Recognizing Narcissistic Abuse and Steps to Take for Healing and Recovery
- Stefanie Sherman, LCPC, LMHC, CMHC
- Apr 14
- 8 min read
Talk of Narcissism is everywhere these days. You have likely seen a social media post, seen it in the news or heard friends or family talking about it, but there is very little understanding of what it is.
What Is Narcissistic Abuse?
Narcissistic Abuse is the current umbrella term that covers unhealthy and toxic relationships that often include manipulation, control, and emotional harm to dominate another person into meeting the needs of one person. Narcissistic abuse does not need to include a person who is diagnosed with Narcissistic Personality Disorder, and treatment does not include labeling the other person. Instead, we look at patterns of behavior, communication and abuse and decide what will work for each individual. This abuse can occur in relationships, families, workplaces, or friendships. It is often subtle and hard to spot because it involves emotional and psychological tactics rather than physical violence. It becomes confusing because when needs of both parties align, the relationship goes very well.
The origins of Narcissism comes from the story of the Narcissus, a vain but handsome and masculine God in Greek Mythology. The story varies wildly, but in his arrogance he rejects the advances of all men and women around him, so he is cursed and falls in love with his own reflection in a pool of water. As he wastes away or perishes, he is turned into the daffodil (whose scientific name is Narcissus).
Later, Narcissistic Personality Disorder became an official diagnosis added to the DSM in 1985 (the same year as PTSD) by the American Psychiatric Association. This diagnosis is rooted in a lack of empathy, grandiosity, entitlement, interpersonal exploitation and a need for admiration. This diagnosis is still under development by the APA and is difficult to study due to the nature of people struggling with narcissism not agreeing that they have a problem and therefor rarely submit to testing.
Currently, Narcissism is seen as a spectrum ranging from entitlement to malignant Narcissism, and includes types such as communal, covert and grandiose (classic) subtypes. The expansion covers expressions that range for both men and women but generally follow the same patterns of manipulation. These patterns fall into 5 different clusters: Behavioral Problems, Interpersonal Problems, Antagonistic, Dysregulation, and Cognitive Issues. While many of these behaviors can be unhelpful or unhealthy, there are 4 key behaviors to keep an eye out for that cannot be justified as healthy. For example: lying is often labeled as an unhealthy behavior in a relationship, but if I lied to my father about the circumstances leading up to his surprise 60th birthday party, that might not cause harm in that relationship.
Key Indicators of Narcissistic Abuse
Gaslighting-creating a situation and then denying your reality, which often erodes one sense of self and personal trust. This is often mistaken for other manipulation tactics, but gaslighting includes the set-up.
For example: hiding your hearing aids and then saying that you must have lost them and you are irresponsible.
Arrogance-Different than confidence, it is truly driven by insecurity and often based without evidence.
Vindictiveness-Often the easiest indicator to spot as this behavior is likely external and visible. It is a punishment for not bending to their will, and will be "justified" through a skewed sense of justice.
For example: keying your car because you broke up with them.
Exploitation-all the manipulation and control is to exploit a person in the relationship to get their needs and wants met, through means that a person does not agree to of their own free will.
For example: Financial abuse in the relationship to prevent someone from leaving them
There is no healthy way to explain the above indicators. If you notice these patterns regularly in your interactions, there is likely narcissistic abuse.
How to Know If You Are Experiencing Narcissistic Abuse
It can be hard to recognize abuse when it happens gradually. Here are some signs to watch for:
You feel confused, anxious, or “off” after spending time with the person.
You constantly apologize or feel responsible for their mood.
Your self-esteem has dropped since the relationship began.
You feel isolated from your support network.
You make excuses for their behavior to others or yourself.
You might struggle to express your needs, wants or be able to say no.
You feel trapped or fearful about leaving the relationship.
You notice patterns of manipulation or emotional blackmail.
Or, you might describe yourself as:
A Fixer
People-Pleaser
Mediator
Perfectionist
Highly Empathetic
Family Peace-Keeper
If these signs or descriptors sound familiar, it might be time to consider some changes.
Steps to Take for Healing and Recovery
The Survivor's Climb is a framework for healing from Narcissistic Abuse that centers around shifting the focus back to the survivor's needs and creating a strong, lasting foundation for long-term healing. Drawing inspiration from Maslow's Hierarchy of needs; self-esteem, self-knowledge and emotional regulation come before belonging to set up a true safe base for future relationships and grounded, intentional recovery.
Pause and Meet Basic Needs
Take a moment for a factory reset. When is the last time you drank water, had a decent meal or a good night's sleep? Dehydration can mimic symptoms of depression, hunger can present as anger or irritability and sleep deprivation impacts all types of mental health concerns. Starting here and meeting these needs first sets up the base for everything to come.
Make a plan for Nervous System Regulation
Long-term emotional and psychological abuse takes a toll on the body. What systems are meant to prepare you to survive in moments of danger, become your baseline and overtime begin to feel normal. This kind of survival leads to long term health issues including digestive disorders, hormone disorders and auto-immune disorders and more. Mentally, many victims suffer from burnout, anxiety disorders, and trauma. While the body is not likely to get regulated while you are still in the situation that may have caused it, assessing where you are and how to begin moving the needle towards regulation is a key step in overall health and recovery. This is a great step to bring in help such as your medical team and find a counselor.
