Why Victims of Narcissistic Abuse develop PTSD

Big thank you to Rev. Sheri Heller for another wonderful article!

When we met for an initial therapy consultation, Madelyn was a psychological and emotional wreck. Yet when she shared about her childhood in the Philippines and her subsequent exploits with travel and academia, it was clear that her life was filled with love and encouragement. She had a doctorate in chemistry and a supportive husband of over two decades. Her adult children were happy, responsive and ambitious.
So why was she plagued by insomnia, emotional dysregulation and paranoia? She was disembodied and labile, yet she had no treatment history or even any notable symptoms prior to the past year. At the prompting of friends and family she sought therapeutic help.

As a therapist who typically treats complex trauma, Madelyn’s presentation fit the mold of someone plagued by systemic childhood abuse. However, the chronology of her life did not reveal abuse or neglect. It wasn’t until we touched on her relationship with the new CEO where she was employed, that it all fell into place. Her distress was rooted in narcissistic abuse.
Initially the ostensible solidarity and engagement of Madelyn’s female boss was motivating. She felt galvanized to work with another successful accomplished woman. What ensued amid the intermittent reinforcement and accolades was backstabbing, gaslighting, sabotaging, and disparagement. Fueled by unrestrained envy, the CEO triangulated Madelyn’s clients into a web of deceit, creating a culture of confusion, fear and cognitive dissonance. When we identified these dynamics as the source of her acute trauma, Madelyn resigned. Many others in the organization followed her lead.

Given the prevalence of a strong family system and the achievement of developmental milestones, the prognosis for Madelyn was very favorable. There was no exacerbation of earlier traumas which would contribute to a ‘complex ptsd’ diagnosis. The plan to intensively treat the acute trauma caused by narcissistic abuse successfully spanned a little over six months. Removing herself from the toxic relational dynamic and dismantling the brainwashing assisted Madelyn with restoring her sanity and getting back on track with her life.
The American Psychiatric Assoc. defines Post Traumatic Stress Disorder (PTSD) as “a psychiatric disorder that can occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, rape or other violent personal assault.”
Dr. Judith Herman explains in her seminal book Trauma & Recovery, that although similar to PTSD, complex trauma (aka complex PTSD) refers to a prolonged history of subjection to totalitarian control over an extensive period (months to years), which threatens one’s life and arrests the course of normal development by its repetitive intrusion of terror and helplessness into the survivor’s life.

My experience as a survivor and a therapist specializing in treating both complex trauma and narcissistic abuse syndrome has shown me that the violent personal assault inflicted by NPD abuse causes the manifestation of PTSD syndrome in victims, irrespective of whether they present with a prior history of complex trauma. Suffice it to say victims of narcissistic abuse who are beset by complex trauma may evidence a greater exacerbation of symptoms and present with a more challenging prognosis and recovery, than those grappling with an isolated acute episode of trauma.
According to Tracy Malone’s PTSD checklist at Narcissistic Abuse Support hyper-vigilance, pervasive depression and anxiety, dissociation, flashbacks and cognitive dissonance are just some of the symptoms ignited by narcissistic abuse.

Whether it be an employer, family member, a friend, clergy, a healthcare professional or a romantic interest, the relational dynamics with a malignant narcissist are destabilizing and debilitating irrespective of how constitutionally strong one is and how balanced and nurturing one’s upbringing was. As Dr. Patrick Carnes wrote in The Betrayal Bond: Breaking Free of Exploitive Relationships, “What moves betrayal into the realm of trauma is fear and terror. If the wound is deep enough, and the terror big enough, your bodily systems shift to an alarm state. You never feel safe. You’re always on full-alert, just waiting for the hurt to begin again.”
Indeed the machinations of narcissistic abuse are designed to heighten sympathetic arousal, causing the victim to experience responses of fight, flight, freeze and fawning. These responses are the hallmark of PTSD, and as long as there is what Carnes refers to as a betrayal bond, anyone is susceptible.

As far as the narcissist is concerned, the more malleable the target the better, but if they identify a challenging target who offers enviable supply, they will go after them. The more easily seduced and naive, the greater the leverage the narcissist has to dupe the target with deliberately contrived lies and agendas. Naturally those who were groomed to mirror their caregivers, to over-function and accommodate abuse and neglect and normalize heinous acts of abuse, are ripe for narcissistic victimization. Nevertheless, these predispositions are not always a decisive measure for who becomes the narcissist’s mark. Nor does it suggest that it is only those from backgrounds replete with traumatic relational injuries who are susceptible to the insidious maneuvering of the narcissist. Most importantly narcissists target those whose inner light and talents they want to covet, usurp and ultimately destroy. Hence, it’s not surprising that victims of narcissistic abuse usually embody the empathy and the gifts that narcissists lack. Seeking a source of supply that serves as an ‘extension’ of what they lack and crave, the narcissist is discerning as to whom they choose to exploit and destroy.

