Institutional betrayal and sanctuary trauma are currently not listed as diagnoses in the DSM-5-TR or ICD-11.
Institutional betrayal is occasionally associated with moral injury or burnout.
Institutional betrayal focuses on an organization failing to prevent or respond to wrongdoings within the organization.
Sanctuary trauma focuses on the experiences of a person who was treated poorly or abused in an organization that the person believed was a safe place.
Sanctuary trauma is usually used to describe the experiences of those living with the effects of military sexual trauma. See the “Military sexual trauma (MST)” section for more information.
Neither institutional betrayal nor sanctuary trauma are currently listed as diagnoses in the DSM-5-TR or ICD-11.
Institutional betrayal, a term introduced by Dr. Jennifer J. Freyd,36 refers to institutions (i.e. a governing body or organization) causing harm to those who depend on those institutions (e.g. employees, residents). This term is commonly used to describe experiences of moral injury or burnout where the institution (and those in charge) fail to intervene and prevent or respond supportively to challenges within the institution, where an individual expects some degree of fair treatment or protection.36-38
Dr. Steven Silver39 defines sanctuary trauma as a psychologically traumatic event that “occurs when an individual who suffered a severe stressor next encounters what was expected to be a supportive and protective environment and discovers only more trauma.”
Institutional betrayal and sanctuary trauma both involve actions that bring up feelings of vulnerability, helplessness, fear, and shame, and both occur in environments or institutions that we expected to be safe—such as families, schools, workplaces, governments, hospitals, the military, and religious institutions.
The difference between the two concepts is that institutional betrayal focuses on the failure of the institution, whereas sanctuary trauma focuses on the experience of the individual who expected the institution to be a safe place or sanctuary.