Toxic Narcissism in Relationships: Identifying PTSD and C-PTSD

Written by Angela Atkinson

When you’re in or have recently left a relationship with a narcissist, there are many negative side effects you’ve got to deal with as a result of the gaslighting and manipulation that goes along with it – and one of the most common issues for survivors and victims of narcissistic abuse in relationships is PTSD and C-PTSD.

What is PTSD and Who Can Get It?

Millions of people are affected by PTSD (Post Traumatic Stress Syndrome/Disorder) and C-PTSD (Complex Post Traumatic Stress Disorder) each year and it can affect anyone in any age group.

PTSD has been talked about in the media as a serious problem that affects soldiers returning from traumatic experiences involving combat, but what we don’t talk about as often are people who have been emotionally and mentally abused by narcissists, psychopaths, and other negative people.

That’s why soldiers are what most people think about when they hear that term. The fact about PTSD is that soldiers aren’t the only ones who can be drastically affected by the debilitating reality of traumatic experiences – and it doesn’t have to result from physical combat.

In fact, for those affected by C-PTSD, which occurs when the traumatic event is spread over the course of weeks, months, or years. In these cases, the trauma usually involves some form of emotional and/or psychological trauma, whether or not physical injuries are sustained.

How PTSD is Connected to Narcissistic Abuse

A person who has been in a car accident, storm, plane crash, been raped, or suffered some other type of external trauma can develop emotional illnesses that may morph into depression, and it may also become a form of PTSD.  People who have suffered from a variety of types of trauma and abuse over the course of weeks, months, or years through hostage situations, abusive and toxic relationships, sexual abuse, and other forms of domestic violence can be affected by this same type of PTSD. This group, of course, includes people who are suffering from narcissistic abuse.

Victims of narcissistic abuse and other ongoing forms of physical, emotional, and psychological abuse can be affected by a form of PTSD called C-PTSD, or complex post-traumatic stress disorder. This is related to the fact that their trauma was ongoing over the course of weeks, months, years, or even decades in many cases. Conversely, those who experienced one-time or shorter-term trauma may have PTSD that would not be labeled complex.

What is C-PTSD (Complex Post-Traumatic Stress Disorder)?

Complex Post Traumatic Stress Disorder (C-PTSD) is a serious mental health condition affecting a large percentage of victims and survivors of narcissistic abuse. This disorder can take years to treat and many professionals aren’t familiar with its symptoms or misdiagnose it.

Some therapists and other mental health professionals may even victim-blame if they aren’t familiar with the subtle tricks of a narcissist. Unfortunately, it can be a lifelong condition, but it can be managed with mindfulness and behavior modification, among other therapies and modalities.

If you are affected by C-PTSD, you may wish to supplement your therapeutic treatment with narcissistic abuse recovery coaching. Or at the very least we recommend that you find a therapist who understands your unique situation. Check out this guide on how to find a therapist who understands narcissistic abuse and recovery.

Identifying PTSD or C-PTSD in Yourself or Someone You Love

Those who are experiencing PTSD or C-PTSD often first recognize they are affected by having had a freeze-response or a “fight or flight” response to a traumatic experience. This normal reaction to impending danger is ingrained in our psyche to prevent us from harm, but in PTSD, that natural response may deeply change a person.

Even though the person is out of danger and no longer needs to be afraid, he or she often reacts to non-threatening experiences and events with a “fight or flight” response.

What does PTSD look like?

The three main characteristics you might notice if you are suffering from PTSD experience include the following.

1. Exaggerated emotional and physical responses

A person with PTSD might become frightened from loud noises or being surprised. He or she may begin to shake uncontrollably, shrink from the situation, or leave the premises. Anxiety is always present in the PTSD or C-PTSD affected person.

Related: How to Deal with the Crippling Anxiety Caused by Toxic Relationships with Narcissists

2. Troubling Memories

PTSD may cause a person to frequently recollect the traumatic event. He may become very irrational and emotions may run wild because he’s mentally ‘rewinding’ the event and playing it in his mind over and over.

