Latest / System Speak: Complex Trauma and Dissociation / Guest: Michael Salter

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Guest: Michael Salter · System Speak: Complex Trauma and Dissociation

• 0:08
  Speaker 1: Over:
• 0:11
  Speaker 2: Welcome to the System Speak Podcast, a podcast about Dissociative Identity Disorder. If you are new to the podcast, we recommend starting at the beginning episodes and listen in order to hear our story and what we have learned through this endeavor. Current episodes may be more applicable to longtime listeners and are likely to contain more advanced topics, emotional or other triggering content, and or reference earlier episodes that provide more context to what we are currently learning and experiencing. As always, please care for yourself during and after listening to the podcast. Thank you.
• 1:01
  Speaker 3: Professor Michael Salter is a criminologist at the University of New South Wales, where he studies the criminological aspects of complex trauma, including the intersections of technology with abuse, violence, and exploitation. He's the author of two books, organized sexual abuse and crime, justice, and social media, and a range of papers on child abuse, gendered violence, and technology. He conducts multi method research with victims and survivors of child sexual exploitation, domestic violence, and sexual assault, and conducts multi sectorial policy analysis with the aim of improving responses to survivors and preventing violence and abuse in the first place. He sits on the board of directors of the International Society for the Study of Trauma and Dissociation, and he is an expert advisor to the Australian Office of the e Safety Commissioner, White Ribbon Australia, and the Canadian Center for Child Protection. He is an associate editor of Child Abuse Review and a member of the editorial board of the Journal of Trauma and Dissociation.
• 2:10
  Please note, this episode has a trigger warning for examples of trafficking given, but without abuse details given, as well as other types of abuse mentioned in context. As always, please care for yourselves during and after listening to the podcast. Thank you. Welcome, Michael Salter.
• 2:33
  Speaker 1: I'm a criminologist. I'm based here in Sydney, Australia, and, the focus of my research is on the kinds of abuse and neglect that gives rise to dissociative conditions. So I do a lot of interview based research with adults who have a dissociative condition, and I talk to them about their lives and about their childhoods and also about their experiences with different services and institutions. So, you know, why why haven't they been better protected by schools, by child protection services, and what's been their experiences as adults when they've been seeking help through mental health care or the criminal justice system. And a big part of my work is just documenting their encounters with different services and then trying to advocate for improved care and support.
• 3:34
  Speaker 3: What I love about this is that you are literally documenting the stories of people who no one has listened to before.
• 3:42
  Speaker 1: Look. What I what I don't understand is why people don't listen. I mean, these are really important stories. We learn a tremendous amount from survivors that have a lot to teach us about how to improve our institutions and how to improve our society. And I guess I'm sort of frustrated that more people aren't listening to survivors because it really is to everyone's benefit.
• 4:12
  Speaker 3: I heard you speak recently at the ISSTD conference about marginalized communities. Can you give I know I know you're not here to present all of that again, but can you give a little bit of a recap about that and some about that study?
• 4:28
  Speaker 1: Yeah. We we received funding for a two year study looking particularly at women with lived experiences of complex trauma. And, you know, we here in Australia, we've been having a really high profile national conversation for five or six years now, particularly about domestic violence and about sexual assault, and probably not a lot of recognition that a a lot of women who experience TV and sexual assault in adulthood also have child abuse histories. And also that there's many experiences of violence that fall outside those categories. So, you know, it's it's not uncommon for frontline domestic violence and sexual assault workers to be in contact with women who have experienced, you know, organized abuse, sexual exploitation, you know, ongoing abuse within their families.
• 5:24
  You know, that's those are quite common reports. So we received funding for a two year study interviewing women, broad range of women. We interviewed about 40 women with lived experience of complex trauma about their experiences and particularly their efforts to get help from health and welfare services and criminal justice. And then we did interviews and focus group work with practitioners, so professionals across a range of sectors, not just mental health, but also also legal services, alcohol and drug services, homelessness services. And just putting together a picture of, you know, what does it look like if you have complex trauma?
