When working with NVS, you will find yourself working with emotions involving shock, anger, fear, and guilt. Often the victim will be suffering from PostTraumatic-Stress Disorder (PTSD), or Complex Post Traumatic Stress Disorder; Symptoms of PTSD are often grouped into three main categories: Re-living (flashbacks, hallucinations, nightmares etc), Avoiding (people, places, thoughts, loss of interest etc), and Increased Arousal (excessive emotions, problems relating, difficulty in sleeping and concentration, outbursts of anger, anxiousness, panic attacks etc). You may also notice that your client is inclined to “dissociate” while you are talking to them. That is, it seems as if the client is tending to “compartmentalize their experience.”; in so doing, they may appear to be detached from their emotions, body, or immediate surroundings, this experience is called derealization.
Dissociation can be caused as a direct result of trauma, often experienced in multiple forms during narcissistic childhood traumas (i.e. physical, psychological and sexual abuse). The dissociation is an automatic and effective defense mechanism to overwhelming acute stress the child is being subjected to; it is as if the child “jumps out” of their body in order to disconnect from the intolerable reality of the abuse while it is happening; by dissociating, the child is able to endure the highly traumatic experience without having to fully experience it. I once worked with a client who was sexually abused as a child by her narcissistic father. He would call her in when she was playing outdoors with her friends, he would sexually abuse her, then send her straight out again to play. She recounted how, during the sexual abuse, she would escape out of her body, get up on top of the wardrobe and watch what was happening to the child in the bed. She referred to the child in the bed as the “bold girl”, and the child on top of the wardrobe as the “good girl. The bold girl never went outside the house, it was the good girl who went back out to play with all her friends. This defense mechanism protects the child against total annihilation of the self when their nervous system is strained to the limit. However, the long term effect of dissociation is that it may decrease the victim’s psychological functioning and adjustment. Dissociation is a crucial strategy that protects a person during a crisis, unfortunately, trauma survivors often rely too heavily on dissociation whenever they feel stressed in a situation, it can become their automatic freeze response to stress. Numbing the body is not an advantage when a person is called to live in the world, because it can impair their ability to take appropriate fight or flight responses if faced with any threat from outside the self. Of course, there are varying levels of dissociation, from day dreaming to fantasy, from leaving one’s body to derealization (the constant experience of dissociation). In the therapy room, dissociation severely diminishes the client’s ability to be present to the process, if it goes unchecked it may become a stumbling block. The therapist needs to go slowly at first, building trust and safety so as not to derail the person’s system. By explaining what dissociation is, the therapist can gently bring the client’s attention to when they are “leaving”. Taking time to build and practice new skills (in a playful way) as the go. The sequelae of narcissistic abuse may include any of the following symptoms: low self-esteem, self-mutilation (self harming), suicidal thought, chronic pain, PTSD, depression and somatizations.