What is Narcissistic Abuse Syndrome? Signs, Symptoms and Recovery

The narcissism blogosphere has been discussing it for years. Rehab clinics are offering treatment courses for it. Yet many psychologists haven’t even heard of it.

So what is narcissistic abuse syndrome?

Well, it’s a term used to describe the common symptoms experienced by victims of narcissistic abuse. It’s also sometimes also called “narcissistic victim syndrome”, or “narcissistic victim abuse syndrome”.

Although narcissistic abuse syndrome sounds like a clinical diagnosis, it’s not an official condition.

The American Psychiatric Association publishes a manual of mental health disorders called the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition or DSM-5 for short. 

This is the go-to handbook for diagnosing mental health conditions, according to the latest scientific evidence. Narcissistic Abuse Syndrome isn’t in it.

It’s also not on the radar of psychologists conducting research into narcissism. At the time of writing, a Google Scholar search for “narcissistic abuse syndrome” returns just 11 results – and only one of these is an actual academic source.

Now, this is not to say that narcissistic abuse doesn’t happen, or that it doesn’t have a profoundly harmful effect on people.

No one doubts that. But the question is whether it’s recognizable as a syndrome, or a disorder, distinct from other similar conditions such as post-traumatic stress condition (PTSD).

How to Recognise Narcissistic Abuse Syndrome?

Have you ever been cooking up something delicious in the kitchen, and someone walks in and says “Wow, that smells great!”? Suddenly you realize that you can’t smell the food at all.

You had become, as they say, “nose blind”. Because the smell of the cooking increases gradually over time, the smell receptors in your nose are adapted. Each little change became the new normal.

The person walking into the kitchen didn’t experience this gradual adaptation, so they get hit with the smell all at once.

A similar thing often happens with narcissistic abuse. It starts out minor and increases gradually, so you get used to it at each step.

At the same time, the narcissist may employ manipulation tactics to make you question what’s going on, and make you feel like you are to blame for the way you feel.

Because it can be hard for victims to realize that they are indeed victims, let’s go over some of the signs you have been abused by a narcissist. 

There are two ways of looking at this: 

• The signs of narcissistic abuse: By this I mean the signs of the abuse itself, that is, what the narcissist says and does to you that can be classed as abuse.

• The symptoms of narcissistic abuse: This means the symptoms that you experience as a result of that abuse, such as changes to your behavior, or your emotional/mental state.

What Are The Signs of Narcissistic Abuse?

Are you suffering from narcissistic abuse? See if any of the behaviours below seem familiar. Note that this isn’t an exhaustive list (there’s more information in this article on narcissistic abuse).

Verbal abuse

Verbal abuse can sometimes take obvious forms, such as:

• Insults / name-calling
• Shouting / becoming angry with you
• Belittling
• Making accusations
• Blaming you for things that go wrong
• Shaming you when you don’t act how they want
• Being demanding/making orders
• Undermining you
• Making unrealistic demands

But it can also take more subtle forms:

• Use of sarcasm
• Criticizing you excessively, perhaps disguised as jokes, or sometimes delivered in front of other people
• Interrupting you
• “One-upmanship” – everything you say, they have something better
• Downplaying – if something positive happens to you, they say it isn’t that good really

Psychological abuse

The psychological abuse people experience at the hands of narcissists can be extensive, and can be as damaging as physical abuse. It can include:

Manipulation

Influencing your behavior in subtle or not-so-subtle ways. Twisting how situations happened to make you feel like you are to blame, even for things that are absolutely their responsibility.

Emotional blackmail

The goal is to control your behavior by triggering fear, obligation, or doubt in you.

It can include threats, intimidation, or punishments for acting in ways they don’t want you to act (if you have a high degree of empathy, they may exploit that by threatening to harm themselves).

If you act in ways they want, you will be rewarded – they will be nicer to you and give you praise and affection.

Gaslighting

Gaslighting means making someone question their memory, judgment, or perception of events.

The name comes from the 1938 play “Gas Light,” in which an abusive husband dims the gas lights in the house, but claims to his wife that they haven’t been dimmed.

