Toxic Trauma Bond or Narcissistic Abuse?
Today, I’m going to explain the symptoms, risks, and treatments associated with intimate partner violence as it's all around us and knowing more about it can save you, your friend, your family member, or co-worker’s life so please pay attention! Intimate Partner Violence (IPV) encompasses physical, sexual, and psychological harm by a current or former partner or spouse. It remains a significant public health issue globally and within the United States. Our emergency services are often frequent utilizers of interacting and being present with individuals with these traits. Research indicates IPV costs the world 1.5 trillion dollars. Below are evidence-based statistics highlighting the prevalence and impact of IPV on us individually:
Global Statistics
I want to preface that I believe these statistics are skewed under as our society greatly shames victims and does not support them. Additionally, the criminal system is arduous and challenging to navigate for those who are fearful of the system. many do not report this information. It's private and complex, therefore men won’t be reporting as often as women just knowing more about their personalities.
Prevalence Among Women: Approximately 30% of women worldwide aged 15 and older have experienced physical and/or sexual IPV in their lifetime.
Regional Variations:
Africa: 36.6%
Eastern Mediterranean: 37%
Europe: 25.4%
South-East Asia: 37.7%
The Americas: 29.8%
East Asia: 24.6%
Homicides: In 2023, an average of 140 women and girls were killed daily by a partner or relative, totaling approximately 51,100 deaths globally. Most likely more when contributions of suicides secondary to mental health decline are also considered.
United States Statistics
Lifetime Prevalence:
Women: 41% have experienced contact sexual violence, physical violence, and/or stalking by an intimate partner.
Men: 26% have experienced similar forms of violence. Men historically do not come forward to speak about their adversities as often as women due to our culture. Our culture is hopefully changing. For more stories and statistics please see https://mankind.org.uk/survivors-stories/
Annual Incidence: In 1998, approximately 876,340 violent crimes were committed against women by current or former spouses or boyfriends. citeturn0search24
Homicides:
In 1999, 1,218 women and 424 men were killed by an intimate partner.
In 2005, these numbers were 1,181 females and 329 males.
Injury Leading Cause: In 1992, domestic violence was the leading cause of injury for women aged 15 to 44, surpassing rapes, muggings, and car accidents combined. citeturn0search24
Dating Violence: 22% of high school girls and 32% of college women reported experiencing dating violence in a 2000 study.
Stalking:
1 in 6 women (15.2%) have been stalked during their lifetime.
1 in 19 men (5.7%) have experienced stalking.
Health Consequences
Mental Health: Victims of IPV are at increased risk for depression, post-traumatic stress disorder (PTSD), anxiety, and suicidal behavior.
Physical Health: Injuries commonly include contusions, lacerations, fractures (especially of the head, neck, and face), and traumatic brain injuries.
Reproductive Health: Women experiencing IPV have a higher risk of unintended pregnancies and sexually transmitted infections, including HIV.
These statistics underscore the pervasive nature of intimate partner violence and its profound impact on individuals and societies.
Many people do not realize that intimate partner violence is often due to someone who is not mentally well or was not taught healthy love. They are relying on their relationships to get their needs met instead of their own efforts, failures, and acceptance of who they are. Therefore when they are getting caught or close to being found out, they will avoid, distract, and withdraw in an effort to protect their egos. This can be especially challenging when you have a partner who is an eternal optimist and codependent, with someone who is essentially preoccupied or unable to meet their needs.
This is why having a specialized trained therapist is essential to prohibit more harm as they want to go to therapy to appease their partner, to one up the other partner and beat them in therapy, or they just want the attention?
Narcissistic abuse is a pattern of manipulative, controlling, and emotionally harmful behaviors enacted by an individual with narcissistic traits or narcissistic personality disorder (NPD).
From an evidence-based perspective, narcissistic abuse is often examined through the lenses of attachment theory, trauma-informed care, interpersonal neurobiology, and cognitive-behavioral frameworks and is formed throughout a person’s development. Research on emotional abuse, coercive control, and the impact of narcissistic traits in relationships provides key insights on risk, treatment, and outcomes. Let’s check it out together as it's a vital part of keeping our children, families, communities, companies safe!
Recognizing Narcissistic Abuse in Couples Counseling
The spectrum of codependency can be so encompassing, it's hard to tell when it's actually narcissistic abuse, versus an unhealthy individual or misaligned/incompatible relationship that doesn’t know when to leave? If you identify with struggling with any of these aspects in your relationship, please at a minimum seek out a CODA.org meeting to see what you can do right now.
