. This is the case of Sybil when she says: "I feel myself panicking, I am afraid, but as long as the situation passes, it passes too; I stop thinking about the situation". Like Sybil, Camila states, "I don't even want to hear about accidents anymore.” Referring to criterion B of the DSM-IV-TR 1994 diagnosis of PTSD, we see that the intrusive memories of the event, repetitive dreams and nightmares of the distressing event in the victim of a serious traffic accident led her to live and act as if the event in question were happening again. This explains the feeling of vulnerability that they display on a daily basis. To some extent, this is an effort to expel or assimilate the situation experienced, if we refer to Freud (1920) through his theory of the break-in of the protective surface layer ("excitement barrier") of the psyche. This feeling of vulnerability, understood in terms of latency, frequency, duration and intensity, is reinforced in the psych traumatized person in the aftermath of his or her accident according to the losses or damage recorded during this accident. We see from the corpus of interviews that Sybil came out of her accident safe and sound. Thus, this feeling is short-lived, rarely occurs and is of low intensity. For Drexler, this feeling is of constant duration, occurs often and is of moderate intensity because he came out of his accident with a dislocated shoulder that makes him fragile. In Camila, on the other hand, this feeling is very pronounced, it lasts, manifests itself very often and is of a strong intensity due to the fact that she came out of this accident with bodily damages and lost her loved ones (her 4 months old baby and her brother-in-law with whom she was traveling). The emotional organization of the victim being damaged, avoidance and hypervigilance define her mode of conduct.
Hypervigilance
After an accident, the fact that the victim sees him/herself as fragile, vulnerable, etc. leads him/her to develop a set of behaviors that have a protective value for the subject, but above all denote a feeling of vulnerability. This is due to the fact that the victim's emotional organization is undermined. Given that the production of the accident is accompanied by a high intensity of distress and suffering, it invites the psych traumatized person to be more rigorous and attentive to environmental stimuli. Thus, Drexler states respectively: "vigilance is now required, because in any case, we are obliged to be vigilant now, the things that happen to others have already happened to us. So, we are obliged to be vigilant". Obviously, the accident victim who experiences trauma has been confronted with his or her own mortal condition. His or her vision of a safe and just world and belief in the profound goodness of human beings may crumble, and his or her sense of being safe from danger may become tetanized or heightened. Drexler shows us this way: "when you go through what I went through, there are two things you tell yourself: either you will change because God made you change, or things like that can't happen to you easily anymore". After the traumatic event, the subject constantly perceives danger everywhere and the idea of danger haunts him or her, so that he or she has tense nerves and is perpetually on guard. This state can lead to hypervigilance or concentration problems. Sleep disturbances are often observed in the person psych traumatized by the accident. Camila comforts us in this position when she says: "the noises for me... it's as if I were reliving the drama, sleep wouldn't come, I was constantly forgetting, if I put money in a place, I forget the place and sometimes find it after 4 months on another occasion". She goes on to say: "the slightest movement, noise or change around me attracts my attention and not only when I am in the car... my husband's little car or the cab but even when I am at home or at the market. “Whether it is avoidance or hypervigilance, both are evocative of a feeling of vulnerability that plunges the victim of a serious road accident into a real situation of disability.
The Reality of The Handicap Situation 
The term handicap is used to designate a state of limitation, incapacity and social disadvantage. Gardo’s concept, taken up by Le Breton & Tissera (2005), presents disability as "a tear in the space of life". From there, we can see that the accident is likely to cause a considerable tear in the life space of its victim. This is how the victim experiences an incapacity, a decrease in terms of functioning and a restriction of participation in society.
Disability
Vulnerability, while taking on the meaning of risk, refers to the fragility of a person confronted with a situation or who may be affected by an event. To speak about handicap is to say that this one almost always conveys a kind of fragility in those who are victims of it (carriers) as well as in the concretization of an action (moral, intellectual or physical).
Drexler teaches us through this statement
We are young, we are technicians, what each one expects from the other is to be available, to be able to face all the technical situations that we will find on the field [...] We have to be as active as possible to be active, which means that the one who has the most physical or even tactical failures is on the sidelines, and there, I have an eternal physical failure (lowers his head, lifts it and then rubs his eyes and wipes his face). It makes you uncomfortable to know that you can't help where you used to help. As Le Breton & Tissera (2005) demonstrate, the disabled person embodies, because of his or her disability, an otherness that takes root in oneself, his or her body becomes an exile, and constitutes a real broken mirror that leads to confusion in the recognition of oneself and one's potential. The confrontation with the physical or sensory otherness, with the mental difference, arouses the anguish of the fragmented body, the frightened astonishment to be oneself, thus weakening this last. We go to the evidence thanks to the words of Camila. She says: sometimes if you have to save, I ask myself, you're going to save and then if it happens that you go out and do not come back anymore, how is it going to happen? for me, even dress, I can no longer manage to dress, it has left me a way of living, for me, life does not tell me anything anymore... after this accident, sometimes you say you're going, you're going... where is the world going? to die tomorrow? it's a bit like that for me, no, you're held back by the things of life, to die tomorrow? if you commit yourself to something and after that... that's where I'm blocked in relation to this accident, blocked from moving forward.
The serious traffic accident that forms the basis of the trauma and generates the feeling of vulnerability is suffered
During its course, the victim can only experience it passively, powerless to take the initiative. This affects the victim's motivational organization and puts it in short-circuit, leading to the loss of hope for projects that were once dear to her heart and a great difficulty in considering the future. 
