Betrayal Trauma Is a Very Real Response to a Violation of Trust. Here’s How to Cope

When Rebecca Knudsen, a licensed marriage and family therapist and the founder and director of Thrive Relational Recovery in Centennial, Colorado, first started seeing couples in monogamous relationships disrupted by cheating, she sometimes found herself wondering if one spouse had strayed because the other was behaving so strangely.

"I almost came to the conclusion that there was infidelity ‌because‌ the partner seemed kind of [erratic]," she says. The cheated-upon partner was often obsessive, on edge, fearful, controlling, angry enough to throw things out the window.

Knudsen saw heartbroken clients "hammering their spouse with question after question all hours of the night," desperate to know every painful detail, terrified not to know. "Nothing feels safe anymore," Knudsen says. "You spend so much time questioning everything."

In trying to help couples move toward resolution — whether reconciliation or separation — Knudsen had to treat symptoms a therapist might expect to see in a survivor of a violent attack or a sudden loss: hypervigilance, or the sense of always having to be on guard; sleeplessness; flashbacks, triggers and nightmares.

What Knudsen came to realize was the infidelity had brought on the symptoms, not the other way around. Her clients were experiencing textbook trauma presentations.

Betrayal trauma, trauma that results from a violation of trust at the hands of someone you thought would keep you safe — maybe safer than anyone else in the world — is a relatively new therapeutic field.

It was first identified and described in the 1980s and '90s but only gained traction as a diagnosis in the last 20 years, according to Barbara Steffens, PhD, founder of the Association of Partners of Sex Addicts Treatment Specialists (APSATS) and author of ‌Your Sexually Addicted Spouse: How Partners Can Cope and Heal.‌

While more resources have become available both online and off in that time, Steffens says betrayal trauma still isn't widely recognized.

People can experience betrayal trauma in romantic relationships — either through infidelity or other types of intimate deception, including financial malfeasance and differences over care of shared children — but they can also experience it as children of abusive parents or guardians, or even with trusted authority figures such as religious leaders or doctors. Sufferers may have to come to terms with a betrayal that went on, with or without their knowledge, for years, and often must continue to interact or even live with their betrayers.

Acknowledging this kind of hurt isn't straightforward. When there may not be one clear event, a start or end point, some survivors may struggle even to put together the story of what happened or understand it as over.

Nor is betrayal trauma necessarily reducible to one agent. "There's collective trauma among communities as a result of a lot of societal factors," says Ajita Robinson, PhD, who specializes in grief and trauma as executive director of Friends in Transition in Bethesda, Maryland.

When the betrayal, and the trauma that results from it, have both gone on for a long time — especially when they begin in childhood — living with this kind of distress becomes normal. "Folks will name their experiences, but they don't code them as trauma," Robinson says. There's no clear separation between cumulative trauma and life as usual: "The trigger isn't removed because it's in the fabric of the environment they often navigate."

Robinson works with a number of individuals who have grown up with neighborhood violence, incarcerated parents, parents who were abusive or who misused alcohol.

Often, their friends and neighbors are dealing with the same things, and trying to do anything except get through it can feel like a risk: "They're afraid that if they begin to peel the layers back and name the trauma they won't be able to put it back together, to navigate in their day-to-day life," Robinson says.

But this trauma also doesn't have to be rooted in a familial or romantic relationship, says Stephanie Tuazon, LCSW, a licensed social worker in Los Angeles who specializes in trauma, stress and fatigue, particularly in people of color.

Unfair or unpredictable treatment from a boss, for instance, can make a workplace that felt safe — "I have a sense of trust, a sense of enjoyment or connection" — a place of alienation and fear. Before you think, "No big deal, it's just work," consider: For most of us work is, directly or indirectly, our means of access to health care, housing and other basic necessities for survival.

That may ring true for veterans, too, according to Rhonda Stewart Jones, LCSW, the head of About Face, which specializes in therapy for members of the military, doctors, rescue workers and other people with jobs that make them likely to experience trauma.

"Many folks I've sat with have said, 'Why did we go to this war anyway?' It really impacts how they are as people, often paranoid, often questioning, not able to truly settle down, so their level of comfort as we know it is no more," she says.

As you might expect, diagnosis and treatment can be particularly difficult to obtain for people who have been systemically underserved by health care institutions, including women, people of color, queer and trans people and immigrants, among other marginalized communities.

Treatment models for cisgender, heterosexual couples have historically encouraged women to see themselves as complicit and culpable if their partner betrays them.

Licensed marriage and family therapist Krista Haws, LMFT, who ended up in couples therapy with her husband after he betrayed their relationship, found herself labeled "codependent" — told, in other words, that she was enabling his behavior because she was too reliant upon him for her own sense of self, an explanation she rejected.

When it came to available therapy at the time, Haws, who now counsels both betrayed and betraying partners at Thrive Relational Recovery, found the betrayed spouse often either gets ignored or blamed.

If the women looking for mental health resources are women of color, especially Black women, the obstacles are particularly pronounced, and the resources available are especially likely to reinforce the trauma.

