The Impacts - Inner Works Therapy

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The impacts of being brought up by, in a family with, romantically involved with, in a friendship with or working with a person on the narcissistic spectrum are manifold.  

Impaired sense of self: Nearly all children of narcissists ask: ‘Who am I really?’ How can someone truly know who they are when they have been brought up by someone who is totally self-involved and full of unmet needs, who is repelled by emotionality and who has no capacity to know, empathise, attune and mirror. Parts of self that should be free, seen, playful, useful and thriving are waylaid into adapting to aid survival.  

CPTSD: a relational trauma – cause by people who are/were supposed to protect you and love you e.g. primary caregivers, a lover, a manager. This kind of deep trauma happens when love is betrayed. Chronic anticipation of upset, even at an ambient level, affects the brain: a narcissist’s unpredictable, scary and cruel actions, words and emotions represent a threat to the brain – to its sense of safety and hence survival.  

Unprocessed trauma at a CPTSD diagnosable level includes dissociation, flashbacks, nightmares, sleep issues; avoidance of reminders of trauma, anxiety and depression, hypervigilance, emotion regulation difficulties, anger, fluctuating empathy levels; a negative self-concept, a sense of worthlessness, guilt, interpersonal problems, and a feeling of disconnection.  

At a lesser degree we can have ‘remnants’ of CPTSD, as well as an amygdala with a ‘set point’ that means you only feel comfortable at a certain level – either when over-exercising, or you may feel uncomfortable when you try to relax. You might notice that you are calmer when a crisis hits, or drama feels like your ‘normal’.  

Anxiety disorders: self-abandonment, emotionally and physically, in order to focus on the narcissist leaves lifelong anxiety and a lack of an internal sense of safety. Anxious attachment, especially evident in friendships, leaves people worrying about having said or done the ‘wrong thing’. Assertiveness sounds great but is regarded by the narcissist as an affront. The brain remembers the consequences and equates assertiveness with conflict.  

Narcissistic abuse can result in a range of anxiety issues including hypervigilance, social anxiety (self-policing), worry, phobias and fears. Having experienced trauma, a person can experience catastrophising thoughts e.g. ‘everything is going to fall apart’, ‘something bad is going to happen’ and the body follows by making it a survival response. Anxiety also arises from the sense of being ‘watched and hated’ which leaves is mark on the nervous system.  

Need for control: This is the arena of self-blame (also affected by the narcissist’s ‘blamer’ mentality): the psyche of the child of the narcissist cannot acknowledge that the parent is dangerous, that would be too terrifying. Instead, the child takes control by blaming themselves. This ‘Moral Defence’ continues into adulthood and is extremely common in adult children of narcissists – ‘that happened and it is my fault’. The need for control sits at the heart of many of the impacts of narcissistic abuse – e.g. worry, anticipatory anxiety.   

Sadness: a deep and pervasive sense of sadness is the most common overarching impact of narcissistic abuse in my experience. Sadness = separation anxiety. Over time, we learn now to nurture, be with and honour our sadness while also constantly cognitively re-framing it.  

Toxic Guilt: toxic guilt is one of the most common impacts in my experience. This is the most powerful tool in the narcissist’s toolbox. Guilt gets confused with ‘I am bad’ rather than ‘I have done something bad’ (which is most often not the case). The narcissist’s powerful ability to play the victim and manipulate plays a part. Sensitivity to ‘disappointing’ the narcissist will have come from childhood; the child feels guilt and shame for not being ‘good enough’ (which would be impossible anyway) or for hurting or not being able to help the self-absorbed and hypersensitive narcissist. This worry about potentially ‘hurting’ others carries on in adulthood.  

You might also be experiencing guilt around ‘reactive abuse’ – some of your behaviours in response to the abuse may have been less than desirable, but were actually a normal result of the emotional torture you had endured.

Toxic Shame: a huge area in narcissistic abuse impacts and a powerful control tool for narcissists. Shame and self-blame are intimately connected. It is a neurophysiological response that if not deal with will cause us to ‘hide out’ in plain sight as adults, often developing a ‘false self’.  

Shame binds to many other emotions and most damagingly to our core identity, thus we have an internalised sense of ‘I am wrong/bad/broken’. There are many sources of shame in being brought up by a narcissist – from being subject to their ‘bad’ projections, to not being ‘good enough’ for the narcissist, and from not being seen and soothed after an upsetting event. Shame can also be masochistic and part of self-sabotage.  

