How to deal with narcissistic abuse

Samir Kadri
Author: Samir Kadri Medical Reviewer: Rychel Johnson Last updated:

What is narcissistic abuse?

Narcissistic abuse refers to the actions and words of an abuser whose focus is solely on their wants and needs. This abuse can be emotional, physical, psychological, sexual, or financial in nature.

Narcissistic abuse comes in a variety of forms from constant, subtle criticisms and accusations to violent threats. The objective of a narcissistic abuser is to control and manage their victim’s behavior.

If you are in a relationship with a narcissistic abuser, you may feel constantly isolated, frustrated, confused, and ultimately, guilty. Narcissists are well-practiced in manipulation and as a result, you may not realize you are a victim of narcissistic abuse until well down the line. Abusers are adept at painting themselves in a positive light whilst putting their friends and partners down [1].

Narcissistic personality disorder

Narcissistic abusers can often be diagnosed with narcissistic personality disorder (NPD). Symptoms of NPD include an unreasonable level of arrogance, vanity, and lack of empathy [2].

Typically, people with NPD struggle to form healthy relationships and friendships with others. As they struggle with self-worth, they rely on external praise to provide validation and to feel valued. They believe they are entitled to the devotion and respect of their friends or partner and when they feel they haven’t received it, they can become hostile and dangerous [3].

Forms of narcissistic abuse

Narcissists deploy a range of coercive methods to gain control over their victims. Below are six forms of narcissistic abuse:

Emotional Abuse

Emotional abuse is when a person abuses their position in a relationship to shame, scare, insult or generally exert control over the other person. Emotional abuse can start with small criticisms and worsen over time.

Emotional abuse can occur in romantic relationships, parental or other familial relationships, and between colleagues and friends.


Gaslighting is when an abuser makes their victim doubt their perceptions of reality. The abuser will purposefully twist the truth to exert control over another person. Over time, this can lead to you doubting your perceptions and making it easier for the abuser to control.

The narcissistic abuser sidesteps any claims made by their victim that may implicate the abuser [4]. They can also imply that the victim’s perception of events is warped due to some fault of their own e.g., the victim’s cognitive limitations [4].


This is when abusers project their troubles onto another person as a defense mechanism. For example, someone may publicly mock another about their sexuality but privately struggle with their own sexual identity. They feel as though they are allaying their fears by projecting their embarrassment onto another person.

Guilt Tripping

Guilt tripping occurs when someone tries to get you to carry out their will by making you feel bad for them. It is commonly deployed by narcissistic abusers to convince their victims to bend to their will.

A severe form of guilt-tripping occurs when narcissistic abusers attempt to play the victim card. This is when they make it seem that everyone around them, including their partner, is out to get them, absolving themselves of any blame for their situation.

Love Bombing

Whilst the beginning of a romantic relationship can be a wonderful time for couples to look back on, it can also be a period where narcissistic abusers seek to gain control of their partner.

They can dote on you incessantly, declare their love for you incredibly quickly or shower you with attention and gifts. All of this ‘love bombing’ is done to gain your affection and trust, before then using these to manipulate you.

Characterized by excessive clinginess and jealousy, constant yearnings for validation, contrived attempts at establishing a connection between the two of you, and pressure to make you commit to them – love bombing is a clear sign of narcissistic abuse.

Narcissistic Triangulation

An abuser will intentionally seek to pull a third person into your pre-existing conflict to strengthen their position.

They may attempt to create conflicts between you and the third person, making up and exaggerating negative things the two of you have said about one another. The abuser then acts as a messenger between you and the third party, attempting to limit the amount of direct contact you have with one another. All the while, the abuser is acting empathetic to the plights of both you and the third party, seeking to gain your favor by pitting you against one another.

Another example could be when they regularly leverage stories of how an ex-partner treated them poorly. This allows them to subtly influence and control your behavior towards them in your relationship.

Stephen Karpman outlined three roles necessary in the creation of dramatic situations. These can be applied to the ways narcissists deploy triangulation. The three roles in narcissistic triangulation are the persecutor, victim, and rescuer [5].

As the persecutor, the narcissistic abuser adopts an aggressor’s stance. They use threats, criticisms, and put-downs to assert their superiority and control over the other parties.

