PTSD Related Conditions How Narcissistic Abuse Can Cause C-PTSD By Julia Childs Heyl, MSW Julia Childs Heyl, MSW Julia Childs Heyl is a clinical social worker who focuses on mental health disparities, the healing of generational trauma, and depth psychotherapy. Learn about our editorial process Updated on May 12, 2023 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Yolanda Renteria, LPC Medically reviewed by Yolanda Renteria, LPC Yolanda Renteria, LPC, is a licensed therapist, somatic practitioner, national certified counselor, adjunct faculty professor, speaker specializing in the treatment of trauma and intergenerational trauma. Learn about our Medical Review Board Print martin-dm/E+/Getty The visibility of trauma as a widespread clinical ailment is gaining steam. The general public's increasing knowledge of trauma is due to how common traumatic experiences are. In a study conducted on general populations across 24 different countries, 70% of participants had experienced at least one traumatic event. In the same study, 30% of folks reported experiencing four or more traumatic events within their lifetime. As the knowledge of trauma expands, there is increased awareness of the different types of trauma responses. This article will explore complex post-traumatic stress disorder (C-PTSD) caused by narcissistic abuse. Read on to learn more about the signs, diagnosis, and treatment of C-PTSD caused by abuse. We will begin by exploring C-PTSD and narcissistic abuse separately and then dive into how they connect. How to Recognize a Covert Narcissist Understanding C-PTSD Let’s begin with understanding what C-PTSD is and is not. First, this is not an official diagnosis recorded in the most recent edition of the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5-TR), which is the primary diagnostic tool used by mental health providers. Instead, it is a set of symptoms that presents as a variation of PTSD. While this isn’t an official diagnosis recognized in the DSM-5, it is worth noting that there have been recent advocacy efforts encouraging the American Psychiatric Association to include it in the next edition of the DSM. While this plea has not been answered just yet, professionals may include it in future editions. C-PTSD is now an official diagnosis in the recently released 11th edition of the International Classification of Diseases (ICD-11). C-PTSD is a set of maladaptive responses that present themselves in daily life. These responses include issues with emotional regulation, negative self-talk, and struggles in relationships. The cause of C-PTSD is repeated and prolonged trauma exposure, such as being a prisoner of war, experiencing/witnessing abuse in childhood, or neglect. This abuse can be physical or psychological. What Is Narcissistic Abuse? It isn’t uncommon to hear the word “narcissist” thrown around to describe someone who is self-obsessed. However, narcissism can often refer to narcissistic traits. There is a difference between someone who is simply selfish, and someone who is excessively grandiose and lacks empathy. The latter is an example of narcissistic personality disorder (NPD). Someone with narcissistic traits and someone experiencing NPD can both be harmful, often stemming from their hypersensitivity and struggle to experience empathy. It is essential to recognize that not all people who have narcissistic traits or experience NPD will become abusive. Mental health professionals initially developed the term narcissistic abuse to describe the effects of parents’ inflicting psychological abuse on children. However, this definition has expanded to include psychological abuse between adults. This abuse can include constant manipulation, humiliation, and devaluation. What Is C-PTSD From Narcissistic Abuse? Remember, C-PTSD is caused by repeated and prolonged exposure to abuse, including psychological abuse. This means that if one is in a relationship with a narcissistic person or has a parent with narcissistic traits, it is possible to develop C-PTSD as a result. Signs of C-PTSD From Narcissistic Abuse The signs of C-PTSD from narcissistic abuse include the added risk factor of having a close relationship with someone with NPD or excessive narcissistic traits. Below are some common signs: Visual and/or emotional flashbacksAvoiding triggers or reminders of the traumatic eventsHypervigilance and sense of threat in daily interactionsDifficulties with emotional regulationFeelings of shame, guilt, and worthlessnessConsistent struggles in interpersonal relationshipsMemory lossHaving a close relationship with someone with a diagnosis of NPD or extreme narcissistic traits Treatment Healing is possible. While C-PTSD isn’t recognized by the American Psychiatric Association or DSM as an official diagnosis, it is a