But shame is also a clever survival response, a resourceful state that allows us to more easily submit to, and be less threatening to, a perpetrator.  

Projective identification: unconscious projections from the narcissist such that you become what they need you to be. We become a ‘host’ to the narcissist’s split off ‘bad’ parts (which they like to control and keep close – here we see enmeshment and merger), and we very damagingly ‘be’ and ‘act’ in accordance with those introjections. Shame makes us more vulnerable to projective identification.  

Distorted core beliefs: Our beliefs about ourselves, others and the world are deeply affected by narcissists – whether through overt or covert means. Distorted narratives about who you really are, open insults, smears, projections, can bind with shame and guilt. This toxic mess runs deep and is powerful; we can even manipulate our environments to confirm their truth.

Subject to the narcissist’s perfectionist expectations of self and others, the most common core belief in my experience is ‘I am not good enough’. Other common beliefs are: ‘I am selfish/worthless/unlovable/powerless/stupid/
weird/undeserving etc’. ‘Others are not to be trusted’ (reflecting the paranoid narcissist’s thought process), ‘Others should not be boastful’ (the hatred of the covert of others’ confidence/happiness). ‘The world is a dangerous place’ (reflecting their anxiety).  

Especially punitive inner critic: That relentless voice, telling you that you are ‘stupid’, ‘selfish’, ‘inadequate’, ‘don’t rest or relax’, ‘do more’, ‘look better’, ‘be perfect’… When we realise that our critics are really a protective mechanism and work with them with compassion, we can start to heal.  

Chronic and acute anger: we have been treated badly and a ‘wounded self’ develops, but until we come to a deep acceptance of the fact the person is/was a narcissist, then chronic anger can continue for years. Narcissists do not allow our anger, nothing can be truly resolved or triumphed over, so it goes underground, becomes toxic and threads like a venous system throughout our life – affecting our thoughts (e.g. rumination) and behaviours, our health, driving addictions, amplifying emotional triggers, damaging relationships and so on, often outside of our awareness. But anger also has great value – it tells us something is wrong, that a boundary has been transgressed. It’s also an umbrella emotion – going beneath to the real emotion is vital.

Gaslighting impacts: tends to trigger people pleasing behaviour by the gaslightee and a sense that somehow they are at fault. Signs and effects include denial, loss of self-confidence, emotional disturbance, depression, anxiety, PTSD, increased vulnerability to further emotional abuse, loss of autonomy, increased risk of codependency, re-traumatisation in future relationships and difficulty making decisions. Other signs and impacts include: overthinking; lack of self-trust; conflict aversion at all costs; loss of joy and chronic self-doubt.   

Ruminations: the endless cycle of repetitive, washing machine thoughts: ‘I can’t believe they did/said that!’; ‘If only I had said/done that’ etc. They represent a failed attempt at emotion regulation. Going over and over events and trying to make sense of them is inevitable when involved with a personality disordered individual. The brain tries ceaselessly to make sense of what happened and gain answers – which simply cannot be achieved. In short, nothing was ever achieved by ruminating.   

Co-dependency: an area that is too comprehensive to address here, it has been described as a ‘confusion of compassion’, but is essentially a disease of ‘control’ – I will over-focus on you (addict, disordered person, emotionally unavailable person, person who is like my parent), and if you change and give me the love I have always sought then it will prove I’m OK, and in fact my life depends on it.  

Moral injury: Can result when a person perpetrates, fails to prevent or witnesses events that contradict deeply held values, moral beliefs and expectations. For example, a narcissist asks their child or partner to lie on their behalf – moral injury is the distressing psychological, behavioural, social and sometimes spiritual aftermath. Guilt, shame, disgust and anger are some of the hallmark reactions, as well as an inability to self-forgive and consequent engagement in self-sabotaging behaviours (e.g. feeling like you don’t deserve to succeed at work on in relationships).

Post-traumatic OCD: combined with genetic factors, that unconscious sense of a lack of safety in childhood and the narcissist’s parentification of a child – leading to an inflated sense of responsibility for the parent or whole family, can also be one of the causes of OCD in whatever form.  

