Blind to Betrayal: Why We Fool Ourselves We Aren't Being Fooled (16 page)

Using new data collected from undergraduate students, Jennifer Freyd, Anne DePrince, and Eileen Zurbriggen found that physical and sexual abuse perpetrated by a caregiver was related to higher levels of self-reported memory impairment for the events, compared to noncaregiver abuse.
^8.

Other research has found that people who reported memory disturbances and forgetting in general also reported higher numbers of perpetrators and closer relationships with those who abused them than did participants who reported no memory disturbances.
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In yet another study, participants who reported memory loss in regard to child sexual abuse were more likely to later experience abuse by people who were well-known to them, compared to those who did not have memory loss.
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One large study even found that general autobiographical memory loss (that is, memory about one's childhood and adolescence) was strongly associated with a history of childhood abuse, and that one of the specific factors associated with this increased memory loss was sexual abuse by a relative.
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Betrayal and General Mental Health

Cathy, similar to many of the individuals we have interviewed, suffered betrayals early in life. It is easy to see the effects. These people's stories are important to help us begin to understand how toxic betrayal trauma can be. Our empirical research has also confirmed that exposure to traumas that are high in betrayal (such as assault by someone close to us) is linked to poorer mental health outcomes, such as symptoms of depression, anxiety, dissociation, PTSD, borderline personality characteristics (which is a syndrome that includes difficulties in relationships), and physical health problems.

For example, in a study conducted with Bridget Klest and Carolyn Allard, we found that for adults who had either chronic pain, chronic health problems, or both, exposure to betrayal trauma was strongly associated with anxiety, depression, dissociation, and physical illness symptoms.
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In our research, we do our best to measure constructs such as betrayal trauma and depression accurately and with precision. Yet no psychological measurement or study is perfect, so it is important to attempt to replicate the results with different groups of people. Rachel Goldsmith, Anne DePrince, and Jennifer Freyd conducted a similar study with healthy college students and found parallel results.
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In addition, using a very different set of measurement tools and a large sample of adults, Valerie Edwards and her colleagues at the Centers for Disease Control (CDC) found compatible results.
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Other researchers have found similar effects. Anne DePrince discovered that trauma survivors who reported traumatic events that were high in betrayal were particularly distressed.
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Similarly, Atlas and Ingram investigated the association of histories of physical and sexual abuse with symptoms of post-traumatic stress. Thirty-four hospitalized adolescents (ages 14 to 17.10 years) with histories of abuse were given the Trauma Symptom Checklist for Children.
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Sexual distress was associated with a history of abuse by family members, as compared to no abuse or abuse by other people, while post-traumatic stress was not. Turell and Armsworth compared sexual abuse survivors who self-mutilate with those who do not.
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They reported that self-mutilators were more likely to have been abused in their family of origin.

Betrayal adds a dimension to trauma and abuse that is toxic and from which it is difficult to recover. In a recent study of intimate partner violence led by Mayumi Okuda, MD, victims were found to have twice as high a rate of new psychiatric disorders compared to nonvictims.
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This particular study was part of the National Epidemiologic Survey on Alcohol and Related Conditions. More than 25,000 adults participated, and about 1,600 of them reported being victims of intimate partner violence. Those who were victims had an increased risk of suffering from post-traumatic stress disorder, major depression, substance use, and bipolar, panic, and generalized anxiety disorder.

Many other researchers have found the same thing. Using different measures, different populations, and different research methods, researchers have found over and over again that
exposure to betrayal trauma is bad for the mind and the body
. We say “on average” because these relationships are not deterministic, but rather probabilistic. Betrayal trauma is bad for the mind and the body in the sense that tobacco smoke is bad for the lungs—the toxic elements substantially increase the risk of damage and disease, but there are always some people who beat the odds.

Betrayal Trauma, Gender, and Mental Health

The fact that betrayal trauma is so toxic may help us solve a persistent mystery in mental health. Women are diagnosed with a host of mental health problems, including depression, anxiety, and post-traumatic stress disorder (PTSD), more often than men are.
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Why? This mystery has inspired countless theories but has remained unsolved. Could these gender differences be related to betrayal trauma? In chapter 5, we explain that girls and women are, on average, exposed to more betrayal trauma than are boys and men. Perhaps some of the increased rates of psychological symptoms seen in women are related to their higher exposure to betrayal trauma. Shin Shin Tang and Jennifer Freyd tested this possibility, using both a large college sample and a community sample.
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They confirmed prior research that traumas that are high in betrayal are more strongly associated with symptoms of post-traumatic stress than are traumas that are lower in betrayal. Using a statistical technique called “structural equation modeling,” they found that betrayal trauma explained part of the association between gender and PTSD symptoms. This preliminary research offers some evidence that gender differences in mental health symptoms may be at least partly due to differences in exposure to betrayal trauma.

