Dr Cathy Kezelman, President of Blue Knot Foundation

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Mark 1:18

Hello and welcome to Brainwaves on 3CR, 855 AM, 3CR, digital radio and 3cr.org.au - my name is Mark, and joining me today we have Dr Cathy Kezelman, the president of the Blue Knot Foundation. Today we're going to be talking about her role at the Blue Nnot Foundation, complex trauma and some of the ways the Blue Knot Foundation provides support to people living with complex trauma. Hi there Cathy, thank you for joining us today.

Cathy Kezelman 1:49

It's pleasure, Mark, thank you.

Mark 1:51

I suppose, first of all, can you tell us a bit about the blue knot foundation and what your role is within the organisation?

Cathy Kezelman 1:59

So Blue Knot has been around in various forms for... 30 years this year, actually - it's our birthday... and we're an organisation that works with people who've experienced what we call complex trauma - so repeated experiences of violence, abuse, neglect, often from childhood, but not always, and can occur, you know, unfortunately, at any time in the life course and repeatedly, so... my role is, you know, dubious title of President, but I'm effectively the CEO - so, you know, I've got a overarching and outward facing role, also have a position on the board.

Mark 2:38

And what types of supports does Blue Knot offer people with complex trauma?

Cathy Kezelman 2:42

So the first thing we do is try and, you know, explain the complexity of complex trauma as simply as people... as simply as we can, because there's a real lack of understanding around it and a real lack of compassion around adults who are still living with the impacts of something that may have happened a long time ago. So a lot of what we do is advocacy, it's information provision... we do that on our website, with fact sheets, videos, all sorts of you know, hopefully quite accessible material. We also deliver helpline, telehealth services, so counselling for people who've experienced complex trauma and may be struggling in the present with its effects. 

We also run educational workshops for survivors and their workshops that help people make connection between what happened to them in the past, what... how it may still be affecting them, the ways they've coped, and how to build on those strengths and resources to cope well into the future and live full and rich lives. The additional things we do is to help build the capacity of professionals and organisations working with survivors - and survivors can present to many different services for many different needs. And so how do we support other practitioners or workers to respond in a way that we call trauma? 

Informed, you know, so we work with other practitioners, workers who who may engage with survivors in all sorts of capacities, and to support them to understand the way this sort of trauma can affect people, the way it may trigger people, the challenges people may have to feel safe and to trust, and how practitioners and workers can respond in a way that we call trauma informed a way that's empathic, compassionate, human and really connects and understands we also trained practitioners to work therapeutically with survivors, so to support them on their healing journey, as well as support workers and practitioners and how to look after themselves and stay healthy and well when working with people who've experienced trauma. 

So... you know, we do a number of other things, but that is, those are the elements that, they're core.

Mark 5:06

And can you define the difference between Post Traumatic Stress Disorder and complex Post Traumatic Stress Disorder?

Speaker 1 5:16

Yeah, so people have heard of PTSD... and, you know, that was first named, really, in relation to, I believe, the Vietnam War. And it's the impact, often, of trauma that we call single incident trauma. So natural disasters, for example, a flood or a fire or a single, you know, sexual, physical assault as an adult, and it causes the set of you know reactions when people have experienced what we call repeated, ongoing, often extreme experiences of trauma, such as, for example, a child who's sexually abused for 5, 10 years of their life by someone... you know, family member, someone who should care for them and nurture them, but who's also helping them that can cause, you know, other impacts other than those that people experiencing PTSD experience. 

And you know what's fairly typical of, and I'm trying to steer away from diagnosis of complex PTSD. Complex PTSD is a diagnosis that approximates for people who've experienced complex trauma, but really the impacts are very fundamental impacts on a core sense of self, one's feeling of self worth, your ability to engage with others, to have healthy relationships, to have healthy relationships with the world. And that's a very core element of the difference between PTSD and complex PTSD. 

The other element is that, you know, many people who've experienced complex trauma have never felt safe, and so when we talk about returning to to a sense of safety, for some people, that's an alien experience. And the other elements of profound betrayal. You know, talks about a child who's been sexually abused, for example, you know, it's not being able to trust the very people who are meant to care for you, and that can have profound effects on, you know, just about every aspect of your functioning. And so with complex trauma, it's about understanding that, and understanding the differences and the way that may play out in physical, mental health and all sorts of other impacts. 