A skilled couples therapist can identify narcissistic abuse through specific behaviors and relational patterns, however, it can be a challenge as the abuser may no longer seek therapy if they are identified as such and or feel they are being judged, which does not go well with their ego. Additionally, individuals with those traits or those diagnoses, often surround themselves with more dependent personality types, which is why they need treatment the most and may not be able to go without their partner’s approval.
6 Key relational patterns in Unhealthy Relationships aka NARCISSISTIC Abuse:
1. Manipulation & Gaslighting
The abusive partner distorts reality, causing the other to doubt their perceptions or memory.
They deny past statements or actions, even when confronted with evidence.
The victim may feel confused, anxious, or constantly second-guess themselves, which keeps them in fight and flight mode, high cortisol levels.
2. Lack of Empathy
The narcissistic partner struggles to acknowledge or validate their partner’s emotions.
Emotional pain or distress is dismissed, minimized, or used against the partner.
They show little interest in mutual emotional connection.
3. Cycles of Idealization & Devaluation
The relationship follows an intense honeymoon phase where the narcissistic partner is charming and affectionate, followed by devaluation through criticism, coldness, or blame.
Over time, the victim experiences emotional whiplash, trying to regain the initial affection.
4. Projection & Blame-Shifting
The narcissistic partner refuses to take responsibility for their actions.
They accuse their partner of the very behaviors they exhibit (e.g., calling their partner "manipulative" when they themselves manipulate).
Conflict resolution is one-sided, with the victim often apologizing or adjusting to keep the peace.
You do not see a give and take dynamic in the relationship, with equal effort in and equal effort out.
5. Emotional Withholding & Punishment
Silent treatment, passive-aggressive behaviors, or withholding affection as a form of control.
Punishment for perceived slights, even if unintentional.
The partner feels like they are "walking on eggshells."
Super scary for the inner child, which often develops managers and firefighter responses.
6. Controlling & Boundary Violations
The narcissistic partner dictates aspects of the victim’s life (finances, social life, appearance, parenting style).
They disregard boundaries and personal autonomy.
Efforts to set limits are met with anger, guilt-tripping, or threats with the belief they are being abandoned, rejected, or found to be defective.
As you may guess, this is hard to see without knowing a couple very intimately. Close friends, colleagues, neighbors, and sometimes family can see the signs but the person may not be able to leave due to the toxicity of the relationship. They may hide these signs or withhold sharing with friends and family out of shame, which is why a neutral objective person can shed light on the intricaces. if presented proactively. I also often see how couples often influence each other and learn from one another, therefore one may have controlling behaviors, while another may lack empathy
How a Mental Health Couples Counselor Can Help?
Assess for Power Imbalances: A couples therapist will look for patterns of coercion, intimidation, and emotional control. If there is true NPD and IPV risk, it is counterindicated to do couples therapy and the therapist will refer them both to their individual therapists. This is why I recommend utilizing Gottman Method Couples protocol for safety, they are well versed in the intimate partner violence components to assess for appropriateness of services.
Validate & Educate both parties on effective communication strategies: Victims often feel confused or blame themselves, therefore turning away someone when they finally started therapy can be very hard for the partner trying to make it work. A trauma-informed approach provides validation and psychoeducation to all parties on the dynamics of intimate partner violence and codependency personalities, they may not be aware within themselves.
Encourage Boundaries & Autonomy: A good therapist will help the victim recognize their right to autonomy and set firm, healthy safe boundaries.
Screen for Trauma Responses: Victims often develop symptoms of complex PTSD (C-PTSD), anxiety, or depression, which often comes with comorbid diagnosis (i.e. substance & behavioral misuse, eating or body dysphoria, avoidance strategies with work) that need to be addressed and treated in order for them to be able to establish their autonomy.
Always Recommend Individual Therapy: If the abuse is severe, couples therapy may not be appropriate, and individual therapy for the victim (and sometimes the narcissistic partner) may be encouraged.
Finding Help for Yourself Is the Most Important Protector!
When working with a couples therapist where a partner identifies as having narcissistic traits or NPD, and would like to proactively work to assess, validate, educate, and empower the victim while maintaining ethical considerations with the co-partner who is seeking services allows healing and closeness. Many people are aware they have a parent or genetic component with these diagnoses and would like to mitigate the harms, therefore I will provide you some suggestions on evidence-based strategies to guide your approach:
1. Assess for Narcissistic Abuse Dynamics
As a Gottman Method Couples therapist, I meet with the couple together and then individually to assess for personality traits that could be counter-indicated with couples counseling. I also use structured tools such as the Psychological Maltreatment of Women Inventory (PMWI) or Narcissistic Personality Inventory (NPI) for screening.