• 6:05
  What does it look like to try and get help, in in the Australian service system? And we find, you know, complex trauma maps onto well recognized in inequalities around gender and sex, around racial inequality, around different kinds of inequality, but also complex trauma is itself a type of inequality. I think traumatized people are discriminated against, and I think traumatized you know, severely traumatized people occupy a marginalized population in and of themselves because of the way that they're treated in society and and I think the way they're discriminated against in service settings.
• 6:46
  Speaker 3: How do you find these people? How how do they connect with your study to be included?
• 6:53
  Speaker 1: You know, when when survivors are you know, I think part of the survivor journey and Judith Herman, you know, talks about this quite a lot in her book Trauma and Recovery, but part of the survivor journey for for many people is they get to a point where they want to talk about what's happened to them and and not just talk to a therapist, but they want to participate socially and politically. They want to engage in a kind of activism, one that's, you know, that is safe comfortable for them, but also they want to contribute to social change because, you know, survivors are often really acutely aware that what's happened to them is not just a personal injury, but that it it speaks to broader social problems and social failings, and they want to be part of the solution. And so what I find is that it's not difficult to to recruit complex trauma survivors for research. You know, when I I can put out a call on social media or I can put out a call through specialist mental health networks or through survivor networks. And survivors are generally pretty good about identifying the point that they're at when they feel safe and comfortable to to talk about what's happened to them with someone who's not a therapist.
• 8:20
  You know, they they they want to be heard, and so that's a really, you know, nice part of my research. Find is that often people volunteer for my research because they've reached that point in their life where they they really want to be heard, not just by me, but they want society to listen. And and I think it's an important part of my research is to create a space, where those stories can be can be heard.
• 8:46
  Speaker 3: I think that that part is beautifully done, and I would agree with you. We had on the podcast not official research, research, but just a general survey and, wanted to know about experience specifically about experiences in therapy because there's so many stories about bad therapy experiences and why is that and what are we doing differently? What is ISSTD doing differently? Why does that matter? This is why it matters.
• 9:15
  All of those kinds of questions. And, over over 800, almost 900 people responded, which we had hoped to get like 30 or 40 or 50. And I was just shocked that so many people wanted to say, no, this is what makes a good therapist, and this is what makes therapy hard, and this is what makes accessing services difficult and just in that tiny taste. And so I can't imagine something that you're doing and the way you're being able to present it and the people who are listening to those results and receiving those presentations from you, what a difference that's making. I think it's so powerful.
• 9:55
  Speaker 1: I think, you know, when it comes to trauma care and trauma informed care, and I mean proper trauma informed care that's actually about building trust and rapport and building, you know, strength and resilience. You know, I I think it is a real it's a huge paradigm shift for the whole health service, you know, not just in my country, but I think, you know, I think internationally. We've we have inherited a mental health system and a health system that is, you know, based on very old fashioned ideas that are now, I think, quite obsolete. And, you know, trauma survivors are a huge bulwark of pressure for change on that system. And one of the reasons why I think trauma survivors, you know, experience a lot of harm in health care settings, and and I think one of the reasons why they they don't feel listened to and they don't feel understood is because, you know, the old paradigm of mental health care is just it's failing.
• 11:01
  It's just failing. I think we are at the cusp of a major reorientation in the way that we approach mental health as as as a community. And it's it's really I know it's really painful for trauma survivors to just be pushing and pushing and pushing for that change, and there's a huge human cost to that. But I I think it's relentless, and I think it will produce results because, ultimately, the the old approach, the old biomedical approach is just not moving the dial, and and not enough people are getting the opportunity to really recover and live the lives that they want to live.
• 11:41
  Speaker 3: How do you explain or teach or present about complex trauma to these audiences that may have not heard about it or understood it before?
