Attentats et psychotraumatismes

Terrorist attacks are intentional, collective, and unpredictable acts of violence aimed at sowing fear and shattering the sense of security. They often cause profound shock, both physically and mentally, to those directly affected, to those who witness or hear about them, and to those who lose a loved one or have a loved one injured.

En 2018, une étude montrait que parmi les victimes directes des attentats du 13 novembre, 54% présentaient « probablement » un trouble de stress post-traumatique (TSPT) dans les huit à onze mois qui suivaient l’événement. Après l’attentat de Nice, une étude a également montré que 62% des enfants et adolescents victimes de l’attaque terroriste présentaient un TSPT.

Ce dossier propose des repères pour comprendre ce qui fait la spécificité de ces événements, leurs conséquences psychotraumatiques, et les moyens d’y faire face ou d’accompagner ceux qui en souffrent. Les attentats sont également à l’origine de troubles de stress post-traumatique et de deuils, à propos desquels vous trouverez des informations dans notre précédent dossier.

This document is intended for the people concerned, their relatives and professionals likely to intervene with them.

À l’occasion des dix ans de l’attentat du 14 juillet 2016 à Nice, ce dossier a été enrichi grâce à un entretien avec la Pr Florence Askenazy, pédopsychiatre et co-responsable du CRP PACA-Corse, et Morgane Gindt, psychologue au sein de cette structure. Leurs retours d’expérience permettent d’éclairer les enjeux du suivi à long terme des enfants, des adolescents et de leurs familles confrontées à un événement potentiellement traumatique, ainsi que les enseignements tirés de dix années d’accompagnement.

Le dossier PDF est actuellement en cours de mise à jour

What is PTSD?

Post-traumatic stress disorder, sometimes referred to by its abbreviation PTSD, is a disorder that occurs following a traumatic event in which one is or feels confronted with death (an armed conflict, an attack, a car accident, etc.) or when one's physical or sexual integrity is attacked (a physical and/or sexual assault, rape, etc.). It's a reaction to intense stress, usually occurring within a month of the event, but can also manifest itself several months or even years after the trauma. It affects more women than men, and children too.

Find out more about post-traumatic stress disorder

Recognizing the symptoms of PTSD

There are four main types of symptoms that persist for at least a month and cause discomfort:

  • Avoidance symptoms: when we avoid going down a particular street, doing a particular activity, etc. In short, we avoid anything that might remind us of the traumatic event. In short, we avoid anything that might remind us of the traumatic event. It can also mean avoiding thinking about it or talking about it, which makes it all the more difficult to come to terms with it.
  • Intrusion symptoms: for example, reliving the traumatic event and the emotions felt at the time. These are particularly violent moments that can paralyze the person experiencing them. They can take the form of flashbacks, nightmares...
  • Hypervigilance: you'll jump at the slightest noise, be on the alert all the time, turn around in the street to see if anyone's following you, etc. There are also sleep disorders, irritability, concentration problems, impulsive behaviour...
  • Negative emotions or ideas about oneself: one will feel anger, fear, guilt or shame in connection with the event, one will feel insensitive or disconnected from others, one's surroundings. It can also be an inabilitý to remember important elements of one's life or traumatic events (typically due to dissociative amnesia and not because of other factors such as head trauma, or alcohol or drug use), or a distortion in the temporality or memory of the event.

⚠️ The diagnosis of PTSD is quite complex and can only be made by a health professional trained in psychotrauma. If in doubt, consult your GP, who will refer you to a psychiatrist or psychologist. In all cases, there are ways of getting better.

Risk factors for PTSD

It's important to understand that PTSD is not a weakness. PTSD is a psychological disorder that can occur in anyone who has been exposed to extraordinary and threatening events. In the following chapters, we'll look at how to identify, manage and overcome PTSD. Not everyone develops PTSD after a traumatic event, but there are factors that increase the risk. These factors include:

• The severity of the event;
 • Captivity;
• Exposure to damaged bodies;
• Physical injuries;
• The person's proximity to the event;
• Lack of social support;
• A history of past trauma;
• A history of other mental health disorders.

Why does PTSD occur?

During a severe shock, the brain activates an automatic response: flee, fight, or freeze. In some people, the alarm activated by the amygdala does not switch off once the danger has passed.

The areas of the brain involved in memory and fear remain in a state of alert. This neurobiological disruption explains flashbacks, nightmares, or disproportionate reactions to noise, smells, or images.

Despite this, not all survivors of an attack develop PTSD. Some people manage to regain their balance thanks to the support they receive, their personal resources, or simply time.
Others will need specialized support. There is no "right" reaction: everyone reacts according to their history, their support network, and how they experienced the event.

Understand the mechanisms of PTSD with the video series "Let's Talk About Trauma"

shutterstock 1956867298 - Cn2r

Attacks: some key points

Terrorist attacks are exceptionally intense events, distinguished by their intentionality and collective nature. Unlike a natural disaster or an accident, they result from a deliberate act, often targeting civilians, and aim to instill fear far beyond those present. They affect the body, the psyche, and the social perception of danger.

