Too much attention is given to narcissistic behavior with little consideration offered to the victims of it. Narcissistic Personality Disorder (NPD) is clearly defined in the DSM-5. Many subtypes have been offered, books written and seminars taught. But what about the abuse some victims have suffered?
Several names have been tossed around to describe what happens to these victims. Some have called it Narcissistic Victim Syndrome (NVS), Trauma-Associated Narcissistic Symptoms (TANS), or Post Traumatic Narcissism Syndrome (PTNS). However, none of these is an official diagnosis. Each of these has a similar list of symptoms:
- Flashbacks of the behavior and trauma
- Extreme fear for their personal safety
- Highly strung or nervous
- Constantly scanning environment for potential threats
- Depression, irritability, and guilt
- Multiple physical complaints
- Might engage in self-harm
- Panic attacks
- Numbing and shock
- Impaired concentration and memory
- Feeling they are going mad
- Insomnia and nightmares
- Obsessive compulsive behaviors or eating disorders
- Suppressed anger
- Might be dissociative
- Might be suicidal
- Constantly second guessing
- Difficulty making simple decisions
Complex Post Traumatic Stress Disorder (C-PTSD) does incorporate a limited number of the symptoms; however it is not in the DSM-5 either. The definition identifies chronic long-term stress resulting from emotional trauma in which the victim has little chance of escape. Some examples consistent with narcissism include continuing experience with:
- Emotional, physical or sexual abuse
- Gaslighting and false accusations
- Push-pull or splitting behaviors
- Alternating raging and hovering behaviors
- Crisis conditions
C-PSTD clients often feel like they could cry at any moment, they aren’t good enough for others, are fearful of forming relationships, have difficulty performing simple tasks, and are constantly distracted. Over time, victims may develop eating disorders, obsessive disorders, depression, hypervigilance, substance abuse or co-dependency.
Unfortunately, the revised definition of Post-Traumatic Stress Disorder (PTSD) is the best option for diagnosing victims of narcissistic abuse. Here is the criteria:
- Traumatic event. Survivors must have been exposed to actual/threatened death, serious injury or sexual violence. The exposure can be direct, witnessed, indirect (hearing it from others) or repeated exposure.
- Intrusion or Re-experiencing. This could look like intrusive thoughts/memories, nightmares, flashbacks, or psychological distress/reactions to reminders of the traumatic event.
- Avoidant Symptoms. Ways that someone may try to avoid memories of the event. It must include one of the following: avoiding thoughts, feelings, memories, people, places, conversations or situations connected to the traumatic event.
- Negative Alterations in Mood or Cognition. A decline in someone’s mood or thought patterns after the event. Includes: inability to remember, negative beliefs or expectations about one’s self or the world, distorted thoughts about the cause/consequence of the event, fear, horror, anger, guilt, shame, diminished interest in activities, feeling detached, feeling estranged or inability to experience happiness.
- Increased Arousal Symptoms. Ways that the brain remains “on edge,” wary and watchful of further threats. Symptoms include: irritability, increased temper/anger, reckless, self-destructive behavior, difficulty falling/staying asleep, hypervigilance, difficulty concentrating, or being easily startled.
- The severity of the symptoms have to have lasted at least a month, seriously affect one’s ability to function and can’t be due to substance use, medical illness or anything except the event itself.
- Subtype: This is set apart from the other symptom clusters. There are several types of dissociation, only two are included here: depersonalization which is feeling disconnected from oneself and derealization which is a sense that one’s surroundings aren’t real.
The new definition of PTSD clearly incorporates the concepts of NVS, TANS, PTNS and C-PTSD. However, it does not open the eyes of clinicians into the severity of narcissistic abuse. More education is needed to help identify when a person has been victimized so the right therapy can be utilized.