Paranoid behaviour, feelings and fears: a common feature of post-traumatic stress. The ‘generalisation effect’ means that after trauma the brain loses its ability to discriminate and makes associations with people/events that are similar, so we see for example an uptick in noticing/believing that people are narcissists or that people don’t like you etc. It is also an impact from a smear campaign. These feelings don’t come out of nowhere: malignant narcissists for example, will go to great lengths to monitor and control their target. As parents, I have heard stories of them setting up hidden surveillance equipment in a child’s bedroom, or they have persuaded a friend/relative to record the child’s conversations with another child. They read diaries and create drama around what they have read at important times in the child’s life.   
Experiences such as this can leave a person with paranoid ideation, feeling that they ‘must’ be perfect in their communications, that they may have made a mistake that will have huge consequences, that people are thinking badly about them or hiding secrets from them, that they need to check a partner’s computer to ensure nothing is going on.    

The image of a narcissist for many is of someone peeping around corners, constantly listening in and ever ready to cause trouble. This inability to create and maintain sacred boundaries has a huge impact on the sense of self and sense of ‘separateness’ from others.  

Major depression and/or Dysthymia: a sense of hopelessness (‘What’s the point?’) and powerlessness is another common impact, with the many symptoms of depression often not noticed for what they are.

Melancholic depression: Loss of the ability to feel pleasure, difficult mornings, intense feelings of guilt (can be mis-attributed to the narcissist’s guilt tripping), chronic sadness, lack of energy, eating too much or too little, physical symptoms such as jiggling your leg,  

Reactive abuse: The narcissist is clever at the ‘set up’. Manoeuvring a situation such that the target’s reaction incurs accusations – ‘you’re mentally ill’, ‘aggressive’, ‘selfish’, ‘out for our money’ – the list is long. The way that we react to the set up can lead us to feel bad about ourselves, not realising that manipulation and projection has been at play. Grandiose narcissists in particular future fake using their financial assets; without being able to see their role in it, they can be eventually be exploited financially, partly because the partner thinks that they don’t have a lot else to offer. In that way our own values can be bent out of shape.  

An impaired connection to gut instinct: Your attachment and survival needs drove you as a child to focus on the narcissist, pushing outside of your awareness your intrinsic and accurate gut instincts and your ability to act on them.

Cognitive dissonance: narcissists can be ignoring and neglectful of your emotional and physical needs and then switch to seemingly attentive and loving behaviours. While crudely reductionist they can also be incredibly insightful – they are not ‘insane’. As a result, the tension of opposing thoughts causes the brain to take the line of least resistance and opt for the easiest route – thus we keep ourselves in abusive situations. CD (as well as gaslighting) can lead to self-doubt, impaired decision making and trust issues.  

Self-doubt: The directional narcissist, the mocking and judgemental narcissist, telling the target what to do, say, wear, how to think etc., means they take up residence in the target’s head. Thus, in their absence we see: ‘What would they think if I do that?’ The brain cleverly remembers the consequences of going against the narcissist’s viewpoint and halts decision making. Self-doubt also tends to be related to childhood emotional neglect and the impacts of gaslighting.

Trust issues: The impacts are varied. As an example, recent research has shown that the brain of an anxiously attached toddler will re-wire itself to cope with a parent’s inconsistent attentions. As an adult, that means the person will have a neurologically impaired sense of people who are untrustworthy – they are simply not picking up on the cues because the brain had to ignore them as a child in order to keep the relationship with the parent (and survive). Other reasons include that the abuse has caused the brain to over-protect us and thus generalise, i.e. ‘nobody can be trusted’, ‘Everybody is a narcissist’. Or our ability to trust can get distorted – ‘X is being nice, what is she after?’ Self-trust is another significant area, e.g. in decision making, in our assessment of our ability to cope in the world, or that some part of us isn’t going to act out.

Emotional triggers: wounds that are buried deep, often around unfairness, unjustness, lack of respect, being made a fool of, not being heard, seen and so on. Schema that are ‘touched’ can leave the person unable to control their reaction to the triggering event in a way that is profoundly out proportion to that event.

Narcissistic fleas: learned and ingrained from being brought up by or relationally involved with a narcissist – these are behaviours, attitudes, thoughts that are ‘narcissistic’ – that do not mean you are on the spectrum of this disorder. For example, overly-strategic decisions about romantic relationships/lying/gossiping/blaming etc. This is a complex picture – victims of narcissistic abuse can themselves look like narcissists, but the core clinical traits are not there.   

Addictions: this is another huge area and very common in those brought up by a narcissist. Addiction = attachment hunger.

Stress impacts on health: long-term high levels of stress and often a lack of self-care lead to a range of health issues.

Many of these impacts are the result too of the personality disordered person projecting their internal state into another, with the resulting feelings of being drained, mined, disorganised and dysregulated. Narcissistic abuse is called ‘crazy making’ with good reason.