To be confronted with a terrorist attack is to be confronted with the human will to destroy. This deliberate violence shatters our sense of security: we understand that another human being intended to do evil, and this undermines our trust in the world. The attack thus causes a collapse of the feeling of security, not only among the direct victims, but throughout society as a whole.

Potentially traumatic events

The unpredictability of the act, its suddenness, and the sheer number of victims amplify the shock. We can feel threatened anywhere—in the street, in a theater, in a place of worship—because the places chosen are often those of our daily lives, which can make flashbacks related to post-traumatic stress disorder more frequent.

Terrorist attacks are among the events most likely to trigger post-traumatic stress disorder (PTSD). They combine several aggravating factors: suddenness, extreme violence, direct threat to life, and also human intent—that is, having been deliberately targeted by an act of hatred. Repeated exposure to media images or narratives can also increase the risk of symptoms, including in people not directly targeted.

Different levels of exposure

The attacks affect a large number of people, to varying degrees of exposure. Thus, to describe the diversity of experiences, we can distinguish:
• victims directly exposed, injured or threatened;
• the bereaved, whether present at the scene of the trauma or not, and the rescuers, confronted with suffering or bereavement;
• and the population more broadly exposed, particularly by the media.

According to the IMPACTS study by Public Health France, which focused on the victims of the January 2015 attacks, those directly threatened were the most affected: six months after the attacks, 31% presented with post-traumatic stress disorder, 19% with depression, 32% with a non-negligible risk of suicide, and 38% with at least one anxiety disorder. But the study also reveals consequences for the mental health of those less exposed, particularly first responders. The effects of a terrorist attack extend far beyond the site of the attack: they affect loved ones, institutions, and society as a whole.

Media coverage

The attacks are almost always broadcast live, which amplifies their emotional impact.
Images broadcast on television or social media can be traumatic, even for those who were not present. Children and teenagers are particularly vulnerable.

Some studies highlight that repeated exposure to violent images via television or social media increases the risk of post-traumatic symptoms. For some direct victims, seeing or hearing the scenes they survived again can trigger flashbacks, anxiety attacks, or insomnia.

The process of public recognition, through captured images, commemorations, or trials, can help some people feel supported, but for others, it maintains an involuntary exposure to a painful past.

Key figures

One in five people among victims and witnesses showed symptoms of PTSD after the January 2015 attacks.

According to the IMPACTS study, conducted with victims of the January 2015 attacks, 18% of respondents suffered from post-traumatic stress disorder six months after the event. This proportion varied according to a gradient of exposure: 3% among nearby witnesses, 12% among witnesses at the scene, and 31% among those directly threatened. Source

Two out of three bereaved individuals presented with a possible complicated bereavement after November 13th.

Among those who lost a loved one in the November 13, 2015 attacks, 66% showed signs of complicated grief, according to the ESPA-November 13 study. Source

382 children received by the CUMP in the days following the Nice attack

Of the 382 children, 53 (14%) were bereaved by the loss of at least one close relative, and for some, by the loss of several (up to three). Source

2934 victims of the November 13, 2015 attacks compensated by the FGTI

The figures include 770 relatives of deceased victims, 682 injured victims and their relatives, and 1,482 victims with psychological injuries. These figures are from November 2024 and may have increased since then. Source

attacks

The consequences of a terrorist attack on my mental health

Beyond the immediate shock and post-traumatic symptoms we have discussed, terrorist attacks can lead to multiple, sometimes lasting, problems: depression, anxiety, chronic pain, fatigue, isolation, or difficulty returning to work. These effects are not limited to those physically injured; they can affect anyone who has been exposed, directly or indirectly, to the violence of the event.

A set of disorders

Most studies show that people who develop PTSD after a terrorist attack very often have other associated disorders:
• a depressive episode;
• generalized anxiety disorder;
• persistent sleep disturbances;
• addictive behaviors (alcohol, tobacco, medication, sometimes drugs);
• a prolonged grief disorder in the event of the loss of a loved one.

These comorbidities exacerbate suffering and delay the return to daily life. They can also increase the risk of suicidal behavior.

What happens in the brain

During a traumatic event, the brain enters a state of maximum alert. The amygdala, responsible for detecting danger, goes into overdrive. The hippocampus, which processes memories, malfunctions: events are no longer recorded as normal memories. The prefrontal cortex, responsible for reasoning, is unable to regain control. > Learn more

As a result, the victim may no longer clearly remember what happened (total or partial amnesia), or conversely, relive the scenes repeatedly (flashbacks). These are not signs of weakness, but neurobiological survival reactions.

Impact on physical health

The body remains marked by extreme stress: it sometimes continues to "defend itself" even when the danger no longer exists. The nervous and hormonal systems remain overactivated, which can lead to:
• chronic pain (muscular, joint, digestive);
• sleep disturbances (waking up suddenly, nightmares, insomnia);
• cardiovascular disorders (hypertension, palpitations);
• digestive problems (cramps, diarrhea, reflux);
• persistent fatigue despite rest.

In some people, these physical symptoms themselves become a source of anxiety, social withdrawal or prolonged work stoppage, creating additional fragility.