Observe relational patterns:
Power Imbalances: Who dominates conversations? Who dismisses or invalidates their partner’s concerns? Does the conversation always turn towards their favor and topic?
Control & Gaslighting: Does one partner frequently distort reality, shift blame, or deny experiences?
Trauma Responses in the Victim: Does the partner show hypervigilance, emotional dysregulation, or fawn responses (over-accommodating to avoid conflict)?
2. Validate & Name the Experience Without Directly Diagnosing the Partner
Partners of narcissistic abuse often feel confused, ashamed, or isolated due to gaslighting. Your role is to help them trust their reality again.
Instead of labeling the abusive partner as "a narcissist," reflect patterns of behavior:
Control symptoms based off of shame or feelings of defectiveness: criticism, blaming anger, irritation, violence, righteousness, explaining, interrogation, accusing, lecturing, pouting, silence, tantrums, hurt, withholding, crying, threatening, lying,
Caregiving is compliance, giving in, going along, pleasing, giving up, pulling for approval with niceness, praise, seductiveness, and teaching.
“You’ve shared that when you express hurt, you’re met with blame or silence. How does that affect your sense of self in this relationship?”
“It sounds like when you set a boundary, it’s met with punishment or withdrawal. That can create a deep sense of anxiety.”
“Look at how your partner is presenting, they look checked out (dissociated or flooded) and just going along to make you happy, does that feel like love to you?”
3. Educate on Coercive Control & Emotional Abuse
Use psychoeducation to describe behaviors in a neutral but firm way:
Explain the cycle of idealization, devaluation, and discard related to mental health symptoms versus trauma within the relationship.
Controlling behaviors are often couched under Narcissistic Behaviors and Caregiving behaviors are often couched under Empath Behaviors
Introduce concepts like gaslighting, emotional withholding, and blame-shifting.
Help them both see that these behaviors are about controlling their own shame cycles, not love.
4. Introduce Self-Assessment & Reality Testing
Encourage the couple to track their own feelings and needs rather than focusing on their partner’s reactions.
Reminding them that this is often unconscious so making themselves conscious is half of the battle.
Many partners do not know their own feelings and needs as they are constantly ensuring the happiness of the other partner and therefore do not assert their feelings.
Provide journal prompts:
“How do I genuinely feel in this relationship?
"When do I feel safe & supported in this relationship?"
"How do I feel after conversations with my partner—more clear or more confused?"
"Am I making decisions out of fear or genuine desire to make myself and my partner happy?"
“How do I gauge my own happiness?”
5. Encourage Boundaries & Emotional Autonomy
Help both parties identify what is and isn’t acceptable in the relationship.
Establish boundaries and emotional autonomy even in therapy, utilizing IFS parts. Therapists are permitted to lean into authenticity and if the time doesn’t feel balanced, they can assert boundaries to ensure equitability in the therapeutic session. Mirroring and demonstrating appropriate boundaries of self care and self worth to victims.
Teach boundary-setting techniques:
Broken Record Technique: “I understand you feel that way, but I need space right now.”
Grey Rocking: Emotional & physical detachment when dealing with manipulation (limiting reactions).
Time & Space Boundaries: Encouraging breaks after conflict instead of immediate forced resolution.
Taking care of yourself is the most important aspect of emotional autonomy. Self-worth is how they harness their power over a partner, which is why we focus on building victims up.
6. Address Resistance from the Narcissistic Partner
Narcissistic individuals may react with defensiveness, stonewalling, or charm in an effort to avoid or control the situation.
Establish firm session rules:
“Both partners will have equal space to speak without interruption.”
“We focus on personal accountability rather than blame.”
Teaching about Inner Child work, from a shame based belief brings compassion and curiosity to the lens of co-dependency and we don’t have to be so critical, defensive, controlling, or caregiving.
If the abusive partner refuses to engage constructively in personal accountability- individual therapy is more appropriate and termination of couples is indicated.
7. Safety Planning for Clients Who May Be at Risk
If the victim is experiencing intensified coercion, isolation, or threats, individual safety planning is essential.
Develop a safe location and plan for the client to go for a cooling down period.
Assess for psychological, sexual, financial, and digital control.
Offer referrals for individual trauma-informed therapy, intimate partner violence specialized services, codependent anonymous meetings and referrals.
Personal Reflections and Resources
If a narcissistic partner continuously undermines therapy, refuses accountability, or escalates abusive behaviors, couples counseling is not safe or effective.
In such cases:
Suggest individual therapy for the active client who is engaged to rebuild self-trust, self-worth, and resilience.
Offer resources for emotional abuse recovery, such as The National Domestic Violence Hotline or books like The Gaslight Effect by Dr. Robin Stern.
