Examine individual changes

'{{short description|Abuse by a narcissist, particularly emotional abuse in parent-child and adult-to-adult relationships}} '''Narcissistic abuse''' is a hypernym for the psychological, financial, sexual, and physical abuse of others by someone with [[Narcissism|narcissistic]] traits or suffering from [[Narcissistic Personality Disorder|narcissistic personality disorder (NPD)]]{{Citation needed|date=September 2020}}. Narcissistic Personality Disorder has been referred to as a mental health condition by several medical research and journal organisations, such as, for example, the [[United States National Library of Medicine]], [[Mayo Clinic]], and [[Cochrane (organisation)|Cochrane]] medical journals.<ref>{{Cite journal|title=Narcissistic Personality Disorder in Clinical Health Psychology Practice: Case Studies of Comorbid Psychological Distress and Life-Limiting Illness|year=2017|publisher=United States National Library of Medicine|pmc=5819598|first1=E. L.|last2=Ennis|first2=N.|last3=Pereira|first3=D. B.|journal=Behavioral Medicine (Washington, D.c.)|volume=43|issue=3|pages=156–164|doi=10.1080/08964289.2017.1301875|pmid=28767013}}</ref> <ref>{{Cite web|last=|first=|date=|title=Narcissistic Personality Disorder|url=https://www.mayoclinic.org/diseases-conditions/narcissistic-personality-disorder/symptoms-causes/syc-20366662|url-status=live|access-date=1 September 2020|website=|publisher=Mayo Clinic}}</ref> <ref>{{Cite web|last=|first=|date=|title=Condition - Narcissistic Personality Disorder|url=https://data.cochrane.org/concepts/r4hp3qkyhfbk|url-status=live|access-date=1 September 2020|website=|publisher=Cochrane}}</ref>{{Relevance inline|date=September 2020}} == Types of abuse == The concept of narcissistic abuse, based on [[Alice Miller (psychologist)|Alice Miller]]’s observations in ''The Drama of the Gifted Child'' based on a mother-son relationship, has grown to be used in reference to all kinds of relationships. There is little evidence to show psychological, financial, sexual or physical abuse manifests itself differently or more often in people with narcissistic traits or narcissistic personality disorder.<ref>{{cite book |last1=McMurran |first1=Mary |last2=Howard |first2=Richard |title=Personality, personality disorder and violence: An evidence based approach |date=2009}}</ref> === Psychological abuse === {{main|Psychological abuse}} === Financial abuse === {{main|Economic abuse}} === Sexual abuse === {{main|Sexual abuse}} === Physical abuse === {{main|Physical abuse}} == Controversy == Historically, narcissistic abuse is based on Alice Miller’s model of the [[narcissistic parent]], laid out in ''The Drama of the Gifted Child'', and taken to apply to relationships beyond parent-child. <ref>{{cite book |last1=Miller |first1=Alice |title=The Drama of the Gifted Child |date=1979 |page=xvii |edition=The Search forthe True Self}}</ref> === Stigma of NPD (narcissistic personality disorder) === People suffering from personality disorders, including, but not limited to, narcissistic personality disorder, face stigma in everyday life, including from themselves, society, and even clinical situations.<ref>{{cite journal |last1=Sheehan |first1=Lindsay |last2=Nieweglowski |first2=Katherine |last3=Corrigan |first3=Patrick |title=The Stigma of Personality Disorders |journal=The Stigma of Personality Disorders |date=2016|volume=18 |issue=1 |page=11 |doi=10.1007/s11920-015-0654-1 |pmid=26780206 |s2cid=23014378 }}</ref> === Clinical stigma === Clinical or provider stigma is the disapproval of, or discrimination against a person based on perceivable patient characteristics that serve to distinguish them from other patients. In an opinion piece by psychologist Erika Penney, Brittany McGill and Chelsea Witham titled "Therapist Stigma towards Narcissistic Personality Disorder: Lessons Learnt from Borderline Personality Disorder", they propose the link to the stigma of BPD and NPD. Extensive research on the stigma against borderline personality disorder has been done but the same has not been done for narcissistic personality disorder.<ref name=penney /> This is significant given that clinical stigma impacts the treatment outcome of patients.<ref>{{cite journal |last1=Ferguson |first1=A |title=Borderline personality disorder and access to services: A crucial social justice issue |date=2016}}</ref> It is a common response for therapists to use [[countertransference]] such as retaliation or devaluation against common narcissistic symptoms and behaviours.