⚠️ Pain and other somatic symptoms in the weeks following an incident may indicate the onset of post-traumatic stress disorder: hence the importance of early detection and regular medical follow-up. Don't hesitate to consult your doctor!

Mourning after a terrorist attack

Losing a loved one in a terrorist attack means facing a sudden, violent, and often highly publicized death. The ensuing grief can be traumatic, as it is accompanied by images, sounds, and stories that intrude upon us and sometimes prevent us from accepting the reality of the loss. The violence of the act, the context of a mass attack, and the human intent behind the death profoundly shake our relationship to the world, to justice, and to trust in others.

“ Death caused by a human act is something else entirely. It enters the realm of barbarity. We bear the weight of that horror. There is no scale of suffering, but there are scales of horror. And in these attacks, we were confronted with pure horror. We carry both the grief and the violence of what caused it. It is a grief that never fully subsides, because it is linked to an absolute injustice.”

Anne Murris, founding president of the “Memorial of Angels” association and mother of Camille Murris

As a bereaved person, we can experience a prolonged state of shock , alternating between anger, helplessness, and incomprehension. Some describe a feeling of suspended time: administrative procedures, investigations, and trials keep the door "open," delaying the possibility of healing. It is known that 30% to 50% of people suffering from prolonged grief also experience post-traumatic stress disorder (PTSD). This is particularly true when the death occurs in traumatic circumstances, especially during a terrorist attack. Some people also develop physical symptoms (fatigue, pain, palpitations), or a feeling of guilt for still being alive—this is even more pronounced following particularly deadly attacks.

Suicide

After a terrorist attack, the risk of suicide can increase, especially when PTSD, depression, or prolonged bereavement are present. In France, the IMPACTS study shows that, among those directly threatened, nearly a third presented a risk of suicide six months after the attacks, highlighting the importance of proactive screening and rapid access to care.

We know that PTSD is associated with suicidal thoughts and suicide attempts; comorbidities (depression, substance use) further increase this risk.

Among some professionals, particularly emergency services and police, and more generally first responders, studies also show more suicidal thoughts, even years after the event.

⚠️Si If you're worried about someone close to you, or if you're having suicidal thoughts, you can call 3114. This free service offers a professional and confidential listening service, 24 hours a day, 7 days a week, staffed by specially trained nurses and psychologists.

An impact on different aspects of life

Psychological trauma is not simply an individual issue; it is often part of a larger process involving legal, administrative, professional, economic, and societal aspects. Consult the booklet outlining all the necessary steps on the Ministry of Justice website.

The impact on work and social life

Returning to work after a terrorist attack can be particularly difficult. After the November 13, 2015 attacks, a quarter of those exposed had to stop working.

Among the responders, primarily from law enforcement, the average sick leave was 40 days. Six months after the incident, 6% had still not returned to work. Furthermore, the teams dealing with this type of event had the highest turnover rate, with a significant number of members choosing to be reassigned to another department or institution.

After a terrorist attack, returning to work presents a major challenge because the body and mind often remain preoccupied by stress, fatigue, or fear, making it difficult to resume a normal routine. Many of us may feel present without truly being so, unable to concentrate, to tolerate noise, or to cope with close proximity to others.

Returning to work depends on several factors: the severity of the trauma, the support received, institutional recognition, and also the employer's understanding. When the work environment is supportive, work can once again become a stable point of reference; when it is perceived as indifferent or demanding, it becomes a source of anxiety and withdrawal.

The causes are multiple:
• exhaustion, difficulty concentrating, anxiety in noisy or enclosed environments;
• relationship difficulties or feelings of being misunderstood;
• fear of not being able to “hold out”;
• confrontation with administrative or judicial procedures.

Some people choose to change career paths; others isolate themselves for fear of bothering others.

The economic and administrative consequences

The repercussions of the attacks are therefore also financial: prolonged sick leave, loss of income, forced career changes, and delays in compensation or pensions. Some victims report difficulties in having their rights recognized (allowances, compensation, reimbursement of medical expenses).

After the November 13, 2015 attacks, more than half of the people said that the events had worsened their economic situation and 14% considered this deterioration to be significant11. Causes included: the closure of their business or a dismissal.

The process can be long and arduous, especially since victims often have to provide several medical certificates and administrative documents.

Bereaved families are also affected: some relatives reduce their professional activity to support a child or parent experiencing post-traumatic stress disorder, sometimes without sufficient compensation.

Emotional relationships

After an attack, relationships with relatives, friends or colleagues often change profoundly.

Furthermore, these symptoms of post-traumatic stress disorder, according to the DSM, complicate emotional and relational life:
• Marked decrease in interest in or participation in important activities;
• Feeling of detachment or distance from others;
• Persistent inability to experience positive emotions (e.g., happiness, satisfaction, tender feelings).

Relatives, not sufficiently informed about PTSD, may become less and less understanding over time of the symptoms of a person who does not dare to talk about what they are experiencing as painful.

Some victims of terrorist attacks, or bereaved relatives, describe a lack of understanding or discomfort from those around them, who "don't know what to say" or who, for fear of reopening old wounds, avoid the subject. This silence can reinforce feelings of isolation, while the need to have one's suffering acknowledged remains essential for recovery.

