Healing From Narcissistic Abuse (Ruthless Lessons, Part 3)

Lissa Rankin, MD
10 min readJun 12, 2023


In Part 1 and Part 2 of this series of “ruthless lessons” in understanding the playbook of how perpetrators of narcissistic abuse operate and how survivors can heal, I shared notes I’ve been taking from the podcast Navigating Narcissism with Dr. Ramini. I’ve been researching the curriculum for an upcoming class, Becoming Unf*ckwithable , about how to improve your discernment, spot the red flags of toxic relationships, protect yourself with good boundaries and wise discernment, and become less vulnerable to ruthless people who intend to exploit you and may suck you dry in an attempt to feed themselves with your life force, money, attention, adoration, time, energy, and good juju.

Register for Becoming Unf*ckwithable here

Before sharing more tips, I want to reiterate that narcissism lives on a spectrum. In Rethinking Narcissism, Craig Malkin talks about how if narcissism lives on a scale of 0 to 10, with 8–10 being too much narcissism and 0–3 being not enough narcissism, we all need a healthy amount of narcissism in the 4–7 range. Pop culture likes to demonize the narcissist and extend sympathy to survivors of narcissistic abuse. It’s easy to understand why, given that the victims of this kind of abuse are so traumatized and the narcissist often gets off the hook with zero accountability or justice. But we have to remember that narcissists are also trauma survivors and are frequently victims themselves of generational narcissistic abuse from abusive and/or enabling parents. While some people insist narcissists cannot be healed, and while that is true if they never seek out treatment, there are some self aware people with narcissistic parts who are actively working on changing their thinking and behaviors. Sadly, the grandiosity of narcissism usually prevents narcissists from getting real trauma therapy, but if they can stomach facing their own shadow, I do believe treatment is possible.

One person who read my last few posts about the red flags of narcissistic relationships responded via email to me, writing, “I hear all the compelling warnings about fleeing the ruthlessness of incorrigible narcissists, and I understand the logic if, in fact, narcissism is a hopeless condition and impossible to curtail. Is that the case in your view, or are there some narcissists who can salvage themselves and if so, how? Please be so kind as to provide some helpful instruction for the narcissists, as well as their victims. I have everything one could want in life, including a magnificently loving and gifted wife, but I have no friends, with my toxic qualities being so readily discernible. Before I lose my darling, I am desperate for a life line.”

Narcissists have almost always been victimized and traumatized themselves, so these behaviors are frequently what we call “legacy burdens” in IFS. That doesn’t mean we should let people off the hook or tolerate the behavior when people behave this way. But it does help us understand why some people do horrible things to innocent people who deserve to be treated better but have often been conditioned to believe they aren’t worthy of being treated better.

Part of why I think it’s helpful to study the patterns of narcissistic abuse is because 1) we want to avoid being victimized in this way 2) we want to avoid victimizing anyone else in this way. So this psycho-education is for both the perpetrators of these behaviors and the people they hurt. I hope it helps you all.

In a future post, I’m going to unpack how dissociative disorders can masquerade as narcissism, when in fact, it’s quite a different animal altogether (largely because the motives and intentions are different.) But for now, let me share some more of Dr. Ramani’s quotes and tips.

1. Trust needs to be earned, but love doesn’t.

Conditional love is a standard feature of all toxic and narcissistic relationships. These are often very transactional relationships, where love feels like it needs to be earned. People who grew up with conditional love, doled out by distracted, ego-centric, narcissistic parents, grow up feeling as though they must need to earn love or jump through hoops to even be seen. Without even noticing it, survivors may find themselves sliding into conditional cycles and feeling like they have to perform or do what the other person wants in order to be loved. This is the core of the trauma bond.

2. In order to feel safe in relationships, survivors of narcissistic abuse often believe they need to let people exploit them.

