Episode 190: Betrayal Trauma Recovery

Now let’s go back into some history. In 1980, the American Psychiatric Association, or the APA, revealed a new diagnostic formulation in its Diagnostic and Statistical Manual of Mental Disorders. Yes that is a mouthful. So in the field, we refer to that mouthful as the DSM, and back in 1980, the addition that was out was the DSM-3. The new formulation was called post-traumatic stress disorder, or PTSD. Now probably most of you listeners have heard about PTSD and have some understanding of what that entails. The diagnosis was intended to capture catastrophic stressors that were outside the range of usual human experience, such as war, disasters, rape, and tragic deaths.

Now the authors of the DSM-3 considered traumatic events to be different from more common stressors, even though those might still be very painful psychologically. These would include stressful life experiences such as illness, financial setbacks, divorce, and interpersonal rejection. They were considered adjustment disorders, which, just an FYI, insurance companies will not pay for treatment if the diagnosis is something under the adjustment disorder category.

Now the DSM when I was going to school, let’s see that was in 1980, so when I was going to school in 1990s, we had the DSM-4, and currently we’re on the DSM-5, edition 5 of the DSM. Dr. Everly says when he’s talking about the PTSD diagnosis in the DSM, he says, “At the time (so back in 1980), many of us considered this dichotomy to be a mistake when it came to rejection and divorce, especially when they involved intimate partner betrayal. In the subsequent revisions of the DSM, the traumatic stressor criterion has actually seemed to become even more narrow, focusing on threats of injury or death or vicarious exposure to severe injury or death. This has weakened even further the concept of intimate partner betrayal as a traumatic experience, which was, in my view once again, a mistake.”

In 1992, Judith Herman wrote the book “Trauma and Recovery”, and she was the first to define complex trauma. Since then, others have built on her original concepts, further developing our understanding of this important topic. So what is complex trauma? Well, Christine Courtois, PhD, a psychotherapist who specializes in defining and treating complex trauma, defines it as “traumatic stressors that are interpersonal, that are pre-meditated, planned, and caused by other humans, such as violation and/or exploitation of another person.”

Now notice that in her definition, complex trauma is both relational and repeated. Michelle Mays, on her website, The Center for Relational Recovery, states: “Complex trauma is most often associated with children who experience various types of relational and repeated violations during key developmental moments. However, it can also be applied to cumulative adversities experienced by cultures, people groups, and communities. And it can be applied to adults who have experienced chronic relational trauma (for instance, ongoing sexual and emotional betrayal) that destroys the foundational trust in their primary relationship. In such cases, complex trauma theory accurately summarizes the levels of stress, distress, and emotional fragmentation that betrayed partners experience.”

Let’s talk for a minute about what betrayal trauma is. I think you certainly know it when you experience it. From the clients that I’ve met with, they will describe is as a gut-wrenching experience. I’ve heard it explained as a searing knife into your heart, and it’s more of a feeling thing than a thinking thing, and then when you start thinking about it, you can’t get it out of your head.

George Everly described betrayal as treachery, deception, and violated trust. It can appear as a broken promise, duplicity, lies, sexual affairs, and even affairs of the heart. The injury can be so great that some people never recover. Michelle Mays on her website describes it as, she says, “Betrayal trauma makes you feel like you are losing your mind. It puts you on an emotional rack and pulls you in opposite directions until you are begging for mercy. It yanks your sense of security out from under you and puts you in a state of emotional freefall. It is severely emotionally distressing, and until you have experienced it, you really can’t imagine how truly life-altering the experience can be.”

She goes on: “As if that is not enough, when betrayal occurs, your brain begins to operate in a different way. The fear center fires up and stays fired up, creating hyper-vigilance, restlessness, anxiety, and a sense of being perpetually on guard. This alters your ability to regulate your mood, to calm yourself, to think, to reason, and to make intelligent decisions. Your fear center hijacks your normal functioning, and you find yourself in a world where every task feels challenging, your mind will not stop racing, your emotions feel out of control, and your coping skills are stretched to the limit. This is the experience of complex, dynamic, multi-dimensional betrayal trauma.”

Now I think when we are growing up, we’re taught to be happy, and we’re taught that in order to truly be happy, we have to be in relationships, and that means learning to trust other people. So there comes a point in our lives where, maybe reluctantly, maybe hopefully, we let down our guard and we begin to trust a person. When relationships become psychologically intimate, that’s the moment we know that we have put our trust in another person, and there is an attachment happening, and we are bonding with this person. We have made ourselves vulnerable to another person, and we do that because we believe this person accepts us unconditionally, that they have our back, that they believe in us. We cherish such a relationship because we believe our partner is understanding, faithful, and devoted in both good times and bad.