So I'm not going to talk about a whole pile of symptoms, because I'm trying to move away from that. It's really about, you know, how people present in the world and when people have been harmed in relationships, really, really important to be able to start to healing relationship, but that can be challenging if you struggle to trust and to feel safe.

Mark 7:46

Could you please speak to intergenerational trauma?

Cathy Kezelman 7:49

Right? Well, intergenerational trauma is also quite complicated. And you know, what we know is that you know, often people impacted by trauma can have the effects, you know, both in the way they can engage with the world, also in the way they can parent, and also the effects of trauma can be passed down, we call it epigenetically, so within one's body. So there are all sorts of ways in which trauma which has not been processed and worked through, can play out across generations. And we've seen this, you know, in all sorts of you know, in wars that in countries where which have been more toward for generations, with, you know, different communities that have lived, you know, often not just individual trauma, but collective trauma, but trauma. 

You know, for many, many generations, we've seen it with the Stolen Generations, with, you know, with, you know, First Nations, children who've been been taken from everything that they connect with. You know, family and kin and country and you know, and that causes, you know, profound trauma which passes on, not just to them, but can pass on, you know, right through to their children, grandchildren and so forth.

Mark 9:10

You mentioned just before something called epigenetics. Yeah. Could you expand a bit on that if you can?

Cathy Kezelman 9:17

Yeah, so epigenetics is the way our genes, our DNA, expresses itself. So there's been studies that show in in families where there's been trauma, that often it can still impact, you know, right through four generations, because of the way it's affected someone's DNA and how it plays out now, and I don't want people to to take from this that when they've experienced, you know, this sort of trauma, that it means that you know they're doomed for the life at all. You know that's not the message here at all. The message is about understanding and understanding the potential impacts, about being empathic around them, but knowing that people can and do here, all.

And recover from trauma with the right support and to know that there's always hope and the possibility of, you know, finding a place that's, you know, much better than we've come from. So I just don't want this to be equated with, you know, that's my destiny. Because, you know, trauma is not people's destiny. Trauma is, you know our experiences and events that it can impact you profoundly and can impact you over time, but for which there are pathways forward to a different place.

Mark 10:31

And what... are some of the ways complex trauma might impact someone's life?

Speaker 1 10:36

Oh well, you know, just as we're all individuals, so people have, you know, individual impacts from complex trauma. That said, there are some you know, commonalities as well. And I did speak around self esteem before. And you know, the ability to struggle with with feeling good about yourself. And much of that can come from the blame that you know, the self blame that people often carry, in the shame that people often carry, and what we know is that that's often reinforced by the stigma that there's been in society around sort of judging people who are really struggling in their lives, rather than trying to understand what happened to someone along life's journey to have impacted them so profoundly and understanding well they're, you know, they're remarkable because they're still here. 

And, you know, they've experienced some very abnormal and, you know, outrageous experiences that no one should ever experience, but they've had the strength to to survive, and they've survived as best they can. People use all sorts of coping strategies, and many of those coping strategies can actually create their own issues. They may not be as constructive, you know, and everyone always thinks of alcohol and drugs. And of course, those are, those are coping strategies. So is over exercise and overwork and others, which may be, you know, more socially sanctioned. 

But they can also have them impact self harm, and obviously, you know, feeling suicidal, and you know, having, yeah, suicidal behaviors, of course, also or other other ways that people that complex trauma impacts people, and you know, needs to be worked through, can also impact people's physical, mental health, and many people with complex trauma of care, you know, whole range of diagnosis, including we spoke about complex PTSD before. And you know, there are many, many different diagnos, but many people, you know, experience anxiety, panic attacks, suffer with depression. 

And certainly in my own experience, my own trauma, I had a time when I would have, you know, had 10 to 20 diagnoses and was profoundly depressed, suicidal, I really struggled to get out of bed at all for a couple of years. And for me, working through my trauma, and I'm not saying that was easy at all. That was a very hard journey, but, you know, it did, you know, take me to a place where, you know, my mental health, hopefully, is, is much more stable than that, and that I'm living a, you know, very full and rich life, and so I believe... 