As the victim, the narcissistic abuser acts like an innocent victim being taken advantage of by another person, and in need of aid from a third party. In doing so, they project their deficiencies and wrongdoings onto another person.

The rescuer is usually a third party used by the narcissist to reinforce their position. They do so by making excuses for the narcissist’s behaviors or bearing responsibility for the narcissist’s feelings. However, the narcissist can also adopt this role, as seen when the narcissist pits two parties against each other. Here the narcissist positions themselves as the mediator to enhance their feeling of superiority.

How does narcissistic abuse affect people?


Victims of narcissistic abuse often suffer from depression. Being criticized and insulted for prolonged periods by someone close to you takes a heavy toll. These can lead to feelings of shame and worthlessness, causing you to isolate yourself and not partake in activities you previously enjoyed doing.

Survivors also find it hard to shake their distorted versions of reality after months or even years of gaslighting. This can lead to extremely low self-confidence, worsening already depressive mood.


It is very common for survivors of narcissistic abuse to live with anxiety. After being subjected to narcissistic abuse, you may be fearful of forming relationships with other people. You may have developed deep-rooted trust issues because of the manipulative actions of your abuser.

Alternatively, you may even feel separation anxiety from your abuser, due to the amount of control they exerted over your life. This can make everyday decision-making and reclaiming your independence seem like a daunting task. These issues can be rectified over time by working with a mental health professional.

Post-traumatic stress

Survivors of narcissistic abuse are more likely to experience post-traumatic stress. You may feel excessively worried due to the amount of trauma you carry in your body. Anything you may associate with memories of the abuse you suffered could trigger a panic attack.

After so much time spent feeling on edge in your abusive relationship, you may feel the urge to stay hyper-vigilant. This can make relaxing difficult whilst simultaneously making you feel incredibly drained. Again, this is an issue you ought to work through with a mental health professional.

Low self-esteem

When you’ve cut off contact with an abusive person, you may struggle to recognise yourself. A narcissistic abuser will have tried to equate your self-worth to their presence in your life. With them gone, it may feel like your self-worth has disappeared with them.

When reflecting on the abuse, you may feel as though it was your fault somehow and you deserved to be treated poorly. This shame can lead to you isolating yourself and not seeking the help you need.

You may also develop problems with self-harming, alcohol, or food addiction. These may occur as a way of you punishing yourself for being abused or as a way of numbing the emotional pain caused by your abuse. Please seek medical advice if you think someone you know is struggling with any of the above ailments.

Physical symptoms

The effects of narcissistic abuse can manifest into physical symptoms [6]. These can include insomnia, headaches, stomach aches, and full-body aches. These may happen due to how stressed you become when thinking about what happened to you.

People pleasing

After suffering narcissistic abuse, you may find comfort in ‘people pleasing’ to gain people’s favor. You could be so used to bending to your abuser’s will that being excessively obliging feels like the only way to get someone to like you.

Cognitive problems

You may struggle to focus on your usual activities such as household chores and your workday. Intrusive memories of narcissistic abuse can be disorientating and impact your ability to concentrate effectively.

In some cases, you can suffer memory disturbances due to post-traumatic stress [7]. These can include both memories of the abuse and everyday memories with emotionally neutral matters [7].

How to deal with narcissistic abuse

Acknowledgment and acceptance of the abuse

Accepting that you were subjected to narcissistic abuse is a fundamental milestone on your road to recovery.

Initially, it can be difficult to accept that someone you cared for could’ve knowingly treated you so poorly. You may wish to make excuses for their behavior or claim you deserved to be abused.

This is a completely valid response; it is important not to suppress your feelings. It is difficult to accept the reality of someone close to you intentionally trying to control and harm you.

Perhaps there was some trauma in this person’s life that you are aware of, or they’ve claimed that they would harm themselves if you stopped contacting them.

Empathizing with their pain is completely normal, and you can urge them to get professional help. However, their behavior is not acceptable. Maintaining distance whilst limiting communication will both keep you safe and give you the time and space you need to recover.

You want to get to a place where you do not deny that you were a victim of abusive behavior and the person who abused you does not warrant a place in your life.

Set Boundaries

Do not hesitate to set clear and concise boundaries with the person who has abused you.

