Betrayal Trauma in South Asian Communities of Aotearoa NZ and Australia

The feeling of isolation and silence often accompanies betrayal trauma, especially in cultures where family honour and stigma can suppress open discussion.

Understanding Betrayal Trauma in a Cultural Context

Betrayal Trauma Theory (BTT), introduced by Jennifer Freyd in 1994, describes the psychological harm that occurs when trusted individuals or institutions—those relied upon for safety, care, or survival—violate that trust [1].

Betrayal trauma occurs when someone’s trust is violated by an individual or institution on which they depend for support and survival [2]. Classic examples include a child abused by a caregiver or a patient whose concerns are dismissed by a trusted doctor. What makes betrayal trauma particularly damaging is the shattering of fundamental trust – the very people or systems meant to provide safety become sources of harm.

In South Asian diasporic communities, this concept extends beyond personal relationships to include cultural and institutional dimensions. For South Asian individuals in Aotearoa New Zealand and Australia, betrayal trauma can be deeply intertwined with culture, family expectations, and experiences of marginalisation in healthcare or society. A gentle understanding of this context is crucial for clinicians aiming to support healing.

When betrayal trauma is viewed through a cultural lens, additional layers emerge. Researchers have noted the idea of “cultural betrayal trauma,” where harm is inflicted by members of one’s own cultural or ethnic community. In South Asian families, which often emphasise loyalty and honour, the pain of betrayal by a family member or community leader can be profound.

The individual not only grapples with personal hurt but may also feel they are betraying their own culture by voicing this hurt. This complex bind – needing support yet fearing one is undermining family or community – is a common thread in how betrayal trauma manifests for South Asian clients.

Family Systems, Honour, and Intergenerational Silence

South Asian cultures place a strong emphasis on family, honour, and societal expectations, which significantly shapes responses to trauma [3]. In many South Asian families, there is an implicit code of silence:

personal problems (especially mental health issues or abuse) are kept private to “protect” family reputation.

The stigma surrounding mental illness or family conflict often leads to suppression of emotions and avoidance of discussions about past traumas [4]. This intergenerational silence means that parents may not talk about their own painful experiences (such as wartime trauma, migration struggles, or past abuse), and children learn that certain topics are off-limits. While intended to maintain honor, this silence can perpetuate shame and isolation. Traumas can be unknowingly transmitted to the next generation as unspoken fears, strict family rules, or emotional distance that the younger members feel but do not understand.

One consequence is that seeking outside help can be viewed as a betrayal of the family itself. In some South Asian communities, speaking to a therapist or counselor is seen as airing “dirty laundry.” A qualitative study of Asian women in the diaspora found that seeking help outside the family is considered damaging to family honor and brings shame [5]. The pressure to maintain an image of the “good family” means survivors of abuse or those struggling with mental health might be urged to keep silent, even when suffering.

For example, if a young woman confides about being depressed or about trauma, relatives might respond with denial or admonitions like “what will people say?” Such reactions, though often coming from a place of fear and cultural conditioning, leave the individual feeling deeply betrayed by those who are supposed to care for them. They may feel that their pain is less important than family reputation, fracturing their sense of trust in the family system.

Intergenerational expectations also play a role. Younger South Asian New Zealanders and Australians might experience conflict between their well-being and elders’ expectations. For instance, a second-generation youth might feel guilty for needing therapy, as if by acknowledging their struggle they are betraying the sacrifices their parents made in migrating [6]. Parents, on the other hand, may feel betrayed or hurt if a child speaks openly about family problems to outsiders, because it clashes with cultural norms of discretion.

This dynamic can lead to overwhelming guilt and self-blame in the person seeking help, compounding the betrayal trauma. Clinicians should be aware that a South Asian client might say “I feel like I’m letting my family down by even being here.” Such statements are windows into how betrayal trauma is uniquely colored by cultural context – the very act of seeking healing can trigger feelings of betraying one’s family loyalty [7].

Betrayal by Institutions: Healthcare Experiences and Stigma

Institutional Betrayal in Healthcare

South Asian individuals in Aotearoa New Zealand and Australia often expect healthcare and social institutions to be supportive and trustworthy. However, many encounter cultural misunderstandings, minimization of their concerns, or outright dismissal by healthcare professionals. These experiences can be deeply alienating, leading to feelings of betrayal by systems meant to provide care and support [8] [9] [10].

The concept of healthcare institutional betrayal (HIB) describes how negative or dismissive encounters-especially when rooted in cultural insensitivity or systemic discrimination-can activate trauma symptoms, reduce trust, and lead to future avoidance of healthcare service [8].

The BITTEN model explains that past traumatic healthcare experiences, including those involving racial or cultural discrimination, can create a feedback loop of mistrust and avoidance. This is particularly relevant for South Asian patients who may already have a history of trauma or marginalization [9].

Cultural Dissonance and Communication Barriers

Communication barriers and lack of cultural competence are major contributors to these experiences. Many South Asian patients report not having regular access to language or culturally appropriate support when using health services [10].  When healthcare providers fail to recognize or respect cultural nuances-such as dietary restrictions, religious practices, or mental health stigma-patients may feel unseen or misunderstood. Even seemingly minor comments or stereotypes can reinforce the perception that the system is not designed for "people like me" [11] [12] [13].

