PTSD Relationship Home
PTSD Relationships
PTSD Group Guide
PTSD Relationship Chat
PTSD Self-help Books
PTSD Crisis Situation
Press Release
Dr.Diane England
Wounded Warrior Treatment Article
Sexual Acting Out Article
Overcoming Anger Article
PTSD and Sexual Assault Article
Don't Overlook Sufferer's Partner Article
PTSD Sufferers vs Narcissistic Article
Share Your PTSD Story
PTSD-related Links
Links to Author's Other Sites
PTSD Relationship Site Map
PTSD Newsletter
Site User Agreement
e-mail me


Don’t Confuse Post Traumatic Stress Disorder (PTSD) Sufferers with the Narcissistic


Do you think it's possible for you or others to confuse someone suffering from the mental disorder of Post Traumatic Stress Disorder (PTSD) with someone suffering from an unhealthy or pathological level of narcissism? Frankly, not only do I think it’s possible that you or others could conclude that a PTSD sufferer was narcissistic but, quite frankly, it would be rather tragic if this happened. Let me explain why I feel this way.

Today, we are concerned about a new generation of PTSD sufferers in the form of veterans of the wars in Iraq and Afghanistan. With regard to this group of young men and women, we are also concerned about such problems as alcoholism and drug abuse—since PTSD sufferers often turn to these substances in an attempt to deal with their PTSD symptoms. Because they do not want to continually be plagued by memories or flashbacks of some of the most horrific times they likely endured, many try to psychologically numb themselves through the use of these chemical substances.

Sadly, over time, a number of them can become alcoholics and/or drug addicts. Then, addictions, blended with PTSD symptoms, further change the PTSD sufferers’ personalities as well as their behaviors. For example, while many with PTSD are often irritated—if not outright angry--alcohol and other drugs add fuel to the fire. These individuals may fly into rages—or even become violent. This type of behavior can seem so inconsistent with their former personalities.

Angry veterans with PTSD---as well as other with PTSD, too—are apt to engage in abusive behaviors towards partners or loved ones, too. You may elect to label some of these more subtle and non-physical forms of abuse as verbal or emotional or psychological abuse. For the purposes of this article, it hardly matters which label for these terms you use. What is important, though, is to realize the destructiveness of that abuse—to the emotional well-being of the PTSD sufferer as well as to any romantic partner or spouse. Of course, abuse in the household harms children present, too.

Certainly, if you are a partner of a PTSD sufferer, I really don’t need to tell you all of this, do I? After all, you invariably know it experientially. That said, though, have you been encouraging your partner to pursue treatment for the PTSD if he or she has not already done so? While you’re loved one may be hesitant to seek such help—and may need your ongoing support to do so—you should remain optimistic that, with the right treatment, both of you should enjoy better tomorrows.

On the other hand, you shouldn’t hold out such hopes for narcissists. And quickly, because you don’t want to find yourself writing off someone who could potentially benefit from help, it’s important not to confuse the two disorders. That said, let me further clarify what I’m talking about.

Similar Behavioral Symptoms—but the Root Causes are Different

Yes indeed, if you have ever read about how those with unhealthy levels of narcissism are inclined to behave, or about the problems they can have with addictions, you may conclude that there are some definite similarities between PTSD sufferers and narcissists. So, if you ever met an addicted and abusive war veteran, let’s say, whom you didn’t know was a veteran suffering from PTSD, you might conclude that he was a narcissist.

Why? Because the narcissist is apt to develop one or more addictions as well as become abusive emotionally or verbally or psychologically.

You might also suspect a PTSD sufferer of narcissism because he disregarded the family, tended to isolate or did not want to participate in important events meaningful to others, was unwilling to assume certain responsibilities, and because of a seemingly general lack of concern for others—which you saw as making him self-centered.

The thing is, the PTSD sufferer lacks a characteristic or trait that truly separates him from the mental health issue of narcissism. And, quite simply, that is grandiosity. Yes, that is the truly distinguishing trait of the narcissistic.

War veterans suffering from PTSD are not apt to want to talk about what they encountered or endured that resulted in their PTSD. However, if they elect to talk about their experiences at all, it will probably be with those who have endured something similar. But then, war veterans believe that only other war veterans can truly understand what they went through.

