Pamela J. Birrell

Betrayal Trauma: Relational Models of Harm and Healing

Abstract We examine a model that emphasizes the importance of relationships as the context of trauma and healing. First, we present an overview of the effects of betrayal trauma and oppression on psychological functioning. Then, we propose a relational model of healing, using elements of the Stone Centers Relational-Cultural theory. Finally, we discuss healing in the wider context of community and an ethic of compassion and mutuality.

Relational health as a mediator between betrayal trauma and borderline personality disorder.

A frequently studied hypothesized cause of borderline personality disorder (BPD) is experiencing interpersonal trauma. A recent study by L. A. Kaehler and J. J. Freyd (2009) found a connection between betrayal trauma and BPD characteristics, with higher betrayal traumas associated with greater BPD characteristics. The present study seeks to expand upon that study by investigating relational health as a potential mediator for the association between betrayal trauma and BPD. A sample of 165 college students completed measures of betrayal trauma life events, relational health, and BPD traits. Mediation analyses showed significant partial mediation for total relational health (bootstrap coefficient = .0168) and its community subscale (bootstrap coefficient = .0204); however, significant mediating effects for the mentor and friend subscales were not found. Given the significant finding for only the community subscale, which may be driving the total relational health effect seen, the results suggest that connection with a valued community may be an important protective factor for BPD after one experiences betrayal trauma.

Shifting the focus: Nonpathologizing approaches to healing from betrayal trauma through an emphasis on relational care

ABSTRACT As the diagnosis and treatment of mental disorders has become increasingly medicalized (Conrad & Slodden, 2013), consideration for the relational nature of trauma has been minimized in the healing process. As psychiatrist R. D. Laing (1971) outlined in his essays, the medical model is an approach to pathology that seeks to find medical treatments for symptoms and syndromes based on categorized diagnoses. We argue that such a model implicitly locates the pathology of trauma within the individual instead of within the person(s) who perpetrated the harm or the social and societal contexts in which it took place. In this article, we argue that this framework is pathologizing insofar as it both prioritizes symptom reduction as the goal of treatment and minimizes the significance of relational harm. After providing a brief overview of betrayal trauma (Freyd, 1996) and the importance of relational processes in healing, we describe standard treatments for betrayal trauma that are grounded in the medical model. In discussing the limitations of this framework, we offer an alternative to the medicalization of trauma-related distress: relational cultural therapy (e.g., Miller & Stiver, 1997). Within this nonpathologizing framework, we highlight the importance of attending to contextual, societal, and cultural influences of trauma as well as how these influences might impact the therapeutic relationship. We then detail extratherapeutic options as additional nonpathologizing avenues for healing, as freedom to choose among a variety of options may be particularly liberating for people who have experienced trauma. Finally, we discuss the complex process of truly healing from betrayal trauma.

Guest editorial: Deconstructing disorder: An ordered reaction to a disordered environment

This special section of the Journal of Trauma & Dissociation offers three theoretical perspectives on the important and understudied topic of psychology’s potential to pathologize reactions to trauma rather than emphasize the central importance of healing. This tendency to pathologize directs all our attention to the victim of the trauma and leaves our violent misogynist culture unexamined. Time has come for a change. The authors of the three theoretical articles featured in this special section each offer important insights into what it means to pathologize in the context of trauma practice and research. McLean and Follette (2016) articulate psychotherapy’s history in medicine and the medical model, stating aptly that the treatment of trauma typically focuses on the eradication of distressing thoughts and feelings, generally seen as deficits located in the individual. Gómez, Lewis, Noll, Smidt, and Birrell (2016) expand this perspective, noting that psychiatric diagnoses have historically neglected to distinguish between interpersonal and non-interpersonal traumas, thus failing to account for the well-researched and consistent exacerbating effects of betrayal on posttraumatic outcomes. Hoover, Luchner, and Pickett (2016) further argue that returning the individual to a perceived normal state is a fundamentally pathologizing goal frequently communicated to psychology’s newest pupils, undergraduate students enrolled in abnormal psychology courses. Although the authors featured in this special section differ in their theoretical orientations, they align in their shared definition of what it means to pathologize survivors of trauma. We distill their messages to three main points. First, human experiences leave predictable and understandable marks; trauma in particular, and interpersonal trauma more specifically, impacts survivors’ minds, bodies, and spirits. Second, these scars do not constitute psychological disorder but instead are the natural and expected consequences of abnormal events, including betrayed trust, violated bonds, and broken boundaries. The effects of trauma are indeed just that—effects of an event—and as such are causally related to the trauma and not to the harmed individual. And third, when psychology and mental health professionals draw that causal path incorrectly, when the field fails to place the

Attitude and the perception of faces

Abstract To assess the effects of affective orientation on the judgment of facial attriutes, 165 subjects were asked to make judgments of the attributes of each of two faces. For each face, subjects were either given no information about the person in the photo, or were given biographical information connoting either a favorable or unfavorable personality. It was predicted that when subjects make judgments along dimensions that were evaluatively loaded (e.g., smilling vs frowning mouth), manipulated attitude would influence these judgments. For the seven dimensions rated by the subjects, four dimensions showed the predicted effect. The other three dimensions, which did not show the effect, were the only ones that showed a significant effect due to the face itself. It was concluded that for dimensions that are not highly structured by the characteristics of the face, attitude can significantly influence judgments of facial attributes.

Memory Matters: Contexts for Understanding Sexual Abuse Recollections, edited by J. Haaken and P. Reavey

For those of us who were caught up in the “memory wars” of more than a decade ago, this book reminds us that even though the conflict about memories of sexual abuse has fallen from our public consciousness, it has not been resolved. It further reminds us of the continuing importance of the controversy, which can be seen as “symptomatic of broader crises in the Western world over sexuality, gender, and authority” (p. 3). The book points out that there are some areas of agreement over the past decade. Researchers and clinicians alike are realizing that memory is not so much something that the individual mind does but a socially structured human activity open to the power dynamics and social contexts of identity politics. Furthermore, there is widening agreement about the ethical aspects of bearing witness to those who have suffered such trauma and preserving their accounts. There are two sections of the book. The first is titled “Looking Back on the Recovered Memory Debate: Claims and Counter-Claims.” This section reexamines the debates of the 1990s from the point of view of retractors, child witnesses, and the media. The second is title “Widening the Lens: Cultural Context for Remembering Child Sexual Abuse.” It looks at current aspects of the debate and the role of truth and narrative in the stories of abuse survivors. The first section begins with two chapters about discourse analysis of the stories of “retractors.” Ashmore and Brown (“On Changing One’s Mind Twice”) see the stories of retractors not as extraordinary evidence of false memories but as situated social activities and moral accountings of the self. Ost and Nunkoosing see the memories of retractors as “effort after meaning”—that we need to ask about the purpose the remembering (and re-remembering) served as well as what needs are met. Kitzinger’s chapter examines the role of the media in memory and the language that it gave to survivors. Before 1980, there was little in the media, and survivors were isolated and silenced by “abusers’ monopoly over definitions of reality” (p. 88). Media attention gave these women an opening for both private reflection and public discussion.