• 11:53
  Speaker 1: Generally, I I start with the statistics, particularly around polyvictimization and multiple victimization. You know, the the issue of child abuse is often seen as separate from domestic violence, which is often seen as separate from sexual assault. But, you know, what what we know is that abuse and neglect, it clusters in people's lives. If you've been subject to one form of abuse or neglect, you're disproportionately more likely to suffer from another form and another form. And so, you know, we need you know, that this is often how I start is just by laying out the the statistics and the likely outcomes for for for people when when they are exposed to these multiple stressors and multiple traumas.
• 12:43
  And then, you know, situating that within a maybe a depressing context, which is institutional failure. You know, child protection services are not protecting kids on a population level. Mental health services are not delivering the gains that we would expect them to deliver given how much money we we we we put in. And so really just just situating the lives of people with complex trauma within that sort of broader picture. And statistics are important.
• 13:12
  You know, statistics really speak to especially to psychologists and to politicians, but stories are really important, and survivor stories are really important. And, you know, over the last couple of years, I've been working with a small group of women who've survived child sexual abuse material. So their abuse was recorded and distributed online, and, you know, this is a group you know, there's a huge population of people out there where this is their story, but, you know, they've really struggled to be heard. And often, for safety reasons, they, you know, they do hide because it's it's not safe to be public about those sorts of experiences. But this is a small group called the Phoenix eleven.
• 13:53
  So eleven young women based mostly in North America, and we've been able to bring that they they're anonymous, but we've been able to bring their stories to politicians. You know, my my home affairs minister met met with them in in February. You know, a range of politicians around the world have heard heard their stories, and it's incredible how much that has moved the dial on political willingness to do something, about about this issue, finally hearing from a survivor. And so, you know, we shouldn't take survivor stories for granted. I think sometimes, you know, survivors can feel really invalidated because no one's listening.
• 14:34
  But then when we find the right forum, the right opportunity for a survivor story to be heard, it's just so impactful. So, yeah, that's certainly been a lesson for me is just never to take, you know, the power of of a survivor's life for for granted.
• 14:52
  Speaker 3: Your your work in this particular area is actually what first got my attention in in understanding some of what you were doing because I I myself did not know that what I had been through counted as trafficking because it was my family was involved, and my therapist had to literally explain to me, no. That is trafficking, and this this this is child pornography or child abuse materials. And having to have that explained to me that it counted because I myself, even as a survivor, it's so stigmatized and so stereotyped or so narrowly understood or not understood that I didn't even understand that what had happened to me was that because it wasn't just, I don't know, a stereotypical story or something. But what I found in connecting with other survivors is that it's much more common even what I experienced than what I thought. And then from that experience to fostering a 17 year old who was, trafficked here to America from Honduras on the beast, the train, and, she got to us because I'm I'm telling stories because we were talking about stories, so I'm sorry.
• 16:15
  I don't usually tell these details at all, even this much, But she she she got to us in foster care because a man in America paid for her and bought her from Honduras, and she was sent over. And when she realized she was 17, 16. And when she realized what happened, she tried to get away from him in the car and jumped out of the car on the highway and so was taken to a hospital, and then no family came to pick her up because she had no family here, and anyone else involved would have gotten in trouble. And that's how she ended up in foster care at our house. And hearing her story, even though it was so different than my own, realizing that there's so many different ways that this happens and so many different ways it shows up.
• 17:08
  For me reading about your work and hearing other people say out loud, this is going on and it needs to stop, and this is happening and it needs to stop. And now it becoming a big conversation politically and in different countries because of some of what's come out in the last year or two is there's something not just validating, but something that gives courage, I think, to other people who have also come forward. And it's been a fascinating thing to both witness and be a part of in some small way.
• 17:45
  Speaker 1: Yeah. Absolutely. I mean, I think that's just a really good overview of the issues, which is that, you know, child sexual exploitation and trafficking, it really is quite a vast and a sort of a diverse phenomenon, but government has only paid attention to it in very select ways. So particularly where child sexual exploitation intersects with other government priorities, particularly around border control, then that's where we see government paying attention to sexual exploitation. So the trafficking of children across international borders or across state borders, and also the focus of government on technology.