And in truth, as much as you may want to be there for your PTSD-suffering partner, what civilian can possibly empathize or understand what they have gone through—or endure now, for that matter?

Why We Mustn’t Confuse the Two Disorders

The PTSD sufferer developed the symptoms he or she did due to involvement in either one traumatic event or traumatic events that were ongoing—such as in the case of war. On the other hand, the narcissist has undoubtedly been narcissistic since childhood. Narcissism is quite stable, in other words, whereas PTSD need not be—not with proper treatment, that it.

While both PTSD and narcissism affect the sufferers’ relationships with the self as well as with others, the narcissist typically does not have any significant problems or conflicts with the person he is being. (Most narcissists are men.) It is the individual forced to interact with the narcissist—his victim, if you will—who is most concerned about the abusiveness and destructiveness of the pathologically narcissistic individual.

The partner of the narcissist, suffering emotionally from a constant onslaught of verbal abuse or emotional abuse or psychological abuse, may well want the loved one to change. What she may not realize is that her narcissistic partner undoubtedly believes that she is the problem. And because the narcissist doesn’t see himself as having any self-created problems—because it is the nature of the narcissist to always blame others—he is highly unlikely to seek out or pursue help. Thus, change invariably will not happen—unless other life experiences create some kind of awakening of self-awareness. But this kind of personal transformation is indeed rare amongst the narcissistic. It is safer to bet on the narcissist not changing.

Then again, even if a narcissist does finally agree to go to a therapist with his partner, she needs to be on guard. He is likely to try and manipulate the therapist to take his side, blame his partner, and then “fix” her. If the narcissist is unable to do this, he is apt to verbally abuse the therapist, walk out, and never return.

Many PTSD sufferers—and especially warriors wounded by PTSD—may also prefer not to seek out treatment. While many of us who have worked with the military have also striven to get across the message that help-seeking behavior is a sign of strength versus weakness, some of the men especially seem disinclined to accept this. In all fairness, they have reasons for wanting to avoid treatment—such as the fear it may impact a military career negatively. Still, as someone significant to the PTSD sufferer, you should make it your mission to help ensure that your loved one does get help—and sooner rather than later. And if you are struggling to do so, it may help you to remind yourself that, unlike the narcissist, he probably can be helped.

In other words, with the support of others, the PTSD sufferer may well pursue a treatment path that leads to positive behavioral changes which you can see and list. On the other hand, the narcissist or narcissistic are not likely to go into treatment—or to stay with it should they ever make it through a therapist’s door. Since they believe that others create their problems, and they see these others as beneath them anyway, they do not feel the same need to engage in therapy to appease a partner as you or I might.

As result of their rather stable world views as well as the attitudes which stem from that, it is often best for the partner or the family member to recognize that it is going to be impossible to get the abusive narcissist to seek treatment and hence, to change. Sometimes the best thing to do is to walk away from—or at least, avoid as much as possible—the narcissist who favors emotional abuse or verbal abuse or psychological abuse.

That all said, it could come to the point whereby it’s necessary to part ways with an abusive PTSD sufferer who fails to get treatment. But at least in the beginning, it’s important to hold out hope.

On the other hand, too many of us have held out hope for narcissists—to our own detriment.

While PTSD is treatable, it still needs to be caught early on rather than later. Also, because it tends to impact the younger warriors more so than the older ones and furthermore, folks in their late teens and early twenties are most apt to deny they have problems, it’s so important for others to recognize what could be going on—or to not confuse one mental disorder with another. As a wife, member of the family, a friend, or a concerned member of the community, you could quietly intervene and encourage the person to seek help.

There is no need for us to have a repeat of what happened for so many veterans and their families after the War in Vietnam--when we didn't yet know what PTSD was and hence, didn't have treatments for it. While we can hold onto hope for today's warriors wounded by PTSD, there may nonetheless be only a small window of opportunity to make a real difference in the lives of these PTSD sufferers. So, ensure any veteran with PTSD doesn't miss it--because you or others mislabeled his mental health disorder as narcissism and therefore, wrote him off as untreatable.