The path to healing after an abusive marriage is more like a winding mountain road than a straight line. Just when a person thinks they are moving forward, the road makes a sharp turn backwards. Sometimes the best way to illustrate the journey is through a story. Here is Michelle’s route.

After 25 years of marriage to an abusive narcissist, Michelle finally decided to divorce her husband. It was bad enough for her to suffer through his rages and threats but now as the kids got older, he was doing the same to the three of them. She spent years successfully protecting her children from these attacks, until the day he took out a gun and threatened to kill himself in front of them. That was it, she was out.

It took every ounce of her strength to file for divorce. He was furious. He pulled out all of the stops and began accusing her of things he did. He rewrote history and spent hours trying to coax his teenage children into believing his version. He even offered bribes of cars and college money in exchange for their loyalty to him. In public, he was out to destroy her. Privately, he sent desperate text messages of his unfailing love for her, begging her to take him back.

Initial visit. At the advice of her attorney, Michelle sought out counseling. When she first came in, she was emotionally flat and told her story as if it happened to someone else. She would pause before answering questions as if searching for the right words. Her memory was spotty and she was easily confused by simple concepts. She intertwined stories of verbal and physical assaults with hints of sexual abuse.

Physical symptoms. Despite the flat affect, her body language was more expressive. Her right hand would move around her neck in a choking position whenever she mentioned sex. Several times, hive like patches on her neck would appear and then disappear in conjunction with noticeable increases in her heart rate. She must have had three or four mini anxiety attacks in one hour.

Initial diagnosis. It was clear that Michelle was suffering from Post-Traumatic Stress Disorder (PTSD) from the repeated and long-term abuse that she experienced. The revised DSM-5 standard allows for the inclusion of these events as opposed to a one time life-threatening event. By making her aware of reaction, she became less anxious about the panic attacks so they didn’t escalate into paralysis.

Assessment of abilities. Michelle was an intelligent woman who had risen to senior management at her bank. She had no trouble remembering details from work, her annual reviews always yielded either a promotion or a raise, and she had numerous long-standing friendships. But ask her about incidents at home regarding her marriage and she acted like a dejected child. She was emotionally aware outside of the home, but inside she regressed except when it came to the handling of her children. All of them said she was a fair, caring, supportive, and loving mother.

Repeated trauma. As part of treatment, Michelle was asked to pick three incidents of abuse: one physical, another verbal, and the last sexual. She wrote about the events at home and brought it into the office. Surprisingly, she began each even by blaming herself for how things happened. She made her contribution equal to his desperate the level of escalation he achieved. She minimized his contribution and maximized hers. She was asked to rewrite the stories at her office and this time from a third-person perspective. The results were amazing. The stories were clearer, less confused, and much more balanced.

Environment is everything. Even though her husband had moved out of their home, it was clear Michelle was being triggered. He had created a toxic environment where everyone, especially her, walked on eggshells to avoid upsetting him. His narcissism was fed though her constant need to be aware of his moods and adjust her behavior accordingly.  One misstep and he would become violently enraged. Michelle lived in survival mode with her fight or flight responses ready at all times. Naturally, she struggled to stop this response.

Hot System Dominance. Michelle’s continual state of survival mode explained her initial symptoms and ongoing confusion. Her Sympathetic Nervous System (SNS) which accelerates her heart rate, constricts blood vessels, and raises blood pressure in order to maximize fuel availability is turned fully on. This manifests in defensive reactions, irrational thinking, inattentiveness, fidgetiness, anxiousness, and irritability. All of which explains her confusion and a diminished executive functioning of the brain.

Triggers at home. Every time Michelle comes home and hears a story from her kids about their father, she is triggered back to her own abuse. She has a physiological reaction that creates an inability to see things clearly and process solutions. Instead, she shuts down and hides in her room feeling completely overwhelmed by her situation. She thought things would get better after the divorce, now they are worse.

The solution. Before Michelle enters her house, she begins to recite new mantras in conjunction with some deep breathing exercises. “I am safe.” “I am strong and smart.” “I am present in this moment.” She becomes mindful of the tension in her body and releases it. As she engages with her kids, she focuses on patience, compassion, and understanding without incorporating her desire to rescue or protect. At first, this is exhausting but over time it becomes more natural. Her SNS is no longer getting activated daily and she soon finds that her sleep patterns have greatly improved as well.

The result. Michelle’s journey to regain her cognitive functioning yielded another result: the ability to critically think though matters systematically and not just emotionally. No longer experiencing triggers from past abuse, she felt more in control and less under the influence of her husband’s power. This restored her self-confidence and opened her up to stronger relationships with others.

While not all journeys are the same, it is important to properly assess the impact of repeated trauma in a person’s life. The constant state of fight or flight is damaging and must be addressed as part of healing.