Highway to Hell: Part 2 NPD and Narcissistic Abuse

When we think about abuse we commonly think about domestic violence, having to confront someone physically hurting us, and doing what is needed to stand up for a child being physically hurt by a parent. While these do constitute abuse, there are many more forms. In researching narcissistic abuse specifically, I found the following types of abuse:

1. Physical – Example: One individual hits another individual causing physical harm.

2. Mental – Example: One individual uses words to convince another individual to believe something that is a lie or not reality.

3. Verbal – Example: One individual uses words in an aggressive way, like threats, to cause harm to another individual.

4. Emotional – Example: One individual ignores the feelings of another individual with the sole intent to cause harm.

5. Spiritual – Example: one individual manipulates, exaggerates, and/or misrepresents religious teachings or scripts to harm, control, or manipulate another individual.

6. Sexual – Example: One individual forces sex and/or sexual acts upon another individual.

7. Financial – Example: One individual withholds needed funds from another individual.

Seven types?! Yes. Seven types. All leave varying scars in varying degrees of severity. Everyone has technically been abused. However, the type of abuse we are talking about is that which does not just leave any scasr, but traumatic scars. Trauma, as related to mental health and defined by Merriam-Webster Dictionary is “a disordered psychic or behavioral state resulting from severe mental or emotional stress or physical injury.” Notice the word “severe.” How does one define severe? It is somewhat subjective. For example, someone who has been raped and beaten may later in life meet someone who is verbally cruel and financially controlling. But that person may not see that as abuse as their previous abuse was so severe. But a person who has never experienced severe abuse and meets a person who is verbally cruel and financially controlling may see the abuse for what it is.

Subjective ideas matter, just as personal perspectives, beliefs, and experiences matter. Understanding the subjective nature of abuse is important moving forward.

To fully understand Narcissistic Personality Disorder (NPD), I did almost a year of research. I read the clinical aspect and extensively read about personal experiences and stories. I also had a large percentage of clients who were having or had experiences with someone with NPD. I took notes, wrote down questions, and dug through professional and personal articles that outlined behaviors, conversations, choices and more. I then found firsthand experiences that exposed behavioral themes. In Part 1 of this series, I outlined a general symptomology from the Diagnostic and Statistical Manual of Mental Health Disorders Fifth Edition (DSM 5). Now, for specifics.

DSM 5 NPD Criteria

In the DSM 5 NPD falls under the section of Personality Disorders. There are 9 different personality disorders and two sections that allow for medical conditions and unspecified personality disorders. NPD requires that for an individual to be diagnosed they must meet 5 of the 9 symptoms listed. The applicable symptoms must occur in early adulthood to the present. As well, the symptoms must exist in various contexts, or environments (e.g. work, home, school). Remember, only a licensed mental health professional should diagnose. If you think you or someone you know may have a mental health issue, disorder, or illness, contact a licensed mental health provider in your area. The symptoms for NPD as outlined by the DSM 5 are (p. 669-670):

1. Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).

2. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.

3. Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions).

4. Requires excessive admiration.

5. Has a sense of entitlement (i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations).

6. Is interpersonally exploitative (I.e., takes advantage of others to achieve his or her own ends).

7. Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others.

8. Is often envious of others or believes that others are envious of him or her.

9. Shows arrogant, haughty behaviors or attitudes.

While these are directly from the DSM 5, there is much more to be considered when giving a mental health diagnosis. So, again… contact a licensed mental health provider when you have concerns for your mental health or that of someone you know.

Themed Behaviors From My Personal Research

I began my research into NPD after watching two documentaries. The changes in certain people’s lives fascinated me! How does someone go from a sweet child to a mildly abusive or downright evil (yes, I said evil) individual? What are the factors that facilitate that change? How much of the change is nature and how much is nurture? These are just a small sample of the questions I had. A lot of it was answered by reading peer-reviewed research into NPD, neurological studies, first-hand accounts of experiences with NPD individuals, as well as first-hand accounts from individuals diagnosed with NPD. From the research I came up with 20 themed behaviors that are most often seen in people with NPD. I have grouped these into 7 categories:

1. Self-esteem issues (e.g. demanding admiration)

2. Anger issues (e.g. shows anger/rage when disagreed with)

3. Fantasy-oriented behavior (e.g. lying constantly)

4. Identity issues (e.g. acts different with different people)

5. Social issues (e.g. little to no boundaries)

6. Relationship issues (e.g. manipulation)

7. Emotional problems (e.g. lack of empathy)

Narcissistic Abuse

If you compare the list of different types of abuse to the watered-down list of NPD behaviors I found in my personal research, you can start to see a correlation between the two. For example, someone who has NPD will most likely show a lack of empathy, which will manifest as an emotional problem for them, but in a relationship will show up as emotional abuse towards the other person. Take some time to really look over these two lists of abuse and behaviors. What stands out to you? Have you ever personally experienced and/or observed the abuse or behaviors?