"For Black women, we have the stigma that we have to be strong, we can't express our emotions and let people know we are struggling. We can't be vulnerable," says Shanita Brown, PhD, a trauma therapist who also teaches in East Carolina University's counseling graduate program.

In Black communities, Brown notes, people often turn to faith first to deal with psychological suffering. Brown's work has focused in part on promoting therapy as a complement to religious counseling, urging church leaders to encourage their congregants to pursue both.

"You can pray ‌and‌ go to therapy," she says. "It doesn't mean you have this spiritual flaw. It doesn't mean you lack faith."

With good reason, Black survivors of trauma may not trust doctors, and "we live in a world where there are not millions of Black therapists," Brown says. White therapists may lack the context and experience — called cultural competence — to understand and respond effectively to a Black client's trauma.

Online, psychological and ideological rhetoric around betrayal trauma varies. Some clinicians use language of inclusivity and intersectionality. There are also many betrayal trauma organizations and practitioners grounded in faith, Christianity specifically. In their treatment, explicitly or implicitly, these groups typically endorse a normative view of sexual behavior, usually monogamous and heterosexual.

Some betrayal trauma therapists purport to treat addiction to sex and pornography as well, conditions that are not recognized as such by the World Health Organization's International Classification of Diseases (ICD) or the American Psychiatric Association's most recent version of the Diagnostic and Statistical Manual of Mental Disorders. (The ICD does list "compulsive sexual behavior" as a disorder.)

The consensus seems to be that sexual betrayal isn't always the result of sex addiction. It's clear why, however, if there ‌has‌ to be a diagnosis, sex addiction can seem like a better and more fitting option than codependence from the point of view of the betrayed partner.

Notably, definitions and treatment tend to be similar across worldviews, and across types of betrayal trauma: What matters is that trust — justified trust, trust you should be able to have — was violated.

Definitions and pathologies may in fact be beside the point: What matters, Steffens stresses, is "fully informed consent. Where the betrayal occurs is when what's agreed to is not followed."

The therapists and counselors interviewed here continue to see traditional talk therapy as a necessary element of treatment, although they also tend to combine it with newer techniques.

One of those techniques is eye movement desensitization and reprocessing or EMDR. This neurologically informed method of treatment involves recalling the trauma while simultaneously moving your eyes side to side or engaging in other side-to-side movement (often referred to as "bilateral stimulation"), according to the American Psychological Association (APA).

EMDR is thought to help "move" trauma from the short-term memory to the long-term, where it feels less immediate and physical, Knudsen says, but more research is needed to fully understand the mechanisms by which EMDR works and how effective it is for various experiences and populations, according to a March 2020 review in the ‌European Journal of Psychotraumatology‌.

Talk therapy is still necessary to build the kind of trust required for EMDR to function. Cognitive behavioral therapy (CBT) is often considered the most evidence-based option, although some betrayal trauma specialists are wary of it.

"I was originally CBT-trained," Haws says, "but the more life experience I've had, the more I've realized how much trauma plays into all the decisions we make. CBT is great, it helps manage symptoms, but it's not going to get to the root cause of what's going on," she says. "My approach is to manage symptoms and then to dig a little bit deeper because that's what's going to help."

Other approaches, says licensed marriage and family therapist Roma Williams, LMFT, founder and director of Unload It Therapy in Houston, include combining EMDR with emotionally focused therapy (EFT). She describes this couples therapy approach as "basically the opposite of CBT. EFT is about what you feel is going on."

In EFT, emotions are validated: "The emotions we have are real and the emotions also serve as a guide," and the emphasis is on awareness of those emotions.

In situations of infidelity-related betrayal trauma, some therapists supervise "disclosures" where all is revealed (at least in broad outline) in order to prevent further distrust and traumatic revelation, although explicit detail may be more distressing than helpful.

After that, Steffens says, the therapeutic focus needs to be on restoring a sense of empowerment to the betrayed individual, whatever the ultimate decision may be about reconciliation or separation.

Without that, betrayal trauma sufferers "lose a sense of agency or trust in themselves," she says. "That's a hard way to walk through life, feeling like I have no say in what happens to me."

Given the barriers above, finding mental health support for betrayal trauma may feel daunting, but it isn't impossible. Here are some tips to help you get started

Consider if you want to look for help within your particular faith tradition and/or cultural community. This can have advantages and disadvantages.

A culturally competent practitioner will understand the particular pressures and challenges you may face, and may share more experience with you than a practitioner who's unfamiliar with the world you come from.

But on the flip side, some churches and treatment programs may not to be worthy of the trust placed in them. Some even repeat trauma by placing blame on the survivor.

"Interestingly, a lot of women that have been within the Christian community are fleeing the faith because of the way they've been raised to stay within marriages that are abusive or sexually inappropriate," says Kim Hansen Petroni, who works with betrayed partners at Coaching Hope 4 U.