Related: Toxic Thoughts and How to Stop Them

3. Problems Relating to Others

If you have PTSD, you might have a hard time trusting anyone. You might become suspicious and jealous of people who love you and want the best for you. You might feel angry and depressed and extremely detached from loved ones.

PTSD and C-PTSD-affected people sometimes feel like no one understands them, so relationships can be difficult to maintain, especially when they get involved in toxic relationships. Other areas that become problematic for the PTSD or C-PTSD-affected are their job, performing the most basic of daily tasks, and the fact that they can’t comprehend that what they’re afraid of isn’t a real threat at that moment.

This is further exacerbated when a narcissist’s abuse is involved because in this case, the messages are initially coming from OUTSIDE your head – they’re the narcissist’s attempts to slowly and methodically break you down – and they work way too well.

Related: 44 Signs You’re Being Emotionally Abused

The mental stress of C-PTSD is devastating and can take a toll on your relationships with others and the ability to function if not identified and treated properly. There are certain types of trauma that can typically cause C-PTSD.

Who Can Be Affected by PTSD and C-PTSD?

Besides traumatic combat experiences (such as narcissistic abuse), there are other events that might precipitate PTSD. People of all ages and who have experienced all types of trauma may fall victim to this devastating disorder. Other than combat veterans (mostly men) here are some trauma victims who are more likely to be affected by PTSD during and after toxic relationships than others:


Children are some of the most likely victims to be affected by PTSD and react to it in various ways that could cause mental and physical illnesses.

      • Events such as car accidents, being bullied at school, violence at home, a loved one’s death or illness, child abuse or a serious accident can precipitate PTSD in children.
      • Symptoms of PTSD in children include re-living the experience, nightmares, avoiding situations, blocking out his feelings and memory of the event and being easily frightened of events that pose no threat of harm.
      • If you notice some or all of these symptoms of PTSD in a child who has been through a traumatic event, make sure you seek help immediately from a health care professional.


Women are statistically much more likely than men to develop C-PTSD and the reasons could stem from domestic violence, being neglected or abused as a child, being raped, physically attacked, being in accidents, having a crushing medical diagnosis, or experiencing the loss of a child or other loved one.

      • Symptoms of C-PTSD in women might include severe depression, abuse of drugs or alcohol, developing an eating disorder, or increasing the risk of heart disease, rheumatoid arthritis, and chronic pain. Suicidal thoughts or actions and other maladies may also occur.
      • Treatment for C-PTSD in women might include anti-depressants or anxiety medication prescribed by a health care professional. It may also include coaching or counseling with someone experienced in helping trauma victims.

Lonely People

People who are alone can suffer from C-PTSD and PTSD. Although some people who are alone in life may enjoy it, most of us need a help and support system that we can call on when depressed or medically impaired. Those who have no one to talk to or interact with are much more likely to develop PTSD.

      • This might include divorced men or women of any age, including but not limited to single parents, whether or not they are primary custodians of their children.
      • People who are the primary custodians for children may have a more difficult time connecting with a support system due to being solely responsible for most day-to-day parental responsibilities.
      • Prolonged social isolation, even when related to taking care of others, can increase and magnifiy C-PTSD symptoms signficiantly.
      • Perhaps a bit ironically, the trauma associated with narcissistic abuse can lead to the desire to avoid social situations and can even cause social anxiety.

The Elderly

The elderly are sometimes at risk for PTSD when they’re abruptly pulled away from their home and placed in a nursing facility. Friends may have passed on and family may live in other areas of the world.

      • It can be scary for the elderly to be alone, especially when they’re struggling with big personal changes and mental or physical health issues.
      • Treatment for PTSD and C-PTSD in the elderly can range from medication to counseling and helping the victim join in other activities as much as possible.

The truth is that anyone who has been through a traumatic experience is at risk. Men, women, children and the elderly may all experience PTSD if they’re victims of extreme trauma and/or the mental and emotional abuse that comes along with a toxic relationship with a narcissist.

What types of events lead to PTSD and C-PTSD?