Narcissistic abuse is a very insidious type of abuse. In other words, the harmful intentions are brought on gradually and, at times, subtly while also “growing” over time. The behaviors become more frequent and severe as time goes on. With this pathway of abuse, it can be challenging to pinpoint and label it as abuse. Often the behaviors are brushed aside by the victims and others. This is due viewpoints that the behaviors seem “typical”, “just a phase.” These and other responses influence the victim and abuser to believe that each has been overexaggerating and excused, respectively.

Narcissistic abuse can be obvious and, as discussed above, subtle. We call these two forms of NPD overt (obvious) and covert (subtle). Overt NPD is easy to recognize for most people. Covert is usually more difficult as the abuser tends to use such subtle methods that it is hard for anyone to see the behavior as abusive. Narcissists will often work to gain support, sympathy, and trust from mutual friends of them and the victim. The victim is labeled as lazy, mean, greedy, selfish, and at times they are even called the abuser.

Depending on how long the abuse has occurred, the victim may have experienced isolation by the narcissist. This can make getting or keeping support from people in the victim’s life very challenging or even impossible. Because people with NPD tend to act differently in public than they do in private, it is also challenging for the victim to convince mutual friends and family that abuse is occurring.

Victim Symptomology

For the most part, victims of NPD abuse tend to display what we typically view as PTSD (Post-Traumatic Stress Disorder). However, this may be seen as a complex and chronic type of PTSD due to the multi-faceted approach the abuser typically takes. Below is a list of symptoms gathered from personal research that came from multitudes of public reports of NPD abuse found in various blogs and forums online:

1. Self-blame

2. Self-condemnation

3. Imbalanced sense of responsibility

4. Intrusive thoughts/memories

5. Negative thoughts about self and the world

6. Sense of detachment/isolation from other people

7. Difficulty concentrating and/or sleeping

8. Hypervigilance, irritability, easily startled

9. Physical/Emotional reactions to reminder of trauma

10. Nightmares/Flashbacks

11. Avoidance of thoughts, people, situations associated with the trauma

12. Distorted sense of blame related to the trauma.

While PTSD includes most of these, it also requires a certain amount of symptoms to be met over a certain amount of time (APA, 2022). It is my opinion that the symptoms listed above may not occur in conjunction with one another. They may come and go. A victim may only be experiencing one symptom. There have been victims who reported having no symptoms until a year or more after they had cut off all communication with the abuser.

Perhaps one symptom that should be added to the list is grief. I know… it doesn’t seem like it fits right? After all, who really wants their abuser back in their life? When I talk about grief in the context of NPD abuse I am talking about the relationship. Let me explain further. Most NPD abuse occurs within a close relationship. This could be a mother, father, brother, sister, very close friend, or a spouse. These are all close relationships that are challenging for any victim to cut out of their lives. And not all victims cut the abuser out of their lives because of those close relationship ties. But, when they do, the victims may miss having the relationship with a mother, with a sibling, with a spouse. When they cut that person out of their lives, it is not the individual they grieve but rather the relationship. For example, if a victim cuts out an NPD mother who was abusive then the victim no longer has a mother-child relationship. That is still a loss and it still may need grief time.

Recovery

A victim’s willingness to seek help for recovery from narcissistic abuse depends on several factors. The first is awareness. Is the victim aware that what they have experienced or are experiencing is actually abuse? The second is support. If a victim is told that the NPD individual’s behavior is “just a phase” or “typical” of that gender or role, or even “this is how he/she was raised” then a victim is less likely to assign abuse to that behavior. Finally, if a victim has been traumatized by abuse in the past, and the NPD individual’s abuse is not as severe, the victim may view it as “better than before.” If you are a family member or friend of a possible victim of NPD abuse, consider these factors before giving up on supporting them to get help for recovery. Be patient. Be kind. Be helpful. Remember that once the victim understands what is going on fully, he or she also realizes that the entire relationship they had with the NPD individual was not “real.” This can be incredibly difficult, causing stress, anger, sadness, and even grief. Like anything else in mental health, the victim has to be willing and wanting to hear the truth of NPD abuse and accept the help.

Reference:

American Psychiatric Association: Diagnostic Statistical Manual of Mental Disorder, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013.