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Psychodynamics of Betrayal Trauma With Strong Resistance / [A33]
This case-based article analyzes betrayal trauma following repeated infidelity in a long-term marriage, focusing on strong resistance against affect integration. Patient A33, a woman in her late 30s with three children, maintains an idealized narrative of the relationship and exhibits marked difficulty tolerating grief, anger, and shame. The discovery of infidelity destabilizes a romanticized worldview that has identity-defining significance, triggering splitting, disavowal, regression, and rationalization to preserve a "perfect" dyadic self-and object-configuration. Although reality testing remains intact, affective breakthroughs occur as intrusive imagery, agitation, and episodic dysregulation, followed by defensive re-idealization and self-blame. The paper interprets these dynamics through object relations and personality-organization frameworks, contrasting defensive reconstruction with psychotic disorganization. Betrayal trauma is conceptualized as existentially shattering insofar as it threatens the epistemic and identity foundations sustained by idealization, thereby intensifying resistance and symptom persistence.
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