• 18:24
  So, you know, that's been the the real sort of focal point for government for twenty years is is looking at abuse online and the way that abuse is facilitated online. And these are all important areas of study and intervention. However, very consistently now for over thirty years, we have clear research evidence, clinical evidence, forensic evidence that particularly around the sexual exploitation of young children, so before the age of puberty, that the primary traffickers of young children remain parents. And this has simply been a very unpalatable, very politically difficult area of child trafficking. And, unfortunately, as a result, it has been easier for governments to ignore this very, very difficult area of work and focus elsewhere on, on areas that are easier and less politically explosive.
• 19:23
  We've simply got to a point now where particularly the Internet is flooded with abuse images of very young children. And when those images are traced back to their source, you know, parents are disproportionately the producers of that material. When survivors are asked about what happened to them, they describe organized abuse. They describe parental abuse. They describe sadistic abuse.
• 19:49
  Some of them describe ritual abuse. So all of the different sorts of abuse that I think government and other institutional authorities have been have swept, frankly, under the rug for for decades is is really coming back out into into light. But I do wanna emphasize that we can't take those those developments. We can't take that progress for for granted. You know, another one of the points that Judith Herman made when she was writing about complex trauma is that to keep these kinds of social phenomenon visible and public, it takes political agitation, and it takes a political movement.
• 20:28
  Otherwise, the social forces of denial will win. And so I think, you know, your podcast is really important. I think survivor networks are really important. I think it's really important that we form alliances to just keep this on the public agenda so that it doesn't disappear again.
• 20:45
  Speaker 3: And when you're talking just for disappear listeners who may not have as much clinical background, when you're talking about intersectionality, you're talking about government programs or things that are already in place, and now these issues are are showing up in those areas, and so they have to pay attention to them differently.
• 21:04
  Speaker 1: Yeah. I think that's right. I mean, certainly in my country, for example, trafficking is a concept and a legal framework that is solely applied to to transnational abnormal migration. So particularly women from Southeast Asia who were brought into Australia for the purpose of sexual exploitation. And, you know, that that that issue of sort of border security and border control has been a major sort of political hot button topic in in my country now for, you know, over twenty five years.
• 21:42
  And so, you know, the the legal you know, the the language of trafficking and the legal framework of trafficking, you you know, it it really just speaks to government priorities in my country rather than the realities of trafficking on the ground, which is, as you say, much more pervasive, much more complicated, and, of course, involves, you know, Australian families trafficking their children online, trafficking their children across Australian borders. But, you know, we don't have any specialist police agency that is targeting that kind of crime despite it being, you know, pervasive and incredibly harmful. However, we do have specialist police agencies focusing on transnational borders and focusing on the online space in particular. So, you know, in you know, part of my work, and I I have a a government funded study being released next month looking at the role of parents in Australia in the production of child sexual abuse material of their children. Just to make the point, you know, this happens.
• 22:47
  This is happening here, and we don't have any specialist policing around this, and we also don't have any victim aftercare. We don't have any specialist support services for victims to make sure they're okay once this has happened to them. You know, there are there are huge gaps in our in our response to this issue.
• 23:06
  Speaker 3: I I like that you included those pieces that that's part of the discussion, not just bringing awareness to this but then also where the gaps are in caring for it because that's part of where the healing happens right not just the talking about it or saying it out loud but also the tending to the wound whether that's individually or collectively for survivors or those who have endured it.
• 23:31
  Speaker 1: Yeah. A really key lesson for me is that we can't just go to authorities or government with the problem and expect them to solve it. You know, once once you know, it's it's up to us to figure out the problem, document the problem, analyze the problem, and then it is up to us to start to identify solutions that we then take to government, and we say to them, this is feasible. This is achievable. You know, this will save you money, for example.
• 24:04
  You know, because because we don't provide adequate support and care to very traumatized people, then they're showing up in homelessness services. They're showing up in alcohol and drug services. They're showing up in child protection services. They're showing up in prison. They're repeatedly presenting to emergency departments with self harm injuries.
