“Sharing our heart, our tenderness, our hopes with another person exposes us to the painful possibility that our trust may be coldly betrayed or unwittingly undermined. This hurt touches all of us at one time or another. None of us will escape life without being betrayed in some manner by someone we have grown to trust and love. Betrayal is an equal opportunity misfortune. “ Amodeo.
Most often in long term therapy we are working to heal the trauma of developmental betrayal in the form of emotional abuse or neglect, physical and /sexual abuse, systemic and systematic failures of caregivers to nurture and protect. Establishing good relationships with our patients is vital for integration of such trauma to occur. And we have a road map- a guide for this in the precepts of the Conversational Model, and the Hierarchy of Engagement. Acute betrayal trauma emanating from our patients relational matrix erupts into this space in devastating and complex ways, requiring therapeutic flexibility with the frame, compassion warmth, and dare I say, wisdom.
In this paper I hope to explore the impact of acute betrayal trauma on patient, therapist and the intersubjective space.