What to Expect From Therapy: Betrayal Trauma

You’ve already guessed that betrayal trauma is not a pleasant experience (who wants anything to do with either betrayal or trauma?), but let’s get on the same page regarding what betrayal trauma actually is before we dig into what betrayal trauma therapy is like. Betrayal trauma is, in short, what someone experiences when the person they depend on for emotional, financial, and/or physical support betrays their trust. Examples of betrayal range from a spouse’s violent outbursts to a partner’s secret credit cards to a parent hiding a health diagnosis. Betrayal trauma can happen in any relationship because betrayal can happen in any relationship. (Read this article for a much more in-depth exploration of what betrayal trauma is and is not.) For now, the focus here will be on the trauma of sexual betrayal.


When a client first comes to see me, they will often identify the presenting problem as something having to do with someone else. “My kids won’t speak to me,” or, “Nobody loves me,” or, “My husband cheated.” Whenever I hear that last one or anything along the lines of a spouse’s secret-keeping, hidden behaviors, or broken promises, the translate app in my brain spits out the following: “I need help with betrayal trauma.”

Clients almost never know what they really need when they begin therapy (ahem, myself included), and I can count on one hand the number of times I’ve been asked specifically for help with betrayal trauma. And yet, the majority of my work with female clients has been around their betrayal and the ensuing trauma. Here’s how I approach treatment for these clients and what you can expect from your own betrayal trauma therapy:

Identify Where You Are in the Processing of the Trauma

I focus on trying to meet clients where they are, especially if I suspect betrayal trauma is at play. If a client comes to our first session together in story-telling mode and wants to get all of the events of the betrayal off her chest, I provide space for that. If a client is shut down and can barely admit to needing help or the reality of the betrayal, I provide space for that. I usually try to ascertain the basics of the timeline: how long she has known about the betrayal, how long the betrayal has been or was occurring, and how long she’s been in a relationship with the person who betrayed her. Creating a cohesive timeline, even with just those three bits of information, helps begin the process of organizing the trauma. The traumatized brain is so disorganized that getting the facts straight about what happened when, with the supportive guidance of a specialized therapist, can offer a soothing structure. Oftentimes, clients are telling me things they’ve never told anyone else, which can be both an overwhelming experience and a comforting one. Most clients feel relieved to have someone else who at least knows what’s happened (and the container of therapy is comforting in and of itself, what with all the confidentiality and legal/ethical boundaries).

Assess Your Day-to-Day Experience

“What are your days like lately?” is a question I often ask in order to get a picture for myself of how traumatized or resilient the client is in the aftermath of betrayal. Clients will often present one way (well put-together with a busy schedule) while the answer to this question reveals a different reality (today is the first day she showered all week and, although her calendar is full, she rarely makes it out of bed to show up for her commitments). Asking betrayal trauma clients to tell me about their day is a way of helping me get to know them, yes, but just as importantly it’s a way for them to see for themselves how their trauma is affecting them or not affecting them. Denial often wants to take over as a reactionary coping skill in the face of betrayal; outlining what she’s really doing day-to-day leaves little room for denial, and shedding denial is an important step to long-term healing.

Explore Safety and Your View of Self, Others, and the World

In the aftermath of sexual betrayal, trust in the relationship is usually destroyed. It is common for self-trust to be severely affected, too; I often hear clients wonder aloud why they couldn’t see what was happening or berate themselves for trusting anyone so fully. Betrayal trauma is unmooring, and in that disorientation, the way you see yourself, others, and the world is affected. To assess how this has all been affected, I ask clients this: How are you keeping yourself safe these days? How have you acted on the lack of trust in your marriage? Isolation and shutting down are common answers; I also often hear about some form of physical separation (e.g. separate bedrooms or homes) between client and partner. The theme seems to be space; after sexual betrayal comes to light, most clients need and take emotional and physical space from their partner. In that space, processing begins, and the traumatized brain wants to quickly make sense of what happened. Because clients likely do not have all the information at this stage (and odds are neither do their spouses, for that matter) to adequately explain the how and why of the sexual betrayal, the traumatized brain fills in the blanks with habitual thoughts. This is where the differences between trauma and resilience often start to emerge: If the client is in the habit of self-blame and inadequacy, she will blame herself for the sexual betrayal and make sense of it by telling herself she wasn’t good enough (or sexy enough, or pretty enough, or smart enough, or emotionally available enough, etc.) for him. If the client is in the habit of depersonalizing other people’s behavior and practicing curiosity with herself and others, she will let her partner bear responsibility for his own actions and wonder what she needs to help herself feel steady and centered. Spoiler: Resilient people like that latter example don’t need betrayal trauma therapy. Also: Betrayal trauma therapy is what helps the traumatized former example become more like the resilient latter one.