It shows that, you know, even though we could create diagnosis, it wasn't really about what was wrong with me, it was about what had happened to me and when I could process the things that had happened to me and put meaning around them and learn to manage my own sort of physical physiological responses to that trauma, I was In a much better place, both physically and mentally.

Mark 13:43

Before you defined somewhat some of the differences between complex trauma and trauma - to recover, to begin that recovering journey, do these different types of traumas require a different approach? And if so, what might the differences in support look like?

Cathy Kezelman 14:01

Yeah, look, I mean, I think for anyone, any human being who's experienced, you know, you know, such horrendous events or adverse events, particularly when they've been perpetrated by other human beings, they can have a profound impact on us. And so, I think, you know, often, many survivors - and this includes people with PTSD as well as complex trauma - you know, withdraw from society and you know, learnt that, you know, they can only rely on themselves because the world is dangerous. 

So, you know, building the capacity to... trust others, to actually look around in one's network and see who may be able to just be there with me and for me, and start to reach out and, you know, build a healthy relationship of support, can actually help to change that internal script around The world is dangerous and everyone is dangerous, but for people. People who've experienced complex trauma that can take a lot longer, because the...betrayal has been so profound, the loss of safety has been so profound, and the lack of support network may also be much greater, because often people who have been harmed in families, you know, and in networks, who are the ones that you know, traditionally are there, there for you. 

And so how do you sort of reframe what your support network's like? What does it look like? And I often, often talk about the family we choose. So we have the family we're born to, but the family we choose, you know, can become very important. And that can... be much harder for people with complex trauma, and it can be much harder for people to understand themselves, because it's not such a clear connection. You know, when someone's had, you know, have been assaulted, physically assaulted, you know, you've got the event, you know what happened, you've got the reaction to it. 

But what we're talking about is, you know, often things that have happened a long time ago, may not have been named, in fact, may have been negated and denied, and then making connection between them and struggling, you know, decades later. And so that connection is not nearly as direct, and it's not nearly as direct also for society, around people, in the community around people. So it can be very hard for survivors to actually, you know, start to understand themselves - and also to forgive themselves for the way they may be struggling, because until they can make those connections and understand that, you know, the reactions they've had to... sort of repeated toxic stress are biological. 

It's the way we all survive, and you know, it puts our nervous system on high alert. But their nervous systems may betray them in a way, and you know, they may struggle with, you know, very strong emotions that they can't manage, or, you know, having impulses that they find hard to control, or using coping strategies that may not be so constructive. And so, you know, all of... you know, piecing that puzzle together can be very difficult. And I suppose the other element to that is that often people experience, you know, degrees of amnesia as well, may not remember what happened or may not be able to put a narrative together of what happened to them, because trauma impacts memory and your ability to... be able to remember chronology in detail. 

So there are all these extra elements that make it difficult for survivors, firstly, to reach out and seek support, to forgive themselves, to make the connections, to have people that they feel they can trust... and to you know, and to have the often the resources, also, to seek the support they need. Because often, people can struggle... you know, and these are all generalisations, obviously, people are individuals... can struggle, you know, in completing their education, or holding down a job and so on and so forth. So, you know, so there are some major challenges in... daily life as well.

Mark 18:10

Before you mentioned that, yeah, one of the ways complex trauma might impact someone, that might affect their memory, their ability to memorise things... is that... a widely known symptom of complex trauma? Or do you think there might be people who have complex trauma, who just who also are aware that they have memory issues, but don't attribute that to... yeah...

Cathy Kezelman 18:31

Well, it's interesting. I can talk about myself. So, yeah, so in terms of memory, I can, I can talk about myself. So when I was... a young adult to middle age, I started to realise that I literally had no memory for about 10 years of my childhood. And that was also, it wasn't just for bad things that happened, it was for everything. And for years I'd just excuse that. I just said, Well, you know, I've got a bad memory. I had a happy childhood. My mother told me I had a happy childhood, but I had no, literally, no detail of it. 