After a while, his wife begins to believe him and questions her sanity.

Exploitation

Using you, sexually, financially, or otherwise without care for your own needs, concerns, or feelings.

Isolation

Abusers often try to isolate their victims from friends, family, social services, or any other form of support that they might seek out.

This puts the victim in a weaker position, taking them away from the support of people who might help them.

Passive Aggressive Abuse

This could be considered as a form of psychological abuse, but as it’s so common, it’s worth giving it special attention. This type of abuse might include:

• Silent treatment: When your behavior doesn’t meet their high (or impossible) standards, narcissists my withdraw attention. Read more about the Narcissist and their Silent Treatment

• Emotional withdrawal: They may engage with you, but on a very basic level, without showing any emotion towards anything, positive or negative. This may last for days.

• Criticism disguised as “helping”: They may point out mistakes you make, but do it in an almost cheerful way, so it seems just like friendly advice. 

Physical abuse

Physical abuse, and the threat of it, maybe used by narcissists as a method of control, to try to get you to behave the way they want, or it may happen during narcissistic rage.

The physical abuse may also be followed by gaslighting (“It wasn’t as bad as that, I hardly touched you”), blaming (“If you didn’t behave the way you do, I wouldn’t have to do it”), or manipulation (“I only do it because I love you”).

Physical abuse can include:

• Acting in a physically imposing way without such blocking your path so that you cannot get away from them.
• Grabbing your arm tightly, or in a way that prevents you from doing something
• Pinning you against a wall
• Pinching, nipping, hair-pulling, or biting
• Pushing
• Slapping, punching, kicking, or otherwise striking you
• Throwing objects at you, or striking you with an object

Sexual abuse

Christine Hammond, a counselor based in the US who specializes in narcissism, describes the three stages of narcissistic sexual abuse:

1. Early-stage: They may start with mild grooming – encouraging you to perform acts you’re not comfortable with, such as sexting. This is to test you, to see if you’ll submit. You may be called a prude or receive other forms of verbal manipulations if you don’t do it.
2. The pushy stage: If you do submit, you’ll be pushed to do more extreme things that you don’t want to do (whatever your limit is, it’s common for abusers to try to take you just a little beyond it, to create a habit of compliance). The punishment for not doing it may escalate to physical abuse.
3. The violent stage: Sometimes the abuse can escalate to violence: rape, degrading/humiliating acts, or sadistic sexual acts (causing you pain for their own pleasure).

Once again we see the familiar pattern of slow, gradual escalation. However it’s important to point out that not all narcissists engage in sexual abuse, and not all become violent.

What Are The Symptoms of Narcissistic Abuse?

Now that we have been through some of the common signs of narcissistic abuse, let’s talk about the symptoms – which is to say, the effect that this abuse has on the victims. 

Not every person will experience every symptom here, and each person responds in different ways.

This is one of the arguments against classifying narcissistic abuse syndrome as a disorder. However, there are some commonalities, so let’s go through some of them.

Physical symptoms

Not all narcissists are physically abusive, but the victims of those that are will of course experience physical trauma.

The extent of this will be in line with how serious the abuse was and can range from light bruises and cuts to extensive bruising, lacerations, and broken bones. 

Beyond these symptoms, victims of abuse are at higher risk of stress-related illnesses, which can cause physical symptoms. These symptoms can include:

• Headaches
• Digestion problems
• High blood pressure
• Muscle tension/pain
• Skin conditions
• Sleep problems
• More colds and infections through reduced immune function

Emotional symptoms

Not surprisingly, some narcissists’ psychological abuse can cause significant emotional problems. Here are some of the more common narcissistic emotional abuse symptoms:

• Low self-esteem – if someone puts you down and points your flaws over and over for a long period of time, you eventually start to believe them.
• Fear
• Anxiety
• Depression
• Stress
• Guilt – victims of narcissists blame themselves
• Obsessive or compulsive behaviours
• Irritability 

Cognitive symptoms

When I say “cognitive” here, I’m referring to the “thinking” parts of the brain as opposed to the feeling side.

So things like memory, concentration, problem solving, and decision making.