There are many other impacts. These can include:
social deficits – narcissists can be very adept at communication outside of the family or relationship but internally, there is no model of open, healthy communication to the growing child.  
enmeshment via financial assistance/financial deals and promises – all about control for the narcissist and often ultimately about who will look after them when they’re older. Narcissists seek people who are dependent, whether through a lack of feeling capable and able, running a secret addiction or who have experienced past trauma. Sociopath narcissists will think nothing of scamming their own children under a guise of ‘a good idea for all of us’. They regard their child’s financial assets as theirs to plunder (here we see the entitlement of the narcissist).  

Emotions as information
Our relationship with our emotions is always affected, whether that be emotion-regulation issues, perceiving emotions as dangerous and overwhelming or as having no value. The idea that we are allowed them and that they inform our needs and wants, that we should in fact be labelling them at a deep and nuanced level is often outside of our awareness.  

This abuse can also leave you feeling fragmented internally, incapable and overly-dependent on others. The void within means you needily turn to other people for advice, love and support, totally relying on their guidance and approval, all the while never realising that the only true love and support that can validate, satisfy, sustain and empower you has to come from within; that you alone can provide all your emotional needs when you are finally ready to make that leap.

Family Systems
This is a huge area that cannot fully be covered here. In families, the ever-present scapegoat child and golden child phenomenon causes a fracture in relationships that often cannot be healed. Both golden child and scapegoat are ultimately competing at a dry well but deep resentment on both sides is a common outcome. These children might as well have been brought up on different planets.

Since narcissism is strongly inheritable, often I see that golden children have clinical narcissistic traits or experience acquired situational narcissism. Others do not, and later come to realise regretfully that their behaviour had an impact on the scapegoat.  

Scapegoated adult children can be similarly so enmeshed and trauma bonded to the parent to the degree that they never ‘leave’ or give up the challenge of getting their needs met, often until later in life when they realise the battle is futile.  

Narcissistic Abuse Syndrome
Have you had a relationship or series of relationships with people who made you feel incredibly excited initially? The chemistry was amazing and you felt almost powerless to resist – you felt such a familiarity with this person. Their attentions helped you to finally ‘fall in love’ with yourself and experience yourself in new and deeper ways; these might be qualities that you disowned long ago or that were not allowed, or put outside of your awareness by a narcissistic parent.   

However, after a time you started to feel like your partner was judging you and you were falling short – then, he or she distanced themselves, leaving you confused and panic stricken. That old familiar loneliness and sadness that was the background tape of your life returned in full – this time making you feel even more defective, anxious, not good enough, alone, potentially traumatised, and terrifyingly empty inside.    

In the relationship you resorted to ingrained psychological patterns of looking after the narcissist (seeing the sad child within them), prioritising them and being overly self-sacrificial.

What actually happened when you met that exciting person was that your unconscious was doing the choosing. The narcissist’s cold energy was reminiscent of your emotionally unavailable parent/caregiver and your unconscious was grabbing at one more chance to resolve the problem or ‘get love from that parent’.   

A number of factors keep you in place including:
  • you are trauma bonded; the narcissist is the cause and the cure – only when the narcissist is approving can you feel calmed
  • your ‘hopeful self’ is in action
  • a dependent personality as a pre-existing state, normally due to narcissistic parenting
  • lowered self-esteem and confidence as a pre-existing state or as a result of the abuse  
  • an empathic drive to heal the narcissist and make them happy
  • cognitive dissonance – the tension of two opposing views – the brain takes the easy route – ‘she/he’s OK really’ and stays in abuse
  • lack of self-love – your abandonment schema is heightened by the narcissist
  • Negative blocking beliefs – ‘Who else will have me?’ ‘Men/women don’t find me attractive’ etc
  • a desire to re-experience your partner as they were in the heady days of the love bombing phase and how way they made you feel about yourself
  • you are good at ‘splitting’ – forgetting the bad behaviours and ploughing on – a defence mechanism you would have used from childhood  
  • your supertraits (agreeableness, cooperativeness, relationship investment traits)

Narcissists are good at creating a feeling of safety and often offer a comfortable standard of living – all of these and the above are hard to leave.  

All the while that a person is in a relationship with a narcissist the psychological damage will be accumulating, often outside of that person’s awareness, even in a short relationship.

