Narcissistic Abuse Syndrome and Sex After Trauma with Dr. Kate Balestrieri

“Narcissistic Abuse Syndrome and Sex After Trauma with Dr. Kate Balestrieri”

a lightly edited Girl Boner Radio transcript

Sarah:

When I first met this guy on paper, he seemed to be perfect for me. He seemed to have the same politics as me, the same world views as me, same social views as me… A month or two in when we started spending time alone in his house, as soon as that door shut in his house and it was just me, especially after like a few drinks, or whatever. As soon as that door shut, and the bullying would begin, and it’s like a switch in the personality.

M: 

One of the things was he couldn’t have sex with me while he was looking at me. I wasn’t allowed to laugh. I wasn’t allowed to smile. It all had to be a scenario that he had come up with ahead of time and it had to be scheduled…

The Master of the Universe thing is… It’s not just he’s having an affair with one person. He’s sexting with two people at once while he’s emailing somebody else and engaging in porn for four to six hours a day. And he was doing it at work. I mean, he could have easily gotten fired. And they’re advertising for sex on Craigslist… It progressed very quickly to talk of whether we were going to stay together or not. And I said, “I love you, but I clearly don’t know you.” And, and he’s like, “Yeah, I’m really good at hiding it.” And I said, “How can I help you through this if I can’t trust you?” And he said, “You can’t. You’re too trusting.”

August (narration):

Some years ago, I published a story about a relationship I was in with someone who seemed to be on the sociopath spectrum. Also known as antisocial personality disorder, it’s marked by a lack of empathy and tendencies to lie, act impulsively, and show little regard for anyone’s safety. Since then, I’ve heard from so many people who’ve found themselves in a similar situation, dealing with sociopathic or narcissistic abuse. Those clips were just two examples. 

Narcissist personality disorder is similar to sociopathy, although with narcissism, the ego is always at stake and drives many of their behaviors. Sociopaths are said to take on whatever persona gets them ahead in the moment, driven by self-interest. 

These symptoms can manifest in many different ways, and affect folks of all genders. When the relationships are abusive, as they often sadly are, the impact on intimate partners can be profound. 

I recently spoke with Dr. Kate Balestrieri, a psychologist and sex therapist who works with people on both sides of this equation, about narcissistic abuse syndrome and ways it can impact everything from sex to our sense of self, as well as helpful steps toward healing. 

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Now, Dr. Kate Balestrieri, starting with a bit about her own sexual awareness journey.

[a few bars of upbeat music]

Kate told me she learned a lot about sex and sexuality growing up, implicitly. As for direct messages that were positive — well, there weren’t many. 

Kate:

So I grew up in a very Catholic family and a lot of what was explicitly told to me was very shaming around sex: “It’s bad. You don’t do it unless you’re married and wanting to make a baby” and otherwise, absolutely not something to be thought of or definitely not discussed or enjoyed.

August (narration):

She said there were a lot of mixed messages in her family and culture and a lot of emphasis on gender roles.

Kate:

…the expectation that women were supposed to be beautiful, they were supposed to be sexy and desired, and that was sort of the currency by which their value is placed. Now, of course, that’s no one’s conscious belief in my family, but those were some of the unconscious narratives that lived very loud. 

I grew up with a lot of mixed messages around how to navigate that balance of being comfortable in your own skin, being sexy, being valuable, being desirable, being desired. And also there was sort of a veil of sex being an obligation and something that was part of a duty. So, I have a lot of confusing ideas about what sex was really supposed to be about, by the time I was, you know, old enough to be sexual.

August (narration):

In hindsight, she said, a lot of that formative information she gleaned early on compelled her decision to go into her field. 

I read a wonderful blog post on Kate’s website, Modern Intimacy, called Recognizing the Signs of Narcissistic Abuse Syndrome. As I told Kate, it really struck me, because, having gone through that myself and spoken to many others who have, I never knew there was a term for it. At least for me, looking back, that felt validating. 

Because the effects of being intimately involved with someone on the narcissist or sociopath spectrum can be profoundly challenging. I have heard of folks who have positive relationships with someone who’s been diagnosed with one of these disorders. But for many folks, it feels like an illness to be the empathetic person on the other side. So I’m glad that term—narcissistic abuse syndrome—includes the word “abuse.” Any abusive relationship can be traumatic. Add narcissism and to that mix and it’s…a lot.

I asked Kate whether this syndrome crops up often in her work. She said yes.

