When Institutions Add to the Harm of Trauma

A while back, a colleague who works with survivors of intimate violence reached out to ask what research studies had to say about institutional responses to reports of sexual assault and other forms of interpersonal trauma.

In that conversation, we talked about growing evidence that the actions institutions take—whether they are schools, businesses, the military, or faith organizations—matter to survivors. As survivors have described to journalists and researchers, institutions can take actions that help or harm.

What was the state of the growing research literature, though? With my colleague’s question in mind, graduate students on my research team took the lead on a scoping review. In a scoping review, researchers carefully identify and map studies in a topic area—in our case, the topic was institutional betrayal.

Here’s a bit of what we discovered and reported in a newly published paper.

What Is Institutional Betrayal?

To understand institutional betrayal, it’s important to first know a bit about the nature of interpersonal traumas.

As I’ve written about in prior posts, interpersonal traumas are often perpetrated by people close to the survivor, such as intimate partners, caregivers, coaches, bosses, and friends. Psychologist Jennifer Freyd described situations in which victims depend on the people who perpetrate abuse and violence as betrayal traumas. Since Dr. Freyd coined that term and introduced betrayal trauma theory in the 1990s, researchers around the world have documented that traumas high in betrayal are linked with serious harm, such as psychological and physical health symptoms.

As betrayal trauma theory developed, Dr. Freyd and her collaborators pointed out that people also depend on institutions—such as the schools or churches they attend and the places they work. In 2014, Smith and Freyd introduced the term institutional betrayal to describe when institutions fail to take actions to prevent or respond appropriately to sexual assault and other interpersonal traumas.

With this history and my colleague’s question in mind, our research team set out to map the state of peer-reviewed, empirical research on institutional betrayal. Focusing on 37 papers published from 2011 to 2022, here are three things I take away from the new scoping review:

1. Institutional betrayal is common and linked to harm. Across the 37 studies, institutional betrayal was common among those who had been victimized. A majority of studies focused on trying to understand links between institutional betrayal and outcomes, such as psychological distress. A clear pattern emerged: Survivors of interpersonal trauma who also experienced institutional betrayal reported worse outcomes than survivors without institutional betrayal, from psychological distress and physical health systems to more negative health care experiences.
2. A focus on college, military, and health care settings paves the way for future research. Most of the studies published from 2011 to 2022 focused on institutional betrayal in college, military, or health care settings. These studies have been critical to building the field’s understanding of institutional betrayal. Drawing on betrayal trauma theory, patterns in the available research, and survivors' accounts of institutional betrayal, however, it’s clear that research on institutional actions is urgently needed in other settings, including K-12 schools and businesses.
3. Disengagement matters. A quarter of the studies reviewed by our team focused on how survivors engaged with their institutions. Not surprisingly, when people feel betrayed by their institutions, they are inclined to stop engaging with the institution. Disengagement can have enormous consequences, such as not getting health care or dropping out of school.

What Do We Do Now?

As a trauma researcher, I find that there’s a lot that’s important in this review—and a lot that is discouraging. For example, across studies with survivors of interpersonal trauma, institutional betrayal was common and linked with harm. This means that many survivors bear the costs of more than the original violence. They also bear the costs of institutional action and inaction.

In that discouraging picture, though, is a path forward. If institutions have the power to add to the harm of interpersonal trauma, they also have the power to play a role in healing. In the words of Dr. Freyd, they can show institutional courage. After all, institutions share an interest in preventing and responding effectively to interpersonal traumas, as I came to understand in writing Every 90 Seconds: Our Common Cause Ending Violence Against Women. They share an interest because it’s the right thing to do—and because institutions and our communities are diminished when survivors cannot meet their full potential.