PTSD From Emotional Abuse

The effects of emotional abuse can lead to complex PTSD.

Asian woman sitting in front of the dressing table feeling depressed

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If you've experienced emotional abuse in your life, you already know that the side effects have a tendency to last longer than the abuse itself.

To find out more about how people can cope with the mental aftermath of emotional abuse, Verywell Mind spoke to Frank Anderson, MD, a psychotherapist and psychiatrist who specializes in the treatment of trauma patients.

This article covers why it's important to recognize negative patterns in relationships, and how they tie back to past abuse. It also describes complex PTSD and breaks down how you can find success in a relationship while overcoming past abuse.

What Is Emotional Abuse?

According to Anderson, emotional abuse can result in effects that mirror those of severe traumatic incidents. All forms of abuse can lead to post-traumatic stress disorder.

While it's easy to identify physical and sexual abuse, emotional abuse can be hard to see, especially when you're in the thick of it. Anderson explains a couple of reasons why it can be so hard to identify.

"First off, it’s often what they [my clients] grew up with, [emotional abuse is] all they’ve known, and [it] becomes normalized," says Anderson. "Secondly, it is often experienced as what I call an invisible wound. If I can’t see it or experience it physically in my body, such as a bruise or broken bone, then it must not be real."

This, of course, is far from the truth. Emotional abuse can include screaming, belittling, gaslighting, manipulating, and any kind of constant pattern that another person uses to break down someone's self-esteem.

Anderson notes that emotional abuse can also include neglect and a lack of love from others. Emotional abandonment, where a caregiver is physically present but emotionally absent, can lead to emotional trauma.

He further explains that emotional abuse takes place in the context of relationships and often involves a parent early on in life. This is known as a relational violation and is often referred to as complex PTSD.

What Is Complex PTSD?

While, complex PTSD (C-PTSD) is not an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM), The International Society for Traumatic Stress Studies (ISTSS) outlines the symptoms that comprise complex PTSD when paired with self-regulatory disturbances:

  1. Difficulty regulating emotion: This is when someone's reaction is disproportionate to the event.
  2. Disturbances in relational capacities: As noted, abuse in the past makes it more likely for people to fall into abusive relationships in the future. This is because they haven't experienced a different type of relationship or the body has normalized an abusive dynamic in relationships.
  3. Alterations in attention and consciousness: Struggling with attention and energy levels is a common symptom in people with PTSD.
  4. Adversely affected belief systems: PTSD may cause people to feel persistent negative beliefs about oneself as being diminished and worthless, which include deep-rooted feelings of shame, guilt or failure.
  5. Somatic stress: This is when your stress and mental symptoms start impacting your physical health. This can manifest as stomach pains, headaches or any other number of physical pains.

Anderson explains that he bears these dysfunctions in mind when helping clients who have complex PTSD. He helps them recognize unhealthy patterns that keep popping up in their relationships.

By explaining the symptoms to his clients, Anderson "helps them link their past to the present day and paves the way toward healing the abuse and developing healthy relationships in their lives moving forward."

Emotional Abuse and Future Relationships

First and foremost, there is a link between people who experienced abuse—emotional, physical, or sexual—in childhood, and those who have unhealthy romantic or intimate relationships. This means that people who have experienced abuse are more likely to end up in relationships that are abusive later in life.

Anderson explains that, especially in the context of emotional abuse experienced early in life, this may be because it impacts the mental template you have for what a relationship looks like. This was also confirmed by study that followed women who had experienced emotional abuse in childhood, and found that they were six times more likely to experience emotional abuse in their romantic relationships later in life.

One theory is that the person is attempting to create a similar situation to handle it differently and break the pattern. Unfortunately, this usually results in the person finding themselves in a romantic relationship that is abusive.

Anderson works with patients to make sure that they recognize signs of emotional abusers in future relationships. He recommends Internal Family Systems (IFS) therapy for many of his patients that have experienced emotional abuse.

This form of therapy focuses on healing the emotional wounds that were created by past relationships. Once someone has addressed this, people are less likely to reenact unhealthy relationship patterns later in life.

Treatment Methods and Coping Mechanisms for Complex PTSD

Bessel van der Kolk, a psychiatrist and researcher best known for writing "The Body Keeps the Score," notes in a paper that complex PTSD requires what he refers to as phase-oriented treatment.

He breaks this down into six phases, all of which could require different types of medications and therapies.

Phase six addresses coping mechanisms, however you can find all of the phases below:

  1. Symptom management: Medication is key for most people with PTSD, so seeing a medical professional is important. Meditation/mindfulness can be more damaging for some people with PTSD, and grounding tools tend to be more helpful.
  2. Create narratives: This involves patience, and is done with the help of a licensed therapist, where you'll learn to identify and describe feelings and habits in daily life. Many times, trauma patients will associate negative experiences with negative feelings, which can cause them to overreact to basic inconveniences. Identifying their feelings can help them understand that just because they feel stressed, it doesn't mean that they are about to experience a traumatic situation.
  3. Recognize repetitive patterns: Once patients learn to identify their feelings, they can identify the actions that they set in motion.
  4. Connect internal states and actions: This is particularly useful for people who respond to unwanted emotions with attempts to regulate like gambling, drinking, or self-harm. Once people can understand what emotions lead them to seek these coping habits, they can start to change them.
  5. Identifying traumatic memory nodes: van der Kolk has found that EMDR and body-oriented therapies tend to work well for patients with complex PTSD. Both of these types of therapies prioritize being present in and in the moment, which can help people learn to feel safe and comfortable facing old memories since they can learn that they are firmly in the past despite the emotional reactions that they tend to cause.
  6. Learn interpersonal connections: A lot of people with complex PTSD struggle to work with others because it requires trust, which is something they've learned to be wary of due to their histories of abuse or trauma. Establishing stronger relationships and healthier patterns will help people cope as they move forward.

A Word From Verywell

By working with a therapist, it is possible to overcome PTSD that you're experiencing as a result of emotional abuse. Remember that it's easy to fall back into old relationship patterns, and while you may have to work to recognize this pattern in your life, you will definitely be happier once you've addressed your trauma.

5 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.
  1. International Society for Traumatic Stress Studies. New ISTSS Prevention and Treatment Guidelines.

  2. Giourou E, Skokou M, Andrew SP, Alexopoulou K, Gourzis P, Jelastopulu E. Complex posttraumatic stress disorder: The need to consolidate a distinct clinical syndrome or to reevaluate features of psychiatric disorders following interpersonal trauma? World J Psychiatry. 2018;8(1):12-19. doi:10.5498/wjp.v8.i1.12

  3. Chiang L, Howard A, Gleckel J, et al. Cycle of violence among young Kenyan women: The link between childhood violence and adult physical intimate partner violence in a population-based surveyChild Abuse Negl. 2018;84:45-52.

  4. McCarthy G, Taylor, A. Avoidant/Ambivalent Attachment Style as a Mediator between Abusive Childhood Experiences and Adult Relationship DifficultiesThe Journal of Child Psychology and Psychiatry and Allied Disciplines. 1999;40(3):465-477.

  5. Bessel van der K MD. The Assessment and Treatment of Complex PTSD. In: Traumatic Stress. American Psychiatric Press; 2001:15-18.

By Brittany Loggins
Brittany is a health and lifestyle writer and former staffer at TODAY on NBC and CBS News. She's also contributed to dozens of magazines.