Camila testifies in these terms
After this accident, sometimes you say you go, you go... where is the world going? To die tomorrow? that's a bit of it for me no, you're held back by the things of life, to die tomorrow? if you commit yourself to something and after that... that's where I'm blocked-in relation to this accident, blocked from moving forward. I am limited in life. Moreover, the accident situation, by affecting the victim's ability to act, to plan, in short, his motivational organization, leads to a decrease in his potential and impacts on his functioning: this is the functional decrease. 
Drexler knows it and tells
When one of us presents a single failure in the expectations that the group has of him, it is normal that he is left out; not the total gap, it is true there will be levels where you are taken, you are put because we know that at this level of work, the physical strength is not too much to do. So, you can be there, but I am no longer at the level to be like the others, to follow a job from A to Z. This functional decline brings with it a loss of autonomy. 
This is the case of Drexler when he says
It's difficult, it's very difficult because, I was used to something else. I was used to a certain autonomy; I was used to a certain freedom in my work, I was used to my phone ringing in the morning, in the evening and all day long... to be wronged is a very bad feeling, it's a very bad feeling. I assure you it's bad. In view of these remarks, we can say that the feeling of vulnerability constitutes a real barrier to the identification of the real value of the subject. In addition, this decrease leads to a disadvantage in the equality of opportunity in a life exercise, especially a professional one.
The disadvantage
The traffic accident in its repercussion, weakens its victim on the mental as well as physical level. In doing so, it puts the victim at a disadvantage. This disadvantage is felt much more in the context of the exercise of a task or an activity which is moreover professional and implies a common participation (work in common). In his work as a construction technician, Drexler has been experiencing disadvantage on a daily basis since his accident. 
He explains that
whenever I have to take people for hard work, I will always be on the sidelines, because everyone knows that I am now fragile in my right shoulder and whenever I have to break, carry heavy loads or do very difficult work, I will always be on the sidelines [...] When I had the accident, I was 200

The results of our study show that the context in which the trip is thought, prepared and carried out is determining in the traumatic experience. So is the context in which one is rescued. This context amplifies the victim's traumatic experience to a certain extent and can also attenuate it, depending on inter-individual variability. The traumatic experiences of these participants show that the accident situation was frightening for them. The fear that accompanies the traumatic event is the cause of the disappearance of all ideas, thoughts and words from the consciousness of psych traumatized subjects. Thus, the victim feels as if he/she has been deprived of language, as if he/she had had a brief moment with no thoughts. Moreover, the results revealed that the serious road accident is experienced by its victim with a very high emotional intensity, probably never experienced before. The results showed that, in addition to the frightening, staggering, sudden, etc. character of the traumatic event, what underlies the psychological trauma is the victim's inability to make sense of what has just happened. Also, the results showed that the impossibility for the accident victim (psych traumatized) to make sense of the situation experienced generates a feeling of guilt related to the inability to locate and give meaning to the situation at the mental level as demonstrated by the work of Bigot (2006 & 2009), Briere (2011) and Gaillard & IDRES (2007). As for the feeling of vulnerability in the victim of a serious traffic accident, the results have shown that the subject experiences and displays it mainly through avoidance and hypervigilance reactions. This feeling of vulnerability, understood in terms of latency, frequency, duration and intensity, is reinforced in the psych traumatized person in the aftermath of his or her accident, depending on the losses or damage recorded during this accident (Crummier & Lauren, 2005). Thus, the said feeling plunges its victim into a real situation of disability where the latter feels unable to perform certain tasks of daily life; he/she experiences a functional decrease which engages a disadvantage at the social and even socio-professional level (Cambon, 2018). The study also highlighted the relationship between the feeling of vulnerability and the connection to the other among the participants. Thus, it was able to reveal that in certain cases, the psychological trauma that gives rise to the feeling of vulnerability engages at the psychic level a "death" of the victim in terms of drive and creates an impasse in his or her couple bond (we observe a drive disinvestment) (Robert, 2005 and Appelbaum, 2012). On the other hand, this feeling of vulnerability improves the relationship of his victim to him, the fraternal (Tonkatsu, 2005) and social (Puram, 2014; Descrier, 2008 and De Mandolin, 1977) bond of the latter intensifies and takes the form of attention, benevolence, unconditional love and protection depending on whether the victim subject is himself an instigator. In the opposite case, the social and even more so the socio-professional link improves following a feeling of pity developed towards the victim.

The present study aimed at apprehending the process or the mechanism by which the feeling of vulnerability plunging the psych traumatized person into a disabling situation rubs off on his link to the other. To this end, through the context of the occurrence of the accident, the reality of the psychological trauma, the reality of the feeling of vulnerability, and the reality of the disabling situation, it was revealed, following Keas (2010) that the intrusion linked to the accident then gives rise to an attempt to reconstitute the equilibrium broken by the ego, which, in passing, is not without consequence on the link to the other of the psych traumatized person (PP). This consequence is dependent on the variants of the link to the other (there is an impasse that is created in the couple link, while the fraternal and social link intensifies, strengthens, in short takes a fusional form although this situation of handicap at the level of the socio-professional link operates by feeling of pity). Moreover, it was revealed that the link to the other of the CP is declined according to the impulsive unbinding and the attempt of the ego to restore the balance within the psychic spaces whose harmony assures to the individual a balance and makes of him an adapted being. This insofar as a serious psychic wound in one of the members involves sufferings in the others and thus justifies the nature of the privileged bond. We have been able to note through this research that after a serious traffic accident such as the derailment of the train in Seka, the organizers of the bond become more precise and can be tainted by a feeling of pity. In this case, they certainly improve the victim's connection to the other, but still generate a feeling of uselessness, functional discomfort and a decrease or even loss of self-esteem. The results of this study suggest that, in order to better identify the variations of the new self of the psych traumatized person and his or her new social constructs, it is necessary to investigate the experience of the people with whom he or she interacts (feelings or experiences).