Raised By Narcissists? Why You Can’t Afford the Wrong Therapist
Julia Hall Roving writer/photographer, founder of The Narcissist Family Files Blog
If you have the misfortune of having been raised by one or more narcissists, chances are you’ve heard classics like these: “You’re just too sensitive.” “You need to learn to let things go.” “When are you going to move on from the past?” And the fauxpology “I’m sorry you feel I’m such a disappointment as a (fill in blank) mother.”
Invalidation, denial, and gaslighting (making you think you’re crazy) are tried-and-true tools of the narcissist’s trade, and if you grew up having the adults meant to love and nurture you use them against you you’re probably especially vulnerable to such treatment as an adult. Unfortunately for many sufferers of narcissistic trauma, looking for support from a therapist can be hazardous terrain.
Seven years ago Los Angeles-based psychotherapist Fiona Steele shifted her long-established practice to work exclusively with clients dealing with narcissist fallout because, she said, it’s an underserved population with an overwhelming need. “I’m in awe of how so few practitioners understand narcissism,” Steele told me. “So many of the clients that come to me have dealt with therapists who don’t have a clue about the insidious ways narcissists suck out the life of the people around them.” Steele advised people seeking therapeutic support for narcissist abuse to find someone with a firm understanding of narcissism and a solid treatment toolkit beyond talk therapy. Her message to sufferers is, “You are not crazy.”
Regina Collins is a licensed professional counselor based in Alexandria, Virginia, specializing in working with narcissist trauma. Many of her clients come to her having been retraumatized by therapists who don’t understand narcissism or narcissistic family dynamics. “Clients often bring up the fact that they feel ‘crazy’ because their experiences were questioned or negated outright by clinicians who don’t understand the behavior patterns of narcissists. This invalidation by someone who is supposed to be safe and trustworthy often mirrors the gaslighting that was experienced in their family of origin,” explained Collins. She pointed out the potentially devastating “forgive and forget” line of advice from unqualified mental health workers: “One of the most distressing issues people have identified is dealing with the clinician who pushes them to ‘forgive’ their parent and continue to have contact, even if it does not feel safe to the client. Numerous clients have shared with me that they were urged to ‘preserve the family’ and continue to see the parent even though the costs were high and benefits few, if any. As clinicians it is our place to support clients as they make their own decisions about contact, and we shouldn’t judge clients if they determine that ‘no contact’ is safest for them.”
Psychotherapist and narcissism expert Julie Tenenberg, practicing in Oakland, California, also emphasized the importance of working with a properly educated therapist. “I’ve had a number of [narcissistically abused] people come to me who have seen a therapist who has unconsciously reinjured the client. The damage of the wrong therapy is new trauma, not just reactivating old trauma,” said Tenenberg. “This population is manifesting shame, guilt, self-neglect, and physical symptoms of trauma. They need a witness who is sensitive, not critical or dismissive, someone who will not reenact the narcissistic response.”
Dr. Karyl McBride, narcissistic abuse recovery pioneer and author of Will I Ever Be Good Enough?, encourages adult children of narcissists to vet their mental health providers to make sure they are conversant with narcissism. “If the therapist does not understand the dynamics of narcissism and its debilitating effects, it is easy for them to encourage the ‘get over it already, the past is the past’ mentality. When they do this, they are not validating the feelings of the client and the childhood issues are deeply minimized and discounted,” she explained. McBride trains clinicians in her five-step model for helping clients, and she has created a referral network of therapists who specialize in working with adult children of narcissists. Can’t find a qualified therapist in your area? Many members of McBride’s network offer phone sessions.
Narcissism has become a buzzword these days often “full of sound and fury, signifying nothing,” to quote Macbeth. But for adult children of narcissists (ACoNs)—those who have lived with the narcissist disordered personality as their primary caretakers—the reality is painfully serious and the health stakes are high.
Narcissistic Personality Disorder
Parents with Narcissistic Personality Disorder (NPD) fundamentally lack empathy and compassion and are incapable of unconditional love. In an effort to scaffold an all-consuming sense of worthlessness formed in early childhood, the narcissist constructs a grandiose self that he continuously asserts and protects with all of his resources. The narcissist’s needs trump everything else, and his children are manipulated within a family system designed to support his ego. A child in a narcissistic family is treated to “normalized” day-to-day psychological and sometimes physical abuse. Such abuse breeds in denial and secrecy, manifesting in families through manipulation, shame, blame, belittlement, rage, and neglect. Narcissists violate boundaries, play family members against one another, refuse accountability, and stop at virtually nothing to maintain control.
Children of Narcissists: The Walking Wounded
In his 2014 landmark work The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, Bessel van der Kolk, M.D., captures the physical and emotional experience of the child in the narcissistic home: “Trauma almost invariably involves not being seen, not being mirrored, and not being taken into account.” He continues, “Being able to feel safe with other people is probably the single most important aspect of mental health.”
For children of narcissist parents, abuse and neglect settle in the body in lasting, often devastating ways. They are the walking wounded, emotionally and physically traumatized and at risk for further trauma. Dr. van der Kolk describes the body’s response to long-term stress:
“Ideally our stress hormone system should provide a lightning-fast response to threat, but then quickly return us to equilibrium. In PTSD (posttraumatic stress disorder) patients, however, the stress hormone system fails at this balancing act. Flight/fight/freeze signals continue after the danger is over. . . . Instead, the continued secretion of stress hormones is expressed as agitation and panic and, in the long term, wreaks havoc with their health.”
