Narcissistic Abuse Therapy

The sign that brings people here

Almost everyone who comes to me after a relationship of this kind says some version of the same sentence: I no longer know whether the problem is me or them. That confusion is the signature of the hold. A difficult partner makes you angry. An abusive one makes you doubt your own mind.

It rarely starts that way. It starts with intensity, the feeling of having met someone unlike anyone before: what is now called love bombing. Then, slowly, it turns. Criticism, coldness, affection withdrawn and returned, blame for everything, and the gaslighting that makes you question what you saw and heard. Friends drift away. You walk on eggshells. You become smaller.

What it leaves behind

• Chronic confusion and self-doubt, even long after the relationship has ended
• A collapse of self-esteem, and of the sense of who you are
• Anxious hypervigilance: scanning for the next criticism or change of mood
• Isolation from friends and family who once mattered
• A pull back towards the person, even when you know you should not go back
• Sleeplessness, exhaustion, and a body that no longer feels like your own

That pull back has a name, the trauma bond. It is built by the alternation of warmth and cruelty, and it is not a sign of weakness. Clinically, what many people live after such a relationship looks very much like complex trauma.

Is it really narcissistic abuse?

Not every difficult person is a narcissist, and the word is now used for every complicated ex. That matters, because it dilutes a clinical reality that is precise and serious. Part of the first appointments is simply to look carefully at what you are living, without a label being imposed in either direction. If you want a starting point, the ten-question test is not a verdict on your partner, but a look at your own experience. The toxic relationship describes the painful relationships that are not a hold.

How the work is done

The process is slow, and the slowness is right. It begins by putting words on what you are living, and discovering, little by little, that your perception was not mad. Then the work turns to what the relationship emptied: trust in your own judgement, self-esteem, friendships, energy.

Alongside psychotherapy, EMDR, which I have practised for more than twenty years, helps with the intrusive memories and the alarm that keep returning. Later, the work often reaches further back: why this relationship took hold so deeply, and what in your own history made you its ideal partner. Emotional dependency, the fear of abandonment, a high tolerance for pain: these are not faults, but understanding them is what protects you next time.

You do not have to have left to begin. For many people, therapy is what makes leaving possible. The day of leaving is not the first day of the work; it is its fruit.

Your safety comes first

Where there is violence, threats, or fear for your safety or your children’s, leaving is not improvised: the moment of separation is the most dangerous. It is planned with specialist domestic abuse services alongside the therapy. In the UK, coercive control is a criminal offence in itself, even without physical violence. In immediate danger, call 999.

Couples therapy is not a first step when one partner is controlling the other. An individual assessment comes first.

Men are abused too

The abuser is most often described as a man, but there are women who abuse in exactly this way, and their male victims are among the least believed of all. If that is your situation, you will be taken seriously here. See also therapy for men.

In London and online, in English and French

Sessions are held in person at 45 Fitzroy Street, Fitzrovia (W1T), and by secure video, in English and French, for people in the UK and abroad. Many people find it easier to begin online, where no one needs to know.

Free reading before you decide

The Hold, my free book on narcissistic abuse, the fear of abandonment and the way out, can be downloaded without sign-up: The Hold, free PDF. The full essay is here: narcissistic abuse, what the clinician means by it. In French: L’emprise.

Dr Philippe Jacquet is a UKCP registered psychotherapist, a Jungian analyst and an HCPC registered art psychotherapist, with twenty-five years of clinical practice. His Professional Doctorate in Analytical Psychology at the University of Essex examined male eating disorders from the perspective of analytical psychology. Registration can be checked on either public register.