I tell my own clients that the best we can do is to shoot for the goal of unconditional love but conditional access. Unconditional love doesn’t have to be earned, but trust has is very conditional, and without trust, it’s not safe to keep someone too close. We all have conditions on what we can tolerate, but love should not be transactional. Ever. You shouldn’t ever have to buy love or expand yourself beyond your true shape in order to prove you love someone or are worthy of being loved in return.

3. Achievement and perfectionism is the common fallout of narcissistic family systems.

Therapist, author of Believing Me, and narcissistic abuse survivor Ingrid Clayton said, “In order to feel safe, I needed to be exploited.” Typically this happens because they learned in narcissistic family systems that if they let themselves get exploited, they get treated better., even if only slightly. If the child is not valuable because of their unique personhood alone, they wind up feeling useful for making money that’s given to the narcissistic parent or being sexually exploited by a molesting parent or being exploited for high achievement by a parent who sees the child as a narcissistic extension of themselves. This profoundly impacts their sense of self worth and makes them feel like their only value is to be used by other people in the name of love. When survivors lack self worth, they struggle to realize that they are enough just the way they are. Because they don’t believe they’re of any value in a relationship unless they are being exploited (as a way to earn love), they grow up very vulnerable to very ruthless people who take advantage of this tendency. Because being used instead of loved is so familiar, it feels safer than being actually loved. It also gives the survivor a feeling of security to know that the person who is using them relies on them, needs them, is dependent on them in some way, and therefore, hopefully, won’t leave them.

4. Narcissistic abusers are two faced. 5. “Chemistry” is not all it’s cracked up to be in romantic comedies.

Achievement and perfectionism are commonly seen in survivors of childhood narcissistic abuse. These trauma symptoms are often missed, because who is going to pathologize a high achieving child? The children who more commonly get spotted as in need of help are the ones who act out, underachieve, or wind up in juvie. But the overachievers usually don’t feel safe to do anything but try desperately to please the often unpleasable narcissistic parent. It’s not unusual for survivors to make a decision early on to just put their head down so they can disprove the family rhetoric that the targeted and scapegoated child is a liar or too sensitive or manipulative. Likewise, the overachieving golden child may overachieve in order to get very conditional attention and approval as a cheap substitute for unconditonal love. There is no such thing as good perfectionism, and these patterns can culminate in compulsive behaviors, obsessive thoughts, rigidity, and dysregulation.

The narcissistic abuser is capable of being the most charming, engaging, charismatic, warm, seemingly compassionate, interesting human being to someone outside the home, especially authority figures and people in positions of power who they want to impress. Then they literally step within the threshold of their home, shut the door, and start abusing everyone in the house, which makes it impossible for people to get help. There’s an intentionality to the abuse. They don’t scream at you in front of other people, which reveals that they have some control over their emotional or physical abuse. They wait until they’ve asked whether they’re on speaker phone, or they wait until you’re trapped in a private setting, out of the public eye, so they can keep their public image intact while letting loose their emotional violence on you in private. That ability to turn it on and off reveals an intentionality that shows they’re not just seeing red and losing control; they’re doing it on purpose. People have a tendency to want to see the agitated, angry, spewing venom person in public before they’ll believe a victim’s story about their abuser. But because they turn it off in public and save it for private settings, victims often do not get believed.

6. Narcissistic abuse in childhood causes kids to abandon their true selves and get replaced by a false self.

The quest for “chemistry” can actually be dangerous for survivors of narcissistic relationships, especially narcissistic families. Chemistry may speak to that emotional draw to a person where the trauma bonded patterns of having to try to win someone over and prove ourselves to them activates a primal attempt at “working through” the narcissistic abuse of the past. In that way, chemistry may be a sort of psycho-dynamic familiarity, that toxic soothing that comes from being with someone where old wounds are being felt.

7. The quest to “look good” in outward facing appearances may wind up being a cheap substitute for an actually good relationship.

