Please don't tell us that the Narcissist "means well" or "didn't mean to hurt us at all". Please don't patronize us by telling us that we exaggerate (we had enough of this 'gaslighting' from the Narcissist as it is), that we live in the past too much (the Narcissist is a canker that may fester forever under our skin), or that we should simply "get over it". Believe me, if we knew how to get over it, we would!
Aside from the three main categories for those suffering PTSD (as listed in the excerpt below), I believe that victims of narcissistic abuse generally fall into two coping patterns; the first (and perhaps most prevalent) is the chronic 'fixer' who takes the role of the overachiever/doormat and always blames him/herself for everything that goes wrong, and the second is the chronic 'rebel'; the underachiever who embraces (and possibly invites) disaster as a way to live up to the ingrained 'loser image' that the Narcissist has painted.
What do victims of Narcissistic Victim Syndrome look like?
(excerpt from: The Roadshow for Therapists)
Therapist need to be seriously aware that narcissism is a very complex disorder that creates a lot of suffering, both to the person who has the disorder, and to those people who have to live with the disordered narcissistic behavior on a daily basis. When I speak of narcissistic abuse, (abuse that can lead to Narcissistic Victim Syndrome), I am speaking about a form of abuse that is very insidious. What I mean by insidious is that the abuse is covert, cunning and often indirect. This form of abuse is often carried out in a subtly and clandestine manner, because narcissists go to great pains to avoid being observed publicly as being abusive. This Dr. Jekyll and Mr. Hyde behaviour of the narcissist (loving one minute and totally enraged the next) can inflict great harm on the victim. Understandably, the fear, distress, confusion, inner turmoil, and chaos that they experience leaves them "walking on eggshells" in order to avoid further conflict with the narcissist. The effect on the victim over time can be very crippling indeed. I liken narcissism to a parasitic worm that manages to penetrate under the skin, where it is out of the sight of witnessing eyes, but is free to injure or consume its host slowly, leaving trauma or disease in its wake. By the way, the narcissist can manage to live on inside the victim even after they manage to escape; it is as if their "seed" goes on.
However, when we speak of Narcissistic Victim Abuse, we are speaking of an abuse that has been caused by someone with a personality disorder, and more often than not, their personality disorder has not been medically diagnosed, therefore the narcissistic individual goes undetected in society (i.e. in the home, the work-place, in organizations, in social settings etc.). It is vital to understand that narcissistic personality disorder is a serious mental disorder in which people have an inflated sense of their own importance, and a deep need for attention and admiration. The narcissist believes that they are superior to others, and have little regard for other people’s feelings, regardless of whom they are (i.e. spouse, children, parents, siblings, friends, colleagues, peers etc.). Other people are merely object there to serve their every need as narcissistic supply, and they will use every form of abuse, without guilt, empathy or conscience, in order to make sure that their needs are served.
Are these clients likely to come into the therapy room and say "I am the victim of narcissistic abuse"? The answer is, absolutely not? They will look like any other client coming into your therapy room for the very first time. They are probably most likely to bring in an issue that is quite mundane and recognizable; such as, they are feeling depressed, having panic attacks, or the feeling that they cannot cope. They have no idea that they have been living in a "war zone" with a narcissistic personality in command (either in the past or in the present). However, you, as the therapist, do not need to be afraid that you will not be able to cope with this syndrome. If you have completed your training, then you should have all the skills necessary to work with this syndrome. Armed with knowledge of narcissistic abuse, and practical skills of working with trauma, you will become a life-line to any victim of narcissistic abuse.
Like all clients coming into therapy, they have a story to tell; therefore they need someone to become an active listener, and to validate what has happened to them. To my mind, it is the validation of the person’s experience that is vital from the very beginning. These clients are not mad, however, frequently they appear highly strung or nervous, and their levels of fear may be high, while their level of self-esteem is low. Often they present with obsessive compulsive behaviours, phobias, panic attacks, so at times they may actually feel that they are going mad. They may experience insomnia, and may have underlying eating disorders, so you may notice they are either under weight (as a means of having some control), or overweight (as a result of eating to self-comfort).
You will find yourself working with emotions involving shock, anger, fear, and guilt. Often the victim will be suffering from Post Traumatic Stress Disorder (PTSD), or Complex Post Traumatic Stress Disorder; Symptoms of PTSD are often grouped into (one of) three main categories:
1. Re-living (flashbacks, hallucinations, nightmares etc),
2. Avoiding (people, places, thoughts, loss of interest etc),
3. Increased Arousal (excessive emotions, problems relating, difficulty in sleeping and concentration, outbursts of anger, anxiousness, panic attacks etc).
You may also notice that your client is inclined to "dissociate" while you are talking to them. That is, it seems as if the client is tending to "compartmentalize their experience."; in so doing, they may appear to be detached from their emotions, body, or immediate surroundings, this experience is called derealization."