The Acute Phase of Trauma: What is the First Week Like – England

Trauma victimstypically report alterationsin their experience of place, person and time associated with a sense of unreality to what has been happening. Being in a serious road accident, work accident, or medical accident can resultin the phenomenon of “dissociation” which may take severalforms,such as an altered time sense, with time being experienced asslowing down or significantly accelerated; feelings of unreality, depersonalisation, out-of-body experiences and general confusion and disorientation. These phenomena are recognised by trauma specialists as‘peri-traumatic dissociations’(Marmar et al, 1996).

Research hasidentified these dissociative experiencesin victims of road accidents and medical accidents, physical assaults, including hostage victims, building collapses, work disasters(e.g. oil rig) and natural disasters, such as earthquakes. These independentstudies plus extensive clinicalfindings pointtowards a predisposition or vulnerability to subsequent psychological or psychiatric disorder arising from peri-traumatic dissociation.

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