Girlhood Betrayals of Women Childhood Trauma Survivors in Treatment for Addiction.

PURPOSE: This research explored the understanding of trauma from the perspective of women who had experienced abuse and neglect in childhood. The goal was to better conceptualize potential avenues or interventions for prevention and treatment.

DESIGN: Qualitative description of the accounts of eight women who were childhood trauma survivors and in treatment for addiction. Open-ended interviews focused on key events or experiences during childhood and adolescence and the use of drugs and alcohol.

FINDINGS: Four levels of betrayal fit the accounts the participants gave as the dominant theme in their narratives. "Primary betrayal" referred to the direct victimization by a perpetrator; "secondary betrayal" referred to the complicity, denial, or indifference of another adult to the child's victimization; "tertiary betrayal" referred to failures of responsible individuals in community settings to protect the child; and "quaternary betrayal" represented self-betrayals. Substance misuse was an adolescent self-betrayal that provided initial solace yet ultimately threatened the integrity of the girls. We found an almost complete lack of support in family and community settings for the participants.

CONCLUSIONS: These findings on betrayal inform health care for trauma survivors and can be a framework for preventing violence against children.

CLINICAL RELEVANCE: Interventions for child and adolescent trauma survivors are critical to prevent the life-long health sequelae of childhood trauma. Pivotal times to engage these survivors include periods when they may be accessed in school and healthcare settings.