My Research: Understanding Narcissistic Abuse from a client’s perspective

Many people who experience narcissistic abuse do not realise they are being abused - Why It Can Be So Difficult to Recognise and Recover

They may know they feel anxious, exhausted, confused, or unlike themselves, but they cannot quite explain why. Often, they spend years believing they are the problem. They may tell themselves they are too sensitive, too emotional, not patient enough, or somehow responsible for the difficulties in the relationship.

My research explored psychotherapists' experiences of working with victims and survivors of narcissistic abuse. One of the strongest findings was that survivors rarely arrive in therapy describing narcissistic abuse. Instead, they seek help for anxiety, depression, low self-esteem, relationship difficulties, overwhelming self-doubt, or a persistent feeling that they have lost touch with who they are.

Narcissistic abuse can occur in many different relationships. While it is often associated with intimate partnerships, it can also occur between parents and children, siblings, extended family members, friends, colleagues, employers, or anyone who holds emotional influence or power within a relationship.

At its core, narcissistic abuse is a pattern of psychological and emotional manipulation that allows one person to maintain control while gradually diminishing another person's confidence, autonomy, and sense of self.

The person engaging in these behaviours may appear charming, capable, caring, or highly respected by others. In many cases they are skilled at presenting a positive image to the outside world. Behind closed doors, however, the relationship may feel very different.

Survivors often describe feeling as though they are constantly trying to avoid upsetting the other person. They become highly aware of changes in mood, tone of voice, or behaviour and may spend significant amounts of energy trying to keep the peace. Over time, their own needs, feelings, and opinions can become less important than managing the emotional environment around them.

One of the most confusing aspects of narcissistic abuse is a process commonly referred to as gaslighting. Gaslighting occurs when a person's reality is repeatedly questioned, dismissed, or rewritten. A survivor may raise a concern only to be told that the event never happened, that they are imagining things, or that they are overreacting. Their memories, perceptions, and emotional responses are repeatedly challenged. Over time, they begin to doubt their own judgement and may increasingly rely on the abuser's version of reality rather than trusting themselves.

Many survivors describe reaching a point where they no longer know what is true. They may find themselves apologising for things they have not done, questioning their own memories, or feeling confused about situations that once seemed clear.

Another common feature of narcissistic abuse is emotional manipulation. This can occur through guilt, blame, criticism, withdrawal of affection, silent treatment, intimidation, or creating a sense that love, approval, or acceptance must be earned. The survivor gradually learns that expressing needs, disagreeing, or setting boundaries may result in conflict, rejection, or punishment.

For those who have experienced narcissistic abuse within their family of origin, these patterns often begin in childhood. They may grow up learning that their feelings are less important than those of the parent, that love is conditional, or that their role is to meet the emotional needs of others. As adults, they may struggle with boundaries, people-pleasing, perfectionism, or an ongoing fear of disappointing others without understanding where these patterns originated.

Many survivors also find it difficult to understand why they remain emotionally attached to someone who causes them so much pain. This can be particularly confusing when there have been periods of warmth, affection, approval, or connection alongside the abuse.

Relationships affected by narcissistic abuse are often characterised by inconsistency. There may be moments when the survivor feels deeply valued, understood, or loved, followed by periods of criticism, rejection, emotional distance, or hostility. This unpredictability can create a powerful emotional attachment in which the survivor becomes increasingly focused on regaining the connection and approval they once experienced. As a result, leaving the relationship, or emotionally detaching from it, can be far more complex than others may realise.

Over time, the impact of narcissistic abuse can be profound. Survivors frequently describe feeling disconnected from themselves. Their confidence may diminish, decision-making can become difficult, and trusting their instincts may feel impossible. Many experience anxiety, shame, self-blame, loneliness, or a deep sense of emotional exhaustion. Some describe feeling as though they have spent so long adapting to another person's needs that they no longer know who they are.

Yet despite the significant impact of narcissistic abuse, the findings from my research were also hopeful.

Again and again, psychotherapists described the resilience of survivors and their capacity to heal when provided with a safe, validating therapeutic relationship. Recovery often begins when people understand that their responses are not signs of weakness or failure but understandable adaptations to prolonged emotional and psychological harm.

Through therapy, survivors can begin to reconnect with their own thoughts, feelings, and values. They can learn to trust themselves again, develop healthier boundaries, process painful experiences, and gradually rebuild a sense of identity that exists independently of the abusive relationship.

Perhaps the most important message from this research is that healing is possible.

If you recognise aspects of your own experience in these words, know that the confusion, self-doubt, and emotional pain you may carry are understandable responses to what you have lived through. With support, understanding, and compassion, it is possible not only to recover but to develop a stronger and more authentic connection with yourself than ever before.