• 24:24
  You know, these are these are group of people that actually have very high health care because their core needs aren't being met. Well, what if we invested that money upstream and we provide them with support the support that they need so that they can live the lives that they want to live? And, you know, and we say that government will you know, this will save you money. Now it's unfortunate that we have to put the argument in that way, but, you know, that's the kind of argument that we do need to make. And over the last year or so, I've been partnering with one of our women's health services in a in a regional area in my state, and they've developed this brilliant plan for a one stop shop for complex trauma where people with complex trauma can come to, like, one service that seeks to meet all of their needs.
• 25:16
  So, yes, there's mental health care, but there's also physical health care. There's massage. There's also psychosocial support. There's practical support around the welfare system and legal issues. And the idea is that someone with complex trauma could just go to the service, and the service would seek to meet all of their needs and explicitly support them to recovery instead of what happens at the moment, which is that people with complex trauma and dissociation are often in touch with multiple services, multiple professionals trying to manage all of these different appointments and rules and systems.
• 25:54
  And so we're currently advocating to government, and we made a presentation to the Commonwealth Parliament last week for for funding for that model because we think that that's what's necessary. So that came from us. You know, it came from the ground. It's been codesigned with survivors. Survivors have a really strong voice in the design of that service, and that codesign process is still going on now.
• 26:19
  And then we take that solution to government, and we say, you know, we don't just have the problem, but we have the solution as well.
• 26:26
  Speaker 3: And they can listen because it needs it meets the needs of both groups. The survivors get the care that they need, but it saves the government and the program's money because they are getting the healing up front rather than continuing to show up different ways expressing symptoms?
• 26:45
  Speaker 1: I think we've also seen increased awareness, over the last ten years of intergenerational trauma as well. Now lots of trauma survivors are fantastic parents, you know, fantastic parents. But for some trauma survivors that haven't been supported to heal themselves, you know, parenting can be really, really difficult. Also, for for moms who've been traumatized as as kids, you know, they're more vulnerable to being targeted by violent and abusive men, and so they're at high risk of domestic violence. And so one of our arguments to the government is, you know, if you support people to recover fully, then, you know, you're not just protecting this generation, you're preventing the transmission of trauma intergenerationally.
• 27:34
  And we can think about intergenerational trauma in a range of different ways. You know, we in in my country and, you know, many countries around the world, but in, you know, in my country, we have First Nations peoples who have been subject to, you know, a few centuries now of genocidal policies and practices that have been really devastating for many communities. And saying to the government, well, you know, you have a responsibility to holistically support First Nations people to heal fully and completely from generations of abuse and neglect and and trauma. So complex trauma is not only about, you know, what's happened in one lifetime. Complex trauma is very often about what's happened across multiple lifetimes.
• 28:22
  It's about our ancestors, our history. I think this is true of, you know, white people as well. You know, the last hundred years has been incredibly militarized. We've had multiple world wars, multiple conflicts. We've sent generations of men out to war.
• 28:38
  They've come back profoundly traumatized. In some cases, then passing that trauma onto their children. You know, we need to think about transgenerational and intergenerational trauma as very much a part of the complex trauma equation. And the challenge to government and to put this challenge to government, which is we we have the right to heal. You know?
• 28:58
  We have the right to health and well-being. We have the right to heal from what's happened over the last, you know, one hundred, two hundred years.
• 29:06
  Speaker 3: The right the right to be human for for healing to come when things go bad or when bad things happen.
• 29:13
  Speaker 1: I think so. And there's a, you know, there's a a bravery to just acknowledging, you know, the extent of the things that human human beings do to each other, to hurt each other in different sorts of ways, but also just to acknowledge the incredible capacity that we all have to heal and also to heal others. You know? Outside of my professional life, I teach meditation for my local Buddhist temple. And, you know, one of the lessons that I think, you know, we can take from meditation practice and particularly the the practice of of loving kindness is you just can't underestimate how powerful care is and and and what a huge difference you can make in someone's life just by telling them that you care about them and showing that to them in, you know, sometimes quite small ways can just be so profound.