If you are a survivor of narcissistic abuse in childhood, chemistry in an adult romantic relationship may be a dangerous thing. Chemistry, that unnamed sizzle you feel in a new relationship, or even in a volatile, ongoing, up and down relationship, is often a signal of old toxic familiarity. Chemistry is romanticized and fetishized when we talk about falling in love and dating and fighting for messy relationships. It’s often a sign that a person feels the activation of old familiar patterns and perhaps the perception that this time, it will be different. This time the person who you want to really see you will finally really see you. If you can not articulate in clear words beyond chemistry what it is you like about a person, then it’s quite likely that the trauma bond is in the house. Respect, kindness, compassion, and mutual growth may not have the “za za zoom” of chemistry, but it’s what makes a healthy relationship healthy. If you aren’t feeling chemistry, but you’re enjoying someone’s company, don’t write it off. Lean into it for a minute and soak up that warm, comforting, but perhaps unexciting bath called safety.

8. Narcissists need all the validation for themselves.

Survivors of narcissistic abuse often feel like they have abandoned their true selves in their adult narcissistic relationships. This makes sense because when those children showed their true selves with their narcissistic or enabling parent, they were actually abandoned- or abused or rejected or scapegoated. Many survivors feel a sense of shame for giving up on themselves, but survivors need to remember that when they did show up as their true selves as children, the narcissistic parent often gave up on them. So it’s a potent survival mechanism, or in IFS lingo, a “protector” part. Understanding these cycles can be central to healing and forgiving yourself.

9. Early on, narcissistic relationships are characterized by too much attention or not enough attention.

Many people in narcissistic relationships need the relationship to “look good”- and they may be soothed by the idea that if I can make this look good, then it is good. And sadly, this superficial patina of “If it looks good, it is good” is a game that narcissistic people can play so well. Survivors may wind up doing very uncomfortable things in order to save face and make it look good, even if they’re selling themselves out, which is usually a repetition of their childhoods.

10. Control and obsession is not love.

The rules of engagement in a narcissistic relationship is that all validation is for them. If there are lots of pots of narcissistic supply, and you’re not the only one needed to validate the narcissist, their tummies may always be full, and they may need less validation in their primary relationships. If they’re a rock star or movie star or celebrity, they may get a lot of narcissistic supply in their work and be less needy with a romantic partner, for example. But if the narcissistic supply dries up (as it did during the pandemic for many narcissists in lockdown, they may become quite demanding, requiring an extreme amount of validation from you. But if they’re behaving badly and you (understandably) stop pouring on the validation 24/7, or if you start challenging the abuse or protesting the abuse, the narcissistic individual is likely to fight you, get defensive, manipulate you, and look for new, fresh narcissistic supply that will fill the hole left by your absence of validation. Or they will just leave you and replace you with an instant swap.

The early part of a relationship with a narcissistic person is either too much or not enough. Either it is an obsessive, overwhelming, way too much attention on you form of love bombing- or it can be about waiting by the phone, wondering if they are thinking about you, wondering how soon is too soon to text back and trying to figure out if they are even interested. And then, when they show up, it can be fun and exciting- and then they disappear again. In healthy relationships, the communication, rhythms, and expectations are more clear and less chaotic, even in the beginning.

A universal error made by so many when it comes to controlling and obsessive partners is conflating control and obsession with love. That’s not love or even intense interest. If someone is stalking you to shower you with attention, that’s just creepy love bombing, not love. It almost inevitably ends up in isolation and abuse, yet we can get hoodwinked because we assume generous intentions when the intentions are to dominate and control. There is a danger in seeing everything through the lens of beneficence, trust and goodness. We don’t want to wind up paranoid, but it’s a good practice to have some healthy skepticism when we meet someone new. It’s a dangerous set up when we can’t spot the red flags because of our innocence, gullibility, and naivete.

For more insights, psycho-education, and tools about how to protect yourself in relationships and heal from narcissistic abuse, we invite you to join us for Becoming Unf*ckwithable.



Lissa Rankin, MD

Lissa Rankin, MD, New York Times bestselling author of Mind Over Medicine, The Fear Cure, and The Anatomy of a Calling.