Kate: 

So I’m a psychologist and a certified sex therapist and a certified sex addiction therapist, in addition to a Patch trained couples therapist. And I throw out all of those terms not to be like, “woo-hoo, I’m so talented” but to emphasize the path that I’ve taken to really understand trauma and its impact on relationships. And so part of what I see a lot in my practice is a lot of abuse, implicit and explicit abuse, and relational ruptures around romantic love, familial love, and of course, sexuality. 

So, I see a lot of people who have a significant amount of trauma. And when we have a significant amount of trauma in our lives, sometimes that can crystallize into more static personality traits. And that is the real underpinning of a narcissistic personality disorder. 

August:

Whether someone develops this disorder because of nature, nurture or a combination of both is hotly debated in psychiatry. Research hasn’t figured it all out yet, but many experts and some studies point to a genetic predisposition, a neurological issue and/or this biggie: childhood trauma—especially in people who become abusive. Neglectful and overprotective parenting are also considered risk factors. 

And regardless, untreated trauma can fuel these traits and lots of relationship challenges, which is what Kate often sees. But not all narcissism is bad.

Kate:

Now we all have some traits of narcissism, because some narcissism is healthy and good, but when someone has untreated trauma, it can really create a lot of defenses that make intimacy very challenging. And so the people in their lives often suffer, because all they really want is to be close. But when someone has had a lot of trauma, and they’re guarded and self-protective in ways that hurt others, of course that creates a lot of conflict and a lot of pain and discomfort. 

So, I find that term—I don’t know who created it; I wish I could take credit for it, but I can’t—narcissistic abuse syndrome. I find that term really offers people who have experienced this in their lives a vocabulary with which to start understanding it. And then moving forward, because once you can name it, once you can describe it, it really feels a lot more empowering to shift through and move to the other side of that in your future or current relationship.

August (narration):  

We hear a lot about signs of narcissism and related abuse. There’s no shortage of articles, blogs or listicles pointing out signs and possible solutions. But what about narcissistic abuse syndrome? While narcissism has been an official diagnosis for some time, there’s not a lot of medical literature around the set of symptoms that can happen when we’ve been harmed by such a person. 

Kate told me that culturally, we don’t have a very synthesized understanding of what this syndrome—but that she is seeing a shift on social media. More and more people are talking about its symptoms, so she thinks it’s “burgeoning more and more to the surface of our conscious awareness.”

Here are some of the common symptoms she sees in her practice:

Kate:  

Some of the earlier things that people who are experiencing this syndrome are likely to notice in themselves is a lot of doubt where they didn’t have self-doubt before. They start questioning everything. They question things that they used to do and know with a lot of certainty. And I don’t mean the healthy kind of skepticism that comes with being in constant reevaluation of yourself. 

What I mean is feeling like they used to be a powerhouse in terms of their industry, or something around the house, or a hobby or an activity that they loved. And now they’re questioning their competence. They’re questioning what they knew about it. They’re questioning if it’s even something they really enjoy anymore. 

And part of that is born out of the kind of whirlwind that is being in this kind of relationship. Most of the attention that you have goes toward understanding the relationship or understanding your partner. There’s a lot of inconsistencies that show up in those kinds of relationships and so it can be really discombobulating, and it requires a lot more focus. But sometimes it’s a direct result of experiencing a lot of gaslighting or a lot of demands on your time. 

So, when someone is involved with someone who ranks pretty high on the narcissistic traits or personality disorder continuum, they’re likely to be drawn into their world and more focused on all of what is important to that person. And they can lose themselves if they don’t have solid boundaries around their own identity, their own thoughts, their own behaviors, feelings and activities.

August: 

So, we hear the term gaslighting, I think, more and more now as well. And I think people, a lot of people, have a general idea that it’s deceptive, you know. That it’s trying to make you feel like you’re the quote unquote, “crazy one,” is what we hear. 

What are some examples of gaslighting and how it might impact sex or intimacy? 

Kate:  

When I think about gaslighting, I mean, I think most people do know it’s born from an old movie where the husband was trying to convince the wife that she was crazy. And so he would manipulate the gaslight on the porch and whether it was on or off he would convince her that it was the opposite. So it was born from that film, and it is such a dangerous and insidious form of emotional abuse. 

Because what it really does is it creates a break between someone’s intuition and their own sense of knowing the world around them and what is actually going on in reality. So they start to second guess themselves and discount all of the incredible wisdom that their mind and body have for them because someone else demands otherwise. 

But as it relates to sex—I see this a lot with more women than men but certainly happens with men, and it happens with non-binary folks as well—but most self-identified women that come to me would talk about gaslighting as it relates to sex in terms of having a fawn response. 