For many victims, relationships with others become more fragile: some isolate themselves to protect themselves, while others seek support from people who have experienced the same ordeal, the only ones capable of understanding what they are going through. Victim support groups then play a vital role by offering a space for listening and mutual recognition, which helps rebuild connections and restore the value of shared experiences.

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We cannot measure how much an attack disrupts an entire life: health, work, finances, even housing for some people, everything is affected.

Anne Murris, founding president of the “Memorial of Angels” association and mother of Camille Murris
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We understand, it's their way of protecting themselves but... And then we lose people, I know I've lost a lot of friends, and sometimes I lose them intentionally.

Anne Murris, founding president of the “Memorial of Angels” association and mother of Camille Murris

Living after a terrorist attack

Several moments following the attack, even years later, can both help in the recovery from psychological trauma and reactivate the suffering.

Judicial time

For many, trials represent a major step in the recognition process. They allow order to be restored to chaos, justice to be obtained, and the victims' voices to be placed in an institutional space where they have the value of truth.

“We are still searching for the truth. Not to accuse, but to understand. This lack of truth fuels the anger. As long as justice has not been served, we cannot close this chapter.” Anne Muris, founding president of the “Memorial of Angels” association and mother of Camille Murris

The November 13th program demonstrates the importance of court hearings in the dynamic between the individual experience of trauma and the collective response provided by society.

Thus, during the trial for the November 13, 2015 attacks, nearly 400 civil parties testified. This provided an opportunity for some to give their testimony in a secure environment, and subsequently to seek psychological help for the first time.

« Le procès, oui, c’est une étape. Mais ce n’est pas ça qui résout le trauma. Le procès, avant tout, il a une portée collective. Il est là pour affirmer que la justice va être rendue de manière collective et pour affirmer à la société que cet acte effroyable, avec de nombreux protagonistes, ne peut pas rester impuni. Mais il ne faut pas confondre la portée collective et ce que ça va représenter au niveau individuel. Qu’est-ce qu’une condamnation va apporter à un individu dans sa vie personnelle ? Peu de choses. » Pr Michel Benoit, psychiatre au CHU de Nice,co-responsable du CRP PACA-Corse

However, these hearings are sometimes very difficult to endure: the detailed review of the facts, the confrontation with the accused and the intense media coverage can revive disturbing symptoms of post-traumatic stress.

Associations such as Life for Paris and Promenade des Anges have therefore put in place listening and psychological support systems throughout the trial, as well as the France Victimes system.

Media time

The media plays an ambivalent role: they inform and unite, but they can also reactivate trauma. Images broadcast on a loop, testimonies gathered in the heat of the moment, sometimes while the victim is in shock and not yet able to speak, and the emotional escalation are all likely to re-trigger the brain's alarm system.

Some studies show that high exposure (more than four hours a day) to images of the attack is associated with more post-traumatic stress disorder several months later.

For those directly affected, media reports, documentaries and anniversaries can reopen the wound.

Some describe it as a feeling of “narrative theft”: seeing their story told without consent or inaccurately. For journalists, the ethics of reporting are therefore paramount: obtaining consent, preserving dignity, and providing context without exploiting.

Dix ans après, a-t-on encore besoin de soins ?

Contrairement à une idée reçue, les conséquences d’un événement traumatique ne disparaissent pas nécessairement avec le temps. Dix ans après l’attentat de Nice, le Centre régional du psychotraumatisme (CRP) PACA-Corse continue ainsi de recevoir de nouveaux patients.

Certaines personnes consultent pour la première fois, tandis que d’autres reviennent parce qu’un anniversaire, un procès, un nouvel attentat ou une étape importante de leur vie (entrée dans les études supérieures, départ du domicile familial, naissance d’un enfant…) réactive leurs difficultés. Chez certaines personnes, les symptômes peuvent aussi évoluer progressivement ou devenir plus problématiques à certaines périodes ou dans certains contextes de vie, sans qu’un événement déclencheur précis ne puisse être identifié.

Cette évolution est bien connue des professionnels : les manifestations du psychotraumatisme peuvent changer au fil des années et nécessiter un accompagnement adapté, même longtemps après les faits.

« On a eu de moins en moins de patients victimes de l’attentat, mais ça ne s’est jamais interrompu. Il y a eu des périodes où des événements traumatiques rappelaient celui de Nice, même quand cela se passait à l’autre bout du monde, par exemple. Ça a été un rappel pour les victimes. » Pr Florence Askenazy, pédopsychiatre, co-responsable du CRP PACA-Corse

Memory and commemorations

In Nice, where 86 people were killed and more than 450 injured on July 14, 2016, the memory of the attack is embodied each year through a commemorative ceremony organized on the Promenade des Anglais, in the presence of bereaved families, survivors, residents and institutions, to honor the memory of the victims.

“Commemorations are a fight against oblivion. They are our way of continuing to exist, of saying that our loved ones mattered and still matter. Life went on for everyone else. For us, it didn't. These moments are essential for society to remember us. It's a constant battle against erasure. It's not just about remembering, but about not letting faces, names, and stories disappear. We carry the memory of those we have lost. It's painful, but it's also the only way to do them justice.” Anne Murris, founding president of the “Memorial of Angels” association and mother of Camille Murris

For many, these ceremonies represent a moment of collective recognition, a way to share the pain and give meaning to the loss.

