What Therapy Is Best for Narcissistic Abuse?
- Two Lights Therapy | Chicago Narcissistic Abuse Therapists
- 2 days ago
- 6 min read
During or after narcissistic abuse, finding the right support is everything. While there are many well-meaning therapists eager to support you, not all are equipped with the proper tools and training to understand the unique challenges, triggers, and dynamics that survivors face. Even some of the most tried and true supports and modalities (that work for a variety of mental health challenges) can cause significant damage to individuals who have been impacted by narcissism. Why? Because being “narcissistically abused” is not a diagnosis. Most of the time, reactions to narcissistic abuse are congruent, understandable adaptations, not symptoms to be pathologized. So, what kinds of therapy are best for narcissistic abuse (while being safe and actually helpful)? It’s an important question.
**Disclaimer: This blog should not deter you from seeking support. The right therapist is out there! I know it's hard to find the right fit, but don't give up. You've got this.
Not All Therapy Is Created Equal
Many generalist therapists are trained to treat anxiety, depression, or relationship issues with a one-size-fits-most approach. These approaches are awesome for, let’s say, generalized anxiety disorder, because they are backed by evidence and shown to work! Here’s the catch—the responses and challenges that arise from narcissistic abuse have been proven to be different from anxiety disorders/major depressive disorder in many, many ways. In fact, the effects of narcissistic abuse have the most overlap with the symptoms of PTSD, but there is still a large portion of the effects that do not overlap with ANY other current criteria. Wild, right? The point is, the unique effects of narcissistic abuse are underemphasized and underrepresented in the current literature.
Narcissistic abuse is not just something that arises from your garden-variety “toxic relationship”. Survivors are often so badly gaslit, traumatized, and invalidated that their very sense of reality is completely crushed. Approaching that kind of trauma with certain “standard” therapies can cause more harm than good. Some therapists might not like to admit that, but it's objectively true.
In fact, survivors are often retraumatized when a therapist fails to recognize:
The role of covert manipulation, trauma-bonds, charisma, and charm
The pervasive shame survivors carry for “falling for it”
The patterns of self-blame, residual love, rumination, chronic second-guessing
The danger of pushing for reconciliation or “shared responsibility”
The Best Therapy for Narcissistic Abuse? Relational, Trauma-Informed, and Specialized
To recover from narcissistic abuse, you need more than coping skills or reframed thoughts. You need a space where your experiences are truly understood, and where you don’t have to prove, defend, or justify the impact of this kind of relational trauma.
Look for a therapist who offers:
1. Attachment-Based, Relational Therapy
Healing does not happen in a vacuum. You need a therapist who knows how to build a safe, attuned connection with their clients. Rapport is everything. While there is a time and place for the blank-slate, blunt therapist who only periodically peaks out from behind clinical neutrality, this is not it! The therapeutic relationship itself becomes a corrective experience, especially when trust and vulnerability have been weaponized in the past.
2. Trauma-Informed Treatment
You may have heard the term “trauma-informed” tossed around. But what does it mean? Trauma-informed, in this case, means your therapist understands how abuse rewires the nervous system, erodes identity, and keeps you in a survival state. A trauma-informed lens also helps guide the pace of therapy (keeping things feel gentle and respectful) so that you don’t feel pushed, pathologized, or misunderstood. Trauma-informed therapists are also open to exploring the therapeutic relationship in a way that allows for your attachment trauma to show up safely in sessions (even when big emotions are directed at your therapist).
3. Expertise in Narcissistic Abuse
Okay, yeah, this is a shameless self-plug. But seriously, this is non-negotiable. I have seen a devastating amount of harm caused by therapists (especially couples therapists—but no shade) who weren’t adequately prepared to deal with narcissistic dynamics. You need a therapist who not only understands narcissistic dynamics but understands narcissistic dynamics on a DEEP level. Just having the language (gaslighting, future-faking, trauma-bonding, love bombing, breadcrumbing) isn’t enough. Your therapist must appear to know what these dynamics look/feel like, and should be someone who doesn’t mistake emotional withdrawal for healthy boundaries or spiritual bypassing for “high road” behavior.
