[3] BTT suggests that an individual (e.g. a child or spouse), being dependent on another (e.g. their caregiver or partner) for support, will have a higher need to dissociate traumatic experiences from conscious awareness in order to preserve the relationship.
[3] Betrayal trauma theory emerged to integrate evolutionary processes, mental modules, social cognitions, and developmental needs with the extent to which the fundamental ethic of human relationships are violated.
[2] A foundational component of the dissociative aspect of BTT postulates that all humans possess an inherent mental mechanism to detect violations of social contracts (i.e., "cheater detectors").
[4] BTT posits that in the context of abusive relationships in which escape is not a viable option, the cheater-detecting mechanism may be suppressed for the higher goal of survival.
Thus, betrayal trauma offers a theory of psychogenic amnesia designed to evaluate both the role of attachment in human survival and the significance of blocking the painful experience.
[5] While physical and emotional abuse during childhood is present in the context of BTT, research has found that CSA leads to more significant disruption in capacities and is more characteristic of a substantial violation of human ethics.
[7] BTT suggests that CSA is closely linked with psychogenic amnesia or other dissociative processes occurring as a means to maintain an attachment with the caregiver and promote survival.
In instances when individuals experiencing traumatic events place a great deal of trust in the legal, medical, and mental health systems to address their wrongs they risk disbelief, blame, and refusal of help.
[11] Similarly, sexual assault committed by close others in the context that the betrayal is implicit, and challenging to detect,[10] has received increased attention in the media through campaigns oriented to highlight the prevalence of abuse in professional and academic institutions.
[13] Although research investigating military sexual trauma (MST) is still in its infancy, literature has identified the perpetrator-victim relationship as a primary impediment to reporting the assault which could impact job status and contribute to disruptions in unit cohesion, ostracization, inability to leave or transfer duty stations.
Evidence evaluating the impact of assault or harassment during military service, and medical care is fraught with victim blaming and implicit policies of disrespectful treatment.
Additionally emerging research has found that institutions (e.g., occupational settings, religious organizations, and schools) have the potential to worsen posttraumatic outcomes or be a source of social harm and injustice.
[14] Additionally, recent studies have identified mentally ill individuals as being at a higher risk for experiencing police brutality, especially with regard to suicide by cop.
[16] Emerging literature has articulated a need for furthering research that evaluates the prevalence and impact of institutional betrayal in healthcare settings,[17] with an emphasis on understanding the relationship between the level of trust patients place in physicians, associated expectations that physicians will prioritize protections to patients' welfare, and incurred adverse medical experiences which are conceptualized as institutional betrayal.
[20][21] Attachment injury has been indicated as an additional component of BTT in romantic contexts, characterized by abandonment or betrayal of trust during moments of need.
Bowlby emphasizes that traumatizing experiences with one's caregiver are likely to have detrimental effects on a child's attachment security, stress responses, coping strategies, and sense of self.
Disorganized IWM: Linked to unresolved traumas and losses experienced by the caregiver and the effect had on the subsequent attachment style with their offspring.
[6] From a neurological perspective, dissociation during times of extreme stress or trauma can invoke neural mechanisms resulting in long-term alterations in brain functioning.
[24] In the context of BTT, dissociation is conceptualized as an adaptive process aimed to maintain self-preservation and serve as protection against psychological pain.
[2] Perspectives from the development of psychopathology paired with attachment theory cite the mechanism of dissociation as a core feature in understanding environmentally produced psychiatric disorders.
[30] In the context of BTT, violations perpetrated by caregivers or close relationships have been implicated to impair views of the assumptive world and contribute to avoidance of the trauma experienced.
As a possible mechanism for such intergenerational transmission, it has been proposed that mothers with betrayal traumas or dissociative symptoms may have more difficulty in creating a safe environment for their children.
Many advocate for evidence-based treatments tailored to specific diagnoses; others feel that betrayal trauma is unique and should be treated with an individualized approach.