How Narcissistic Abuse Can Cause C-PTSD

Sad teenage girl at the street


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.

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 flashbacks
  • Avoiding triggers or reminders of the traumatic events
  • Hypervigilance and sense of threat in daily interactions
  • Difficulties with emotional regulation
  • Feelings of shame, guilt, and worthlessness
  • Consistent struggles in interpersonal relationships
  • Memory loss
  • Having a close relationship with someone with a diagnosis of NPD or extreme narcissistic traits


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.

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.

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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.
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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.