Hansen Petroni herself counsels clients referred to her by a local church after she sought a pastor's help for betrayal. At that time, she found there were more support structures in place for her betraying husband than for her.

Organizations like the APA and the National Register of Health Service Psychologists offer directories like their Psychologist Locator and Find a Psychologist search tool, respectively, to help you find a credentialed practitioner in your area.

These directories typically allow you to specify the kind of treatment you're interested in (such as EMDR or CBT), as well as check insurance and payment details.

You can also try searching directories affiliated with organizations that specifically address betrayal trauma, such as the search tool from APSATS, Steffens' organization.

Also consider letting family members and friends know you're looking for professional support. If they have a therapist they trust, that provider may be taking new clients or able to offer referrals.

If you are dealing with a betrayal in a romantic relationship, considering talking to your partner about going to therapy together and looking for a therapist who facilitates such sessions.

If you are both invested in trying to save the relationship, they need to be willing to do the work with you consistently and understand the effect their actions have had, Haws says. Betraying partners need to realize, she says, that they "caused this situation. The only way to make that anxiety decrease for [their partners] is a consistent pattern."

EMDR or a related technique called brainspotting may be valuable supplements to traditional talk therapy. These methods don't work without the therapeutic trust established by talk therapy, but they may be able to help make traumatic memories feel less immediate, Williams says.

"Both [talk therapy and EMDR] have their place," she says, noting it's "important that we establish this human-to-human rapport first."

Ultimately, betrayal trauma recovery requires feeling safe again in your body, your environment and your relationships.

"Trauma at its root is about a loss of safety," Robinson says. When you are caught up in reliving a betrayal trauma, you are in a state of fighting for your life. "You might say [romantic] betrayal's not life-threatening, but it can be when you consider STIs, and [regardless] it feels life-threatening to lose your partner," Knudsen says.

Depending on your larger life experience, you may be staring down violence and violation of trust that goes beyond you as an individual: "There's definitely generational trauma, for people of color, for Black people — slavery was traumatic, you're born into trauma and that trauma is passed down," Brown says.

Tuazon speaks of their therapy as inseparable from decolonization work. "A lot of times when individuals come and work with me it's not just 'This person is the problem,' it's, 'What are the different systems that contribute to this problem?'"

Well-meaning friends and family members may suggest "staying positive" — advice that puts too much emphasis on the individual, Tuazon says. "Can we look at the social factors as well, what else is contributing to feeling sad about not feeling connected to your relationships or your work?"

It's not up to the individual dealing with betrayal trauma to change those systems. The first step for overcoming betrayal trauma is by necessity localized: learning to calm down physiological responses to betrayal trauma. Some of these expert-recommended approaches can help.

When you're feeling physically and/or mentally activated, find people and things that make you feel safe. Don't, as Tuazon says, try to "think yourself out of hypervigilance: 'I should be safe.'"

Instead, figure out situations where you feel good or even just neutral in your body and mind and pursue them: Sit in the sun, spend time with someone you trust, answer the question "What's something I'm proud of myself for today?"

Try your best to stop seeing people who have hurt you. We know, easier said than done; you may find it's easier to keep certain people in your lives to some degree rather than cutting them off entirely.

"We want someone on the other side of trauma to feel stronger than they were before, [to know] what they will tolerate and what they won't, how to stand for what they want, how to say 'I'm not going there,'" Steffens says.

But give yourself "permission to change [your] mind," Robinson says. Your boundaries may evolve. "We've been socialized to do what's best for other people in spite of the harm that might do to us," she says. Be compassionate with yourself and set your own rules about how you want to be communicated and interacted with.

"You can be a strong person and still be shattered by a reality you didn't know anything about," Steffens says. Remember you've survived something you might have thought you couldn't — and you'll meet whatever may come with that past experience to drawn on.

Experts recommend only doing what you feel you have the emotional stamina for, especially around holidays and anniversaries or occasions that may bring you into contact with your betrayer or triggers.

Keep in mind triggers can be hard to predict, Hansen Petroni says. Trust will be delicate, and not everyone, even trained mental health professionals, is capable of supporting you, or separating you from the emotions your experience may induce in them.

Connecting with a group of people who share similar experiences can affirm for you that your struggles are valid.

"When someone's gone through this kind of betrayal it's really important to have a safe community, so we always recommend a group of people going through a similar thing," Steffens says.

Some groups meet in person, others virtually or over for the phone, Hansen Petroni notes, for people who want to participate anonymously.

Let other people know about the trauma you're dealing with "in safe ways," a little bit at a time, paying attention to how they respond, Steffens says. Do they try to fix it? Do they assume you did something to precipitate the trauma?

Make sure these conversations help you feel safe emotionally. "If you can't have those conversations, that's not a good sign," she says.

Getting involved in your community may give you a greater sense of power and engagement. For example, some of her veteran clients write to their elected representatives about their sense of betrayal, Stewart Jones says. Consider getting involved with a cause related to your trauma. Unrelated volunteer opportunities may also be helpful, as can adopting a pet, she says.