Obtaining supply requires the narcissist to read others well. The narcissist will determine what the target desires so as to embody what is yearned for. They will then morph into that prescribed role and proceed to love bomb. Relying on the basic principles of operant conditioning, the narcissist will specifically reinforce what the target craves through affection, admiration, compliments, gifts and attention. Once the target is ensnared by the rapid fire seduction the narcissist will intermittently withhold, punish, deny and disparage.
Gaslighting, a form of psychological manipulation in which false information is manufactured and deliberately manipulated so as to make the targeted victim doubt reality, memory and perceptions, is carried out by the narcissist to ensure control and induce cognitive dissonance. Peppered throughout the tyranny the narcissist will lavish the victim with crumbs from the proverbial shit sandwich. These intermittent gestures of ‘goodness’ and love bombing intensifies the victim’s attachment to the abuser and fosters further confusion.
This tormenter-redeemer motif is the foundation of a trauma bond.

Over time PTSD symptoms of flooding and dissociation take root in the victim. The weight of extensive smear campaigns, incessant lies and the narcissists recruitment of friends, family, colleagues so as to conquer and divide, takes its toll on the victim. Her character has been torn to shreds causing her to become increasingly untethered, fearful, and doubtful of her perceptions.
Rather than the victim’s deterioration being viewed as evidence of abuse, she is further stigmatized and perceived as delusional and problematic. She is not believed while the narcissist who seems contrite and concerned is lauded and supported by those who erroneously give credence to a horrifying fictional narrative. This exacerbates the victim’s state of trauma and alienation.

In The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma; Dr. Bessel A. van der Kolk, wrote, “Long after a traumatic experience is over, it may be reactivated at the slightest hint of danger and mobilize disturbed brain circuits and secrete massive amounts of stress hormones.”

Hence, the victim turned survivor will struggle with disruptive sensorial discomfort and chronic feelings of danger and fear. The inception of recovery is characterized by a fog of confusion and derealization. As the victim hobbles together a cohesive chronology of her surreal plight she vacillates between the emotional flood of panic, shame, grief and rage and debilitating numbness.
Those with positive supports and a reference point of secure attachments may escape earlier than those who have been conditioned to defer and yield. Eventually those who either extricate themselves or are subject to the classic ‘degrade and discard,’ pursue help through online recovery forums and a multiplicity of publications about narcissistic abuse. If led in the right direction some victims enter treatment with trauma therapists versed in treating narcissistic abuse syndrome.

Sustaining healing occurs when one shatters illusions, reclaims their truth with conviction, and rebuilds their life. Ideally going no contact with the narcissist ensures ongoing stability and safety. Removing the source of danger allows the victim to dismantle the deeply entrenched indoctrination of subjugation and objectification. This undertaking changes a person.
The victim is challenged to confront long-held beliefs and cognitive biases about goodness in the human condition. She is challenged to examine the dark side of human nature and the malignancy of evil and moral depravity. Most difficult to accept is having loved and/or been attached to another who used you solely to fulfill sadistic needs and impulses. Nothing the victim believed was real, was. This realization calls for the victim turned survivor to surrender to the harsh reality that the world is simply not safe or fair. The survivor is required to reconstruct an understanding of humanity inclusive of injustice and cruelty.

It is from this place of humble defeat that the paradox of liberation occurs. It is from this place that the survivor learns to trust her instincts. She learns to find safety within and to navigate through life with a mature capacity for self protection and preservation. Lastly, she discovers that the greatest reward gleaned from her new found philosophy and way of being is that it is the trajectory to living in accordance with relational standards and conditions that nullify any possibility of her ever again being reduced to narcissistic supply.


Rev. Sheri Heller, LCSW
NYC Therapist & Author. Complex Trauma & Addiction. Dual citizen, traveler, lover of art and nature. I appreciate the absurd. Sheritherapist.com

If you would like to read more from this writer you can check out there website here: https://sheritherapist.com/index.html

Rev. Sheri Heller, LCSW

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