What Is Narcissistic Abuse? Signs, Impacts, and How to Heal

Whether it comes from a parent or partner, narcissistic abuse can leave lasting wounds. Learn how to identify it and begin to take your power back.

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If you have a loved one with narcissistic personality disorder (NPD), or someone who consistently displays narcissistic tendencies, you may have experienced narcissistic abuse—whether from a mother, father, or romantic partner.

Recognizing and naming this specific form of abuse is the first step in breaking free from the narcissistic abuse cycle. Once you know what you’re dealing with, you can feel empowered to seek support and begin healing from your abusive relationship. Read on to learn about exactly what narcissistic abuse is, its common signs, how it affects mental health, how to heal, and more. 

What is narcissistic abuse?

Narcissistic abuse is a type of psychological and emotional abuse that’s carried out by someone who possesses narcissistic traits, or someone who has an official diagnosis of NPD, says Charlie Health Group Facilitator Bree Williams, LPCA. 

True narcissists — those who are diagnosed with narcissistic personality disorder — lack empathy, exploit others for personal gain, and manipulate without guilt. These traits often lead to a pattern of narcissistic abuse in interpersonal relationships.

“Narcissistic abuse involves a pattern of manipulation, control, emotional invalidation, and power imbalances,” says Charlie Health Primary Therapist Meghan Jensen, LPC, MA, BS. “You may feel consistently confused, blamed, anxious, or ‘not enough,’ despite trying harder. A key red flag is that issues are always framed as your fault, and there’s little to no empathy or responsibility from the other person.”

It’s important to note that narcissistic abuse isn’t always obvious — it often happens slowly and subtly over time, Williams adds. It’s ongoing and repeated, building over time, which is traumatic. This form of repeated, chronic trauma is known as complex trauma.

What are the common signs of narcissistic abuse?

Narcissistic abuse can look different from relationship to relationship. However, there are some common patterns, signs, and things that narcissists say and do, including the following.

1. Gaslighting

Gaslighting is one of the most classic manipulative tactics used by narcissists. “Gaslighting is when the abuser denies or twists facts, leaving the victim questioning their memory, reality, or even their sanity,” Williams says. “Over time, this erodes confidence and creates reliance on the abuser for validation.”

2. Love bombing followed by devaluation

A narcissistic partner is likely to build you up just to knock you down. It’s common for them to love bomb — showering you with affection, praise, and gifts at the beginning of the relationship, Williams says. “But once they feel secure in the victim’s trust, they often shift to devaluing, criticizing, or withholding affection, leaving the victim confused and desperate to regain that early love,” she adds. 

3. Control and isolation

Narcissists love to get you alone so that they can have more control over you, so they can manipulate you even further and trap you in an abusive relationship. “Narcissistic abusers often try to control who you see, what you do, or even how you feel,” Williams says. “They may slowly isolate you from friends and family, making you dependent on them for connection and support.” As time goes on, you may become increasingly isolated from your loved ones in your narcissistic relationship.

4. Emotional and verbal abuse

A narcissist engages in constant verbal and emotional abuse, knocking you down to manipulate you. “This can include constant criticism, belittling comments, or guilt-tripping,” says Williams. “Over time, the victim may internalize these messages, feeling unworthy, guilty, or ‘not good enough.’” 

5. Triangulation

“A narcissist may involve third parties, real or imagined, like exes, friends, therapists — to create jealousy, rivalry, or confusion, and to manipulate your actions or feelings,” Jensen says. For example, they might say something like, “My ex never had this problem with me,” or “Even my therapist agrees that you’re overreacting.”

6. The silent treatment

A narcissistic abuser may use the silent treatment and withhold communication or affection to punish you or control your behavior, Jensen says. “This creates fear of abandonment and pressures you to conform or apologize, even when you did nothing wrong,” she adds. Withholding affection is a common behavior for a narcissistic parent to use against their children, too.

7. Financial abuse

A narcissistic partner may manipulate you and gain even more control through financial abuse. This may entail:

• Controlling your personal finances
• Gaslighting you about your financial decisions
• Monitoring and questioning your expenses
• Creating debt in your name
• Sabotaging your job so you won’t have your own income 

The mental health impacts of narcissistic abuse

Narcissistic manipulation and abuse have a strong impact on mental health, both in the short term and long term. 

Short-term mental health impacts of narcissistic abuse

It’s no secret that any type of abuse, including emotional abuse inflicted by a narcissistic abuser, can take a toll on your day-to-day well-being. Williams says some of the immediate short-term impacts of enduring narcissistic behavior include:

• Feeling anxious and on edge
• Emotional exhaustion
• Low self-esteem
• Confusion
• Difficulty making decisions
• Physical symptoms like headaches or trouble sleeping

Long-term mental health impacts of narcissistic abuse

The long-term effects of narcissistic abuse can be even more serious, Williams says. Here are a few examples. 