Especially after a sudden and traumatic break-up with a narcissist, the person can experience post-traumatic symptoms. The relationship led to dysregulated oxytocin and dopamine, leaving the person with intense cravings for the narcissist in the aftermath – a connection is required to keep from going into withdrawal. Thoughts follow to make sense of feelings and behaviour; hence we see, ‘but I love him’, ‘who is he with now? ‘are they better than me?’, ‘I will contact him/her just this once’.  

Other impacts of NAS can include suicidal ideation, insomnia, major depression, a core belief of ‘not good enough’ and a deadening of hope and joy for years afterwards.


Other impacts may include:

  • Do you feel essentially defective and toxic at your very core?  

  • Do you worry that you are narcissistic?

  • Do you experience guilt at a level that is pervasive and uncomfortable?

  • Do you fear that you will pass on your ‘toxicity’ on to your children?

  • Do you have a sense of never being good enough?

  • Do you have a pervasive sense that someone is angry with you, that you have done something wrong, that it’s ‘your fault’?

  • Do you feel like you are always being watched and judged?

  • Do you feel that people won’t like you if they really get to know you?

  • Do you have a sense of your own power and ability to control your life, or do you recognise learned helplessness?

  • Do you find it hard to take a long-term view of your future, or seem pretty certain that if you experience abundance, success, happiness, something will go wrong or come out of the blue to take it all away?

  • If someone offers a compliment…if someone really likes you, does that feel more uncomfortable and pressurising than someone who is unpleasant and/or unavailable?

  • Do you have a sense that you don’t deserve success, love and so on?

  • Do you have a strong desire to ‘fix’ and heal people?

  • Do you have a sense of an internal battle? That parts of you are in conflict?

  • Do you self-sabotage in ways you don’t understand?  

  • Are you in touch with your gut instincts and act on them?

  • Do you experience self-doubt and find decision making difficult?

  • Do you feel that you don’t really know who you are?

  • What is your relationship with your emotions? Do you push them away or sit with the pain and let it pass through?

  • Do you tend to blame yourself?

  • Do you have healthy boundaries?

  • Do you suppress your shadow side in order to prove that you are ‘good’ or not who the narcissist said you are?

  • Do you find certain looks, comments or incidents trigger you into utter emotional and physical dysregulation or a rigid thinking style full of ‘shoulds’ and ‘musts’?  

  • If you are a scapegoat, can you see how you are living down to the expectations of the role, and coming to believe that you really are what the narcissist needs you to be?

  • Are you in the grip of an addiction or compulsive behaviour?

  • Do you find that you are constantly drawn to and attractive to people who are ‘quirky’, ‘weird’ or mentally ill? You feel more comfortable with these people.

  • Have you come to see any financial assistance from your parents as the only true measure of their love? Things have more value than people.    

  • In relationships or friendships, do you feel you need to do all the work to make sure that others are happy?

  • Are you overly-controlling in relationships?

  • Are your relationships and friendships tinged with a lack of trust and perceived abandonment?  

  • Do you long for contact with people but when it comes you feel it as overwhelming and destabilising.

  • Do you feel like you don’t fit anywhere? Working in offices or being in groups is stressful; knowledge of how to behave in these environments seems beyond you and you worry about the outcome.

  • Do you veer between thinking you are very special and, alternately, deservedly at the bottom of the tree?

  • Do you have a strong outer critic – you rage at others for their imperfections and perceived transgressions?

  • When you argue with a partner or friend, do you believe in that moment that they are all bad, rather than hold the view that they are good and bad?

  • Are you deeply uncomfortable at the idea of criticism?

  • Are you assertive or do you equate assertiveness with conflict?

  • Do you have a sense of a blockage in your throat when it comes to being assertive?

  • Are you an exhausted and perfectionist workaholic, unable to give yourself credit and suffering with imposter syndrome?  

  • Do you fear success as much as you fear failure?

  • Do you find it hard to give and receive love at a deep level?

  • Are you confused about how much ‘love’ you should offer another person? You are not used to the love you have to give being received well.

  • Do you feel that you will be a burden if you ask for help or express your needs?  

  • Have you been single for years – lost faith in the possibility of a healthy relationship, perhaps not even knowing what real love and a healthy relationship looks like? Deep down you don’t feel that you are attractive enough or deserving enough to have what others achieve with ease.

  • Do you have a physical condition – especially a Musculo-skeletal disorder or thyroid disorder?   

  • Do you ‘scapegoat’ a part of your body – singling it out for a special hatred, and you have no real compassion for or connection with your body overall?
Copyright Lorna Slade 2017-2024
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