Perpetrator Closeness Matters When Considering Effects of Trauma
A new study conducted by Portland Psychotherapy’s Melissa Platt, along with colleague Jennifer Freyd, finds that perpetrator closeness matters when considering the effects of trauma. In this study, 124 female survivors of trauma were recruited to participate. Participants completed a set of questionnaires related to trauma, shame, dissociation, and fear. Next, they were randomly assigned to either see a set of images depicting threatening events of an interpersonal nature such as depictions of sexual harassment and interpersonal violence, or a set of images depicting threatening events of a non-interpersonal nature such as depictions of car accidents and natural disasters. After viewing the images, participants again completed self-reports of fear, shame, and dissociation.
Our hypotheses were guided by betrayal trauma theory, which proposes that people who experience traumatic events perpetrated by someone close, trusted, or depended on for survival (high betrayal trauma; HBT), are more likely to dissociate the abuse from awareness compared to survivors of events perpetrated by someone not close, or non-interpersonal events (low betrayal trauma; LBT). Several studies provide support for betrayal trauma theory as it relates to dissociation. In the current study, we aimed to extend the scope of betrayal trauma theory by assessing whether people who have experienced HBT may also be more likely to experience shame, rather than fear, in the context of trauma-relevant cues. The rationale for this has to do with survival. If a person is assaulted by a stranger, it is likely to be adaptive for that person to experience fear and its action tendency to flee and get the heck out of the dangerous situation and away from the source of threat. However, if a person is assaulted by someone who is depended upon for survival, or someone who feels needed for survival such as a life partner, fleeing may seem to be life-jeopardizing, and in the case of abuse by a caregiver, fleeing truly may be life-jeopardizing.
Rather than responding to HBT-relevant cues with fear, we predicted that people would respond with shame (in addition to dissociation). Shame is an emotional experience that is very painful, tends to stop a person in her tracks, and tends to elicit sympathy in others. In addition, shame either shifts the person’s attention inward to thoughts of being flawed or bad, or else causes the mind to go blank. In either case, awareness is shifted away from cues to suggest that the person is being harmed by someone they need and/or love, and therefore protects the relationship with that person, albeit at a cost.
Results of the study showed that, first of all, there was no overall difference in responses between the interpersonal and non-interpersonal threatening images. It was only when we took into account the person’s individual history of HBT and LBT experiences, that differences in responses to the images showed up. In particular, people with a higher number of HBT experiences in their history became more ashamed and dissociative when they saw the interpersonal threatening images, but not the non-interpersonal ones. What’s more, they did not experience an increase in fear in response to either set of images. On the other hand, people with a higher number of LBT experiences in their history became more afraid when they saw the non-interpersonal images. What’s more, they did not experience an increase in shame or dissociation in response to either set of images.
Thus, we found evidence supporting the idea that shame and dissociation may serve a similar function in survivors of HBT, and that HBT and LBT survivors may have quite different experiences in the context of trauma reminders. This would also suggest that treatment needs may differ depending on type of trauma(s) the person has endured. We believe that these findings have particular significance for exposure therapies, such as prolonged exposure, which has a theoretical underpinning based on fear habituation. Before beginning PE with your client, it may be worthwhile to assess whether your client’s primary emotional reaction is indeed fear rather than shame or some other emotional experience and whether he/she tends to dissociate when reminded of the trauma, which may interfere with the ability to learn that memories are not dangerous and thereby the opportunity to heal.