Impact on Mental Health and Help-Seeking

The consequences of institutional betrayal are significant. Research shows that when South Asian patients perceive their suffering as minimized or their identities as misunderstood, it can compound personal trauma and deter future help-seeking [14]. This is especially damaging in the context of mental health, where stigma is already prevalent within South Asian communities. Many individuals internalize the belief that mental health services are not for them, or that seeking help risks exposure to further stigma or discrimination [10].

Community Stigma as Institutional Betrayal

Stigma within South Asian communities adds another layer of institutional betrayal. Community institutions-such as faith centers or cultural organizations-may avoid addressing mental health issues, reinforcing the idea that such struggles are taboo or a sign of weakness. This collective silence can be as traumatic as overt discrimination, leaving individuals feeling isolated and unsupported [15].

Summary Table: Institutional Betrayal in South Asian Healthcare Experiences

Aspect	Description	Impact
Healthcare System Betrayal	Dismissal, minimization, or lack of cultural competence from providers	Erodes trust, increases trauma, leads to avoidance
Communication Barriers	Lack of language support, cultural misunderstanding	Alienation, reduced quality of care
Community Stigma	Silence or taboo around mental health in community institutions	Isolation, internalized stigma
Compounded Trauma	Both personal and institutional betrayals reinforce feelings of exclusion and mistrust	Worsened mental health, reluctance to seek help

Clinical Considerations for Culturally Responsive Practice

For clinicians working with South Asian clients, an awareness of betrayal trauma in this cultural context is vital. These clients may come to therapy carrying not only the weight of the precipitating trauma (be it abuse, loss, or illness) but also layers of trust injury inflicted by family responses or institutional interactions. Establishing a foundation of safety and trust is therefore the first therapeutic task. Here are several considerations and strategies for clinicians:

• Validate and Acknowledge Betrayal: It is important to explicitly acknowledge the client’s feelings of betrayal. For example, a clinician might say, “It sounds like when your concerns were dismissed by that provider, it really hurt – as if the people who should help you weren’t there for you.” Validating these feelings helps undo the self-doubt many South Asian clients carry (often they’ve been told “don’t make a fuss” or “it’s not that bad”). By naming the betrayal, the therapist can affirm that the client’s reactions are legitimate. This is a crucial first step in rebuilding trust.

  
  

• Understand the Role of Honour and Shame: A culturally responsive clinician should be aware of concepts like izzat (honor) and sharam (shame) that often influence South Asian clients’ worldviews. Recognize that your client may feel conflicted about sharing family issues with you, fearing they are betraying their loved ones or violating cultural norms [16]. Gentle exploration can help here: “What would it mean for you if we involve your family in this conversation? What would it mean if we don’t?” By bringing these cultural dynamics into the open, you help the client see that you respect their values. It also opens a dialogue about how to navigate therapy in a way that honors their needs without unnecessarily triggering shame. In some cases, framing therapy as a path to strengthening the family (rather than betraying it) can be helpful – for example, noting that by healing herself, a young woman might be better able to support her family in the long run.

  
  

• Address Stigma and Confidentiality Upfront: Given the high stigma in South Asian communities around mental health [17], clinicians should proactively discuss confidentiality and how therapy works. Many South Asian clients (especially from small diaspora communities) worry, “Will the therapist share my issues with others? What if they know my family or community?” This fear is not unfounded – some prefer not to see a therapist from their own community for fear of gossip [10]. Emphasize that what is said in therapy stays in therapy. Explain any limits to confidentiality in simple, reassuring terms. Emphasize your respect for their privacy. By tackling this concern early, you chip away at one barrier to trust. Over time, as the client sees that you consistently honour their confidentiality without trivializing their experiences, the therapeutic relationship itself becomes a corrective experience – a place where trust, perhaps for the first time, is not betrayed.

  
  

• Bridge Cultural Dissonance: Many South Asian clients have felt a “cultural gap” with healthcare providers [10]. To bridge this, clinicians should practice cultural humility – invite the client to educate you on what their problem means in their culture. Simple questions like, “How do you and your family view what you’re going through?” or “Are there cultural or religious beliefs I should know about that are important to you?” demonstrate respect and curiosity. It’s also helpful to be aware of historical and social contexts: for example, understanding the generational trauma of Partition or the immigration stresses can show the client you have some insight into the larger picture.

  
  

  You don’t have to be an expert in South Asian cultures (indeed, avoid making any assumptions or generalizations about their specific experience), but being open, non-judgmental, and willing to learn goes a long way. This stance can repair some of the “cultural betrayal” they may have felt from mainstream services in the past. Research suggests that when mental health professionals show cultural sensitivity, it can improve engagement and trust among South Asian families [11].