Oxytocin Dysregulation: A Possible Mechanism to Explain the Effects of Betrayal

Betrayal traumas are events that involve the serious mistreatment of individuals by trusted others, such as rape by a person close to the victim or child abuse by a caregiver. In addition, betrayal traumas are associated with a number of serious negative outcomes, and that association is above and beyond that linked to other traumas (such as accidents or interpersonal events involving strangers). These negative outcomes include a host of behavioral and health symptoms, such as revictimization, troubled interpersonal relationships, problematic trust decisions, and even increased symptoms of physical illness.
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How could betrayal hurt the body? One intriguing possibility is that betrayal can damage the endocrine system—the system that regulates hormones. In particular, we suspect that oxytocin dysregulation is a biological mechanism that links exposure to betrayal trauma (interpersonal violence and abuse at the hands of someone close to the victim) with disease outcome. Although no prior research has looked at these variables together, certain preliminary results and theories from separate studies suggest that possible associations exist between each of the pairs of variables. As already mentioned, there are data indicating that betrayal traumas have negative health consequences above and beyond other forms of trauma exposure. In separate lines of research, substantial evidence indicates that plasma oxytocin is associated with various aspects of human behavior, particularly in the domains of trust, attachment, and interpersonal relationships.
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This strongly suggests that betrayal trauma exposure has implications for oxytocin regulation.

In yet a third line of research, there is an indication that oxytocin dysregulation is associated with various negative physical health outcomes, such as irritable bowel syndrome, chronic pelvic pain, interstitial cystitis, and hyperemesis gravidarum.
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Betrayal trauma theory provides a basis for assuming that interpersonal trauma would affect psychological systems associated with oxytocin (attachment and trust) and that the oxytocin system would therefore be vulnerable to dysregulation in cases of chronic betrayal trauma. If so, oxytocin dysregulation may serve as a biological mechanism that connects betrayal trauma exposure to disease outcome. Oxytocin dysregulation, while inside the individual human body, is strongly associated with trust and attachment, both of which are necessary for successful human relationships.

The Toxic Effects of Betrayal on Relationships

Rebecca Brewerman (the woman in her early sixties whom we first met in chapter 2) also remembers the toxic effects of betrayal. It had a different effect on her than it did on Cathy. Rebecca did not have to resort to the extreme dissociation that Cathy did but nonetheless reported confusion and difficulty in functioning. Rebecca was quick to blame herself and was slow to form trusting relationships: “I was a very anxious, needy child, constantly trying to show that I was smart and charming so that maybe someone would love me and perhaps consider that I was a worthwhile person, that it was not a horrible mistake that I even existed.

“By the time I was about eighteen or nineteen, I started to suffer significantly from the effects of the betrayals. Although I was very bright and worked very hard, I had trouble focusing on just what I wanted to do with my life. As a result, I changed my undergraduate major multiple times, all the way from premed to sociology to physical education. I finally ended up with a BS in science and another in health and physical education. I then went on to get a master's degree in PE at a major university. From there, I taught for eleven years at the college level, until I experienced a rapid onset of obesity (from using chocolate and Pepsi as antidepressants). During this time, I was becoming more and more confused and anxious and depressed, to the point that I started wondering just what was wrong with me.

“Whenever anything adverse happened around me, especially at work, I thought that it was my fault. That had been the tenor of my father's emotional abuse, and the message was still deeply embedded in my soul.”

Rebecca especially regrets the effects the betrayal had on her ability to trust others and form relationships: “For decades, I had trouble relating to others. I did not understand why, as a highly intelligent adult who had had such promise as a child and a teenager, I was now working part-time or minimum-wage jobs and barely able to survive, financially and emotionally. The pressure would build and build until finally I would explode in a meeting or at work, spewing my agony over everyone present. I scared people. I lost jobs that way. I lost ‘friends' that way. I further alienated myself from a world where I felt like a real alien.”

Betrayal and Instability in Relationships

Earlier in her life, Rebecca was diagnosed with borderline personality disorder. Borderline personality disorder (BPD) is a severe personality problem.
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Those diagnosed with BPD are often suicidal, unstable, and unable to tolerate difficult emotions. Rebecca's difficulty with relationships, her seemingly irrational blowing up at coworkers, and her anxiety are all effects of her early betrayal, and yet again, these get diagnosed as a mental disorder, rather than as an adaptation to early betrayal.

Recently, we, together with Laura Kaehler, have investigated the contribution of betrayal trauma exposure to the development of borderline personality characteristics.
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We have looked at BPD using betrayal trauma theory as our framework. As we have explained, betrayal trauma theory proposes that survivors of interpersonal trauma may remain unaware of betrayal in order to maintain a necessary attachment to the perpetrator. Because of this, their ability to maintain important and stabilizing relationships in the future may be compromised.

In two studies, one with students and the other with community members, we found that betrayal and gender were significant predictors of borderline personality characteristics. For men, all three levels of betrayal trauma were significant predictors of borderline characteristics; for women, only high- and medium-betrayal traumas were significantly associated with borderline characteristics. These findings suggest that betrayal trauma may be a key cause of borderline personality disorder.

A further study that we did with Brent Belford found that having healthy relationships was a mediator variable.
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One interpretation of this is that people who suffer betrayal trauma but somehow have good relationships—through good luck or good support—show fewer borderline characteristics than those who don't. We examine this more in chapter 11 when we talk about healing. Safe relationships appear to be a requirement for healing from betrayal.