Some events that could produce enough trauma to cause PTSD are sexual molestation, experiencing a threat by someone with a weapon, rape, kidnapping, car accident, devastating illness, natural disaster including hurricanes, tornados, and earthquakes, and civil happenings such as divorce or being sued. Emergency response workers such as firefighters, medics, pilots, and policemen are likely to develop PTSD if they witness or are part of a traumatic event where the loss of life or devastation is involved.

Symptoms & Complications of PTSD

Symptoms of PTSD you should look for are the same as the ones previously mentioned. They may also include life-altering mental, emotional, and physical health complications including suicidal thoughts, alcohol or drug abuse, and depression.

Complications of PTSD are varied, including the disruption it can cause in jobs, relationships, and functioning on a daily basis to complete even the most menial tasks or experiencing enjoyment in anything. PTSD shouldn’t be ignored. It won’t go away without treatment.

Symptoms & Complications of C-PTSD

Symptoms of C-PTSD include those seen in PTSD, but they tend to be longer-lasting. C-PTSD will usually also present with added symptoms including the following.

  • Low self-esteem.
  • Dissociation.
  • Trouble regulating your emotions.
  • Struggling with short-term memory.
  • Distorted perceptions of reality, yourself, or your abuser.
  • Longer-term memory issues around the trauma or traumatic periods in their lives.
  • Your beliefs and your thoughts might not be in line and you may lose faith in your religion or another long-held belief system.
  • Certain physical health issues are often also associated with C-PTSD, including but not limited to adrenal fatigue,  and various types of autoimmune diseases.

The Best Ways to Treat PTSD & C-PTSD

If you or someone you know falls victim to PTSD, treatment is imperative – and the sooner, the better. Symptoms may occur immediately after a traumatic experience or even months or years later.

One type of treatment doesn’t fit all for those who suffer from PTSD, but there are various ways to get through the disorder and get rid of the symptoms that plague and disrupt your life. These include:

Traditional “Talk Therapy”

Talking it through for PTSD and C-PTSD-affected people is sometimes the best way to treat the disorder. Counselors and psychotherapists that are specially trained in PTSD treatment can usually help the person find closure for the traumatic incident that has caused such a lifestyle change.

Cognitive Therapy

This type of therapy helps a PTSD or C-PTSD affected person to realize that events that took place weren’t his fault and helps alleviate feelings of guilt. A therapist listens to them describe the traumatic event(s) in detail and then helps the person understand the incident and why it happened.

Narcissistic Abuse Recovery Coaching

When the person suffering from C-PTSD is otherwise mentally stable, a good narcissistic abuse recovery coach can help them discover the answers they seek and learn new coping techniques for dealing with the issues that come along with it. This can work together with or independently from traditional therapies.

These types of treatments and remedies work because when the PTSD or C-PTSD-affected person demonstrates that they have a good understanding of the event, they then understand that they’ve been suffering stress because of their thoughts about the situation. If this is something you are personally dealing with, it might help you to know how the therapy-focused treatment and guided self-help coaching options work.

In general, you would work with your therapist or coach to develop a plan for your healing or a self-help plan to address the effects of and overcome your issues related to PTSD or C-PTSD.

Change Your Mind to Change Your Life: Reprogramming Your Brain

You know by now that narcissistic abuse and the complications of it, including C-PTSD, changes you. The fact is that a toxic relationship involving a malignant narcissist changes who you become. It changes what might have been a happy, confident, secure person into someone who doubts their worth and their value every day. It takes away your ability to have a healthy, full life and causes you to hyper-focus on it as you try in vain to resolve it, repeatedly, over and over again. What happens during a relationship with a toxic narcissist to lead to these changes?

This video will walk you through some of the most common feelings and experiences that lead to the loss of self in a toxic relationship, plus we will talk about self-help techniques you can use to heal and start to find yourself again.

The next step is to learn to replace the frightening and negative thoughts with less traumatic thoughts and put the incident into perspective. These therapy sessions will help you learn how to cope with fear, anger, and guilt that often plague people after a traumatic experience.