Whilst this can seem difficult, especially when it is an ex-partner or family member, it is an affirming step for you to take as you recover.

An option you may consider is going no contact with the abusive person. Blocking their number, email address, social media accounts, and any other channel through which they can reach you are all steps you can take.

This space and distance will enable you to heal more effectively and recognize that you did not deserve the abuse this person subjected you to.

Talk to others

Sharing your experience with trusted family members and friends can provide you with much-needed assistance on your road to recovery.

They can offer emotional support and remind you that you do not deserve to be abused. Developing this support network can be extremely useful to your healing process.

Some family members and friends may sympathise with the abuser. Perhaps, they have a close relationship with this person, or they are being suckered in by lies. This can be quite distressing. Asking these people to not talk about the subject is advised. If they refuse to do so, then you can choose to limit the time you spend with them.

Seek professional help

Speaking with a therapist or another suitable mental health professional can be conducive to improving your emotional state and reclaiming your identity.

The therapist can help you understand why you feel the way you feel and together you can work on a plan for how to cope with the abuse you suffered [8].

If you are longing to contact your abuser, struggling to talk with loved ones about the abuse, experiencing symptoms of depression, or having suicidal thoughts – speaking with a therapist or other mental health professional is highly recommended [8].

Healing can take time. A therapist can be a very useful and comforting person to have throughout the process. They will provide a safe space and offer expertise to you as you confront the abuse you’ve suffered and seek to improve your emotional well-being.

Be compassionate to yourself and practice self-care

Realizing that you were involved in an abusive relationship can be disturbing and emotionally distressing.

You may experience self-loathing and feel as though you’ve lost your identity. You may even blame yourself for allowing yourself to be abused.

No one deserves to be abused. The way you were treated was not your fault. The steps you take now can help build a brighter and happier future for yourself, free from this abusive person.

Focus on forgiving yourself rather than blaming yourself for allowing this person to treat you so poorly for so long.

It takes courage to end an abusive relationship. Remind yourself of this regularly and practice self-respect. It can help to tell yourself that you are strong, loved, courageous, and valued. Rebuilding your relationship with yourself is key to reclaiming your identity.

Exercise, eating well, and participating in activities that make you feel happy and relaxed are all steps you can take to facilitate the healing process.

  1. Kacel, E. L., Ennis, N., & Pereira, D. B. (2017). Narcissistic Personality Disorder in Clinical Health Psychology Practice: Case Studies of Comorbid Psychological Distress and Life-Limiting Illness. Behavioral Medicine, 43(3), 156–164.
  2. Jerome C. Wakefield. (2007). The concept of mental disorder: diagnostic implications of the harmful dysfunction analysis. World Psychiatry, 6(3), 149–156.
  3. Konrath, S., Meier, B. P., & Bushman, B. J. (2014). Development and Validation of the Single Item Narcissism Scale (SINS). PLoS ONE, 9(8), e103469.
  4. Stark, C. A. (2019). Gaslighting, Misogyny, and Psychological Oppression. The Monist, 102(2), 221–235.
  5. Karpman S. B. (1968). Fairy tales and script drama analysis. Transactional Analysis Bulletin.7(26), 39–43.
  6. Jabeen, F., Gerritsen, C., & Treur, J. (2021). Healing the next generation: an adaptive agent model for the effects of parental narcissism. Brain Informatics, 8(1).
  7. Samuelson, K. W. (2011). Post-traumatic stress disorder and declarative memory functioning: a review. Dialogues in Clinical Neuroscience, 13(3), 346–351.
  8. Reed, G. L., & Enright, R. D. (2006). The effects of forgiveness therapy on depression, anxiety, and posttraumatic stress for women after spousal emotional abuse. Journal of Consulting and Clinical Psychology, 74(5), 920–929.
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Samir Kadri
Author Samir Kadri Writer

Samir Kadri is a medical writer with a non-profit sector background, committed to raising awareness about mental health.

Published: Feb 2nd 2023, Last edited: Oct 12th 2023

Rychel Johnson
Medical Reviewer Rychel Johnson LCPC

Rychel Johnson is a licensed professional counselor and medical reviewer with a Master's Degree in Psychology from The University of Kansas.

Content reviewed by a medical professional. Last reviewed: Feb 2nd 2023