How To Recognize Narcissistic Abuse Syndrome

Living with a partner who displays signs of narcissism—a general disregard for others, an exaggerated sense of self-importance, and cold-heartedness—can be difficult.

Those relationships may lead to an influx of severe emotional abuse. Sometimes, that abuse leads to what some mental health providers colloquially refer to as narcissistic abuse syndrome. Also known as narcissistic victim syndrome, the experience involves adverse mental health outcomes resulting from being on the receiving end of a person with narcissism.

Narcissistic abuse syndrome is not a mental health condition that healthcare providers can officially diagnose. Still, the experience can be a harsh reality for someone in a relationship with a person with narcissism or narcissistic tendencies.

Learn about how partners of people with narcissistic personality disorder can be victims of emotional abuse.

What Is Narcissistic Abuse?

Often, people who are narcissistic are so preoccupied with their status or image that they become unsympathetic to the emotions of others, which leads to narcissistic abuse.

Look at narcissism on a spectrum, Rashmi Parmar, MD, an adult and child psychiatrist at Mindpath Health in Newark, Calif., told Health. A mild form of narcissism can be necessary for developing a mature ego and self-esteem. On the other end of the spectrum, some people with severe signs of narcissism may develop narcissistic personality disorder (NPD).

The "Diagnostics and Statistics Manual, Fifth Edition, Text Revision" (DSM-5-TR), the most up-to-date criteria for diagnosing mental disorders, defines NPD as a cluster B personality disorder.

According to the DSM-5, signs of NPD include:

• An exaggerated sense of self-importance and desire for admiration
• An extreme focus on success, power, and beauty
• Arrogance
• Being overly critical or belittling of others
• Does not care about others' feelings
• Feeling superior to friends and family and entitled to special treatment
• Jealousy toward others' successes
• Takes advantage of others to serve their own interests

Most people do not have the complete picture when they get involved with a narcissist. Their behavior, or signs of NPD, typically do not emerge until establishing the relationship.

During the early days of a relationship, a person with narcissism or narcissistic qualities is loving and generous. They may even present over-the-top affection, admiration, and extravagant gestures. With such intense attention and special treatment, known as "love bombing," it is possible that the red flags are not obvious.

Narcissists use several techniques to manipulate their partners. For example, gaslighting makes people question their reality by disregarding their experiences and refusing to engage in conversation. That behavior serves to make a narcissistic person's partner more susceptible to emotional abuse.

Sometimes, narcissistic abuse is part of a codependent relationship. The narcissist manipulates the other into becoming dependent upon them. Putting their partner down allows the narcissistic person to feel superior. Essentially, they depend on their partner for those feelings of dominance.

What Is Narcissistic Abuse Syndrome? 

A person on the receiving end of such detached behavior may suffer the effects of psychological abuse. Some experts refer to those effects as narcissistic abuse syndrome.

"People who are in a relationship with a narcissist may experience significant amounts of abuse, particularly emotional abuse," Sheila Forman, PhD, a psychologist based in Santa Monica, Calif., told Health. For example, people receiving emotional abuse may do anything to keep their partner calm. Constantly watching your behavior to ensure your partner is not upset can be overwhelming.

"The affected person feels choked in the relationship, especially with an emotionally abusive and manipulative partner," said Dr. Parmar. "The relationship often revolves around the narcissistic individual at the expense of the other person's emotional well-being."

People with narcissistic personality disorder may not be aware of their mistreatment. They often speak negatively to their partners to invalidate or manipulate their emotions.

Signs of Narcissistic Abuse

There are some common signs to look out for if you think you or someone you love might be struggling with narcissistic abuse syndrome.

In general, a person who is the victim of emotional abuse may show signs like:

• Chronic pain, like headaches
• Depression and anxiety
• Fear or avoidance of criticizing or upsetting their partner
• Isolation or withdrawal from their friends or family
• Loss of interest in their hobbies
• Low self-esteem
• Stress

It is crucial to seek help if you believe you or someone you love has narcissist abuse syndrome. The effects can be severe.

"Narcissistic abuse syndrome can take a severe toll on a person's emotional health over time," noted Dr. Parmar. It can lead to other mental illnesses—like depression, anxiety, and PTSD.

Effects of Narcissistic Abuse 

The person on the receiving end of narcissistic abuse may encounter feelings of worthlessness and confusion. Often, they blame themselves for the negative aspects of their relationship.

A person could lose their self-esteem or self-worth and develop difficulty trusting others and making decisions, noted Dr. Parmar. People enduring narcissistic abuse syndrome will often isolate themselves due to fear and judgment from others not understanding or believing their experiences.

"You might notice yourself being extra cautious around a narcissistic family member and being easily coaxed into agreeing with them to avoid arguments or confrontations," explained Dr. Parmar.

Experiencing narcissistic abuse syndrome can also result in symptoms similar to post-traumatic stress disorder (PTSD). Symptoms include emotional triggers, flashbacks, isolation, detachment, avoidance, and hypervigilance, noted Forman.

Getting Support for Narcissistic Abuse

Working with a healthcare provider, like a therapist or psychiatrist, is a good first step toward recovering from narcissistic abuse syndrome. Though, keep in mind that healing is not always a linear process. 

Not everyone affected by a narcissist may be willing or able to see the impact of that relationship. Some people may even approach a counselor with the goal of self-improvement. They may feel so ashamed, anxious, or paranoid that they believe the problem lies with them rather than their partner.

Therapy is also recommended if a person with narcissistic personality disorder is motivated and open to treatment.

Consider contacting a local mental health rehabilitation center, where people can direct you to experts and other resources. Virtual therapy is another option.

Finally, staying with your partner impacts your health negatively over time and may put you in danger if there is a threat of violence. The National Domestic Violence Hotline can help you understand your options.

A Quick Review

People with narcissistic abuse syndrome are on the receiving end of a narcissistic partner. Often, narcissistic people feel superior to others and lack empathy, leading to emotional abuse.

Consult a mental healthcare provider if you display signs of narcissistic abuse syndrome, such as a loss of interest in hobbies, low self-esteem, and stress. Seek immediate safety and medical attention if abuse becomes physical.