Understanding The Trauma: PTSD From Emotional Abuse

Post-Traumatic Stress Disorder (PTSD) is a condition traditionally associated with veterans of war. However, people can also develop PTSD when they experience emotional abuse. The term PTSD may conjure the image of a person in distress and struggling to re-acclimate to civilian life. Many of our nation’s veterans have experienced severe physical and emotional trauma, but PTSD stemming from emotional abuse can be just as valid and challenging to live with.

PTSD from emotional abuse and mental health: An overview

While this image of a military person with PTSD may be accurate, it is a narrow view of PTSD and fails to account for the innumerable circumstances that can cause PTSD. PTSD can occur in those who are emotionally abused, as well. The human body was not designed to withstand an extended period of emotional abuse, intense stress, or intense fear—this includes reactions to verbal abuse and other types of emotional trauma as well as physical harm. Thus, it’s possible to develop the physical, mental, and emotional symptoms of PTSD in response to any one of these situations, including emotional abuse. 

What is PTSD?

Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder that may occur when someone witnesses or experiences a traumatic event. Physical abuse may or may not have been involved. This can include war, an accident, a natural disaster, rape, sexual assault, sexual abuse, verbal abuse, a car accident, physical trauma or abuse, or any other traumatic experience either witnessed as a bystander or experienced as a survivor.

PTSD can create a wound in the minds of its survivors, as the stress of the event may be overwhelming for the mind. PTSD throws up a mental file that slots the event away to be deconstructed and understood later. This is sometimes described as going into fight or flight mode, and when that happens, a person’s brain releases stress hormones to help the physical body deal with the trauma or abuse. Although fight or flight can be an effective coping mechanism, it may also cause distress. This is because the brain may develop PTSD triggers, which cause the individual to recall the event down the road. When this happens, the fear and distress brought about by the abuse or trauma are re-lived and can have significant consequences on one’s mental health.

Since triggers can be anywhere and PTSD episodes may be violent or marked by extreme terror, people can have intense episodes while in public, at school, or even alone at home. Thus, PTSD is often exacerbated by the fear of experiencing a PTSD episode in an unsafe place or experiencing the judgment of people nearby when a PTSD 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. This can also cause social withdrawal, difficulty in interpersonal relationships, emotional isolation, dissociation, self-blame, or even physical health problems. Other mental health conditions can develop as a result of PTSD.

In both mild and severe cases of PTSD, it’s important to seek professional medical advice and treatment. A licensed therapist can help a person move past PTSD troubling memories, address negative feelings, and develop skills to help them cope as a part of their PTSD treatment plan. 

Can you develop PTSD from emotional abuse?

Yes, it’s possible to develop PTSD after experiencing emotional abuse. This is true regardless of someone’s gender, age, socioeconomic background, or any other identifier. It's possible to experience both PTSD and C PTSD or complex PTSD after emotional abuse. However, emotional abuse from PTSD may not follow the expected cycle. The form of PTSD commonly associated with emotional abuse is called "complex" or "compounding" because it displays PTSD symptoms related to a series of traumatic events, rather than a single event. Therefore, C PTSD results from ongoing trauma, such as emotional abuse, or prolonged exposure to traumatic, emotional experiences. 

Complex PTSD from Emotional abuse 

Complex PTSD (C PTSD) can manifest in unpredictable ways. For instance, someone with C PTSD following a car accident might avoid cars altogether or drive as quickly and recklessly as possible. People with C PTSD have often experienced abuse, neglect, and other forms of emotional trauma repeatedly, and this can have a significant effect on someone’s mental health and emotional well-being. 

Narcissism, trauma, anxiety, depression and emotional manipulation

Emotional abuse appears to go hand-in-hand with narcissism, whether the person with Narcissistic Personality Disorder is the perpetrator in the emotionally abusive relationship or the person experiencing the abuse. It has been suggested that NPD could be a result of some form of abuse.

PTSD stemming from emotional abuse, emotional trauma, anxiety, and depression are often intertwined, leading to a rather extensive diagnosis for some individuals. Even so, understanding that all these emotional disorders can be linked may help mental health professionals create a specific, targeted PTSD treatment plan. Such a plan can ease the symptoms of these related disorders and potentially halt a cycle of abuse and emotional distress.

Narcissistic abuse and PTSD: What's the correlation?