But commemorations can also be sensitive, sometimes trying times. Thus, each year the approach of "anniversary dates" can be accompanied by a resurgence of post-traumatic symptoms: nightmares, flashbacks, irritability or avoidance.

Moving beyond victimhood

Being a victim of an attack means first and foremost having suffered terrible violence, but it also sometimes means bearing a status that confines you.

For some, moving beyond victimhood doesn't mean erasing the event or forgetting the suffering. Rather, it means reclaiming their professional, emotional, and personal life by taking back control of their narrative.

It is in this spirit that the association Life for Paris announced its dissolution, based on the idea that being a victim is not a fixed identity, but a transitional state. However, this position cannot be considered a norm, and it is up to each individual concerned to choose how they wish to be defined.

Getting informed and taking action as a relative of an affected adult

Being close to a victim of a terrorist attack, whether a direct victim or someone bereaved, confronts you with a devastating reality. You may feel helpless: what to say? How to react? How to help without causing harm? To understand your loved one, it is essential to learn about psychological trauma and the experiences of victims.

The role of loved ones is crucial: a supportive network can be an essential resource on the road to recovery. Conversely, denial or clumsiness can plunge the person back into isolation and suffering.

Allowing oneself to talk about it

When a loved one has been affected by a terrorist attack, whether because they were present at the scene or because a loved one was killed, the most important thing is to allow people to talk about it. Speaking about the event, the memory, or the person who died is neither too difficult nor too disturbing: it is often a way to keep the connection alive, to give meaning back to what has been shattered.

“When we talk about our child, there’s often an awkwardness. As if our pain is disturbing. What hurts isn’t the silence, it’s the fear others have of saying her name. Camille existed, she must continue to exist in our conversations. We mustn’t impose ourselves, but show that we’re there. Say, ‘I’m thinking of you,’ without trying to console at all costs. Little phrases like ‘it’ll pass’ hurt. No, it doesn’t pass. We learn to live with it, but it doesn’t disappear.” Anne Murris, founding president of the “Memorial of Angels” association and mother of Camille Murris

We can simply listen, without trying to console at all costs, or changing the subject out of discomfort. What hurts the most is not talking about it: it's when silence falls, when we no longer dare to utter the name of a loved one or mention what happened.

✔️To do:
• Listen without interrupting, even if the words are awkward or repetitive;
• Let the person choose what they want to say, without judging or fearing the subject;
• Simply say: "You can talk to me about it if you want," or "I'm here when you need me."

❌ To be avoided at all costs:
• Change the subject to avoid embarrassment;
• Trying to “put a positive spin” or to end the conversation;
• Saying “it will pass” or “we need to turn the page”: we don’t erase, we learn to live with it.

Protecting and supporting

After an attack, whether a close person was present at the scene, injured or lost a loved one, the essential thing is to ensure their safety and offer them a stable environment.

Daily life needs to become predictable again: regular schedules, simple meals, a calm environment. Psychological trauma disrupts sleep, concentration, appetite, and mood. These problems can last for several months, or even longer.

We can help in very practical ways: offering to accompany someone to a medical appointment, doing the shopping, babysitting, simply being there without being intrusive. These simple gestures lighten the mental load and show the person they are not alone.

Depending on the situation, it may be helpful to contact a victims' association (such as France Victimes, Life for Paris, Mémorial des Anges, or 13onze15 Fraternité et Vérité). These organizations can refer individuals to professionals trained in post-attack support, assist with administrative or legal procedures, and sometimes offer appropriate psychological support.

Warning: Never pressure someone to testify publicly or participate in a trial if they don't feel the need to. The role of a loved one is to support them, not to decide for them.

It is also important to watch for signs of a suicidal crisis. Terrorist attacks are among the most traumatic events; those directly affected or bereaved are at higher risk of depression or suicidal behavior. In the event of a crisis, I do not hesitate to call emergency services (15) or seek professional help immediately. If I want to help someone in distress, I can contact the national suicide prevention hotline, 3114. 3114 is available 24/7, free of charge, throughout France. A healthcare professional, specifically trained in suicide prevention, will listen to me.

⚠️ Maintain your own balance
Supporting a victim can be emotionally draining. As a loved one, it's important to take care of yourself by:
• Talking with a trusted third party (friend, doctor, psychologist);
• Allow yourself to feel anger, sadness, helplessness;
• Remember that you cannot "fix" things for the victim.

post-traumatic stress disorder, domestic violence

It's proven: social support is a key protective factor against psychological trauma. Someone with a strong support network is less likely to develop post-traumatic stress disorder and will recover more quickly. Your support, even if it's not professional, is therefore essential.

How to help a child/teenager who is a victim of an attack?

There is no "typical profile" of a child victim of a terrorist attack. Some quickly develop visible symptoms (nightmares, anxiety, learning difficulties), while others seem to cope "relatively well" for a while. Studies emphasize this variability in reactions: the fact that a child does not immediately show signs does not mean they are not suffering. This is why careful, long-term monitoring is essential.

