Narcissistic Abuse Syndrome

Narcissistic Abuse Syndrome

Signs and Symptoms of Narcissistic Abuse Syndrome

Authored by Jane Squire MSc

Edited by Hugh Soames B.A.

Reviewed by Michael Por, MD

Living in a narcissistic relationship has been described by survivors as living ‘an actual waking nightmare’ where they were initially unaware of the abuse being crafted, plotted and planned against them. Even well into narcissistic abuse recovery many victims report feelings of hopelessness as they are increasingly confronted by the cold facts that many beliefs they held true in a relationship are revealed to be false, or worse still fabricated and manipulated to suit the narcissistic partner.

Living in an emotionally abusive relationship is something nobody should have to endure, although narcissistic abusers can be very difficult to identify. Life with a narcissistic partner can lead to a raft of psychological issues and seriously impact a persons mental wellness. Issues of PTSD and devastatingly negative self esteem can persist for years after the abuse has ended, so it is vitally important to seek high-quality narcissistic abuse treatment if you think that you or someone you love is struggling with narcissistic abuse syndrome.

What Techniques does a Narcissist Use

Although narcissistic abuse generally falls under the description of mind control or emotional manipulation, there are several ways narcissists tend to do so. Consciously or unconsciously, individuals tend to manipulate words and language to control their partner’s behavior. Narcissists use manipulative techniques such as gas lighting to confuse and disorient their partners and make them more vulnerable to emotional abuse and other forms of manipulation.

“Gaslighting” is a term that might be overused these days but has secured its place in popular culture as a way to describe a narcissists’ manipulation of someone else, usually a romantic partner although not limited just to them and can include their family, friends or colleagues and business associates.

The term gaslighting comes from a famous 1944 George Cukor movie1 “Gaslight” based on the play of the same name about a husband who tries a host of abusive tricks to convince his wife she is insane even though she is completely sane. Eventually, through the involvement of other people, the wife questions what her husband has been telling her and making her feel and she reasserts her sanity. While it’s just a movie, the message is apt in the real world.

Understanding Narcissistic Abuse

To understand narcissistic abuse, it’s crucial to first have a general understanding of what a narcissist is and how they act. The clinical definition is narcissistic personality disorder2, and it means someone who has an elevated sense of their own self-worth. Their lives are largely driven by satiating their exaggerated belief in their importance to the detriment of most people they meet, seeing them as objects they can manipulate to bolster their desire for admiration.

Narcissists use a host of behavioral tricks including: deception, creating doubts in other peoples’ minds to the benefit of the abuser, guiding friends and family and others into decisions that make the narcissist look good even if it hurts those people mentally and/or physically, creating distrust among a social group so people think only the abuser is trustworthy, and more.

Knowing these traits can be vital to stopping the abuse. Narcissistic personality disorder is a clinically recognized disorder typically diagnosed by a professional healthcare worker. Narcissists are often extremely intelligent people who know how to manipulate others without them realizing it, so it can be hard to push back against abuse.

What is Narcissistic Abuse Syndrome?

Narcissistic abuse syndrome is a disorder that occurs when a person lives and spends a long time with a narcissist. People who struggle with narcissistic abuse syndromes often doubt their values and reasons, but there is no doubt that the problem is real.

When doctors diagnose a patient, they will look at the symptoms that the person is suffering. If you’ve got a fever with runny nose and congestion the doctor might diagnose you with the flu. Narcissistic abuse syndrome is the combination of symptoms that can occur when someone is suffering narcissistic abuse, and they can come in different forms. If you fear you are suffering this abuse, it might help to talk with a licensed therapist for further insight.

  • Emotional symptoms
    Narcissists are experts are saying things to people and acting in certain ways that make the victim’s emotions fluctuate widely, often to include emotional behavior that the person has never displayed before. The following are examples of just some of the emotional responses that an abuse victim might suffer: agitation, anxiety, depression, fear, guilty a feeling of losing control emotionally, panicking, and more.


  • Behavioral symptoms
    While emotional manifestations of narcissistic abuse syndrome will be internal and not always noticeable to others, the abuse can also produce behavioral symptoms.3 These are physical manifestations of a change in how a person acts around others that can be a vital clue to detecting the abuse. They can include: acting anti-social, alcohol and drug abuse, pacing up and down, restlessness, and several other behaviors.


  • Cognitive symptoms
    Somewhat related to emotional symptoms, cognitive manifestations of narcissistic abuse syndrome are those that create a concerning change in how a person thinks. The most typical examples of these adverse impacts include: confusion, loss of concentration, memory loss, nightmares, weakened ability to solve problems, and more.


Victims of Narcissistic Abuse Syndrome

In many cases, it is simply an idea put in your head by your narcissistic partner and may likely even be a form of narcissistic projection, but those who struggle with narcissistic abuse syndrome often have a hard time recognizing this reality. Because your mind is so confused by constant abuse and emotional manipulation, you will begin to question what you know to be real.

Victims of Narcissistic Abuse Syndrome generally fall into one of two categories

1. Unconscious Narcissistic Abuse Syndrome 

This stage occurs when the victim is unaware of the abuse being perpetrated, or they in a stage of active denial. Friends and family may well see what’s happening yet to the victim they are seen as interfering, jealous, or simply trying to ruin their relationship. Depending on the skill of the narcissist or whether they are an overt or covert narcissist, or the level of their actions everyone around the victim may be blissfully unaware of the dark forces at play. Victims of narcissistic abuse syndrome often have a hard time recognizing the reality of their situation because their minds are so confused by constant abuse and emotional manipulation.