PTSD can be difficult to navigate when dealing with narcissistic abuse, particularly if your abuser is your romantic partner or someone close to you. You may lack support from your family or friends when embarking upon your healing journey, and the toll narcissistic abuse takes on its survivors can be substantial. Emotional abuse from narcissism often requires you to cut off contact entirely with your abuser to begin healing, and the resulting PTSD symptoms can take time to overcome.

Narcissistic abuse often involves something called "gaslighting," which essentially is a tool to convince a narcissist's subject that they are crazy or unworthy and that all perceived abuse is either imagined or deserved. Recovering from emotional abusers that use narcissistic abuse tactics is sometimes more complicated than processing a single traumatic event. In some cases, it may require a complete overhaul of the way an individual has come to think about themselves, the abuse they experienced, and their abuser.

Symptoms of PTSD from emotional abuse

According to the latest diagnostic and statistical manual (DSM-5), the symptoms of PTSD are far-reaching and can look different based on the cause of the trauma in question.

It is important to note, though, that a person with PTSD may also have other emotional symptoms (such as difficulty with emotional regulation) and even physical symptoms. According to the criteria of the DSM-5, without these four PTSD symptoms present for at least four weeks, a PTSD diagnosis is not usually relevant. Moreover, if these symptoms are present but daily life is not affected, then PTSD is not usually diagnosed.

Intrusive and paranoid thoughts from trauma

Intrusive thoughts from PTSD are unwanted and often have different themes. They might be thoughts about harming or abusing oneself or others, irrational fears, feelings of paranoia, or even flashbacks from the event itself. They may come during the day or in the form of chronic nightmares. These PTSD thoughts are often difficult to push away and may affect daily living and emotional well-being.

Avoidant behavior

Avoidant behavior is usually engaged to avoid triggering the symptoms from PTSD. You might avoid certain places around town, not listen to or watch certain songs or movies, or keep your distance from specific people to keep the symptoms of PTSD away. Avoidant behavior may make daily tasks difficult, as you cannot always avoid the triggers of PTSD. 

Persistent negative thoughts/feelings, depression, and anxiety

Negative thoughts, actions, and emotions in PTSD are not fleeting moments of sadness, anger, or frustration, but are instead persistent and ongoing that may negatively impact your ability to live your life. If you are experiencing PTSD, you may feel that no one can be trusted, that you are bad or evil, that you are unworthy of love, that everyone is out to get you, etc. Negative thoughts from PTSD can eventually lead to other problematic thinking patterns. This type of thinking can be common for those living with PTSD from emotional abuse.

Arousal/reactive symptoms from emotional abuse

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

Support and therapy for healing: Trauma therapy and other treatment options for PTSD recovery

There are several treatments available for PTSD. However, when people experience PTSD from emotional abuse, more extensive treatment may be required because the individual with PTSD is typically not working to recover from a single event, but from a cycle of abuse. Compounding trauma or abuse is not impossible to recover from, but it may demand a lot of introspection, rewiring, and healing.

How counseling can help in recovery and healing: PTSD from emotional abuse or trauma

Counseling is one of the most common treatments for PTSD, and a variety of PTSD support groups or talk therapy sessions can be an effective course of action for healing. One type of therapy that can be used to heal from PTSD is eye movement desensitization and reprocessing therapy (EMDR), but there can be many other options for PTSD as well. Peer-reviewed studies demonstrate that these forms of therapy can help defuse and redirect intense emotions, build self-esteem, teach coping skills and strategies to increase positive emotions, and help those who have undergone psychological abuse learn to nurture healthy relationships with others. 

In some severe cases, a physician may prescribe medication such as selective serotonin reuptake inhibitors (SSRIs) to help manage symptoms.

Online therapy and support with BetterHelp

Sometimes, people with PTSD from emotional abuse have trouble attending in-person counseling sessions. This is often because of the shame associated with the condition as well as reactive PTSD symptoms that can cause embarrassment in public. Online therapy is sometimes a feasible alternative because you can attend sessions from home. BetterHelp is one internet-based resource that offers professional treatment, daily tips, and high-quality sources of information about PTSD.  

The effectiveness of online therapy for improved mental health

For those concerned about the effectiveness of online therapy for treating PTSD, researchers have found some encouraging results. Some treatments for PTSD such as cognitive behavioral therapy (CBT) are now recommended in the form of online counseling. More studies are being conducted to evaluate the effectiveness of other therapeutic interventions delivered online such as Eye Movement Desensitization and Reprocessing (EMDR). Researchers have found that EMDR delivered online can be a successful way of treating PTSD as well as other mental disorders. It may be a viable option for your situation as well.