When a child or teenager recounts a memory of the attack, or the loss of a loved one during the event, the reaction of those around them is crucial. Feeling that their emotions are heard and acknowledged helps restore a sense of security and reduces the risk of post-traumatic stress disorder.

Belief and protection above all

The most important thing is not to find the “right” words, but to be present, consistent, and calm. One can simply say:
• “I know it’s difficult, you can talk to me about it whenever you want.”
• “I’m here, even if I don’t have all the answers.”
• “You have the right to be afraid, sad, or angry.”

These simple phrases show the child that they can express what they feel without embarrassment, even if adults do not share the same emotions.

✔️To do:
• Listen without interrupting, or trying to “correct” the child’s emotions;
• Provide stable reference points: meal times, bedtime, smooth return to school;
• Answer her questions honestly, without dramatizing or lying;
• Explain what happened using age-appropriate language.

❌ To be avoided at all costs:
• Avoid phrases like “you have to turn the page”, “you are brave, don’t think about it anymore”;
• Do not force him to speak or attend commemorations if he does not wish to;
• Avoid overexposing him to media, images or adult discussions about the attack.

Warning signs

Children and adolescents are not "protected" from psychotrauma because of their young age. Whether they have confided in me about a sexual assault or not, I can be alert to the signs of post-traumatic stress disorder to help them get better. Symptoms can include intense fears, nightmares, difficulty distinguishing past from present...

In most cases, children and adolescents who have suffered sexual violence will be more affected by what is known as complex post-traumatic stress disorder.

Dix ans après un événement traumatique, les enfants et adolescents concernés ne présentent pas forcément les symptômes les plus connus du trouble de stress post-traumatique, comme les reviviscences ou les conduites d’évitement.

Warning signs:

  • Difficulty regulating emotions
  • Fragile attachment
  • Regressions and abrupt emotional changes
  • Aggression towards self and others
  • Behavioral, attention and learning difficulties
  • Sleep and eating disorders
  • Somatic manifestations (stomachaches, headaches, eczema, etc.)
  • Feeling of never being in the right place
  • Guilt, self-hatred, lack of self-confidence
  • Risky behavior
  • Difficulty setting limits

Les symptômes évoluent avec le temps

Dix ans après un événement traumatique, les enfants et adolescents concernés ne présentent pas forcément les symptômes les plus connus du trouble de stress post-traumatique, comme les reviviscences ou les conduites d’évitement.

Dans leur pratique clinique, les équipes du CRP PACA-Corse observent aujourd’hui plus fréquemment, chez les adolescents suivis après l’attentat de Nice :

  • Des difficultés d’endormissement ou des rythmes de sommeil très décalés ;
  • Des cauchemars ;
  • Des troubles de la concentration ;
  • Des difficultés scolaires ou de l’absentéisme ;
  • Des angoisses de séparation ;
  • Des difficultés à se projeter dans l’avenir.

« Ce qu’on conseille pour tous les enfants et adolescents qui ont vécu un attentat, c’est de faciliter la socialisation, d’éviter le repli, d’éviter de rester à la maison tout le temps. De même, être devant la télévision quand il se passe un drame et regarder en boucle, ce n’est pas bon, ni pour les parents, ni pour les enfants. Le message simple, c’est celui d’éteindre la télé et d’aller faire une activité autre. » Pr Florence Askenazy, pédopsychiatre, co-responsable du CRP PACA-CORSE

Understanding complex trauma in children and adolescents
the child's voice

How do you help a child on a daily basis?

For toddlers (0-5 years)

  • I create routines

Stable routines provide a sense of security, essential for reducing anxiety. Reassuring gestures, such as a cuddle before bedtime or comforting stories, create soothing moments that help mitigate the effects of trauma.

  • Playing with my child

Play is an effective way for young children to release their emotions. Role-playing with dolls or figurines enables the child to express difficult feelings and experiences indirectly. Creative activities such as drawing or painting also help children to express their feelings non-verbally.

  • I encourage physical contact

Gentle, comforting physical contact (e.g. cuddling) releases soothing hormones and reduces stress. Simply carrying my child in my arms strengthens the emotional bond.

For children aged 6 to 12

  • I bet on creative hobbies

I encourage my child to express himself through art (drawing, painting, writing, dancing...). Artistic expression offers a way of giving shape to emotions that are difficult to verbalize. It helps children better understand and cope with painful experiences. Diaries can also be a useful tool for expressing feelings.

  • I encourage open discussion

I try to create an environment where children feel safe to talk about their feelings and experiences. I encourage them to ask questions and express their feelings without judgment. In return, I offer age-appropriate, honest and reassuring answers.

  • I offer soothing activities

Sporting or artistic activities release endorphins that act as natural antidepressants. Taking part in sports, dance classes or manual activities can help release accumulated stress and promote emotional well-being. Meditation and yoga are also beneficial for some children.

For teenagers aged 13 to 18

  • I'm not afraid to talk about it

It's not always easy, but expressing their experiences openly can help teens understand and process their emotions. Open dialogue creates a safe space for sharing thoughts and concerns.

