Psychodynamics of Betrayal Trauma With Strong Resistance

The article presents a constellation of psychological suffering in a dyadic relationship after the partner's infidelity. While in most instances, such events are experienced as traumatic, in the presented case, the patient's suffering is particularly characterized by an inability to process grief, anger and shame due to strong resistance against facing the reality of her own emotions. The resistance can be explained with a priorly significantly idealized relationship, embedded in a generally 'romanticized' world-view, akin to infantile subjective realities. The shattering realization that the relationship is imperfect and her partner is fallible led to a split defense in which the patient's unconscious attempts to hold on to the idealized perfection of reality are regularly defeated by strong, almost unbearable affects with somatic symptomatology. The article discusses the psychodynamics of the split defense as a reaction to the inability to integrate the severe ambivalence between the loved object and the harm that it caused. Embedded in the context of an infantile ideation with intact reality testing, it reveals how the experience of betrayal trauma takes existential dimensions, threatening the epistemic foundation on which the patient has believed to have built her entire adult life. We contrast the present case with psychotic disorganization and take an analytic perspective on personality organization and the psychodynamic impact of existential trauma and split defense.