Neuroplasticity and Healing After Narcissistic Abuse-Induced C-PTSD

Did you know that narcissistic abuse causes your brain to literally change its structure? The good news? You can change it back, thanks to a recently-discovered concept called neuroplasticity. Here is an introduction to neuroplasticity that can help. By using this simple sort of “brain training,” you can overcome the effects of abuse – including panic attacks, stress, depression, fear, and more.

Neuroplasticity offers a new kind of hope for survivors of narcissistic abuse, this is how our brain can “rewire itself” by forming new neural connections throughout life. This means that the neurons (nerve cells) in the brain can compensate for injury and disease and to adjust their activities in response to new situations or to changes in their environment. Even better, we can intentionally control this process if we choose to do so.

Exposure Therapy

Eliminating fear is one of the goals of exposure therapy and is based on the theory that after a traumatic event happens, a person learns to be afraid of thoughts, feelings, and circumstances that remind him of the traumatic happening. This can work with PTSD, but not generally with C-PTSD.

  • A therapist can help you control those thoughts and feelings and learn how not to be frightened of the memories associated with the event. If you have PTSD, you might spend a lot of time focusing on memories of the event and reliving it.
  • Exposure therapy can help “desensitize” your reaction to the memories and replace them with less stressful thoughts. Relaxing is key to successful exposure therapy and the therapist might use breathing exercises to help with this.

Support Groups

A supportive group of people can help PTSD and C-PTSD-affected people overcome their fears and emotions. A group can be family members since they are most affected by the person’s PTSD.

  • A good therapist will help the PTSD and C-PTSD-affected person and their family communicate with each other and voice concerns. Honesty is paramount in family group therapy and can help mend and foster relationships that are repairable.
  • Supportive group coaching and/or therapy may also be with those who have experienced the same or similar traumatic experiences. Sharing stories and emotions with others who are in the same boat helps each person build trust and self-confidence and realize that he’s not alone.

Neuro-Linguistic Programming (NLP) 

Neuro-linguistic programming (NLP) is a way of enhancing communication, personal development, and psychotherapy created by Richard Bandler and John Grinder in California, United States in the 1970s. This is a modality that is often used to help in healing from narcissistic abuse.

There are three main components that create the human experience: neurology, language, and programming.

Our neurological system regulates our basic bodily functions, while our language determines how we interact with the people around us. And then our programming is what helps us to perceive the world – it determines literally what we experience in our lives. So, NLP, or Neuro-Linguistic Programming, basically means using the fundamental dynamics between your mind (neuro) and language (linguistic) and how the combination of those two things affects our body and behavior (programming).

In other words, to use NLP for personal change is to intentionally choose to change your thought patterns and processes in order to achieve the life you really want – and not more of what you don’t. Read more about NLP here.

EMDR (Eye Movement Desensitization and Reprocessing)

An experienced, trauma-informed counselor trained in EMDR can help you change reactions to remembering a traumatic experience by focusing on the memories while performing certain actions.

  • Actions you might perform could be eye movements, sounds, and tapping.
  • The documentation isn’t totally clear as to how EMDR works to solve problems, but studies suggest that PTSD and C-PTSD-affected people will often experience fewer symptoms after the therapy.

Light Therapy

One of the problems with PTSD and C-PTSD is that sufferers have trouble sleeping. Light therapy has been shown to drastically reduce symptoms of PTSD and C-PTSD and is a very inexpensive method of treatment.

  • Bright lights affect a person’s internal clock and metabolism and also cause positive reactions to inflammation, the immune system, and stress such as that caused by traumatic experiences.
  • Depression can also be alleviated with light therapy.

Dog Therapy

It may seem out of the box, but dog therapy has been found to seriously help those who may be suffering from PTSD. A dog is known as a “soldier’s best friend,” and many dogs have had specific training to help soldiers with PTSD as a result of combat stress and experiences. They can benefit victims of narcissistic abuse the same way.