• 30:12
  And so, yes, you know, human beings are fragile and dependent and vulnerable, and as a result, you know, we can be hurt and hurt others. But the reverse is true. You know, we can heal and and heal others. And I think that's a really important point around the trauma informed care paradigm. It's not just about talking about victimization and suffering.
• 30:37
  It's talking about hope and healing and the fact that that's realistic and the fact that, you know, everyone has the right to a good life, but, actually, everyone, that's a very realistic goal. You know, it's just about inviting our whole society to participate in achieving that goal for of a good life for everyone no matter what's happened to them.
• 31:00
  Speaker 3: It somehow makes meaning and transform some of the hardest and worst moments of humanity and turns it into something that means something and is something that is so good and powerful. And like Judith Herman says, empowering where it's not just what happened to me, but what I can offer others in good.
• 31:26
  Speaker 1: It's interesting. I was I was at an ISSTD conference a couple of years ago, and and Rich Lowenstein was talking. Rich has been the kind of clinical coordinator and and and and head of the Shepherd Prat Centers now for decades. So he, you know, he's worked I I think he estimates with over ten thousand people with dissociative conditions now. And one of the points that he made was for people with a dissociative condition, how elevated their compassion and and empathy is.
• 32:00
  And he was talking about some of the very sort of prosocial characteristics of of a lot of people with the dissociative condition. And I hadn't thought about it in that way before. You know, I hadn't thought about I hadn't thought about the particular sorts of personalities that I often encounter when I'm doing my my my work. But, you know, because, you know, trauma survivors are very, very aware of just how vulnerable and fragile human beings are. But as a result, many of many survivors, you know, are so compassionate and and empathic, and and, you know, there there's an aspect, I think, with trauma where to to be effective in the trauma space, often you you need, you know, you need your own pain.
• 32:52
  You know, you need to your own pain. You need to process your own pain. I mean, it's important that we've taken responsibility for our own healing before we go out to to try and help others. But, you know, pain and suffering, it is a resource because I think it does speak to something fundamental about the human condition, and it it allows us to, I think, stand alongside other people who are suffering and and, you know, and offer them a sense of connection and and understanding at a time when otherwise they might feel very, very lonely. So I I I I think trauma and and and pain, I think it is it can be a very powerful and positive connecting force between people if if if we allow it to be and if we're supported to allow it to be.
• 33:46
  Speaker 3: What else do you want to share about your work or different areas of it? I will have Heather Hall is coming on the podcast later, so she's going to talk about some of those aspects that she shared in your presentation that you did together. But what what else about your work specifically or other pieces would you like to share while you're still on?
• 34:09
  Speaker 1: We when when we were doing our complex trauma studies, so this is the big study with a lot of interviews and, you know, interviewing survivors and then interviewing professionals. And we had a workshop towards the end of the study with professionals, people that work in complex trauma, and we were talking to them about vicarious trauma. So many of your listeners will be familiar with this concept, but vicarious trauma describes the fact that professionals who work with traumatized people can then start to develop trauma symptoms as a result. And so we were talking to them about vicarious or secondary trauma, and it was really interesting. One of the women on the focus group said, you know, she said, I'm so sick of hearing about vicarious trauma.
• 35:01
  She said, you know, I'm so sick of it. She said, I I love my job. And she said, I love working with people with complex trauma. And she said, you know, I love learning from my clients. She said, you know, I'm I'm a stronger person because, you know, I listen to my clients, and I learn from them, and I learn from their strength and their resilience, and it makes me a better person.
• 35:20
  It makes me a stronger person. And she said, have you ever heard about vicarious resilience? And so we went and we looked at this, and there's a little bit of literature on vicarious resilience, which is about people, professionals who work, in complex trauma and the fact that by working with clients with complex trauma that you learn a lot of the positive lessons that they've learned in their life, and you it there's a lot of evidence that working in the complex trauma field teaches us about resilience and growth and, you know, and sort of spiritual development. And so we were we we went back and we looked at all of our interview data because we hadn't asked professionals about vicarious resilience. You know?
