Understanding Complex Trauma: A Path to Healing and Recovery with Dr Cathy Kezelman

Complex trauma, characterised by repeated experiences of violence, abuse and neglect, affects a significant portion of the Australian population.

With over 1 in 4 adults impacted, it is crucial for healthcare providers to adopt trauma-informed practices to effectively address the needs of individuals with complex trauma experiences.

This is the passionate advocacy of Blue Knot Foundation President Dr Cathy Kezelman — to drive socio-political change and trauma-informed responsiveness to complex trauma.

Drawing from her personal journey of living with and recovering from complex trauma, she offers expert insights on effective trauma management.

In this featured leader article, Dr Kezelman shares her wealth of knowledge, blending her professional expertise with her own transformative experiences, to provide invaluable guidance on navigating and overcoming trauma.

Prevalence and Impact of Complex Trauma

Complex trauma refers to the ongoing and extreme experiences of violence, abuse, and neglect endured during childhood or adulthood. In Australia, a conservative estimate suggests that more than one in four adults are living with the consequences of it.

Individuals who have experienced repeated harm often develop sensitivities and vulnerabilities, affecting their ability to trust, feel safe and engage with healthcare providers.

“It is about what healthcare providers can do to not trigger those trauma reactions and create an environment which is emotionally and physically safe, and which supports a person to heal and recover from their trauma,” Dr Kezelman said.

Being trauma-informed means recognising the possibility that individuals seeking healthcare services may have experienced trauma and understanding the impact of trauma on their responses and behaviours. It involves creating an emotionally and physically safe environment that supports healing and recovery.

Dr Kezelman noted that healthcare providers must shift from a traditional biomedical approach to a holistic perspective that considers a person’s life context, background and culture.

By integrating trauma-informed principles, healthcare providers can foster patient choice, control, and empowerment while prioritising safety and trustworthiness.

Integrating Trauma-Informed Practice in the Healthcare System

Although many practitioners and services claim to be trauma-informed, achieving true trauma-informed care requires a comprehensive organisational approach.

It involves cultural and philosophical changes that permeate all aspects of healthcare service.

Adopting a “what happened to you” approach rather than focusing solely on “what is wrong with you” is vital. Combining biomedical, psychological, and social perspectives can lead to more effective care.

Dr Kezelman noted it is about patient choice, control and empowerment, as well as safety and trustworthiness, and being attuned to each and every person in the context of their lives, their backgrounds, and their culture.

“To integrate trauma-informed practice into the Australian healthcare system, people with lived and living experience need to be engaged in every element of the system, so their expertise transforms ‘business as usual’,” she added.

Barriers to Addressing and Treating Trauma

A significant barrier in healthcare is a lack of awareness about trauma, particularly complex trauma, as a fundamental cause of physical and mental health issues.

“This often leaves trauma off the radar, and as a result means that a range of presentations is left poorly understood and, as a result, not adequately responded to,” she said.

The biomedical model often overlooks the adverse experiences that profoundly affect individuals’ lives and contribute to health risk behaviors which can increase the likelihood of a range of physical and mental infirmities.

Effectiveness of Trauma-Informed Programs

Research indicates that trauma-informed programs lead to improved mental health outcomes, including reductions in depression, anxiety, and additional trauma experiences.

Such programs prioritise physical and emotional safety for all and specifically those with trauma experiences. It fosters trust, connection and engagement fostering positive relationships with service providers, helping to change the impacts of the prior negative experiences of relationships which were harmful and traumatic.

“As survivors feel more empowered and experience greater autonomy and choice they are able to reach out more consistently and participate in services providing support to foster their path to healing and recovery,” she said.

Trauma-informed programs have been established to be particularly effective for marginalised groups, or those with experiences of discrimination and oppression.

Reaching Out for Help

“If you have been abused, violated or betrayed as a child it can be a real struggle to trust anyone and to reach out for help. It can also be difficult to imagine that you could ever feel or be safe, or find a way to start to feel better with the support of another person or service.”

The Blue Knot Foundation offers trauma counselors who listen and provide tailored support, whether in the form of information, resources, ongoing counseling, or other assistance. Blue Knot recognises the difficulties survivors face in trusting others and taking the first step towards healing. By offering a safe space and empowering individuals with choices, Blue Knot Foundation facilitates the healing process and demonstrates that recovery from childhood trauma and abuse is possible.

“No one pretends that the path is necessarily easy, but it is one that does not need to be travelled alone.”

The field of trauma care in Australia is experiencing increased recognition and awareness, driven by societal changes, such as the COVID-19 pandemic and growing attention to domestic violence and sexual assault.

However, there is still progress to be made in addressing the specific needs of individuals with complex trauma experiences.

Blue Knot and its partners play a critical role in breaking down the stigma, educate, inform and build the capacity of communities and workforces to acknowledge, respond to and support people struggling with the impact of complex trauma on a path to healing and recovery.