And then as I started to explore what was going on, I became more agitated by... you know, that awareness and saw how very abnormal that was. And, you know, did start to... and, you know, couldn't actually piece together what had happened to me. I started to experience, you know, flashbacks, which were, it's like a sort of reliving of parts of what's happened to you, and you experience those with all of the emotions and the sensations and the movements of, you know, whatever bit of trauma has been relived. And I started to piece together, you know, bits and pieces of what had happened, to try and build a sense of my own story. 

Because, you know, really, it's very hard until you actually know what's happened to you. It's really hard to know who you are. And yeah, that was really challenging for me, but I found it was really challenging for people in my immediate circle - not just because, you know, I was to the external world behaving very strangely, and I was not the person they knew - but I think people didn't understand that. I think it was really a struggle, particularly because I was, I was a doctor. I was considered, you know, on top of it, you know, able to function quite well, and then I was not able to function, and I was not able to actually explain what had happened or what was going on, because I didn't know yet. 

And, you know, this was incredibly confusing for me, but incredibly confusing, you know, to my medical colleagues, to, you know, other people who, yeah, you know, you would assume are sort of well educated, but yes, I think it's, I think there's a real lack of awareness, and I think also within sort of legal circles and you know, when you start to go through a court process, which wasn't a part of my experience, when you know, that's really dependent on, you know, details and facts and chronology and you know, and when you know people have experienced this sort of trauma become witnesses, or, you know, they're often considered unreliable witnesses, because they may not have the accurate information, or they may appear to change what they're saying. 

But that's the function of traumatic memory, and it's not well, very well known, something that [?Lunotz] tried to really impart and truly, really help educate around it, because it actually makes total sense. You know, for me, what it was, was a mechanism called dissociation. And dissociation, when you think about it, is a very powerful mechanism of the brain that's, you know, really protective. And what it does is, you know, certainly the way I perceive it is, when I was a child and I was going to be overwhelmed by all of this, you know, bad stuff that was happening to me, what dissociation did was, you know, break, break those bits of experience and bits of memory and bits of emotion into...separate parts which were not not connected. And that caused my amnesia and ability not not to remember, but it also allowed me to survive. 

And I suppose then, as I started to heal and recover, I became, you know, very actively dissociative. And, you know, became much more aware of that. But that, to me, made total sense, and did explain why I couldn't access those memories, because they'd been locked away from my consciousness, and they just gradually came back through flashbacks and other words. So it really is, you know, it's both fascinating... as well as you know, sort of needs to be celebrated, but also very challenging. And can be, can appear, and is sort of damaging at the time, but also it's enabled you to survive and see another day.

Mark 22:36

If you don't mind me asking, was it helpful for you to define what was happening to you as dissociation? Once you could identify that experience as dissociation, did that help you to sort of explore how, what was going on for you?

Cathy Kezelman 22:36

Well, I mean, you know, at the time, it helped me to understand didn't need, really need a name, just to understand that bits of my experience were coming back, you know, because at the time, I was just so subsumed by my trauma that, you know, I was really struggling just to... live in the present at all. But you know, because I'm someone who needs to know and understand, I then, of course, you know, read a lot, and... needed to make sense of it. So yes, you know, being able to explain it in a way that made a lot of sense to me - yeah, absolutely, it helped. But that was not necessarily the first part of the process, that was down the track when I had some ability to sit back, reflect and try and understand - was when I was in the midst of it. I was in the midst of it.

Mark 23:53

In situations when a friend or family member has identified a loved one is struggling with the impacts of complex trauma, but might not be aware of it, how can they go about supporting that person? Is it important someone struggling with the effects of complex trauma identify it as such?

Cathy Kezelman 24:12

I don't know that... you know, again, I'm not big on some names and titles, but I think, you know it's helpful if you're walking alongside someone, that, you know, you can support them to start to share what's worrying them in the present day... and you know, gently suggest what you may perceive. I don't, you know, it's very important not to push anyone into somewhere they're not ready to hear. So it's often best to be led by the person. And just, you know, be there to hear and listen and support them to make the connections. And of course, obviously there's, you know... professionals out there that can help support the process. 

