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When Narcissistic Abuse Occurs in Family Systems

ACON= acronym for Adult Child of Narcissistic (Caregiver/Parent)

Wow, May is here!…How did that happen?… For many mothers, May is a joyful time to embrace and partake of festivities, also honoring seasoned caregivers who play a strong role in nurturing the new generation of nurturers. However, for some childbearing women, motherhood may not be a happy time. Due to a range of reasons , approximately 20% (or more) of all childbearing women may experience perinatal depression or anxiety (PSI, 2017). It is never a woman’s fault that she develops perinatal depression/anxiety (PMAD). Rather, a complex interplay of biological, hormonal, neurological, and environmental events can blend to create the perfect storm for an “episode.” Fortunately, these eruptions of psychological pain are temporary and can be resolved with excellent care by trained practitioners (therapists, psychiatrists, doulas, lactation consultants, pediatricians, Ob/Gyns) and a supportive tribe of helpers (healthy extended family and friends, etc).

Furthermore, a subset of those women who experience a PMAD also have relationship trauma/loss history which can include physical, emotional, sexual abuse by a prior caregiver/parent or a current romantic relationship. It is these women who are exponentially more vulnerable to not only developing a PMAD but also experiencing more severe “episodes”, due to the layers of trauma/loss woven into the already challenging sleep deprivation, hormonal fluctuations, role and identity changes that jolt a new mother into this chapter of her life. It is this subset of women which I am devoting this article to, in an effort to provide some solace, that there is hope to heal and recover, even in the face of the Hallmark commercials depicting the myths and expectations of what motherhood “should” look like, but very clearly does not for many women.

So, May is Maternal Mental Health Awareness Month, and with that comes social media posts galore about the prevalence of maternal depression and anxiety. Thankfully, with the help of the internet age and technology, maternal mental health is one of the “in” topics addressed across all dimensions of media. In general, I am pleased to see mental health awareness evolving into a less stigmatized topic over the span of the last decade and beyond. However, even with a tremendous amount of advocacy on many levels, there is still much work to be done to completely incorporate maternal and family wellness from the standpoint of mental health into the mainstream discussion and to ensure adequate and competent care for mothers and families.

Many organizations have worked and continue to work diligently to press for legislation, training, and awareness of maternal mental health (some of those are listed at the bottom of the article). Barriers to care continue to be a problem for families who are disadvantaged, impoverished, or face financial, geographical or discriminatory challenges of any kind. Women in unsafe relationships (whether familial, romantic or work related) are particularly isolated and at risk for a more complicated recovery unless they are linked with supportive and competent mental health care which includes a trauma-informed approach.

Karyl McBride, PhD, P.C., is considered one of the pioneers in the research, writing and treating of adult children of narcissistic parents. Her website, books, and literature are groundbreaking and very helpful for adult survivors of psychological abuse by a narcissistic parent. I often refer my mom clients to Dr. McBride’s writings when I discover that my client carries the trauma of emotional abuse, with her family-of-origin pain is rising back up in the form of flashbacks. At just the moment my client is trying to bond with her baby and make the passage to motherhood, she may be plagued with feelings of doubting her ability to be able to love her own baby unconditionally based upon the blueprint she was given as a child.

With support and trauma-informed counseling, my mama clients who have been impacted by narcissistic abuse do move through pain and healing to attach and bond in a healthy manner with their babies. Without competent and compassionate help, these new moms would be passing on another generation of unresolved trauma to their offspring. Again, not all moms who experience a PMAD have a history of narcissistic abuse by a caregiver (or romantic partner), but for those who do, this trauma is sure to rise up at just the moment she is attempting to embrace the joy of motherhood. Likewise, if a mother is in a relationship with an emotionally abusive partner or is employed in a toxic work environment with emotionally abusive personnel, she is also more at risk for developing a PMAD. These psychological stressors are additional risk factors that magnify the dramatic hormonal, biochemical, and role transition dynamics in a new mom’s passage to motherhood.

In providing psychotherapy for a new mom with a PMAD who also has a history of narcissistic abuse (either in family-of-origin or in a romantic or work relationship), I will not only provide the evidence-based interventions (for PMADs) of mindfulness-based cognitive behavioral therapy and interpersonal therapy, I will also blend in other trauma-informed approaches that support my client in working through some very complex relationship dynamics. Some of these approaches may involve expressive arts, trauma-informed approaches which include bilateral simulation (such as EMDR and other techniques), and lots of psychoeducation and therapy about narcissistic abuse recovery, boundaries, reclaiming self-worth, and creating a safe tribe of supportive others, to name just a few. Acute depression and anxiety symptoms may lift fairly quickly with interventions addressing PMADs, while the more long-term work delves into family-of-origin, trauma/loss and attachment concerns.

The next blog post with further describe recommendations and resources for supporting new moms who are experiencing relational trauma. Stay tuned for Part 2.

*This blog post originally appeared in the author’s blog, From Andrea’s Couch*
Postpartum Support International: 1-800-944-4773 (National Warmline)

When Narcissistic Abuse Occurs in Family Systems

Andrea Schneider, MSW, LCSW

Andrea Schneider, MSW, LCSW is a licensed clinical social worker in private practice in the San Francisco Bay Area. She is currently the Lead Counselor at Cal State Maritime Academy, where she counsels college students and leads Counseling and Psychological Services (CAPS) at the integrated Student Health Center. In her private practice, Andrea provides psychotherapy for individuals experiencing trauma and loss. She is also a writer, educator, and podcaster. Website:

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APA Reference
Schneider, A. (2019). When Narcissistic Abuse Occurs in Family Systems. Psych Central. Retrieved on August 8, 2020, from


Last updated: 18 Jun 2019
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