<ref>{{cite journal |last1=Behery |first1=W |last2=Dieckmann |first2=E |title=Understanding and treating pathological narcissism |journal=Schema Therapy for Pathological Narcissism: The Art of Adaptive Re-parenting |date=2013 |page=285}}</ref> Such responses are likely to reenact familiar behavioural patterns and reinforce unhealthy coping mechanisms in patients. Common countertransference to narcissistic behaviour shown in table below. {| class="wikitable" |- ! Patient Experience !! Observable Behaviour !! Common Therapist Countertransference |- | Overcompensation to avoid a sense of vulnerability. || Idealisation of the self or expression of superiority. || Admiring, disengaged, bored, resentful,inadequate, or frustrated. |- | Avoidance of uncomfortable emotions. || Avoidance of emotions with self-stimulating or self-soothing activities (e.g., gambling, alcohol, risk-taking, grandiose fantasising, binge eating, or excessive dedication to work). || Anxious, critical, disengaged, frustrated, helpless, overwhelmed, or feeling stuck. |- | Activation of rage when vulnerability threatens to surface || Rage and uncontrolled aggression. || Anxious, afraid, overwhelmed, ‘walking on egg-shells,’ confused, mistreated, angry, resentful, urge to retaliate, or urge to withdraw. |} The de-stigmatization of mental health disorders is important discourse for clinical psychologists and the widespread use of highly stigmatizing language may promote avoidance of further research and discrimination against people with NPD.<ref name=penney /> === Self stigma === Self stigma is the process in which a person internalizes the stigma and stereotypes around them by applying them to the self<ref>{{cite book |last1=Bathje |first1=Geoff |title=Encyclopedia of Critical Psychology |chapter=Self-Stigmatization |year=2014 |pages=1713–1716 |doi=10.1007/978-1-4614-5583-7_395 |isbn=978-1-4614-5582-0 }}</ref>. This can lead to problems with self-esteem, depression and identity<ref>{{cite journal |last1=Sheehan |first1=Lindsay |last2=Nieweglowski |first2=Katherine |last3=Corrigan |first3=Patrick |title=The Stigma of Personality Disorders |journal=Current Psychiatry Reports |date=2016 |volume=18 |issue=1 |page=10|doi=10.1007/s11920-015-0654-1 |pmid=26780206 |s2cid=23014378 }}</ref>. Research has shown that the public is less likely to think individuals with personality disorders need professional help<ref>{{cite journal |last1=Furnham |first1=A |title=Mental health literacy and borderline personality disorder (BPD): What do the public "make" of those with BPD? |date=2015}}</ref> and instead hold the belief that those with personality disorders should be able to exhibit control over behaviours caused by said disorders<ref>{{cite journal |last1=Aviram |first1=RB |title=Borderline personality disorder, stigma and treatment implications. |journal=Harvard Review of Psychiatry |date=2006|volume=14 |issue=5 |pages=249–56 |doi=10.1080/10673220600975121 |pmid=16990170 |s2cid=23923078 }}</ref>, combined with the clinical belief that people with Narcissistic Personality Disorder are untreatable.<ref>{{cite journal |last1=Lewis |first1=B |last2=Appleby |first2=L |title=Personality disorder: The patients psychiatrists dislike |journal=The British Journal of Psychiatry : The Journal of Mental Science |date=1988 |volume=153 |pages=44–9 |doi=10.1192/bjp.153.1.44 |pmid=3224249 }}</ref> Low public mental health literacy has been linked to low treatment-seeking from those suffering from disorders the sufferers themselves stigmatize<ref>{{cite journal |last1=Corrigan |first1=PW |title=The impact of mental illness stigma on seeking and participating in mental health care |journal=Psychological Science in the Public Interest : A Journal of the American Psychological Society |date=2014 |volume=15 |issue=2 |pages=37–70 |doi=10.1177/1529100614531398 |pmid=26171956 |s2cid=2942361 }}</ref>. Narcissistic personality disorder has notably low treatment-seeking behaviour, most often seeking treatment for less stigmatized [[comorbid]] issues.<ref>{{cite journal |last1=Dhawan |first1=Nikhil |last2=Kunik |first2=Mark E |last3=Oldham |first3=John |last4=Coverdale |first4=John |title=Prevalence and Treatment of Narcissistic Personality Disorder in the Community: A Systematic Review" |journal=Comprehensive Psychiatry |date=2010 |volume=51 |issue=4 |pages=333–9 |doi=10.1016/j.comppsych.2009.09.003 |pmid=20579503 }}</ref> ==See also== {{Portal|Psychology}} {{Columns-list|colwidth=30em| * [[Abusive power and control]] * [[Atlas personality]] * [[Child abuse]] * [[Flying monkeys (psychology)]] * [[Healthy narcissism]] * [[Self psychology]] }} ==References== {{Reflist|2}} ==Further reading== * Angela Atkinson, Jillian Tindall, ''Navigating No-Contact with a Narcissist: A Recovery Roadmap for Survivors of Narcissistic Abuse'' (2017) * Patricia Evans, ''Controlling People: How to Recognize, Understand, and Deal with People Who Try to Control You'' (2003) * Alice Little, ''No Contact - The Final Boundary: Surviving Parental Narcissistic Abuse'' (2016) * Alice Miller, ''The Drama of the Gifted Child'' (1979) * Steven Stosny, ''Treating Attachment Abuse'' (1995) * Estela Welldon, ''Mother, Madonna, Whore: The Idealization and Denigration of Motherhood'' (1988) * Shahida Arabi ''POWER: Surviving and Thriving After Narcissistic Abuse: A Collection of Essays on Malignant Narcissism and Recovery from Emotional Abuse Paperback'' (2017) {{Narcissism}} {{Abuse}} {{DEFAULTSORT:Narcissistic Abuse}} [[Category:Narcissism]] [[Category:Abuse]] {{Domestic violence}}'