  • Dogs can help PTSD and C-PTSD-affected people express and feel love again, they are great companions for those who feel alone and they can help reduce stress, frustration, and feelings of loneliness by encouraging outdoor walks and socialization with new people.
  • Dog therapy for PTSD and C-PTSD-affected people hasn’t definitely been proven to be an effective treatment for PTSD, but you may talk to your doctor or therapist about acquiring an emotional support dog that has been trained to help provide companionship for the PTSD or C-PSTD-affected person.


Even the military is now using this ancient Eastern practice to treat soldiers with symptoms of PTSD and recognize its ability to help PTSD and C-PTSD-affected people to gain an awareness of their feelings and heal from the experience.

  • Yoga brings a sense of calm to both the mind and body and those who suffer from PTSD find that it helps them see things differently and recover enough to go on with their lives rather than reliving the past.
  • Anxiety caused by PTSD can also be relieved by practicing Yoga. The poses, stretching and meditative thoughts soothe mangled nerves and allow the person to calm him or herself without using medication, alcohol, or other means to seek relief.

Recovering from PTSD

Recovery from PTSD can take a long time, depending on how fast it’s recognized in the PTSD or C-PTSD-affected person as a problem, and the treatment is obtained. There are health professionals who specialize in the treatment of PTSD and can diagnose and prescribe the treatment that’s going to be of most help for a child, woman, man, or soldier.

Most types of treatment last from six to twelve weeks, but it could take more time, depending on the severity of the disorder. Even though good and helpful treatments are available, the person with PTSD may not recognize they’re having a problem.

Sometimes PTSD can be treated by an antidepressant medication or SSRIs (selective serotonin reuptake inhibitors) that can help with feelings of sadness and worry. Much of what causes PTSD are the chemicals in the brain – and the lack of serotonin – so medications can be used with some success.

If you or a loved one is under treatment for PTSD, make sure you ask the therapist or health care professional how long the treatment may take and what you can expect from it.

It’s very important that loved ones or others close to the PTSD or C-PTSD-affected person and help get them to a therapist as soon as possible. That’s why helping someone realize they’re affected by PTSD or C-PTSD can be so vital.

Due to the importance of treatment, whether the person in your life who might be C-PTSD-affected is yourself or someone you love, it’s important to research and discover all you can about the symptoms of PTSD, treatment, and recovery options.

Start Getting Help with Narcissistic Abuse-Induced C-PTSD Today

Online help is readily available for survivors of narcissistic abuse. Here are some options to begin healing from narcissistic abuse right away.

Have you or has someone you know been affected by PTSD or C-PTSD during or after a toxic relationship with a narcissist? 

Related Articles for People Dealing with C-PTSD Related to Narcissistic Abuse

Related Video: Trauma Bonding and C-PTSD in Narcissistic Abuse


  • Angela Atkinson is a certified trauma counselor and the author of more than 20 books on narcissism, narcissistic abuse recovery, and related topics. A recognized expert on narcissism and narcissistic personality disorder who has studied and written extensively on narcissistic personality disorder and narcissistic abuse in toxic relationships since 2006, she has a popular narcissistic abuse recovery YouTube channel. Atkinson was inspired to begin her work as a result of having survived toxic relationships of her own. Atkinson offers trauma-informed narcissistic abuse recovery coaching and has certifications in trauma counseling, life coaching, level 2 therapeutic model, CBT coaching, integrative wellness coaching, and NLP. She is a certified trauma support coach and certified family trauma professional. She also has a professional PTSD counseling certification. Her mission is to help those who have experienced the emotional and mental devastation that comes with narcissistic abuse in these incredibly toxic relationships to (re)discover their true selves, stop the gaslighting and manipulation, and move forward into their genuine desires – into a life that is exactly what they choose for themselves. Along with her solution-focused life coaching experience, Atkinson’s previous career in journalism and research helps her to offer both accurate and understandable information for survivors of abuse in a simple-to-understand way that helps to increase awareness in the narcissistic abuse recovery community. Atkinson founded Narcissistic Abuse Recovery Support, the SPANily Narcissistic Abuse Recovery Support Groups and the Life Makeover Academy. She offers individual and group coaching for victims and survivors of narcissistic abuse here at and at NarcissisticAbuseRecovery.Online.

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