But if you're the first person that person trusts, then you've got a very unique role and a very privileged role, but a challenging role. And I suppose what's important is, you know, the message to me is, message from me is, do what you can, to walk alongside someone, to not shut them down, to be there, to hear and listen, not to try and solve it, but just to be, you know, gently helpful... but also to look after yourself, because it's a challenging journey, and I suppose, for, you know, for that person to find out as much as they can, as well, around what this might be, to help them make sense of it. So then they, as they make sense of it, they can support the person they're supporting.

Mark 25:59

What are some of the barriers that get in the way of someone living with the impacts of complex trauma, from attributing those difficulties with something that has happened to them or is happening to them?

Speaker 1 26:10

Yeah. I mean, I think, you know, we spoke a little bit about that before. It's about understanding... just the whole picture, and that connection between something that happened so long ago - and being able to make those connections. And that's why you know, information can be very valuable. You know, finding out you know more about, you know, just the stress response and how, you know, people respond to things that, you know... are challenging, helping to normalise that, helping people to, you know, to make sense of themselves, to understand that, you know, they're not alone - that, you know, many others experience this as well - and know that you know that there is help and hope there. 

I think that's, you know, very important part of it. But it can be a long journey. It can be, you know, hard to... understand this. And it's, it doesn't happen in one go. It's, it's a very gradual process that takes time.

Mark 27:10

We're talking to Dr Cathy Kezelman, the President of the Blue Knot Foundation. We're talking about her role at the Blue Knot Foundation, complex trauma, and some of the ways the Blue Knot Foundation provides support to people living with complex trauma. Welcome back to Brainwaves on 3CR. We're talking to Dr Kathy Kezelman, the president of the blue Knot Foundation. We're talking about her role at the Blue Knot Foundation complex trauma and some of the ways the blue knot Foundation provides support to people living with complex trauma. 

It was recently reported that 683 Victorian police officers and staff members have been investigated for alleged sex crimes and family violence offences between 2019 and 2024. In cases of complex trauma where a crime has been committed, do these types of statistics make people feel less safe to report to the police?

Cathy Kezelman 28:07

Look, I mean, obviously those statistics are pretty chilling and horrendous, but I suppose, sadly, what they're reflective of is that... these sorts of crimes are a social practice that are not uncommon. And I'm not trying to scare, you know, listeners, but... that's hard to say is that you know, above the, you know, the average percentage or you know, but we just know that, unfortunately, it's not infrequent that people perpetrate crimes - that includes police. It includes, you know, we had a Royal Commission to Institutional Responses to Child Sexual Abuse. There are 4000 institutions in which children were sexually abused. 

So it's a pervasive social practice. Obviously, we would like to think that, you know, no police, no teachers, no religious personnel would ever commit any crimes like this.We'd actually like to think that no human beings ever did, but that's, unfortunately not the case. But obviously it makes it harder. Yep.

Mark 29:13

Are the current processes in place for people to report crimes where abuse has occurred, fit for purpose? And if not, what would the ideal system of reporting look like?

Cathy Kezelman 29:25

That's a very big question. (LAUGHS) It's a very, very big question. Obviously, the... it would be good to have great clarity around where to go, who to go, and to always have people who are, you know, well informed, receptive, truly trauma-informed, can actually provide support as well as context to what's going to happen. Because I know, you know, part of the challenge is often that there's no clarity around what this will look like, and that you know, certainly going through a whole criminal justice process, not just the reporting, but you know, right through the court process, if that's what people choose... can be very challenging. 

And certainly you know, victims, you know, can feel like... you know, they lose... yeah, I mean, that felt disempowered by the crime, and then they felt, often feel repeatedly traumatised in the process. So it's about, how do we get a system that is actually not created for the system, but is created for the victim survivor who's going through there, keep them fully informed, have right... the right support mechanisms in place, and have a system that doesn't require people to repeat time and again what happened to them, or to not believe them or to invalidate them... and also have very clear pathways where there are not delays in the system, where there's not all sorts of legal games that can cause their cases to go on for three or four years. 