Now in a psychologically intimate relationship, powerful attachments and bonds are formed. Not only does this bond let us know that we’re understood, appreciated, and unconditionally accepted, it tells us that we are safe, which for anything else to happen the way that the brain and the nervous system work together, safety has to be the foundation upon which things are built. This bond can be so powerful that there’s evidence that the presence of a psychologically intimate partner can positively affect our blood pressure and our stress hormones.

Psychologists have long known that the deepest cravings of human nature are the desires to be appreciated and to be safe, so betrayal by an intimate partner violates these core human desires and needs. It destroys the core assumptions upon which all enduring relationships must rest, and if some of our primary relationships early in childhood were also ones that we could not feel safe, again just imagine how much more this undoes us when it happens again in our adult romantic relationships.

Betrayal represents a traumatic death, not of a person, but of a relationship. Dr. Everly says, “As you might expect, individuals who have been betrayed by a partner in a trusting, psychologically intimate relationship experience many of the symptoms of PTSD. They will often report guilt, depression, psychological numbing, suspiciousness, hyper-vigilance, and withdrawal from others. They may also experience nightmares and continually, almost addictively, re-living both the positive moments and the negative moments of the relationship, especially in the moment of the revelation of betrayal. Again, as you might expect, the betrayal engenders a terrible loss of self, the rise of self-doubt, the inability to trust again, and the desire to avoid relationships in the future.”

I had a partner I was working with years ago, and she described it to me. She said, “I feel like I just learned that everything I’ve learned up until this point in my life was based on lies, and I don’t know what’s real or not.” She kind of looked out the window and she was like, “I feel like if I were to say, wow, look at that blue sky today, you wouldn’t maybe say it to me because you don’t want to make me feel bad, but you would be thinking to yourself, that’s not blue.” She’s like, “I feel like none of the information I’ve been given is accurate, and I have to question even the most basic things, like do I think blue is the same color you think blue is? Or is blue something else in your mind than it is in my mind?”

Intimate bonding with another person serves as an important developmental role. It enhances our changes of survival in an otherwise hostile environment. Now as a result of these intimate bondings, there are biological substrates that support the formation of psychologically intimate relationships, so the hormone oxytocin, for instance, increases the likelihood of forming an intimate relationship. Deep within the center of the brain, the cingulate cortex is believed to play a role in fostering attachment and bonding with others.

Dr. Everly says, “Betrayal is likely to adversely affect these substrates. We know that violated attachments result in a rise in the immunosuppressive and catabolic hormone cortisol, along with an apparent hypersensitivity with the amygdala-centric fight or flight centers of the limbic system. The psychological injury of betrayal is likely to create, in a sense, a functional physical injury within the brain that is challenging to recover from, but not impossible.”

Michelle Mays writes about emotional dysregulation that happens as a result of betrayal trauma. She says, “As the information slams into you, your body gets hot and adrenaline fills you like a million lightning bugs firing at once. Your hands shake. Your knees cave. Your heart starts to race. Your mind is like a skipping record, racing and jumping, the thoughts coming too fast to even think them, flying by in a kaleidoscope of remembered conversations and events. Color and sound all mix together in a shower of lies, and now your body gets cold, and the shaking is in your limbs. Your heart slows as a deep brick-like dread fills your stomach and chest, and the tears come, more tears than you had any idea a person could cry.”

She says, “That is a description of what it feels like in the body to experience emotional dysregulation that’s related to trauma, so remember feelings and emotions are felt unconsciously in the body before they ever consciously register in awareness in our conscious mind. When trauma occurs, the body’s autonomic nervous system shifts into high gear within a nanosecond, and the body ratchets up into a state of threat preparedness. The body registers danger, sends signals throughout, elevating adrenaline, cortisol, and other stress hormones that prepare the body to fight back, run away, or if those are not possible, to shut down, to go into freeze. The body is created to be able to respond to stress in this way, and then to calm itself and settle back down into a balanced state of being after the threat has passed. Think of this as kind of an emergency brake system. It’s not meant to be used all the time, but it’s there when you need it.”

Now with a trauma like betrayal trauma, the problem is it’s not like this system gets ready for fight or flight and then calms itself back down. That system is in that state of threat preparedness for months, sometimes years, and it has some default settings or too much adrenaline and too much cortisol and other stress hormones that are constantly pumping through the body, making it difficult to calm down and settle back down into this balanced state of being. It becomes the new way of being.

Dr. George Everly says that there are seven ways we can heal betrayal trauma. So the first one is do not blindly blame yourself. Do not denigrate yourself. Avoid self-destructive coping behaviors. Do not compromise your integrity, the person you are, or the person you believe you can be. So that’s number one.