According to neuroscientists, there is a connection between the trauma suffered through abuse and changes in the brain areas that control some of these cognitive functions – memory in particular.

Also, according to Dr. J. Douglas Bremner of West Haven hospital, there are long-term impacts in around 15% of victims.

As well to impaired cognitive functioning, victims of abuse may also experience unwanted or intrusive thoughts. For example, they may:

• Have flashbacks to particular instances of abuse
• Be plagued by negative thoughts about themselves
• Obsess over minor mistakes they make

Such thoughts can be a great source of distress and can be difficult to control.

Want to know more about What Narcissistic Abuse is?

The Symptoms of Narcissistic Abuse Syndrome

Many victims of narcissistic abuse come to a therapist, not because they’re being abused, but because they don’t feel right with themselves.

They may not even know they are being abused – least of all their partner is a narcissist.

They are seeing a psychologist for reasons many other people do – they are experiencing emotional disturbances, and want to find out why, and how to fix them.

Some symptoms that are more common among victims of narcissistic abuse specifically are:

• They don’t believe they are being abused: This might be because the abuse is very subtle – remember, not all narcissists progress to extreme forms of abuse. Or it may be that the narcissist has employ gaslighting and manipulation so that the victim doesn’t see the abuse for what it is.

• They hold their abuser in high regard – perhaps even idolize him.

• Loneliness – this might be because abusers try to isolate their victims. But there’s another factor here – that relationships with narcissists are often lonely, due to how one-way they are. 

• They compromise their own preferences and values to please the narcissist. For example, a narcissistic mother may push their daughter down a career path they don’t like, or a narcissistic husband may pressure their wife into sexual activities she’s uncomfortable with.

Perhaps these aspects of narcissistic abuse make people see it as a syndrome in its own right, as opposed to a combination of disorders like complex PTSD, anxiety, depression, and stress. 

However, critics might argue that these symptoms do occur in other situation of abuse, such as due to abusive sociopaths.

What does narcissistic abuse feel like?

How do victims of narcissists feel? The above descriptions of narcissistic abuse are a little clinical and don’t capture the essence of what people experience.

A study in 2018 interviewed women who were in intimate relationships with narcissists who eventually became abusive. Below is a collection of some of their comments.

In the beginning, the relationship was positive. Narcissists are indeed often very charming and charismatic initially.

“We did everything together. I was absolutely smitten with him.”
“He used to say to me ‘I can’t believe how lucky I am’…he was very charismatic, funny… I really did like him.”

Soon things started to change. Abuse starts to creep in, but they sometimes rationalise this away.

“I’d dressed up really nice, and he turned around and said ‘you’re not wearing that’ and I burst into tears and had to go and get changed”
“My part-time job funds would all be used on his wants, which was marijuana and alcohol that sucked, but it was also like, oh this is love, and we’re having heaps of fun”
“Slowly everything started to be his way, his wants, his needs…I was always really, really, overly accommodating…I wasn’t upset about that at the time… I was so happy to have what I thought was love.”

However, they did have some doubts. 

I had some question marks about him… when you’re young and idealistic you think, oh, it’ll be OK.”
“There were incidences of um, probably red flags that I could have taken notice of, but I didn’t.”

The abuse progressed, and the women started to experience serious symptoms. Fear was common.

“It was a constant state of fear because I never knew. He was unpredictable, so I was constantly in a state of shaking…fear for my life…I felt completely helpless, I felt like a baby.”
“I felt scared for my future. I knew it was gonna end badly.”
“…if I tried and cooked, then he’d find a million things wrong with it, so I just never cooked. I was just so fearful of it.”

But the narcissist could always bring them back around after an abusive episode.

They experienced the cognitive symptoms too.

“I would often get really detached as well…zone-out, especially with the lecturing …be off in my own daydream world for an hour.”
“I can’t even remember half of it coz, you know, you sort of block it out after having to go through it all.”

And then gaslighting – making them believe things that aren’t true.

“Always blaming me for being the one cheating. I’ve never cheated in my life…That was constant…really working away at you. I’m thinking, am I doing these things? Am I actually doing these things? Making you believe that’s the actual truth.”