• 36:07
  We we hadn't asked them about what they like about their job. So we went back and we looked at the interview transcripts. We've got pages and pages of transcripts from professionals and and just pulled out so much so many points from these interviews where just spontaneously professionals talked about exactly this. They just said, I wouldn't be doing anything else. You know?
• 36:29
  I've I've worked with in complex trauma for twenty years or thirty years or forty years. I love my job. And, you know, and talking about why they love their job. So we're we're pulling that out, and we're writing that up as a separate paper. And it's something it was really a lesson for me now when I go out and when I am training professionals around complex trauma and when I'm speaking to people that work in the complex trauma field, I I now always bring this point up, which is, you know, let's not just talk about what's difficult about sometimes working with people with complex trauma, but let's talk about why you love it.
• 37:07
  Let's talk about why you do it. You know? Let's invite other people into the field by talking about the positive transformative aspects of this this work. So that was a real turning point for me. It also made me think about why I do my work and the really pleasurable parts, you know, of working with survivors and how much I've enjoyed that.
• 37:31
  Yeah. And I just think that that's a really important conversation for us to have as professionals who who work with people with complex trauma is, actually, we really like it. You know? We like we really enjoy the company of survivors, and and that that's something that we need to advertise to other people because sometimes complex trauma work is discussed discussed in a I don't know, like a like, it's it's hard and it's challenging and it's all of these things. Well, it is that, but it's also joyful and hopeful, and there's a full spectrum of emotion emotion doing this work.
• 38:10
  So, yeah, I think that's just such an important part of the story here, and it's really important that we tell it, that that working in the complex trauma field brings us so many benefits, you know, and one of the things that professionals said to us was just they marvel at how strong their clients are, and they they are just astonished that human beings could be so so strong and and resilient.
• 38:42
  Speaker 3: I actually love that you shared that because I'm secretary for the vicarious trauma special interest group with the ISSTD, and I think that that is something that we could absolutely focus on and talk about some more and something worth following up there. And so I'm grateful that you shared that.
• 39:03
  Speaker 1: It's it's my pleasure. We need to finish the paper, but I I'd love to share it with the special interest group.
• 39:08
  Speaker 3: Absolutely. What else anything else that you want to share today?
• 39:13
  Speaker 1: No. No. I think that's it for me. You know? But I do, you know, I do think things are changing for survivors.
• 39:20
  I think I think the landscape really is shifting particularly around dissociative conditions. I think in October time, we'll be in a much better place, you know, than we are today. I think it's unfortunate that we have to work so hard to get those changes, but this is a struggle. And part of what we're pushing back against, it is the social forces of denial and disbelief that just don't wanna hear about these stories and don't wanna hear these these lives. And it is a real project of social change that we're all engaged in.
• 39:54
  But, you know, as hard as it is, it's so important that we that we celebrate the changes that we're seeing and the improvements that we're seeing and that we hold on to hope. And I, you know, and I am really, really hopeful, that in my lifetime, you know, we will get the outcomes that we that we want and the outcomes that survivors deserve.
• 40:16
  Speaker 3: I think what you just said was really key about survivors, what they deserve, but but also what you said earlier about how you've included their input in the treatment model and the the suggestions that you've presented to the government that this is a solution and here's some ways that would work. I think that's so important. When we did that big survey last year, which was a poster session at ISSTD this spring when it was canceled in San Francisco, and one of the biggest things that came out of that was the feeling of like guidelines being updated and needing to be updated and people not listening to survivors and survivors feeling left out of the process and sort of taking from the disability rights advocates about nothing for us without us. And it has been amazing to watch Australia do this so well collectively. Like we've had Kathy Kesselman on the podcast and talk about Bloom Knot Foundation and the updated guidelines that are so fantastic there and all these different areas that are starting part of that shift where survivors are having an input in not just, advocacy but also clinical input of when you do this, this is what our experience of it is and why that needs to change and and sort of that impact how that gets passed down from clinician to clinician to when they are not trained well or don't know things like the way the ISSTD has taught and provides the webinars and classes and things.
