The phrase "how could you" is most commonly recognized as the title and recurring question in Jessie Murph's song "How Could You," which expresses feelings of betrayal and heartbreak in a relationship gone wrong. The lyrics describe hurt caused by someone who crossed a line after being given space and trust, with strong emotions of regret and anger throughout the song.
If the query "how could you" was intended differently or more broadly, it generally functions as an expression of disbelief or questioning when someone is shocked or hurt by another's actions. The most relevant and popular cultural reference to "how could you" is indeed Jessie Murph's song from 2022, and its lyrics vividly capture the emotional turmoil behind the question.