How Victims are Affected by Abuse

The Conflicts of Therapy

By: Dr. Sam Vaknin

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Statistically, the majority of abuse victims are female and most abusers are male. Still, we should bear in mind that there are male victims and female offenders as well.


Ideally, after a period of combined tutoring, talk therapy, and (anti-anxiety or antidepressant) medications, the survivor will self-mobilise and emerge from the experience more resilient and assertive and less gullible and self-deprecating.

But therapy is not always a smooth ride.

Victims of abuse are saddled with emotional baggage which often provokes even in the most experienced therapists reactions of helplessness, rage, fear and guilt. Countertransference is common: therapists of both genders identify with the victim and resent her for making them feel impotent and inadequate (for instance, in their role as "social protectors").

Reportedly, to fend off anxiety and a sense of vulnerability ("it could have been me, sitting there!"), female therapists involuntarily blame the "spineless" victim and her poor judgement for causing the abuse. Some female therapists concentrate on the victim's childhood (rather than her harrowing present) or accuse her of overreacting.

Male therapists may assume the mantle of the "chivalrous rescuer", the "knight in the shining armour" – thus, inadvertently upholding the victim's view of herself as immature, helpless, in need of protection, vulnerable, weak, and ignorant. The male therapist may be driven to prove to the victim that not all men are "beasts", that there are "good" specimen (like himself). If his (conscious or unconscious) overtures are rejected, the therapist may identify with the abuser and re-victimise or pathologise his patient.

Many therapists tend to overidentify with the victim and rage at the abuser, at the police, and at "the system". They expect the victim to be equally aggressive even as they broadcast to her how powerless, unjustly treated, and discriminated against she is. If she "fails" to externalise aggression and show assertiveness, they feel betrayed and disappointed.

Most therapists react impatiently to the victim's perceived co-dependence, unclear messages, and on-off relationship with her tormentor. Such rejection by the therapist may lead to a premature termination of the therapy, well before the victim learned how to process anger and cope with her low self-esteem and learned helplessness.

(continued below)

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Finally, there is the issue of personal security. Some ex-lovers and ex-spouses are paranoid stalkers and, therefore, dangerous. The therapist may even be required to testify against the offender in a court of law. Therapists are human and fear for their own safety and the security of their loved ones. This affects their ability to help the victim.

This is not to say that therapy invariably fails. On the contrary, most therapeutic alliances succeed to teach the victim to accept and transform her negative emotions into positive energy and to competently draw and implement realistic plans of action while avoiding the pitfalls of the past. Good therapy is empowering and restores the victim's sense of control over her life.

Yet, how should the victim go about finding a good therapist? Watch this Video!

Appendix: A Patient’s Complaint

“I don’t want to hear you say that about my family!”

“Even if it is the truth?”

“I did not come to you for the truth! I came to you to find comfort and solace!”

“Healing is not possible without confronting reality, by avoiding it.”

“It would definitely not be possible if you make me even more depressed than I am! Why can’t you be like other life coaches and narcissistic abuse experts? They are empathic! They love people! It is such fun to work with them! They are so much brighter than you!”

“I don’t know if they love people but they sure love their money.”

“No! They are empaths! I can see the pain in their eyes!”

“Via YouTube? Well done! What if they are faking it?”

“That they would go to the trouble of faking it just proves that they care about us, the great unwashed that you so loath!”

“So, let me get it straight: if someone is only after your money, but takes the trouble to fake empathy and sympathy, it proves that he or she actually does care about you.”

“At least they work hard, even if it is only acting on their part! I appreciate that and I want to give them my money! With you, I feel bad! They make me feel good about myself!”

“They confirm your victimhood and justify all your decisions?”

“I am the victim here! But it is good to hear it from an objective expert!”

“You consider these people objective – or experts? How would you know that they are experts?”

“They definitely know more than you can ever hope to learn about spirituality, human connection, and the soul.”

“They may well do. I don’t particularly like fairy tales.”

“You see? Smug! Arrogant! How would you ever understand the first thing about narcissistic abuse?”

“Funny you should say this. I actually invented the phrase ‘narcissistic abuse’ in 1999 and was the first to describe the syndrome and the predicament of victims of narcissistic abuse in great detail.”

“That doesn’t make you an expert on narcissistic abuse.”

“Well, I can’t argue with that. I have invented the field but I am not an expert in it. Interesting thinking, I must admit. So, you don’t mind living in a fantasy, as long as it makes you happy?”

“We all live in fantasies all the time! It is cruel to force people to give up on their fantasies without providing them with other fantasies to replace them! You are a mean and nasty man and I suspect that you enjoy causing people pain with your extreme brutal honesty.”

“But all psychotherapies do the same: force you to confront the truth. Many of them do so even more forthrightly than I do.”

“That’s why people prefer online coaches and counselors to therapists. Psychotherapy is bunk: it causes more pain that it cures.”

“You think that this should be the main purpose of psychotherapy: to salve your pain?”

“If you are asking a question like this, you should never be in the healing professions. You need help yourself. I will WhatsApp you a list of YouTube channels that I found very useful in my recovery. They also give one on one sessions.”

“You consider yourself recovered?”

“Fully! And no thanks to you! Go, find another job, trust me, you are no good at this one! You made me break up with all my friends and family, brought on a severe depression, and coerced me into doing things which do not make me smile! You are a failure at this! And I don’t care how many phrases you coined! Have some modesty and humility to learn from your betters and from people with YouTube channels who know much more about both narcissism and narcissistic abuse than you do!”

(Dial tone)

Also Read

How Victims are Affected by Abuse


Post-Traumatic Stress Disorder (PTSD)


Recovery and Healing from Trauma and Abuse

What is Abuse?

Coping with Your Abuser

Coping with Stalkers

"Trauma Bonding" and the Psychology of Torture

Traumas as Social Interactions

How Victims are Affected by Abuse


The Toxic Relationships Study List

Spousal (Domestic) Abuse and Violence - Articles Menu

Verbal and Emotional Abuse - Articles Menu

HealthyPlace Narcissistic Personality Disorder (NPD) Community

Case Studies on the Psychopath and Narcissist Survivors Support Group

Ask Sam on the Psychopath and Narcissist Survivors Support Group

Ask Sam on the Narcissistic Abuse Recovery Forum

Domestic Violence and Abuse statistics - Click here

Open Site Family Violence

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