So there's many, many things, you know, many, many ways that this process can be improved. And certainly there have been some changes to, you know, to processes, but yeah, there's obviously a long way to go.

Mark 31:26

One in four Australians live with the lifelong effects of abuse, neglect, violence or exploitation experienced throughout their lives. If a greater number of people had access to the support they need, what effect would that have on the community?

Cathy Kezelman 31:42

Well, obviously, the more people who can get the support they need, the more people will, you know, firstly, for themselves live... you know, more meaningful lives, more connected lives, they will... you know, these are broad generalisations... hopefully be healthier, more able to engage in society, contribute back to society, and build a society, a community which is more mutually supportive of one another. You know, I mean, obviously, what we haven't talked about, and you know, I'm not an expert in this area, is, you know, perpetration of crimes as well. 

And... but another part of it is, you know, how the community often stands by, you know, sort of bystander stuff, and doesn't get developed, and thinks it's not part of their their their issue. But given the fact that you know we're talking about more than one in four adults, you know we should stop pretending this is about someone else, this is not happening to us. It affects us all. But how is... we... how can we as a society, become more understanding, become more passionate and find a way to actually support people who are struggling in their lives? 

Because we all have stuff that happens to us at long life's journey. Let's stop pretending so we're all in together, rather than saying this, and them and us. You know? There's the them who, you know, something's wrong and up, and then there's us, and we're all great, you know? So, yeah.

Mark 33:07

This might be a hard question to answer, because everyone is different, but... what does recovery look like? And when someone with the effects of complex trauma identifies they are doing better than than they were, what has usually changed in their lives?

Speaker 1 33:25

Yeah, as you said, everyone's different (LAUGHS) So... noting that this is a generalisation... what's different I think, well, you know, for me, I'm talking about me is that trauma no longer subsumed my every day - that you know, what I had experienced became part of me. I had a sense of what it had meant, but I also had done a lot of processing so that I could... understand it, understand who had done what and why, not necessarily forgive them, but put that in context, but know that, you know, I had, I was well resourced, and that means some internal strengths with the strategies and the capability to be out there, to engage with people, to, you know, to connect with them, to have healthy relationships and to play a meaningful role. 

So I think for individuals, as we said, it's very different. Maybe one person may be able to, you know, be able to get out of the house, you know, once a day, to go for a walk for half an hour - that may be recovery for them. But you know, so everyone's got different aspirations. For someone else, that may be taking their paper perpetrated to court and getting a getting a sentence. For others, that maybe being able to... be there with their family in a way that, you know feels safe. So many, many answers to that.

Mark 35:05

And lastly, for anyone who might be about to explore the way complex trauma has impacted their lives, what resources might you direct them towards?

Cathy Kezelman 35:16

Well, obviously I'd direct them to Blue Knot. (LAUGHS) So, I mean, it's for adults, so it's Blue Knot, B, L, U, E, K, N, O, T, dot org dot A, U - certainly call our helpline, which is 1300 657 380, and that operates nine to five, seven days a week.And just, you know, explore and read as much as, you know, as much as you want at the time. Because what we find is that different people come and go from information at different times and draw out different... you know, different parts that are important to them at that point in time. Connect with others. Look around your support network. Who is, who is there for you, or could be there for you, and start to talk - if you feel up to it, if that's where you're at.

Mark 36:10

Yeah. Thank you for coming in today, Kathy, and sharing your experience and some of your story with us.... Yeah, I just, yeah, I really appreciate it.... I feel like I learned a lot, and I'm hoping that our listeners also, yeah, learn some things that they might not have been aware of before.

Cathy Kezelman 36:31

Yeah, okay, thanks.

You can find more about our shows on our website, brainwaves.org.au, or on the three CR website, 3CR.org.au or on iTunes. Feel free to send us feedback or suggestions for shows via email at brainwaves@wellways.org - thanks for listening, and we'll be back next Wednesday at 5pm for another episode of Brainwavess on 3CR. If any of the things we have talked about today have distressed you, you can contact Lifeline on 13 11 14, or Listen well, warm line on 1 300 111 500.

3CR ID 37:11

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