Examine Your Support System

Trauma usually requires space for processing, but oftentimes taking space morphs into isolation. De-isolating clients is my number one concern as they begin true betrayal trauma recovery. First, I commend them for showing up to therapy; this is the first step in de-isolating. If you’re in therapy for betrayal trauma, you are officially not alone in your experiences anymore! Second, I ask questions like: Who have you told about the betrayal? Who might you be able to tell? Have you learned through experience that some people aren’t safe to talk to? We explore the relationships they have outside of their marriage or partnership and assess together who could be or has been safe. I recommend a few group options, usually more for consideration than actually joining at this point. I work with the client to make a realistic plan for who to reach out to and when. This is almost always the first homework assigned, more often than not with an open-ended timeline as well as the expectation that it will need to happen in order for healing to take place.

Begin to Establish a True Self-Care Routine

I usually ask clients the same set of questions: How are you sleeping? How do you take care of yourself when trauma comes up? Where do you turn when you have nowhere to go? Physical, emotional, and spiritual self-care are essential to recovery, and the earlier we can work together to establish routines around these three areas, the better. Sleep usually serves as the first measure of trauma and the last measure of healing; sleep hygiene and a nighttime routine make a big difference in the rest a person can get, which makes a big difference in the brain’s ability to heal after trauma. I often tell clients that they’re asking their brain to do a LOT and it can’t function let alone heal without proper rest and sleep. True self-care is about merging healing and reality. Clients will often begin the self-care discussion by saying things like, “I need to get back into running,” or, “I should read every night like I used to.” This tendency to hold their traumatized selves accountable to pre-trauma productivity and performance is common and yet so harmful; it adds shame to what is already a brutal experience. For a client that used to run, I’ll tell her to start by setting a goal to walk around the block. For the client that used to read every night, I’ll suggest she fall asleep to a nightscape meditation. I honor the healing by challenging the client to push beyond their current comfort zone while simultaneously honoring the limitations the trauma has created in her.

Early, Consistent, and Persistent Psychoeducation

Psychoeducation is just a long word for informing the client about trauma. From the very beginning, I share bits and pieces of knowledge about betrayal trauma and its effects on the brain and body. I tell clients how old traumas can be reactivated by newer traumas. I share studies and statistics about the intergenerational transmission of trauma. This where my position of authority in the therapy room comes in very handy: Clients to lend weight to my words, and I want them to hear these psychoeducational words clearly and often. I repeat myself constantly, not because the clients don’t get it or aren’t smart enough (it’s not rocket science), but because the traumatized brain has trouble integrating new information. It can take dozens of repetitions for an important fact or helpful mantra to stick. This is another way betrayal trauma therapy can offer organization and structure: In the context of trauma, EVERYTHING makes sense. Helping clients understand trauma is essentially helping clients understand themselves, learning to make helpful sense of their experiences and their responses. This helps to fill in those pesky gaps that the traumatized brain needs filled while also lending some self-compassion to what clients may feel shame about.

This is only the beginning.

Again, you have probably already guessed: Betrayal trauma recovery can take a long time. I tell clients to expect at least a full year of intense, focused work. It usually takes longer. Assessing the processing of the trauma, measuring day-to-day experiences, exploring safety and trust, identifying and using support, practicing true self-care, learning and integrating new information… this all begins at the beginning and continues throughout the course of treatment and beyond. Healing from betrayal trauma is multi-faceted, multi-layered, and very subjective. There are lots of tools that work for most people and no tools that work for everyone. This article may make some hopeful sense to you and you may send it to someone who finds it offensive and off track. The good news is, as betrayal trauma becomes more well-known and the research around it continues to emerge, more and more treatment methods and programs are developing. My fingers are forever crossed that you never have the need for betrayal trauma therapy, and all my fingers and toes are crossed that should you have the need, you will find the right program, therapist, resources, and tools for you.

Thank you so much for being here.

1 Comment
  1. You made a good point that determining one’s triggers is one of the first things to consider when it comes to trauma therapy. I’d like to look for a good counseling service soon because my sister has been having anxiety attack these past few months. I think it’s about time for me to try to convince her to get professional help.

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