Many of my clients wonder if it’s even possible to get PTSD from narcissistic abuse. The short answer is absolutely, yes you can.
You may recognise that you have symptoms such as nightmares, flashbacks, extreme hyper-vigilance and a constant feeling of anxiety. Yet you may not have realised these are classic PTSD symptoms, or you may attribute PTSD to something war veterans get, so think this is something that can be applied to you, or that your symptoms are valid.
This in itself can be a response to being in a relationship with a narcissist. You will have experienced gaslighting, chronic stress and a toxic cycle of abuse for so long that you may have lost sight that these symptoms are not a ‘normal’ part of life, or doubt whether they are valid.
However, if you are reading this, there is also part of you that recognises these symptoms and suspects you have PTSD from the abuse you have endured. You may well be starting to realise and accept the harm being in a relationship with a narcissist has caused you. Let me reassure you that experiencing symptoms of PTSD after narcissistic abuse is very real and something I see every day in my clients. Indeed, it is not unusual for people to exhibit symptoms of complex PTSD (C-PTSD) if they have been subjected to sustained narcissistic abuse over a long period of time. However, in this article I will focus on PTSD.
How does narcissistic abuse cause PTSD?
Narcissistic abuse is deeply and chronically stressful. A narcissist’s behaviour is consistently unnerving and involves neglect, lies, betrayal, rejection and punishment. This means you rarely know where you stand with a narcissist so it’s impossible to ever really feel safe and secure in the relationship. Instead it feels like a rollercoaster and you find yourself living in a more or less permanent state of heightened arousal. The cycles of abuse mean that your nervous system never gets a chance to calm or settle. This means you rarely, if ever feel at peace and the longer this goes on, the more harm it can cause psychologically.
So, you may become accustomed to feeling on-edge all the time, are ‘jumpy’, deeply anxious about everything, have heightened emotional responses and are quick to cry. You are likely to experience physical symptoms too – a racing heart, acute sickness deep in your stomach, an overwhelming feeling of panic.
You may be wondering why you have such a strong reaction. Put simply, this is a trauma response as your brain recognises they are a threat to your psychological safety. The relationship with the narcissist was not a safe place for you to be. When the brain detects a threat, it mobilises your sympathetic nervous system which is designed to prioritise responding quickly – you perhaps know this as the ‘fight/flight/freeze’ response. Even when you have left the relationship, these responses can remain if you have any interaction with them or fear you might, for example seeing them – or someone you think is them – as you go about your daily life.
Please know that it doesn’t have to stay this way. Therapy can help you to understand more about what is happening (and why it is normal), process the trauma you have experienced and learn practical ways to calm your nervous system.
Do I have PTSD from narcissistic abuse?
Although it’s helpful to educate yourself, it’s also not wise to diagnose yourself with PTSD (or C-PTSD) from information online, so this is designed to give you a guide only. Any symptoms you are experiencing may reduce by themselves when you remove yourself from the relationship. If they continue after 4-6 weeks and depending on their extent and how they are interfering in your life, you may wish to visit your doctor. The NHS gives some more guidance here.
However, you may not wish to have a formal clinical diagnosis, or visit your doctor, or you may not have had a positive experience with getting support. In which case, educating yourself about the types of symptoms and getting help from a psychotherapist who understands narcissistic abuse and recovery can help you to understand and make sense of what you have experienced and your symptoms.
The types of PTSD symptoms you may be experiencing include:
Nightmares and/or flashbacks.
You may wake up in the night drenched in sweat having had yet another terrifying dream. You may also be experiencing flashbacks where you relive a very difficult, or frightening memory and it feels like it is happening in the present moment. You might feel like the narcissist is right there with you and experience very real physical sensations, such as a racing heart, sweaty palms and nausea.
While flashbacks and nightmares are very difficult and can feel overwhelming, they are a very common response to trauma. They may calm down and go away on their own in time, and if not, you can learn practical ways to manage them – this article has some excellent suggestions. If they do not go away and are causing you a great deal of difficulty in your life, therapy can help you.
Hyper-arousal and hyper-vigilance to threats.
Hyper in this case means excessive. So you will feel excessively activated, aroused and constantly ‘looking out’ for threats. This means you are probably feeling very alert, jumpy, easily startled and feeling on edge a lot of the time. You will also usually experience physical symptoms such as an increased heart rate and breathing.
This is your brain’s natural ‘threat’ and stress response working overtime and it is exhausting. It also often means you can’t sleep well, feel very irritable and have difficulty concentrating. This of course can make life and work very difficult.
Emotional overwhelm or zoning out
You may find yourself feeling very low or anxious all the time and have trouble managing your emotions more than usual, for example crying a great deal or having angry outbursts.
On the other hand, you might find that you are ‘zoning out’ and don’t really feel much at all, especially any more pleasant emotions such as joy or contentment. Any feelings you do have may be focussed on self-blame and shame about the narcissistic abuse you have experienced.
This may lead you to withdrawing from people (who perhaps you are finding difficult to trust), and activities that usually give you pleasure. This is another indication that you would benefit from expert help sooner rather than later so you can find more helpful behaviours.
Avoiding things (including your feelings)
While some people struggling with PTSD can reach for alcohol or drugs to numb their feelings, many of my clients are high-functioning in their lives and like to keep themselves fit and healthy. However, when taken to excess, this can often be an indication of high levels of avoidance too. So, you may be keeping yourself very busy with work as a way of not dealing with being alone, or processing what has happened. Or you may be focussing heavily on controlling your food or excessively exercising. Although it can help in the short term, in the longer term it can of course create more problems. If you recognise this, therapy can absolutely help you find a way to manage things in a more sustainable way.
Physical symptoms that are unexplainable
You might have spent years dealing with difficult physical issues that doctors have struggled to get to the bottom of, such as IBS or fibromyalgia. You may feel dizzy, have chest tightness, acid reflux, repeated headaches and general feelings of nausea. Your body can have very real physical reactions to narcissistic abuse and if recognise these, especially if they are combined with the other symptoms above, it may be helpful for you to prioritise your mental and physical wellbeing and get some specialist help. Please contact me if you’d like to discuss how I could help you.