• 42:02
  And I think it's so powerful and I love watching Australia because you're doing these things so well collectively. Right now you're representing all of Australia. So it's done so well in those examples of including those perspectives and that empowering piece like Judith Herman talks about or giving voice to the community or other marginalized populations of listen to them and let them help in healing for them and have a voice for that, I think it's so powerful, and I think that that's absolutely part of what's changing.
• 42:43
  Speaker 1: I think that's right. We we're seeing the mainstreaming here in Australia of sort of co design and consultation frameworks and even, you know, codesigning consultation frameworks with survivors. You know? Not only do you want to be consulted, but how do you want to be consulted? You know?
• 43:01
  What constitutes meaningful feedback from your point of view? And also sustainable feedback as well. And I think that's the other challenge for survivor and lived experience groups is making sure that actually people are funded and supported to participate in in collaboration and and cooperation. So I would like to see more of this done, to be frank, you know, not just in Australia, but but internationally. And it would be, I think, a really useful project to start to work more closely with survivor and lived experience networks And to to bring together, yes, there's clinical expertise, that's great, but the lived experience expertise and bringing that into guidelines because it it really does it it improves their effectiveness.
• 43:58
  It's it's not only a moral principle, which is that survivors have the right to participate in decisions that impact them, and as you say, nothing about us without us, which I think actually originally as a phrase comes from the HIV and AIDS activist movement in the eighties. And, I mean, that's a really interesting study in a social movement that essentially you know, certainly in my country, you know, people living with HIVAIDS, you know, were incredibly impactful on on on health care policy. But it's so you know, until quite recently, that was the outlier. And instead, what we had was, you know, doctors and psychiatrists making decisions for clients who, you know, were expected to be very compliant with treatment, and yet, you know, if people were compliant with treatment, they often didn't get good outcomes because, clearly, for trauma survivors, their treatment wasn't trauma informed. So it would be fantastic to think about how we can normalize and mainstream these codesign and collaboration practices so that they are sustainable and that it's realistic for survivors as well.
• 45:13
  We can't just expect survivors to just be consulted and not be supported financially for providing that that expertise.
• 45:22
  Speaker 3: Oh, that's fascinating. I have loved this discussion. Thank you.
• 45:26
  Speaker 1: It's my pleasure. Thank you so much for the invitation.
• 45:28
  Speaker 3: Were you in San Francisco?
• 45:31
  Speaker 1: I was. Yes. Yeah. For a week.
• 45:35
  Speaker 3: Did you go to the dinner the night before we canceled it?
• 45:40
  Speaker 1: I must have. I'm trying to decide.
• 45:44
  Speaker 3: I think you sat next to me, and I didn't know that you were you.
• 45:48
  Speaker 1: Yeah. I'm pretty sure we met at the conference.
• 45:52
  Speaker 3: That's so funny. I'm sorry. That's so funny. I think I sat between you and Peter Naves and ate octopus, but I have cochlear implants. And so sitting it was a sweet little restaurant, and everyone was having a good time, and it was lovely, and I'm so glad we got that moment before it all got canceled.
• 46:11
  It was my last pre pandemic moment and it was it was a really positive experience but I have cochlear implants and so I could not hear in that cellar at all. It was hard for me.
• 46:25
  Speaker 1: No. I'm glad that we had that connection, but yes. And then and then COVID hit, and it's just been crazy ever since.
• 46:34
  Speaker 3: That's so funny. I apologize. I didn't mean to get off topic. I just now the pieces just now came to me.
• 46:40
  Speaker 1: Of course. No. No. No. Thank you, Emily.
• 46:44
  Thank you for everything you're doing as well. It's just wonderful to see this big audience that you've pulled together. It's a it's fantastic.
• 46:52
  Speaker 3: Thank you.
• 47:12
  Speaker 2: Thank you for listening. Your support of the podcast, the workbooks, and the community means so much to us as we try to create something together that's never been done before, not like this. Connection brings healing, and you can join us on the community at www.systemsspeak.com. We'll see you there.