Can You Develop PTSD from Emotional Abuse?

By: Corrina Horne

Updated February 07, 2020

Medically Reviewed By: Debra Halseth, LCSW

Content/Trigger Warning: Please be advised, the below article might mention trauma-related topics that include sexual assault & violence which could potentially be triggering.

Post Traumatic Stress Disorder is a condition typically associated with war, and very little else. The name itself conjures the image of a man in distress, coming home from war, and struggling to re-acclimate to civilian life. While this image may be true, it is a narrow view of PTSD and fails to account for the countless circumstances that can cause PTSD. While war certainly qualifies as an unbelievably stressful, traumatic experience, the human body was not designed to withstand any extended period of abuse, intense stress, or intense fear, and can develop the symptoms of PTSD in response to any one of these situations.

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What Is PTSD?

Post Traumatic Stress Disorder is an anxiety disorder that occurs when someone has witnessed or been a part of a violent event. This can include war, an accident, a natural disaster, rape, abuse, or any other form of assault, both witnessed as a bystander or experienced as a victim. PTSD creates something of a wound in the mind of its victims, as the stress of the event is far too much for the mind to fully comprehend and deal with. Instead, it throws up a file of sorts that slots the event away to be deconstructed and understood later. Although it is a coping mechanism, it can cause distress, because the brain may experience triggers, which then bring up the event, and the fear and distress brought about by the trauma are relived.

PTSD is a serious condition and can be debilitating for the people it affects. Because triggers can be anywhere and episodes can be violent or marked by extreme terror, people can have intense episodes while out and about, in the middle of school, or even while seated alone at home. So the condition is often exacerbated by the fear of experiencing an episode in an unsafe place or experiencing the judgment of people nearby when an episode occurs. Some people with PTSD may go on to develop agoraphobia for this reason, and may struggle to perform day-to-day tasks without assistance.

PTSD Symptoms

The symptoms of PTSD are far-reaching, and look different based on the cause of the trauma in question. The four core symptoms, though, are intrusive thoughts, avoidant behavior, persistent negative thoughts and feelings, and arousal and reactive symptoms. Without these four symptoms present for a period of at least one month, a PTSD diagnosis is not given. If these symptoms are present but daily life is not affected, PTSD is also not usually diagnosed. PTSD is a disorder that deeply and overwhelmingly affects a person's ability to cope and function.

Intrusive thoughts might be thoughts of harming oneself or others, irrational fears or feelings of paranoia, or even flashbacks from the event itself. Intrusive thoughts may come in the form of daylight-hour thinking, or may come in the form of chronic nightmares. These thoughts will likely be difficult to push away or stamp down and affect daily living.

Avoidant behavior is usually engaged in to avoid triggering the symptoms of PTSD. You might avoid certain places around town, avoid songs or movies, or avoid certain people in order to keep the symptoms of PTSD at bay. Avoidant behavior can also eventually wreak havoc on your life, as you cannot always avoid the triggers of PTSD, and cannot simply stop going to work, school, or the grocery store, which could all potentially trigger you.

Negative thoughts and feelings in PTSD are not fleeting moments of sadness, anger, or frustration, but are instead persistent, ongoing negative thoughts that negatively impact your ability to live your life. Some negative thoughts associated with PTSD include the notion that no one can be trusted, that you are bad or evil, that you are unworthy of love, or that everyone is out to get you. Negative thoughts in PTSD can eventually lead to paranoia and other problematic thinking patterns.

Arousal and reactive symptoms are best described as feelings or impulses that feel out of your control. Constantly having angry outbursts, for example, followed by feelings of remorse. Being easily startled or frightened is another reactive behavior, as is reckless behavior, such as engaging in deliberately dangerous stunts. These symptoms can function as a means of avoiding your experience, or can be an unconscious recreation of fear and adrenaline.

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PTSD From Abuse

PTSD can develop following abuse. Because abuse is often not a single event, but a recurring cycle of behavior, PTSD from abuse often does not follow the standard cycle, but instead falls into the category of "complex PTSD," or PTSD that stems from multiple traumatic instances, rather than just one. While someone with PTSD following a car accident might avoid cars altogether, or drive as quickly and recklessly as possible-or a back-and-forth of the two-people with complex PTSD are not reliving or working through a single event, but a compounding event that builds upon abuse, neglect, and trauma again and again.

PTSD from abuse often requires far more extensive treatment, as you are not working to recover from a single event, but from what can be a lifetime of abuse. Each trauma you have endured must be processed and healed from, so recovery can not only require an extensive period of therapy, but can require you to create strong, firm boundaries regarding your relationships with family, as family are often the source of abuse, and many people close to both of you will be unable to see the abuse and may not understand your perspective. Compounding trauma is not impossible to recover from, but does demand a lot of introspection, rewiring, and healing. For this reason, if it is possible, clients are encouraged to remove themselves from the source of the abuse during treatment, to make sure harmful thought patterns and experiences do not hinder the healing process.

Narcissism and Emotional Abuse

Unfortunately, emotional abuse seems to go hand-in-hand with narcissism, whether it is the person with Narcissistic Personality Disorder perpetrating the abuse, or experiencing it. It has been suggested that NPD is actually a direct result of some form of abuse, as the condition is not known to exist from infancy, nor is it known to develop without the presence of some type of abuse in one's past, whether that came from a parent, a caregiver, or a loved one. PTSD, emotional abuse, anxiety, and depression are often intertwined, leading to a rather extensive diagnosis for individuals. Fortunately, understanding that all of these disorders can be linked and related helps mental health professionals create a specific, targeted treatment plan that can ease the symptoms of all of the disorders-and hopefully halt a cycle of abuse and mental distress.

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In narcissistic abuse, PTSD can be difficult to navigate, particularly if your abuser is a partner or someone close to you or the people in your environment. You may not have the support of many people when embarking upon your healing journey, and the toll narcissistic abuse extracts from its victims is substantial. Emotional abuse from narcissism often requires you to cut off contact entirely from your abuser-or, in a case where eliminating contact is not possible, enacting severely limited contact-in order to begin the healing process. Narcissistic abuse often uses something called "gas lighting," which essentially is a tool to convince a narcissist's victim that they are crazy or unworthy, and that all perceived abuse is either imagined or deserved. Recovering from narcissistic emotional abuse is far more than processing a traumatic event; it requires a complete overhaul of the way you have come to think about yourself, the world around you, and your abuser.

Can You Develop PTSD from Emotional Abuse?

Yes. PTSD can absolutely come from emotional abuse. The form of PTSD most commonly associated with emotional abuse is called "complex" or "compounding" PTSD, as it displays symptoms from a cycling series of traumatic events, rather than a single, stark event. This makes the treatment for PTSD markedly more involved and difficult, as patients are required to work through what could be a lifetime of trauma, abuse, and reactive behaviors that have come to be seen as normal and expected, often creating a vicious cycle of abuse, freedom, and abuse. Although many people are able to break the cycle of abuse long enough to leave their abuser, if healing does not take place prior to the start of another relationship, they may fall back into an abusive relationship, as they are vulnerable to the type of manipulation employed by emotional abusers.

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PTSD is a complex disorder, borne of trauma, and may be perpetuated by a lack of healing from the initial source of trauma. Many clients experience their first trauma in childhood, at the hands of a parent, caregiver, or family member, and continue the cycle well into adulthood, moving from authoritative relationships to romantic relationships. If you have experienced emotional abuse or narcissistic abuse, reach out to a mental health professional to begin a treatment plan to heal from your abuse and develop healthier thought patterns about yourself, your life, and your abilities.


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