  • I turn it to the future

Having future goals gives meaning to the experience: sports competition, studies... This can help teenagers focus on building a positive future rather than remaining focused on the painful past.

  • I make sure he's well looked after

I facilitate my teen's participation in peer support groups. Teens can find comfort and advice from those who share similar experiences. Participating in social activities, clubs or support groups can be extremely beneficial to their recovery.

Who to ask for help?

Several specialized care centers can help victims of attacks, particularly with regard to psychotraumatic repercussions.

Which centers should you be aware of?

  • Emergency Medical-Psychological Units (CUMP) are activated almost immediately following events such as attacks and are accessible to victims within a month of the event, generally.
  • Les Centres Régionaux du Psychotraumatisme (CRP) sont présents dans chaque région pour accueillir les personnes concernées par un psychotrauma. Certains centres sont spécialisés dans la prise en soins des adultes, d’autres des enfants. Pour trouver le CRP le plus proche de chez moi, je consulte cette cartographie.Le rôle des CRP n’est pas nécessairement d’assurer eux-mêmes l’ensemble des soins. Ils évaluent les besoins des personnes, proposent une prise en charge spécialisée lorsqu’elle est nécessaire et peuvent également les orienter vers des professionnels du territoire formés au psychotraumatisme lorsqu’une prise en charge de proximité est plus adaptée.Attention, il y a parfois un temps d’attente avant d’obtenir un rendez-vous. 
  • Community Mental Health Centers (CMP) are facilities offering free psychiatric and psychological consultations. They provide outpatient care and can refer patients to specialized services if necessary. They are located throughout France (to find the one closest to you, type "CMP" + the name of the nearest major city into any search engine).
  • Psychologists and psychiatrists working in private practice, outside of hospital settings, specialize in treating psychological trauma. These consultations are not covered by insurance, except under specific programs. Depending on your coverage, some supplemental health insurance plans may cover several sessions or reimburse a certain amount.

Which therapy works best?

CBT, EMDR... There are several therapies recommended for the treatment of post-traumatic stress disorder. To help me decide which therapy to turn to, I can consult this page dedicated to therapies and other treatments for PTSD.

Who can I turn to for help with my child/teenager?

In addition to the structures listed above, assistance may be offered:

  • In medical-psychopedagogical centers (CMPP) all over France; to find them, type "CMPP" into any search engine. These centers offer specific support for children and adolescents
  • Children's CMPs offer free psychiatric and psychological consultations. They offer outpatient care and can refer to specialized services if necessary. There are CMPs all over France (to find the one nearest you, type CMP + the name of your nearest town into any search engine).
  • In teenagers' homes, which are specially designed to support and help teenagers and young adults
  • PMI (Protection maternelle et infantile) services, for pregnant women and young children

Self-help or self-support

In addition to seeking professional help, there are techniques I can use to help me cope with PTSD. These aren't meant to "cure" the trauma or replace treatment or therapy, but rather to offer some tips for everyday life > see the document "10 Techniques to Help Yourself"

Psychological help: mental health, panic attacks, anxiety, psychologist help, emergency number

Se rétablir après un attentat 

Il ne suffit pas d’avoir bénéficié de soins pour retrouver une qualité de vie satisfaisante après avoir vécu un attentat. Souvent, avoir vécu un événement potentiellement traumatique affecte la santé mentale, physique, et questionne aussi la place que nous occupons dans la société.

Accepter que le rétablissement prenne du temps

On aimerait souvent tourner la page rapidement et reprendre une vie normale. Le rétablissement après avoir vécu un attentat, ou après avoir perdu un proche dans un attentat, est pourtant rarement linéaire. On peut aller mieux pendant un temps, puis être à nouveau submergé· par une situation, une parole, une relation, parfois sans comprendre pourquoi. Ces fluctuations sont fréquentes. Le rétablissement ne passe pas uniquement par le fait de « parler du passé ». Il s’agit aussi de retrouver un sentiment de sécurité, au sens large.

La pair-aidance

Certaines personnes trouvent un soutien précieux dans la pair-aidance. La pair-aidance repose sur l’accompagnement par des personnes qui ont elles-mêmes vécu une situation, comme un attentat et parfois un trouble de stress post-traumatique associé, et qui se sont formées pour mettre leur expérience au service d’autres personnes concernées. Il ne s’agit pas de témoignages spontanés, mais d’un savoir expérientiel structuré.

Être accompagnée par une personne qui a vécu une expérience similaire peut permettre :

  • De se sentir comprise sans avoir à tout expliquer ;
  • De réduire le sentiment de honte ou d’isolement ;
  • De normaliser certaines réactions ;
  • De mettre des mots sur ce que l’on vit, à son rythme.

Pour certaines personnes, rencontrer quelqu’un ayant traversé une expérience similaire peut renforcer le sentiment que le rétablissement est possible. Il peut donc être bénéfique de bénéficier de la pair-aidance ou, à terme, de se former soi-même pour accompagner d’autres personnes !