set of distinct symptoms that trauma-informed clinicians work with to best understand your emotional experience. Therefore, the first step in seeking treatment is to find a trauma-trained professional. They will assess for any mental health diagnoses that could be causing the emotional discomfort. Recommended treatments include psychotherapy and somatic therapy. There is often a stabilization period in the initial stages of beginning psychotherapy for C-PTSD. During the stabilization period, the therapist will work with clients to help them shift out of a crisis. This process often includes extensive support for developing emotional regulation skills. After stabilization, professionals recommend the use of somatic therapies to process trauma, followed by other trauma-informed approaches to help enhance people's life experiences. EMDR, an abbreviation for eye movement desensitization reprocessing, is a form of somatic therapy. Developed specifically for the treatment of trauma, clinical evidence supports EMDR’s ability to decrease symptoms of C-PTSD significantly. Other somatic modalities include somatic experiencing, brainspotting, IFS, craniosacral psychotherapy, sensorimotor psychotherapy, etc. In addition, as part of treatment, therapists introduce activities to help people feel safe and grounded in their environment. Techniques like belly breathing, grounding, acupuncture, trauma-informed messages, trauma-informed yoga, and physical exercise. How to Develop and Practice Self-Regulation Coping With C-PTSD Following Narcissistic Abuse One of the most painful aspects of C-PTSD from narcissistic abuse is how emotional abuse can create an impossible sense of loneliness. Part of the healing is understanding you aren’t alone. The impact of narcissistic abuse can leave people not knowing what healthy relationships look like, so reading about healthy relationship dynamics or working with a trusted professional can help you gain clarity and start building a safe support system. Consider seeking a support group for survivors of narcissistic abuse. If your abuser is also an alcoholic or addict, Al-Anon can be a great resource in developing strength and remembering you aren’t alone. Pain is present, but healing is always possible. If you’re experiencing suicidal thoughts, contact the Suicide Hotline at 988. Reach out to the Domestic Violence Hotline if you need support in an abusive relationship at 1-800-799-SAFE. If you’re in danger, call 911 or head to the nearest emergency room immediately. 8 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Benjet C, Bromet E, Karam EG, et al. The epidemiology of traumatic event exposure worldwide: results from the World Mental Health Survey Consortium. Psychol Med. 2016;46(2):327-343. doi:10.1017/S0033291715001981 Karatzias T, Shevlin M, Fyvie C, et al. Adverse and benevolent childhood experiences in Posttraumatic Stress Disorder (Ptsd) and Complex PTSD (C-PTSD): implications for trauma-focused therapies. Eur. J. Psychotraumatology. 2020;11(1):1793599. doi: 10.1080/20008198.2020.1793599 Hyland P, Murphy J, Shevlin M, et al. Variation in post-traumatic response: the role of trauma type in predicting ICD-11 PTSD and CPTSD symptoms. Soc Psychiatry Psychiatr Epidemiol. 2017;52(6):727-736. doi: 10.1007/s00127-017-1350-8 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. 5th ed. Washington, DC: American Psychiatric Association; 2013 Howard V. Recognising narcissistic abuse and the implications for mental health nursing practice. Issues Ment Health Nurs. 2019;40(8):644-654. doi:10.1080/01612840.2019.1590485 Shevlin M, Hyland P, Roberts NP, Bisson JI, Brewin CR, Cloitre M. A psychometric assessment of disturbances in self-organization symptom indicators for icd-11 complex ptsd using the international trauma questionnaire. Eur J Psychotraumatol. 2018;9(1):1419749. Doi: 10.1080/20008198.2017.1419749 De Jongh A, Resick PA, Zoellner LA, et al. Critical analysis of the current treatment guidelines for complex ptsd in adults. Depress Anxiety. 2016;33(5):359-369. doi: 10.1002/da.22469 Bongaerts H, Minnen AV, Jongh A de. Intensive emdr to treat patients with complex posttraumatic stress disorder: a case series. J. EMDR Pract. Res. 2017;11(2):84-95. doi: 10.1891/1933-3184.108.40.206 By Julia Childs Heyl, MSW Julia Childs Heyl, MSW, is a clinical social worker and writer. As a writer, she focuses on mental health disparities and uses critical race theory as her preferred theoretical framework. In her clinical work, she specializes in treating people of color experiencing anxiety, depression, and trauma through depth therapy and EMDR (eye movement desensitization and reprocessing) trauma therapy. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for PTSD Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.