Harm, abuse and betrayal are three forms of violence that may be experienced as fused, as separate or as interlinked together. A patient might describe receiving acute physical harm yet what matters more may be how a witness failed to intervene. Both action and non-action can constitute violence, just as harm may be directed both to and away from the self. What shapes these forces, and how are they connected to the loyalties that are forged in our early childhoods? How do these then function later in life, in the unions and partnerships that we might commit to or seek to avoid?