4.) Other Kinds of Therapy That Tend to Work Well for Narcissistic Abuse Survivors
Parts Work/Internal Family Systems Therapy for Narcissistic Abuse
EMDR Therapy for Narcissistic Abuse
Coherence Therapy
Somatic Therapies
Therapies focused on the impact of domestic violence
Therapies for Childhood Trauma Survivors
Why Survivors Need a Specialized Approach
Survivors almost always feel shame. “Why didn’t I leave sooner?” “How did I not see it?” “What’s wrong with me?” You don’t need a therapist who rushes you to “let go and move on.” You don’t want a therapist who helps you see how you “invited” the abuse (I hated even writing that). You need someone who understands, helping you to rebuild self-trust SLOWLY by honoring the ways your nervous system was hijacked and honoring any feelings you still have for your abuser.
The right therapy helps you:
Name the manipulation without minimizing it or self-blaming
Reclaim your identity, intuition, voice, and life
Understand what has happened to you
Feel safe enough to stop over-explaining yourself
Recognize red flags without second-guessing yourself
Final Thoughts: You Deserve More Than Generic Support
If you’ve experienced narcissistic abuse, please know: it wasn’t your fault, and you’re not “too much” or a burden for needing this level of care. Recovery is real, but it starts by finding the right kind of therapy and the right kind of therapist. Don’t settle for someone who treats this like just another breakup or a projection of your insecurities. Find someone who gets it.
Frequently Asked Questions About Therapy for Narcissistic Abuse
How do I know if my therapist understands narcissistic abuse?
Ask them directly. A knowledgeable therapist should be familiar with narcissistic abuse terms, but they should also be able to confidently explain how they approach treatment for narcissistic abuse specifically. They should never minimize your experience, normalize the behaviors, push for forgiveness prematurely (or at all, frankly), or imply mutual blame in cases of emotional abuse.
Why is trauma-informed therapy so important for survivors?
Because narcissistic abuse is a form of relational trauma. It impacts your nervous system, identity, and sense of safety in life and in relationships. Trauma-informed therapy helps you process what has happened without it being retraumatizing.
Is EMDR or somatic therapy helpful for narcissistic abuse?
Yes, but only in the right context. EMDR and somatic work are powerful options, but they must be integrated carefully within a relational framework. Processing trauma too fast or in the wrong environment (one that doesn’t yet feel safe) can actually worsen symptoms. The relationship with your therapist still matters most.
What if I feel ashamed for not leaving sooner? Will my therapist judge me?
This fear is incredibly common. Narcissistic abuse uses cycles of hope, fear, and confusion to keep you paralyzed. The right therapy will help you stop blaming yourself and start understanding the nervous system adaptations that helped you survive.
How long does it take to recover from narcissistic abuse?
Ah yes—the question we all want answered. Unfortunately, there’s no set timeline. (I know, don’t hate me.) Recovery depends a lot on your support system, the length of time you were abused, and the quality of therapy you receive.
Ready to Work with a Narcissism Specialist?
I’m a Chicago-based therapist who specializes in narcissistic abuse recovery. I use an integrative, relational, attachment-focused approach with EMDR when appropriate. If this sounds like what you're looking for, reach out here.
Narcissistic Abuse Therapy: https://www.twolightstherapy.com/narcissistic-abuse-therapy
Narcissistic Abuse Intensives: https://www.twolightstherapy.com/narcissistic-abuse-intensives
EMDR for Narcissistic Abuse: https://www.twolightstherapy.com/emdr-for-narcissistic-abuse
Therapy for Antagonistic Relationship Challenges: https://www.twolightstherapy.com/therapy-for-antagonistic-relationships
Two Lights Therapy Center PLLC | Chicago, Illinois.
Narcissistic Abuse Recovery Therapy
Please Note: The information provided in these blog posts is for informational and educational purposes only. It is not intended to be a substitute for professional therapy or therapeutic services. While licensed psychotherapists write these blogs, readers should not use this content as a replacement for individualized advice or treatment. If you are experiencing a crisis or need immediate assistance, please call 911 or contact other emergency services in your area.