August (narration):

When you have a fawn response, you immediately try to please a person to avoid conflict or stay safe. The term was coined by therapist and author, Pete Walker and it’s been added to the trauma responses you may be more familiar with: fight, flight and freeze. 

Walker has said that fawning can ultimately lead to a sort of death of the individual self. We detach from our own needs, desires and bodies, to please someone else’s expectations.

Kate:

And that looks like being convinced to be sexual when they may not want to be. Their hesitation or their desire to pause or slowdown is dismissed. 

They’re told that they’re a “prude.” They’re told that they are “silly.” They’re underestimating the risk of being with a new partner and not getting tested, for example. They’ll reiterate things to me like noticing a skin blemish that looked like it could be an STD and asking the partner about it and that partner saying no, no, no, that’s a mole or it’s a scratch or it’s a this or it’s a that. And later, in fact, they realized that it was in fact an STI. 

But I think maybe some of the more quiet gaslights that happen around sex are around infidelity. A lot of cheating happens, and people’s bodies are really, really smart. And one of the symptoms that women will talk about and not have an answer for is a sudden shift in their pH in their body’s chemical process. They’ll notice changes in their body’s smell, changes in discharge, changes in the sensation that they experience in their genitals, and it’s usually attributed to a shift in their Ph. 

And what we found in the research around that is that when people are having multiple partners, especially if they don’t use protection, that can cause shifts in partners’ pH, because there are foreign bodies and you know, lots of things being moved around, if you will, right. So, bodies are adapting.

August (narration):

And yet, if you confront an abusive, narcissistic partner about a possible STI or concerns you have about them breaking your relationship agreements, they might gaslight you by telling you it’s “all in your head” or to “stop being so jealous” or “paranoid.”

I received a related listener question and Kate agreed to weigh in. It’s from Kira, who wrote this:

“My ex was very controlling, especially around sex. At first we had the best sex I have ever had, but gradually, he started making excuses to get out of sex and even started restricting me from physical touch like kissing. I’m in a much healthier relationship now. But I have a really difficult time initiating anything sexual. It’s as though I’m assuming my boyfriend isn’t that into me, even though rationally that does not seem true. Just wondering how I can move past this.”

Kate:  

Oh, that’s such a heartbreaking situation. 

Well, I think, you know, a couple of things to consider is that when we experience any kind of sharp change in a relationship, so when that sex goes from being off the charts amazing to being completely shut down, that can be a wildly jarring for anyone’s, of course, mind and their body. And it can feel a bit like a traumatic event, even though, you know, most people would say, “Well, what’s traumatic about that, right? Something changed.” But it can feel like a big rejection. 

We do tend to have a lot of complicated feelings around sex. And many women carry this idea that if they are more sexual than their partner that means something about them that is not okay. But the reality is that women have sex drives that are buried, and so do men, and sometimes you’ll be in sync with a partner. Sometimes you won’t. 

But what I would offer this woman to think about is how can she kind of listen to her body, speak with her partner about her concerns? What might she need to hear from him in order to trust that he desires her as much as she desires him? And do they want to talk about what it would look like if something changed? How would they communicate about that? 

And, you know, she might want to work with a sex therapist for a little while just to kind of move through some of that pain and feel more embodied and empowered in her sexuality again, because when somebody shuts you down like that and really, you know, gives you the heisman, it can feel really painful. But you can reclaim that.

August (narration):  

I absolutely agree. And Kira, I hear about that scenario often, so you are definitely not alone. I hope you’ll give yourself a lot of grace and compassion. I also wonder if scheduling sex could be a good starting point. That’s basically a form of initiating, but it might not feel as intimidating. I hope you’ll keep communication open with your guy, too, so he can support you through this. 

Kate also shared thoughts on sex after trauma of all kinds, another area of her expertise that’s so needed. She told me that trauma literally impacts just about every domain of our existence, including how we see ourselves and shape our identity. It can impact the ways we perceive information around us, our health, the attachment in our relationships with loved ones and friends, our work, our achievement—everything.

Kate:  

So you can imagine that a trauma that has impact in all of these other domains really gets compounded when it speaks to how we are sexually. 

And so when you think about, what does all of this mean, I think it’s important to really parse out how this trauma impacted me? What am I okay with and what would I like to change? 

And that can sound really simple. But sometimes pulling back the layers of the onion give us a lot of “aha moments” that can move us through stuck points but also can be challenging or painful to kind of reevaluate and reorganize. 

August:  

Oh those questions are so meaningful. When you shared them, I imagined how impactful it could be to sit with them, maybe journal with them or explore them with a therapist. 