  
  

• Culturally Adapted Interventions: Consider adapting your therapeutic approach to align with the client’s cultural values. For example, if a client is uncomfortable with individual-focused therapy due to their collectivist upbringing, you might integrate family into the process (with the client’s consent) or frame goals in terms of community and family well-being. Some South Asian clients find strength and meaning in spiritual or religious practices; a culturally responsive clinician can incorporate this (such as mindfulness meditation, prayer, or yoga-based breathing techniques) if appropriate. The key is to signal that all aspects of the client’s identity are welcome in the therapy room. This is the essence of culturally responsive care – seeing and valuing the client’s cultural context rather than asking them to check it at the door [18]. By tailoring interventions in a way that resonates with the client’s background, clinicians send the message that therapy is a safe and inclusive space, not another institution that requires the client to conform or hide parts of themselves.

  
  

• Build on Strengths and Resilience: South Asian communities also possess immense resilience, family support networks, and coping strengths (such as faith, humor, or communal support during crises). While acknowledging trauma and betrayal, it’s equally important for clinicians to help clients tap into their resilience. This might involve exploring stories of overcoming adversity in the family or community. For instance, if a client’s parents survived significant hardship to build a life in New Zealand/Australia, that narrative can be reframed not as a reason to “suffer in silence” (a common guilt the client may carry), but as evidence that perseverance and healing are part of their heritage. Strength-based approaches can empower the client to break the cycle of silence. It reassures them that seeking help is not a weakness or betrayal of their culture, but rather an act of courage that aligns with the strength their culture has always shown in the face of challenges.

  
  

• Trust as the Cornerstone: Above all, clinicians must earn trust patiently. Given the betrayal trauma background, a South Asian client may test the waters for a long time before fully trusting the therapist. They might downplay their issues initially, or repeatedly ask for reassurance that you won’t judge them. This is normal. Consistency, reliability, and empathy on the therapist’s part are crucial. Small gestures matter – remembering details they share about their family, being punctual and professional, and gently checking in when discussing a culturally sensitive topic (“Is it okay that we talk about this? I know it might be hard.”) all signal trustworthiness. Over time, as one therapeutic relationship proves safe, it can become a model for the client to rebuild trust in others areas of life, too. Part of the healing from betrayal trauma is experiencing a relationship where trust is honored and not broken. Therapists can provide this experience.

Culturally responsive practice is not a special technique but a mindset of empathy, respect, and attunement to the client’s background. It acknowledges that for many South Asian clients, trauma is intertwined with feelings of cultural betrayal and institutional mistrust. Therefore, healing must address both the trauma and the context. By creating a space where South Asian clients feel understood in their entirety, clinicians help repair the tears in the fabric of trust. This might involve the therapist, in a sense, standing in for the institutions or family members that failed the client – by being consistently supportive, the therapist shows that not all caregivers or systems will betray them. Such experiences can gradually open clients up to the idea that they deserve support and can find allies in their healing journey.

Moving Forward: Healing and Trust-Building

Betrayal trauma is deeply painful, but with the right support, individuals and communities can heal. For South Asian populations in Aotearoa and Australia, part of this healing is breaking the long-held silence and stigma. We see encouraging signs: younger generations are starting to speak more openly about mental health, advocacy groups and ethnic media are addressing topics like depression and domestic violence, and culturally tailored services (such as helplines and support groups in South Asian languages) are emerging. Clinicians can play a pivotal role in this positive change by fostering culturally safe therapeutic environments.

Research in the UK has recommended that services “establish trust and cultural safety” for South Asian service users, recognizing the impact of alienation and powerlessness these clients often feel [10]. In practice, this means engaging with communities, hiring diverse staff or cultural consultants, and continuously educating oneself on cultural competencies.

On an individual clinical level, healing from betrayal trauma for South Asian clients centers on rebuilding trust – in themselves, in others, and in institutions. Therapy can guide clients to listen to their own voice (after years of being told to stay silent) and to trust their perception of what happened to them. Clinicians might help a client separate the concept of “loyalty” from “silence,” and to redefine loyalty in a healthier way (e.g., “I can be loyal to my family while still setting boundaries or seeking help”).

It’s a delicate process, but as the client grows in self-trust, they often feel empowered to address or confront the sources of betrayal. Some may choose to have honest conversations with family members, while others might find closure internally or through community healing rituals. There is no one right path – culturally attuned clinicians can help clients discover what reparation looks like for them personally, whether it’s rebuilding a strained family relationship or finding a sense of belonging in a supportive peer group.

Lastly, understanding betrayal trauma in South Asian communities requires us to see the whole tapestry of influences: the weight of honor and expectations, the scars of historical trauma and migration, the sting of racism or dismissal in healthcare, and the profound desire to be heard and valued. South Asian clients may come to clinicians carrying wounds inflicted not just by individuals, but by family systems and societal systems.

With compassionate, culturally responsive care, clinicians can help transform these wounds into scars of strength. The journey involves patience and cultural humility, but the reward is significant – it opens the door for a client who once felt betrayed and silenced to finally feel safe, seen, and supported. In the therapy room, as trust is gradually restored, we witness the resilience that has always been present in South Asian communities rise to the surface, allowing genuine healing and empowerment to take place.

Till next time,

Jannine