When a Trauma Is Also a Betrayal

The person who was supposed to be closest to me hurt me the most.

Important people (such as parents, partners, and friends) let this happen to me.

I feel betrayed.

These are some ways that people who had survived traumas described betrayal to our research team when we were developing the Trauma Appraisal Questionnaire (TAQ). Today, years of research from around the globe show that betrayal is common in interpersonal traumas and part of the harm of trauma. Here are three things to know about trauma and betrayal.

1. What are high betrayal traumas?

Violence and abuse can take many forms—from psychological and economic to sexual and physical. Across different forms of violence and abuse, the victim-perpetrator relationship can vary, too. Sometimes the people who perpetrate violence are strangers or acquaintances. They were often close to or trusted others, such as friends, bosses, parents, teachers, coaches, and intimate partners.

In some instances, such as child abuse and intimate partner abuse, the very same people who perpetrated abuse were the people on whom the victim depended. Psychologist Jennifer Freyd, who developed betrayal trauma theory, gave a name to situations in which victims depend on the people who perpetrate abuse and violence: high betrayal traumas.

2. What are the consequences of high betrayal traumas?

High betrayal traumas are linked with more severe psychological and physical health symptoms than other traumas. For example, high betrayal traumas have been associated with more severe posttraumatic stress disorder (PTSD) symptoms than other traumas. But that’s not all. High betrayal traumas have also been linked with psychological distress that ranges from dissociation and alexithymia to depression and anxiety.

Beyond psychological distress, high betrayal traumas predict memory disruptions for the trauma as well as attention difficulties. High betrayal traumas have also been linked with poorer health and more physical health problems relative to other forms of trauma.

High betrayal traumas can also have relational consequences, affecting how people view relationships and trust, for example.

Girls and women are more likely than boys and men to be victimized by someone close, such as sexual and physical assaults by intimate partners. The gendered nature of high betrayal traumas helps to explain gender differences in psychological distress, such as depression. That said, when high betrayal traumas are perpetrated against people of all genders, the relational harm and health consequences should be taken seriously regardless of gender.

3. What can we do about high betrayal traumas?

The most important thing we can do about high betrayal traumas is to prevent them from happening in the first place. While intimate violence is terribly common, it is not inevitable. Indeed, researchers have tested multiple approaches to preventing dating violence with positive outcomes. Recently, researchers reviewed the findings from 20 trials testing sexual violence prevention programs with more than 35,000 adolescents. They found good evidence that prevention makes a difference.

When prevention fails, though, we need to make sure that our communities have services for survivors. A range of services is needed after high betrayal traumas, from crisis and other immediate support services to long-term healthcare, including therapy. In terms of therapy, there’s evidence that several approaches can be helpful. For example, cognitive processing therapy has been shown to reduce PTSD symptoms after sexual assault across multiple studies. In addition, feminist researchers and clinicians have emphasized that because the harm of high betrayal traumas is relational, approaches to healing must also be relational.

There’s a role for you and me to play in responding to high betrayal traumas, regardless of our professions. Consider, for example, that social support can make a real difference after traumas, including high betrayal traumas. Indeed, when a research team looked at multiple studies of high betrayal traumas, they found that survivors who had greater social support reported less severe PTSD symptoms.

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Each of us can also play a role in advocating for prevention and intervention services in our communities. Perhaps you can advocate for offering prevention programming to adolescents in your local schools or faith communities. Maybe you can champion expanding crisis and long-term health services for survivors of high betrayal traumas.

After all, we each share an interest in preventing and responding effectively to high betrayal traumas, as I came to understand in writing Every 90 Seconds: Our Common Cause Ending Violence Against Women. That’s because intimate violence costs individuals and our communities. Together, though, we can make a difference by working to prevent and respond effectively to intimate traumas.

To find a therapist, visit the Psychology Today Therapy Directory.

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