A therapist sits across from a couple in crisis. One partner, eyes downcast, admits to years of financial deception. The other, voice shaking, struggles to process how their reality has been undermined for so long. As the clinician, you recognize the telltale signs of betrayal trauma unfolding – but do you have the specialized skills to guide them through?
At the Mind-Body Training Institute, we have collaborated with renowned couples therapy expert Dr. Stan Tatkin (developer of the Psychobiological Approach to Couple Therapy), to provide essential guidance for clinicians navigating the complex terrain of betrayal trauma.
Why Standard Therapeutic Approaches Often Fall Short
When a client walks into your office shattered by betrayal, your usual therapeutic toolkit may not be enough. Betrayal trauma isn’t just a crisis of trust—it’s a psychological earthquake that can destabilize identity, memory, and your client’s ability to regulate emotionally and physically. Many therapists approach these cases without the structure or specialized framework needed for real healing.
“The person being betrayed— it tears their sense of self and self-worth apart. Even the most steady person is going to doubt themselves… That person is a mess. Their brain is abuzz with recalculating the data… They thought they knew what the relationship was and they were wrong. They thought they knew who this person was, and they’re obviously wrong.”
— Dr. Stan Tatkin
If you’re working with betrayed individuals or couples, here are five essential skills that go beyond general trauma training:
1. Recognize Non-Obvious Betrayals
Affairs are only the beginning. Financial secrecy, emotional triangulation, mismanaged third-party relationships, and chronic deception are all forms of betrayal that can create just as much devastation.
Key Clinical Insight: Betrayal isn’t defined by your standard of harm—it’s defined by your client’s lived experience. If it shattered their sense of safety, reality, or autonomy, it counts.
Your ability to name these less obvious betrayals is the first step in doing this work responsibly.
2. Hold Power Imbalances with Clinical Integrity
Your instinct as a therapist might be to create balance in the room. But when it comes to betrayal trauma, trying to “equalize” too soon can unintentionally reinforce the injustice.
“The secret keeper has to lack power in order for this to work in the long run… The person who’s been screwed has all the power. The person who did the screwing has lost all their leverage, and you the therapist has to cast them that way.”
— Dr. Stan Tatkin
What This Looks Like in Practice:
- The betrayed partner needs temporary power to set terms for continuance
- The secret-keeper needs to surrender control and begin rebuilding trust from the ground up
- You must hold that asymmetry with care, creating safety while allowing the healing process to unfold
3. Tolerate Dysregulation Without Collapsing into Comfort
Your clients will often come to you volatile—swinging between rage, grief, numbness, and shame. You might feel the urge to comfort them, to smooth it over. But if you do that too early, you may unintentionally send the message, “You’re overreacting.”
“Part of the problem is that everyone wants to get out of pain now, and the therapist in this case can’t really let that happen, because, in this case, learning comes from regret, comes from loss. Otherwise, we do things again, and we’ll never learn about ourselves.”
— Dr. Stan Tatkin
Clinical Challenge: Your job is to hold space for the intensity. To stay with the fire without dousing it. Because it’s through that discomfort that your client will begin to find their way forward.
4. Work Strategically, Not Just Empathically
Empathy is essential—but it’s not enough. Betrayal trauma recovery requires a clear roadmap. You need to know when to investigate, how to sequence your interventions, and what phase your clients are in.
“So getting people to understand this is the therapist’s job—to set the table and to cast the characters in the beginning, because I have not found any other architecture that actually can work in the long run where there isn’t a repeat offense by either party.”
— Dr. Stan Tatkin
Warning Sign: If you rely solely on a client-led, non-directive approach, you may allow avoidance or gaslighting to persist unchecked. Your role isn’t just to witness—you need to guide, redirect, and sometimes interrupt patterns that are keeping your clients stuck.
5. Coach True Accountability in the Secret-Keeper
Remorse isn’t the same as transformation. You’ll often see guilt and shame in the betraying partner, but those feelings don’t automatically lead to repair.
Your Critical Role: Help them move from damage control to genuine change by:
- Supporting them to own their actions fully
- Practicing radical transparency
- Committing to sustained repair behaviors
Without this structured approach to accountability, trust can’t be rebuilt.
Success Is Possible: Healing After Betrayal
While the path is challenging, healing from betrayal trauma can lead to surprising growth. Dr. Tatkin shares:
“Their marriage was better than it ever had been, because they were able to tolerate the suffering that is necessary to learn from this error, this mistake, and be good, not just okay, but great.”
What made the difference? A therapeutic approach that honored the gravity of the betrayal while creating a clear path forward through accountability and growth.
Strengthen Your Clinical Skills with Expert Guidance
These aren’t just helpful skills—they’re essential if you want to work ethically and effectively with betrayal trauma. If you found yourself questioning how to implement one or more of them, you’re not alone.
Betrayal is not just a relationship issue—it’s also a trauma issue.
Many therapists mistakenly frame betrayal solely as a breakdown in communication or trust. In doing so, they overlook its deeper impact on a client’s sense of self and reality. Without fully understanding the profound effects of betrayal—not only on the relationship but on each individual—therapists risk doing a disservice to their clients and may find themselves confused about why therapy isn’t progressing, especially for the betrayed partner.
That’s exactly why we created “The Psychological Earthquake of Betrayal Trauma: Clinical Insights for Therapists,” a free 3-part video training series with Dr. Stan Tatkin, globally recognized developer of the Psychobiological Approach to Couples Therapy® (PACT).
In this free training, you’ll learn:
- How betrayal can destabilize identity, prompting obsessive thoughts, self-doubt, and deep relational distress
- The neurobiological underpinnings of betrayal trauma and PTSD-like symptoms
- Practical application of the PACT model to work with complex relational dynamics more confidently and compassionately
- A clear framework for navigating the healing process from crisis to repair
Dr. Tatkin brings decades of clinical experience integrating attachment theory, neuroscience, and couple therapy into practical, effective interventions that honor the gravity of betrayal while creating paths to healing.
When you sign up, you’ll also be added to the Mind Body Training Institute’s email list to be notified of future free courses. You can unsubscribe at any time.