Educate Yourself About Narcissistic Abuse
The fog that accompanies many toxic relationships obscures truth and understanding, and education can help clear the confusion. Learn what you can about types of abuse(free worksheet here), coercive control, narcissistic abuse and unhealthy patterns in relationships (resources page here). The more you learn about manipulative patterns, the easier it becomes to spot them in your life and relationships and help you decide what you want to do next.
Education is also about allowing you to come to terms with what may be happening and stop justifying, minimizing or ignoring behavior that is harming you. Consider the 3 strike rule. If you set a boundary with someone where you explicitly label their behavior as harmful to you and offer them a path to trust through different behavior. If after this conversation, this harmful behavior happens again, give them the benefit of the doubt once more as patterns of behaviors can sometimes be automatic, but remind them explicitly that their behavior is harmful. If the person chooses this harmful behavior a third time, it is on you to remove yourself from this person who is choosing behavior that they know harms you, otherwise you are accepting a repeating pattern and signaling to the other person that your boundaries don't matter as you will not enforce them, even in self-preservation. What kind of boundaries you might set or what this might look like leads us to the next step.
Get Real About What Changes You Want to See
You may discover there are in fact toxic, unhealthy or abusive patterns in your relationships, so the next step is determining where you want to go from here. There are many reasons people may stay in a relationship, sometimes staying is the safest option at the time for you, your loved one or children involved. That is ok. Sometimes you are ready to tackle the momentous task of preparing for leaving. Or even limiting or altering contact. The journey is completely up to you, but in these situations, hoping the other person will change is futile. Recent research indicates brain differences in people who suffer from Narcissistic Personality Disorder, specifically in the pre-frontal cortex. What does this mean? Well, specifically that the person may lack the capacity to change, not just that they don't want to. So treatment will be centered on what you have the power to change and acceptance of the things you do not have power over, such as the other person.
***Leaving an abusive relationship is often the most dangerous time for a victim, even if there has never been physical abuse. Coming up with a safety plan is critical, consider talking this out with a trusted friend, family member, doctor or counselor before you make changes to the relationship.***
Reclaim Your Identity
So much is given up in toxic relationships, and to "keep the peace" often times personal needs, wants, values, dreams, interests, etc are buried or hidden. It's time to rediscover them, especially as you determine what changes you want to see in your life.
Explore your personal values (worksheet found here) apart from that of the toxic person. How do these values guide your decision making for what is next? Which solution best fits YOUR values?
Work to meet you basic needs on a regular basis. (insider tip: if meeting your own BASIC NEEDS causes a fight, there is a problem in the relationship).
Consider writing out your Bucket List. Does staying with this person inhibit or block you from reaching these dreams? Have they trashed, minimized or argued with you about your dreams on your bucket list?
Set personal goals and celebrate small victories!
Set SMART Goals (Specific, Measurable, Attaintable, Realistic and Time Oriented) that center with getting your life back on track based on your values or even your bucket list.
Seek Support
If your social support system has been devastated by the relationship, this is the time to start to build it back up. Reach out and begin bridging the gap with people you have trusted in the past or begin forging new supports. Let your bucket list guide you if you are stumped in making new friends. For example, maybe you've always wanted to take a writing class or learn martial arts. In signing up for these things, you will put yourself around new people who share a common interest. You will likely need a team, so consider opening up to your doctor, getting a therapist if you do not already have one, explore legal support if you need to, in addition to healthy family and friends. You do not have to nor is it recommended to walk this journey alone.
Be Patient
Healing is not linear. You may have setbacks or difficult days. There may be on-going abuse and post-separation abuse. These situations do not resolve overnight and can sometimes take time to untangle. Allow yourself to feel emotions without judgment and keep moving forward. Give yourself compassion that this journey is incredibly difficult but the peace you find at the otherside, (and I promise, there is another side) is worth it.
When to Seek Professional Help
If you are on this page and exploring this topic, it is probably time to consider counseling, as most people won't find themselves here for light reading. Counseling really can be for anyone, even if you are reading this article because you are worried about someone in your life who may be experiencing this. Bottom line, if you are here for education, likely to enable changes somewhere in your life and counseling can help.
Narcissistic Abuse, coercive control and emotional abuse are really complex topics and healing will cover a lot of ground. Communication, setting boundaries, identifying red flags, and nervous system regulation when dealing with a manipulative person is different than applying them in normal situations, so professional help is recommended.
If you experience symptoms like severe anxiety, depression, or PTSD, professional support is critical. Therapists can offer specialized treatments such as cognitive-behavioral therapy (CBT) or trauma-informed care, but please take time to vet your therapist. Not every counselor has training in Narcissistic Abuse and this knowledge is crucial to maximize therapy effectiveness in these cases.
Moving Forward After Narcissistic Abuse
Recovery means reclaiming your life and peace of mind. It involves learning to trust yourself again and building healthy relationships. Remember, you deserve respect and kindness, and no amount of abuse is healthy or ok. And there is a light at the end of the tunnel and peace is achievable.
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