1. Post-traumatic stress disorder

Enduring narcissistic abuse is traumatic. Many survivors of narcissistic abuse develop symptoms similar to post-traumatic stress disorder (PTSD), including hypervigilance, flashbacks, and emotional numbness. You can develop PTSD from narcissistic abuse, specifically complex post-traumatic stress disorder (C-PTSD). C-PTSD is the result of prolonged exposure to manipulation and emotional harm. Depression, anxiety disorders, and difficulty trusting others in future relationships are also common.

2. Substance use disorder (SUD)

Survivors of emotional abuse and trauma in general may turn to substances like alcohol and drugs to self-medicate and numb difficult feelings. Data shows that trauma survivors are more vulnerable to developing a substance use disorder.

3. Anxiety and depression

Research shows that people who have experienced psychological or emotional abuse are more likely to develop anxiety and depression, especially when the abuse is ongoing. Since narcissistic abuse typically occurs repeatedly over a longer period of time, this is a risk factor. 

How to heal from narcissistic abuse

Narcissistic abuse recovery takes work and requires a multi-faceted approach, including professional help and self-care. 

Therapy for narcissistic abuse

If you’re struggling with negative mental health effects from narcissistic abuse, it’s important to seek help from a mental health professional, especially one who is trauma-informed. Whether you opt for online therapy or in-person therapy, Williams says trauma-informed therapy can help survivors process their abuse and trauma, rebuild low self-esteem, and develop healthy coping strategies. A few types of therapy for narcissistic abuse recovery are:

• Cognitive behavioral therapy (CBT), including a specific form of CBT called trauma-focused CBT (TF-CBT), is especially helpful for children and teens who are survivors of trauma
• Eye movement desensitization and reprocessing (EMDR) is a type of therapy that helps you process deep-rooted trauma by using bilateral stimulation 

• Prolonged exposure therapy (PE) is a specific type of exposure therapy that helps you revisit and process traumatic memories
• Somatic therapies focus on the mind-body connection, since your body stores and remembers trauma

Support groups for narcissistic abuse

While not a substitute for therapy, support groups can help you feel less alone as you heal. “Connecting with others who have gone through similar experiences can help reduce feelings of isolation and shame,” Williams says. “Support groups, whether online or in person, provide validation and community.”

There are many support groups specific to survivors of narcissistic abuse, or you can look for more general support groups for survivors of emotional abuse in general.

One resource that can help is the National Domestic Violence Hotline. You can browse their directory of local providers to view local centers that provide various services, including support groups. (Side note: you can also call or chat with the National Domestic Violence Hotline for 24/7 support for abusive relationships). 

Rebuilding self-esteem

The narcissistic abuse cycle often results in lowered self-esteem. It’s important to rebuild your self-esteem so you can recognize your worth and feel more confident in your life, both in relationships and beyond. Jensen recommends the following tips to help you build your self-esteem.

• Practice self-compassion by treating yourself kindly, especially when you’re struggling or feeling low
• Pay attention to your thought patterns and notice when you’re being unkind to yourself so you can challenge your inner critic (this is something a CBT therapist can help you with, too)
• Surround yourself with loved ones
• Engage in activities that affirm your value, whether that’s creative expression, volunteer work, or personal achievements

Create healthy boundaries

Moving forward in all your relationships, healthy boundaries are crucial to protect yourself from toxic relationships in the future. Here are some tips Jensen recommends for creating and maintaining healthy boundaries. 

• Get comfortable saying “no”: You don’t have to feel guilty saying no, no matter the request. “Your needs matter as much as anyone else’s,” Jensen says.
• Watch for red flags: Be on the lookout for red flags, especially early in the relationship, before you’re in too deep. Jensen says disrespect for your feelings, privacy, and time are red flags to be cautious of. Any narcissistic behavior is a major red flag.
• Know your limits and communicate them: “Know what behaviors you will and won’t accept — and stick to them,” says Jensen. You can’t control other people’s behaviors, and it’s up to you to enforce your boundaries. Additionally, learn not to feel guilty for saying “no,” since your needs matter as much as anyone else’s, she adds. 

How Charlie Health can help

If you’re a survivor of narcissistic abuse hoping to heal, Charlie Health can help. Our virtual Intensive Outpatient Program (IOP) provides more than once-weekly mental health treatment for people dealing with mental health conditions—including those that can result from narcissistic abuse.

Our compassionate, trauma-informed clinicians incorporate evidence-based therapies such as CBT and exposure therapy into individual counseling, family therapy, and group sessions. With this kind of support, you can reclaim your sense of self, rebuild self-esteem, and create healthier relationships moving forward. Fill out the form below or give us a call to start your healing journey today.