Number two: He says it’s ok to look back on the relationship to find things you would have done differently, but again it’s critical to avoid the blame game. I often tell my partners that when you’re looking back on the relationship and doing an assessment and taking inventory of maybe what you could have done differently, one of the things that makes that difficult is that often the things that backfired against you are actually pro-relational. Things like giving someone the benefit of the doubt, things like forgiving, like those are all positive things in healthy bonded relationships. However, when there’s an addiction going on, when betrayal trauma is happening, these pro-relational behaviors that we give to our partners actually tend to backfire against us instead of strengthening the relationship.

Dr. Everly states that number three is to avoid rebound relationships. They almost never turn out well, he says. Resist the temptation to immediately fill the hole in your heart. Don’t rush to replace the loss. You need time to consider what happened, and being alone for a while is not a bad thing. A lot of the partners that I talk to, when the marriage disintegrates, it takes a big hit to their self-esteem. They’re wondering if they’ll ever find love again. They’ll wonder if any healthy person will ever be attracted to them again, and rather than sitting in that alone and doing the individual work, which takes time, it can be tempting to get back on the dating apps and to find somebody to have a healthy relationship with.

I often comment to them and say if you want to start dating, we’re going to have to talk a lot about this because you’re in a vulnerable situation, and you’re still kind of repairing yourself after the loss of this relationship. So again I’ve had some clients meet somebody fairly soon after the dissolution of their marriage. Sometimes it works. I don’t know stats if there even are stats on how often it works. I would probably say the first relationship after a divorce is probably not the one who’s going to work, and I have a few clients where it seems to be the one that’s working.

The fourth thing that appears to foster the healing of betrayal trauma is to seek out success. Begin to focus on strengthening yourself and your self-confidence. Find something at which you can be successful. Start small at first if necessary. I often add to this, be mindful of what you’re still carrying emotionally in your nervous system, and don’t overload yourself with things you’re trying to be successful with.

The fifth step is to take care of your physical health. Avoid self-medication. Think about changes in your diet and activity levels. We know that exercise is a powerful anti-depressant. Walking briskly four times a week can be as good as an anti-depressant. Five minutes into a brisk walk, you will feel a release. That’s serotonin. And rest is also essential, as are boundaries. You’ll need to be intentional about what you accept and what you won’t accept.

The sixth thing that fosters healing is thinking about keeping a daily journal. It can help you track your ups and downs and helps you identify the factors that are slowing your recovery, as well as those factors that tend to speed it up.

In the final analysis, Dr. Everly says the best way to heal from betrayal trauma is to learn to trust again. Now I know when I say that to partners who have experienced betrayal trauma and gone through the trauma of divorce, they look at me like I’m crazy. I know it’s a risk, but anything worth having, like the chance to find a kind, compassionate, and unconditionally accepting partner, is worth failing for.

There’s a book that I am reading. It’s called “The Book of Awakening” by Mark Nepo, and it’s kind of a daily read. So back in June, on June 15, he wrote this, which I think just goes so well with healing from betrayal trauma. The topic is staying porous. “Be patient toward all that is unsolved in your heart, and try to love the questions themselves.” That’s from Rainer Maria Rilke.

Mark Nepo writes, “I am jogging in the city on a hot summer day, and my legs are in a rhythm, carrying me without much guidance through small crowds, past roses and bus stops. I begin to think about my struggle not to give myself away. When growing up, I had to check myself at the door like a coat in order to relate to others. Often I had to pretend to be less than I was in order to be loved. For years, I would shelve my light to take care of others. Like a fireman, I’d drop whatever I was doing to rush to the rescue. For so long, the choice seemed only to stay open and lose myself or to close up and cut others off, but today, while running freely through the streets, close to others but not entangled, I realize I am leaning after many attempts that I can stay close and porous, caring and present, without holding everyone’s anxiety and without going underground. At least I can try. I am dripping and breathing like a small horse. It is clouding over. It begins to rain slightly. I move through the beautiful people and ask for a hot dog with mustard and sauerkraut. As I chew the simple food, rain from the sky meets rain from my body, and in the rain, sweating, the tang of sauerkraut on my lip, I feel joy. Others shuffle by. Today there is no room for worthlessness.”

His suggestions for the day: Sit quietly and bring to mind a time when you lost yourself completely in another’s problems. Center yourself and bring to mind a time when you maintained your sense of self, but cut off another completely to do so. Breathe thoroughly and try to let the two feelings coexist—compassion and sense of self. Inhale sense of self, exhale compassion. Inhale sense of self, exhale compassion.