Symptoms of low self-esteem and depression appeared too.

“…frustration, sadness…got down on myself… I got to that really low, really low point in myself”
“I cried almost every day, usually alone in my car on the way to work.”
“…started losing my self-esteem. You get caught in this rut, and you just can’t get out of it … esteem just gets lower and lower.”

How to Deal With Narcissistic Abuse Syndrome?

The first step you should take if you believe you have narcissistic abuse syndrome, or if you think you are experiencing narcissistic abuse, is to find support. 

Find a psychologist or counselor who has experience in dealing with narcissistic personality disorder, and contact them. 

It can also help to find a trusted friend to talk to. Make it someone who doesn’t know the narcissist, so that they have an unbiased opinion. Having someone in your corner will be a great help in all the other efforts you make.

Coping strategies For Narcissistic Abuse

Whenever your dealing with a difficult situation in your life, you have two ways of coping with it:

• Emotion-focused coping: finding ways to deal with the emotions you’re experiencing.
• Problem-focused coping: removing or overcoming the source of your difficulties.

Let’s look at these in turn.

Emotion-focused coping for narcissistic abuse

Below are a few strategies that can help you manage – to some degree at least – the emotional symptoms of narcissistic abuse.

These are not cures, but they might give you a little extra emotional strength, and some mental clarity to help you think more clearly.

• Mindfulness meditation is a mental technique in which you bring your attention into the present moment. It can help you break out of negative thought loops, and it can help deactivate your body’s stress response. There is a beginner’s guide over at mindful.org.

• Exercise: Researchers have found that physical exercise can increase your resistance to emotional stress. Light to moderate cardio exercise is good for this purpose. If you can find a buddy to exercise with, and do it outdoors in a natural environment, that’s even better.

• Slow breathing: Try breathing in a 5-2-7-2 pattern – in for 5 seconds, hold for 2, out for 7, hold for 2, and repeat. Studies have shown that this can calm the nervous system, and reduce levels of stress hormones like cortisol and adrenaline.

• Practice self-compassion: Although it is easier said than done, it can really help to be on your own side, and stop blaming yourself. If you find yourself being self-critical, try to switch that for self-compassion. Ask yourself, what would you say to a close friend or loved one in your situation? Would you speak to them the way you speak to yourself? Probably not. What would you say to soothe and comfort them? Say that to yourself.

Problem-focused coping for narcissistic abuse

For victims of narcissistic abuse, the priority is to stop the abuse from happening. But depending on the nature of the relationship, your plan for doing this can be quite different. 

In a relationship, this certainly means ending the relationship and breaking of ties with your abuser.

If the narcissist is a relative, it can be more complex. Some people have broken ties completely with narcissistic parents and siblings – it depends on the abuse’s nature, extent, and impact.

• Get support: I’d like to say this again because it’s important – get some support before you try anything. Seek out a qualified, experienced counselor, and/or join a support group. Contact friends any trusted friends you know who might be able to help, even if that just means having someone to talk to.

• Set boundaries: This doesn’t mean argue, but simply to state what you don’t want them to do. For example, state that they can no longer shout at you, or insult you – if they do, you will end the conversation and go to another room. Be sure to follow through.

• Make an exit plan: Speak to your support network about what you intend to do. What will you say, exactly? Make a list of the different ways they might respond, and work out what you will do or say in each scenario.

• Avoid tit-for-tat: Although it is tempting, do not try to play the narcissist at their own game, and try to manipulate or do something to hurt them. Avoid doing things that may trigger further abuse.

Healing after narcissistic abuse

Emotion-focused and problem-focused coping are both about how to deal with narcissistic abuse while it is ongoing.

But this is only the beginning of the journey. Once you have gotten out of the cage, it’s time to begin the healing process.

Some of this will happen by itself. Once the source of abuse is gone, you may feel some initial relief, and you may feel like there is now a force pushing your well-being upwards.

However, sadly, abuse can sometimes cast a long shadow over people’s lives, even after it has finished.

The symptoms may improve, but they won’t disappear overnight. Seek help from a qualified professional – they will be able to advise you on a path to healing the wounds you’ve suffered.