Narcissistic abuse and C-PTSD

You may have heard the experience of being exposed to narcissistic abuse explained as being akin to the proverbial frog in boiling water, or feeling like you are dying of a thousand cuts. It is by no accident that the proverb of the unfortunate frog and the reference to an ancient Chinese form of death by slow torture has become synonymous with attempts by victims to describe this confusing, furtive, and methodical form of emotional abuse.

Chronic post-traumatic stress disorder

Experiencing a relationship with an individual who is either diagnosable as having narcissistic personality disorder (NPD), according to the DSM-V criteria, or alternatively is displaying high, but sub-clinical, levels of narcissism, causes enormous stress and long-term physical and mental damage to their chosen victims. The continuously high level of stress over years, and sometimes over a lifetime, can cause those victims to develop symptoms of chronic post-traumatic stress disorder (C-PTSD).

What are the signs and symptoms?

The signs and symptoms of C-PTSD in the victim of narcissistic abuse cross over with many of the classical PTSD signs and symptoms and may be as follows:

• flashbacks
• avoidance
• low self-esteem
• hyper-vigilance
• lack of control over emotions and lack of emotional regulation
• dissociation
• altered self-perception
• difficulty forming new relationships
• preoccupation with the abuse and the abuser
• feelings of hopelessness and despair

So why does this happen?

The toxic effects on the body and mind of a victim of narcissistic abuse are becoming increasingly well documented and there is a growing evidence base that it affects the victim physically as well as emotionally. Long-term toxicity due to continuous 'average stress' and abuse can cause just the same, or even greater, damage to the brain and mental health as can short-term extreme levels of stress.

The physical changes

Empirically, survivors of narcissistic abuse report increased physical ill health; and auto-immune disorders such as crone's disease, graves disease, hashimoto's, lupus and a variety of musculoskeletal inflammatory disorders. There is also first-hand reporting amongst health professionals of increased incidences of cardiovascular disorders such as high blood pressure, strokes and other cardiac problems in patients believed to be suffering from this type of covert emotional abuse. There have also been documented changes in the brains of those suffering C-PTSD from these relationships.

The hippocampus:

The hippocampus is paired; one on each side of the brain. Hippocampus is the Greek name for seahorse as it is a similar shape. Scientists increasingly understand the vital importance of the hippocampus and have seen a relationship between the levels of the stress hormone, cortisol, and a reduction in the size of the hippocampus. After years of overstimulation from excessive stress hormones in either a child suffering from a narcissistic parent, or an adult in a long-term romantic narcissistically abusive relationship, the hippocampus becomes chronically over-stimulated which attacks the neurones. Eventually, it shrinks. This is serious as the hippocampus is crucial for learning and damage to this area affects the ability to store short-term memories for conversion to long-term. It therefore affects the ability to learn.

The amygdala:

The amygdala (there are also two), is almond-shaped and is part of the limbic system, which is known as our reptilian brain. The amygdala is the seat of our primitive emotions and responses, including fear, anger, hate, lust, guilt and shame. It also has a role to play in controlling the heart rate and is crucial for survival and for the detection of danger. When the amygdala becomes overstimulated through a constant state of fear, it becomes 'hijacked' and unable to separate non-threatening situations from threatening. This can cause a victim to become hypersensitive and overreactive.

The amygdala sends out fight or flight signals at the slightest hint of threat or danger - often misinterpreting safe situations. This hyper-vigilance leads people to develop panic attacks and phobias, amongst other maladaptive mechanisms, and also avoidance of relationships and situations where they feel a heightened sense of threat even when it is not actually present. Damage to this vital part of the brain can be devastating to the individual's ability to conduct their life with a degree of self-regulation and live their lives to the full without self-limiting behaviour to keep themselves safe.

Narcissistic abuse syndrome

Long-term manipulation, gaslighting and the constant mixed messages within narcissistically abusive relationships take a great toll on a victim's well-being, self-esteem and sense of safety. This results in mental, emotional and physical changes that collectively are called narcissistic abuse syndrome (NAS).

Professional help is needed to heal from NAS and the C-PTSD connected with this type of covert abuse as it may be that the victim is the only one who is seeing it. Others may witness the fact that you are the one becoming increasingly dysregulated and labile - something that the narcissist will capitalise on: it helps them 'play' the victim and place the blame at the true victim's door.

Unfortunately, trying to explain the impact of this to others who do not have an understanding of the true nature of narcissistic abuse and how C-PTSD affects the victim, can inadvertently and unintentionally compound the abuse by gaslighting your emotions and your experience. Working with a counsellor who can help calm your overstressed systems and return your sense of safety can go some way to restoring your brain's normal functioning and helping you to go on to live a calm regulated life where you can again experience joy and hope for your future.