This specific type of trauma is a violation of trust and mistreatment.

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If someone you've depended on for survival has violated your trust or well-being, either during a one-time incident or over time, you may have experienced betrayal trauma.

Author and professor emeritus of psychology at the University of Oregon Jennifer Joy Freyd, PhD, was the first to introduce the concept.

"In the early 1990s I was trying to make sense of why people often seemed to remain unaware of or forget certain types of trauma," Freyd tells Health. "I realized that the need to stay attached to a caregiver could override the need to detect betrayal even when the betrayal was traumatic, like sexual abuse. Betrayal captures the dilemma people face." This betrayal usually causes a person to feel shame and fear, and it can have lasting mental health repercussions. Here's what to know about this specific form of trauma.

Betrayal Trauma , Man and woman. Relationships concept. Multiple exposure.
Credit: Getty Images

What is betrayal trauma?

In short, betrayal trauma is trauma stemming from mistreatment by a caregiver and/or a trusted person, like an intimate partner. It can include physical violence or emotional or sexual abuse.

Not everyone who experiences it reacts the same way. "How people respond [to betrayal trauma] depends on the person and details of the experience," says Freyd. "But we do see common reactions, including anxiety, depression, and dissociation."

Clinical psychologist Melissa Platt, PhD, who specializes in working with survivors of trauma, first became interested in understanding betrayal trauma when she worked with veterans returning from Iraq and Afghanistan in the mid-2000s.

The veterans Platt interviewed as a part of a post-traumatic stress disorder (PTSD) study often answered "no" to many of the PTSD assessment questions, and yet they seemed deeply pained.

"It seemed like the PTSD interview was not always asking the right questions in situations in which the trauma was perpetrated by a commander, fellow unit members, or anyone else the veteran trusted or depended on for survival," Platt tells Health. "Since then, my career has focused on understanding and treating betrayal trauma."

The difference between betrayal trauma and PTSD

Traditionally, psychologists and other mental health professionals have focused on PTSD as the typical negative health impact of trauma. "Although PTSD does impact a lot of survivors, its diagnosis and treatment do not take into account the particular ways that being abused by someone trusted or depended upon impacts a survivor," says Platt.

Traditional PTSD results in fear and problems caused by trying to avoid fear, while betrayal trauma often results in shame and dissociation, as well as problems caused by trying to avoid shame and dissociation. "These different trauma consequences necessitate quite different treatment approaches," notes Platt.

Examples of betrayal trauma

Childhood physical, emotional, or sexual abuse perpetrated by a caregiver are types of betrayal trauma. But it's not restricted to childhood. Infidelity and intimate partner violence are other examples of events that can cause betrayal trauma, because they all involve a breach of trust between people in an intimate relationship.

Betrayal trauma can also happen when an institution, such as a government or law enforcement body, harms the individuals it claims to serve.

"Anyone can experience betrayal trauma, but our research suggests that women experience more betrayal traumas than men, while men experience more non-betrayal traumas than women," reveals Freyd.

Betrayal trauma recovery

Betrayal trauma is not a diagnosis; it's a way to understand a type of harm inflicted on a person. With that in mind, there's no single treatment approach. But Platt says the following elements are necessary for deep healing to be possible:

Psychoeducation

Betrayal trauma survivors often believe that there's something wrong with them because they experience dissociation, have difficulty trusting themselves, and have mental health symptoms they can't explain. "They often believe they are 'bad' because they feel bad and because shame is a normal survival response to experiencing betrayal trauma, but they are not usually aware that is the case," says Platt.

Dissociation and shame are actually survival mechanisms that keep a person from making waves while they are in the relationship with the perpetrator, which might make things worse. "Survivors need to understand that these symptoms are signs that their mind was trying to help them to survive, rather than signs that there is anything wrong with them," says Platt.

Somatic focus/interoception

Betrayal trauma survivors are often disconnected from their bodies, but developing the skill of interoception can help them heal. "Interoception is the ability to recognize and understand the body's internal sensations," Platt explains. "Without adequate interoceptive skills, psychoeducation will not be effective in changing the survivor's negative beliefs about themselves because the negative beliefs will still feel true."

While it can be scary at first for survivors to tune in and listen to their body, ultimately they often learn that their body's messages are more trustworthy than they ever could have imagined. "Many somatic approaches, such as somatic experiencing and sensorimotor psychotherapy, help survivors develop interoceptive skills," says Platt.

Compassion and self-compassion

It's crucial that therapists who are working with betrayal trauma survivors embody compassion, so that the survivor can feel safe enough to do their own work.

"Survivors also need to learn to treat themselves with kindness and compassion in order to be able to stay the course and heal," says Platt. "Approaches such as compassion-focused therapy and mindful self-compassion offer wonderful tools for building compassion and self-compassion."

Patience

Betrayal trauma typically involves abuse over the course of months, years, or even decades. And therapy for betrayal trauma can also take time. As Platt explains, it's about healing rather than fixing or getting rid of symptoms.

Since Freyd's first betrayal trauma paper was published in 1994, research on betrayal trauma has increased at an exponential rate. Hundreds of articles and chapters on betrayal trauma are now published each year. "This gives me hope that survivors will have access to more and more betrayal-trauma-informed providers in the coming years," says Platt.

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