Narcissist-Trauma-Related Health Problems
According to Dr. Karyl McBride, Director of The International Resource Center for the Daughters, Sons, and Partners of Narcissists and author of Will I Ever Be Good Enough?, there is a clear and disproportionate pattern of physiological fallout among her clients, stemming from narcissist trauma. Having worked with hundreds of ACoNs, McBride said, “I’m continuing to be amazed how these people come out of these relationships with narcissists having severe health effects.”
McBride cited PTSD symptoms such as anxiety, depression, and insomnia; migraines; autoimmune disorders such as chronic fatigue syndrome; addiction; adrenal exhaustion; and heart problems among the population of people she treats. “Bottom line is trauma causes all kinds of physical problems,” she said.
The Cult of Narcissism
Los Angeles-based psychotherapist Fiona E. Steele has practiced for over three decades and for the last 8 years has exclusively treated ACoNs and people in relationships with narcissists because, she said, the demand is overwhelming. Steele told me the majority of her clients are just waking up to the reality of narcissistic abuse. “Their whole life they’ve been looking in a fun house mirror. It’s almost like they’re coming out of a cult,” she said. “They feel shame and isolation. We’re taught not to say anything bad about our parents. In that sense the culture supports the narcissist.”
Steele described the body’s response to years of “being on hyperalert, white-knuckling it.” She listed common health problems among her clients resulting from disrupted cortisol (stress hormone) levels: autoimmune disorders such as Lupus and Chronic Fatigue, thyroid problems, back pain, irritable bowel, arthritis, depleted adrenals, and complex PTSD symptoms such as anxiety, depression, insomnia, and nightmares.
The Toll of Consistently High Stress Levels
Regina Collins is a licensed professional counselor based in D.C. Her early work treating substance abuse pointed to trauma treatment, which led her into the field of narcissist abuse recovery. Collins described the narcissistic family as one where “everyone is rotating around the narcissist on continual high alert. Consistent high stress levels take a physical toll.” She compared the environment for the body as driving a car with your foot on the gas pedal all the time, or with your feet simultaneously on the gas and the brakes.
Collins is outspoken about the need for more understanding of the physiology of trauma. Among her clients she sees a pattern of extremely high anxiety, insomnia, muscle pain, autoimmune disorders, depression, and disregulation. She explained that chemical disregulation as a result of trauma can lead the sufferer to seek balance through behaviors that can become self-destructive but are meant to self-soothe—behaviors such as substance abuse, eating disorders, self-harm, gambling, and shopping. “They give the brain a shot of dopamine for relief,” she said. “It makes perfect sense from a coping standpoint.”
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The Hypothalamic-Pituitary-Adrenal Axis
Psychotherapist Julie Tenenberg, with a practice in Oakland, California, specializes in treating narcissistic trauma. “All of my patients with a narcissist parent have health problems,” she said. “Growing up in a narcissistic home places stress on the body that threatens our homeostasis—the hypothalamic/pituitary/adrenal (HPA) axis,” Tenenberg explained.
The HPA axis regulates stress and many body processes, including digestion, immune response, emotion, and energy storage and release. Tenenberg listed common problems she sees among her clients: autoimmune disorders, hypo- or hyperthyroidism, leaky gut, cardiovascular issues, irritable bowel, and insomnia. “Often they are illnesses that traditional M.D.s don’t pick up or acknowledge,” she pointed out. “That invalidation can reactivate trauma.”
Hope for ACoNs: Trauma Treatment
Although narcissistic abuse takes a toll on the body, there are ways to reduce or even overcome its effects. Dr. McBride developed a five-step recovery model that she uses with her clients and teaches to other professionals in her field. Others I spoke with utilize emotional freedom therapy (EFT) and eye movement desensitization and reprocessing therapy (EMDR), which are believed to help the body release long-held trauma. Dr. van der Kolk also cites EMDR as well as a range of other trauma therapies such as yoga, writing, and theater.
McBride emphasized the importance of working with the right mental health professional. “If the therapist does not understand the dynamics of narcissism and its debilitating effects, it is easy for them to encourage the ‘get over it already, the past is the past’ mentality. When they do this, they are not validating the feelings of the client and the childhood issues are deeply minimized and discounted,” she explained.
No Contact Can Help
In some cases, limited or no contact with abusive parents can be curative. Jeanie of Alberta, Canada, grew up with a narcissist mother and an enabling father with narcissistic traits. Her mother routinely criticized and ridiculed Jeanie, publicly humiliating her and overtly favoring her other children. “My mother would wake me up early every Saturday morning to clean the house while she cuddled and giggled in bed with my younger sister until noon,” Jeanie recalled. Her mother also restricted Jeanie’s clothing and hair style while giving free rein to her other children.
By the time Jeanie was 17, she was suffering from symptoms that would later be diagnosed as multiple sclerosis. She also developed intense anxiety, depression, high blood pressure, migraines, and undiagnosed digestive problems. She said, “I felt like a walking black void, worthless and destroyed.”
When Jeanie was finally tested for MS in her late 30s, she said her brain scan “lit up like a Christmas tree” with lesions, indicating that she had had the disease for years. Six years after she cut off contact with her family of origin, with support from her husband and children, a followup brain scan showed a dramatic reduction in lesions. “My doctor was amazed. She’d never seen anything like it,” said Jeanie. “I’m convinced my lesions have decreased because of going no contact.”
Julie L. Hall is the founder of The Narcissist Family Files Blog and the author of the forthcoming memoir, Carry You, about life, and a few near deaths, in a narcissistic family (read excerpts). Her articles on narcissism regularly appear in The Huffington Post.