Se rétablir, ce n’est pas seulement se soigner

Le rétablissement ne repose pas uniquement sur les soins psychologiques ou psychiatriques. À Nice, le rétablissement des personnes s’est aussi appuyé sur la mobilisation de toute la communauté : associations, activités culturelles, ateliers artistiques, lieux de mémoire, rencontres entre victimes, espaces de convivialité ou encore actions menées par la Ville.

Ces dimensions collectives sont essentielles. Elles permettent de lutter contre l’isolement, de recréer du lien social et de redonner progressivement une place à chacun dans la vie de la cité.

« Il y a eu beaucoup de choses qui ont été faites dans la cité, avec les artistes locaux, par exemple des BD qui ont été mises en place avec des artistes, des dessins qui ont été réalisés, des ateliers de photos… Tout ça c’est très important et ça ne passe pas uniquement par la santé mentale. Ce sont un nombre d’expériences non négligeables qui, je pense, ont beaucoup aidé à la reconstruction collective et individuelle – parce que les deux vont ensemble. On ne peut pas penser une reconstruction individuelle sans penser la reconstruction collective. .» Pr Florence Askenazy, pédopsychiatre, co-responsable CRP PACA-CORSE

Videos are often a good tool for psychoeducation. To learn about PTSD in a simple way, check out our YouTube channel .

Social workers and volunteers: how can we help?

Professionals who regularly interact with victims of attacks, whether as social workers, healthcare professionals, educators, volunteers in associations, or in emergency reception and accommodation centers, are on the front line in screening for post-traumatic stress disorder.

Spotting the signs of PTSD

In your daily interactions with these individuals, you often witness the concrete difficulties they face, particularly the psychological aftereffects of the violence they have suffered. Your role in screening for PTSD is crucial in order to direct victims to the appropriate resources. Here are the signs to watch for:

  • Flashbacks;
  • Recurring nightmares;
  • Hypervigilance;
  • Excessive startle reactions;
  • Intense emotional distress
  • Difficulty concentrating;
  • Sleep disorders;
  • Avoidance behaviors;
  • Sudden changes in behavior or mood.

Advice and guidance

It's not always clear what to do when supporting someone suffering from PTSD. Beyond referring them to a healthcare professional, we can provide daily support to the individual:
When advising and guiding men, women, and children who are victims of attacks, provide them with clear information about post-traumatic stress disorder (PTSD) in a language and format they can understand. Use adapted information sheets, translated if necessary, so that victims can better understand what is happening to them.

  • Assure them that seeing a psychologist or mental health professional doesn't mean they're "crazy". Emphasize that they won't be forced to tell their whole story again, and that there are ways to feel better.
  • Creating a reassuring and stable environment is essential to helping victims of attacks feel safe. Make sure to maintain a lasting connection with the people you advise and guide. Social support plays a significant role in the PTSD healing process, so maintaining an ongoing and empathetic relationship can be a major protective factor for their mental well-being.
  • Listen to the person you're supporting and their needs, without doing things for them or forcing them to do things at a time when they don't feel ready. Let them go at their own pace: it's not necessarily the right time for them to lodge a complaint, start therapy or work on traumatic memories.

Protecting yourself

Your involvement with victims of attacks can have a significant impact on your own mental well-being. Repeated exposure to traumatic narratives increases the risk of developing vicarious post-traumatic stress disorder (vicarious PTSD).

Certain signs may alert you to the state of your mental health and the possibility that you are developing vicarious PTSD. For example:
- If you find it hard to let go of your work when you get home;
- If you feel constantly preoccupied with someone you're caring for;
- If you feel disproportionately angry or irritable;
- If you feel overwhelmed by your emotions without being able to keep a distance.

Other signals may include disturbances in your sleep, increased or excessive alertness, or changes in your eating habits or social behavior. If you notice these persistent signs, don't hesitate to talk to a healthcare professional, such as your GP. They can help you find strategies to manage your stress and anxiety, and direct you to additional resources if necessary. Getting help at an early stage can help prevent symptoms from worsening.

Vicarious PTSD?
Vicarious PTSD is a form of traumatic stress that affects individuals who are repeatedly exposed to the traumatic stories or experiences of others, often as part of their work or professional commitment. Unlike "classic" PTSD, where the individual is directly exposed to a traumatic event, vicarious PTSD develops in those who hear about or witness the traumas experienced by others.

To find out more, consult :
- Our scientific dossier on vicarious PTSD
- Our factsheets on the risk of psychotrauma among legal professionals and journalists.

Cultural recommendations

Image1 - Cn2r

The web radio broadcast of November 13th, the other story of the trial, France Inter (podcast)

Image2 - Cn2r

Victims, and then what?, Arthur Dénouveaux and Antoine Garapon (essay)

Documentary November 13th Our Lives in Shatters - Cn2r

November 13th, Our Lives Shattered, Valérie Manns (documentary)

31f5bc7ba215e20f5484c8b092382c85 - Cn2r

Of the Living, Jean-Xavier de Lestrade (fiction)

1781345287842 - Cn2r

10 ans : le documentaire de Nice-Matin à l’occasion des 10 ans de l’attentat du 14 juillet 2016 (documentaire)

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