2. Conscious Narcissistic Abuse Syndrome 

During the conscious stage a victim finds themselves in the lead role of their own horror show, doubting their own sanity after being gaslighted, questioning their partners motives yet wracked with feelings of disloyalty for doing so. Often, a conscious victim of narcissistic abuse syndrome may reach out and confide in close acquaintances, only to find these acquaintances already poisoned against them with stories of mental illness and erratic behavior. Narcissistic abuse victims can feel a tremendous amount of social isolation and this isolation is not always imagined, in many cases it is real.

Sadly, modern human nature is irrationally pre-programmed to look for the negatives in a situation, with scant regard for positives. For example, the narcissist will likely find a sympathetic ear as they tell others of your poor parenting choices, with friends seemingly lapping up this information to fuel their own need for gossip and self illusory superiority.

Warning Signs of Narcissistic Abuse

Spotting the warning signs of narcissistic abuse syndrome starts with reviewing the symptoms and assessing whether you think you match with them. If the answer is yes than this gives you the starting point to try recovery and potentially therapy to end the abuse.

If you are not concerned about the one being abused yet you think that someone you know might be suffering from narcissistic abuse syndrome, the same logic applies — observe their behavior and compare it to the list of potential symptoms as a first step.

Should you conclude that you are suffering from abuse, or if you think that the symptoms indicate that someone you know is a victim, then you might want to consider the steps that need to be taken when considering leaving a narcissist.

Narcissistic Abuse and PTSD

Many of symptoms reported by individuals suffering from narcissistic abuse are similar to symptoms of PTSD including:

  • Negative & damaging thoughts
  • Being emotionally or physically triggered in situations simpler to traumatic situations
  • Experiencing flashbacks
  • Avoiding certain people or situations
  • Feelings of isolation and detachment
  • Hypervigilance


Narcissistic Abuse in Codependent relationships

Opposites attract: Whilst codependency can be viewed as the the opposite of narcissistic personality disorder many codependents are targeted by, and equally attracted to those with high levels of narcissism.4

Both narcissists and codependents can appear extremely charming and enigmatic at the start of a relationship with the narcissist intent on ingratiating themselves, and the codependent delighting in lavishing attention on their new partner. The codependent will find it easy to ‘fall’ for the attention and the narcissist quickly becomes besotted by the complete control offered by the codependent. Both the codependent and the narcissist create a trap from which escape is both difficult and emotionally challenging.

Narcissistic Abuse Recovery

There are some generally accepted ways that people can tackle narcissistic abuse, either on their own or with the assistance of a medical expert to help with addressing it.

It’s important not to dwell on the damage that the abuser has done, because narcissists could take your anger at them and be able to manipulate that into further abusing you. Instead, whether you seek professional help or decide to confront the abuse alone, it is vital that you put literal and figurative distance between you and the narcissist — even if it’s a loved one and it means cutting them out of your life entirely as the only way to stop the abuse. When abusers don’t have easy access to you, they can’t succeed with their abuse.

Regardless of the option you choose for confronting and overcoming the abuse, rest assured that narcissistic abuse syndrome is not permanent and does not have to have long-lasting impacts. It’s a cliché but it’s true that acknowledging the abuse is the first step to ending it.


References for Narcissistic Abuse Syndrome

  1. Samuels J. Personality disorders: epidemiology and public health issues. Int Rev Psychiatry. 2011 Jun;23:223–33. [PubMed] []
  2. Caligor E, Levy KN, Yeomans FE. Narcissistic personality disorder: diagnostic and clinical challenges. Am J Psychiatry. 2015 May;172:415–22. [PubMed] []
  3. Searight HR. Efficient counseling techniques for the primary care physician. Prim Care. 2007 Sep;34:551–70. vi–vii. [PubMed] []
  4. American Psychiatric A, American Psychiatric A, Force DSMT. Diagnostic and statistical manual of mental disorders: DSM-5. Washington, DC: American Psychiatric Association; 2013. []
  5. Stinson FS, Dawson DA, Goldstein RB, et al. Prevalence, correlates, disability, and comorbidity of DSM-IV narcissistic personality disorder: results from the wave 2 national epidemiologic survey on alcohol and related conditions. The Journal of Clinical Psychiatry. 2008 Jul;69:1033–45. [PubMed] []
  6. Arabi, S. (2017). Power: Surviving & thriving after narcissistic abuse. Brooklyn, NY: Thought Catalog Books[Google Scholar]
  7. Baldry, A. (2003). “Sticks and stones hurt my bones but his glamce and words hurt more”: The impact of psychological abuse and physical violence by current and former partners on battered women in Italy. International Journal of Forensic Mental Health, 2(1), 4757. doi:10.1080/14999013.2003.10471178 [Taylor & Francis Online][Google Scholar]
  8. Brown, S. (2010, August 28). 60 million people in the U.S. negatively affected by someone else’s pathology. Retrieved from Psychology Today:[Google Scholar]
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  11. Lowen, A. (1997). Narcissism: Denial of the true self. New York, NY: Touchstone[Google Scholar]
Narcissistic Abuse Syndrome
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Narcissistic Abuse Syndrome
Narcissists use a host of behavioral tricks including: deception, creating doubts in other peoples’ minds to the benefit of the abuser, guiding friends and family and others into decisions that make the narcissist look good even if it hurts those people mentally and/or physically, creating distrust among a social group so people think only the abuser is trustworthy, and more.
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