You mentioned earlier that you can feel very stuck, especially if you’ve gone through abuse by somebody who is narcissistic. It can be really challenging to connect with that inner voice. So I could see on the surface feeling a little, Wait a minute. I don’t know. Where do you go with that?

Kate:  

I’m so glad you asked because it can feel really daunting to be like, Wait a minute. Should I know the answer to these questions? I’ve never thought about this. I would say most of us don’t think about these things. We’re not conditioned to think about our sexuality with such nuance, right? Most of us are conditioned to be sexual in kind of a ritualized way and then thank you very much, it’s done, and we move on with our lives. 

So, you don’t have to have all these answers. And that’s why working with a sex therapist or a trauma informed therapist, ideally both, can really help you slow down and take the time to explore the answers. 

The other thing I want to offer is that the answers to these questions may not be static. They may change and evolve as you change and evolve. 

August (narration):

So checking in with yourself every once in a while, Kate said, can be a really helpful way to continue developing the relationship you have with yourself. 

When we’re in an especially dark place, in the thick of an abusive relationship or just finding our way out, it can be difficult to know what we’re working toward. We just want to survive or feel better. But Kate said there’s a lot more goodness to anticipate, beyond just being “okay.

Kate:  

Well, I think in in addition to relieving the immediate distress of a situation and when I say immediate distress, I mean, kind of that emotional discombobulation and overwhelm that can come when we feel dysregulated so learning how to stay more regulated and embodied, in my opinion, is one of the biggest gifts of healing. Because when we can get our mind and body in a more aligned present state, we have a lot of more control over how we can maximize the rest of our potential as humans, and that I mean that intellectually, socially, creatively. We’re just able to do and be so much more. 

And so the sense of vitality and aliveness that comes from healing, and when I say healing I don’t mean, you know, kind of returning to a pre trauma existence, because unfortunately, that bell has rung. We won’t get back there. But healing really means assimilating that experience into who you are currently. And giving it meaning that allows you to grow as opposed to meaning that holds you back. And that can sometimes be the most challenging obstacle in healing from trauma, but it is the most powerful.

August:  

That desire to go back really resonated. When you said that, I thought wow. That must be a challenging thing to hear, and also a very freeing thing to hear. Because if you’re trying to go back and you can’t, it must feel just so frustrating.

Kate:  

Yeah, it does. It does. And that is one of the really unfair parts of trauma. Something happened to you that you didn’t want, you didn’t plan. And now you can’t be without it. And that just is awful. It’s an injustice. And it can be a catalyst for so much more growth in a direction that maybe you never knew was possible before.

August:  

What’s one piece of advice that you would share for anyone to work through, either a sexual trauma or narcissistic abuse?

Kate:  

Just one kernel? [laughs] Well, I think one thing I would really emphasize is that your body is so much more intelligent than, than even we, as professionals and clinicians know. We’re still, you know, researching the depths of knowledge that our bodies are able to communicate to us. 

So, listen to your body. And if you don’t know what it’s saying, slow down even more and do what you can to be present in your body and just aware of what’s going on below your eyeballs. Because that gift, that knowledge that internal knowing is what will guide you from making decisions that you don’t want to make in the future.  

It’s when we get so busy in our lives and start doing, doing, doing and focusing on everything and anyone outside of ourselves, which is easy to do just being a human in 2021, but it’s also really enticing for trauma survivors because it can be scary to be in our bodies. But if you can get in there and just stay there, even if it’s just for a few minutes a day, that is going to make a world of difference. 

The other thing that I would offer is that healing is not a linear path, so give yourself permission to be messy and clumsy. Clean it up when you can and move forward, because we are all imperfect little messes of awesomeness. And that’s just going to be the reality whether you have trauma or not. So, love yourself through it. Don’t shame yourself for it.

[a few bears of upbeat music]

August:

Learn more about Dr. Kate Balestrieri at modernintimacy.com, which features tons of helpful articles. She also offers a course on healing from toxic relationships. Follow Kate on Instagram at @themodernintimacy and @drkatebalestrieri. 

To hear a special bonus episode on surviving narcissist or sociopath abuse and what I’ve learned from producing this series, join me on Patreon at patreon.com/girlboner. I’ll be sharing an exclusive chat there in the next couple of weeks. By joining you can also get access to prize drawings, occasional bonus segments, Ask Me Anything chances and more. 

*****

The full episode also includes Dr. Megan Fleming’s thoughts for a listener who said she recently broke up with an abusive sociopath and is worried that his porn addiction/compulsive sexual behaviors will continue to haunt her. Stream it up above or on your favorite podcast app!