Author: Staff

by

Darlene Lancer, JD, LMFT

A trauma bond is an attachment to an abuser in a relationship with a cyclical pattern of abuse. Patrick Carnes, Ph.D., coined the term in 1997. He defined it as an adaptive, dysfunctional attachment occurring in the presence of danger, shame, or exploitation in order to survive. It is a trauma reaction created due to a power imbalance and recurring abuse mixed with intermittent positive reinforcement; in other words, good and bad treatment. The abuser is the dominant partner who controls the victim with fear, unpredictability, belittling, and control.

Behavioral psychologists call “intermittent reinforcement” conditioning (or “training”) behavior through the use of giving intermittent rewards. Positive reinforcement is when the abuser acts friendly, romantic, or vulnerable following the abuse. It’s easy to go into denial about the abuse to maintain a positive connection with the perpetrator and cling to the hope that the relationship will improve.

Looking for rewards can become addictive, like constantly checking your phone or email. This is how gamblers keep chasing an elusive win to get back their losses, even as they go into debt. Slot machines are programmed to encourage addictive gambling based on this phenomenon. This repeated pattern leads to a cycle of abuse. There may be expressions of remorse or false promises that the abuse will stop. This is similar to the “merry-go-round” of denial that accompanies addiction where the addict promises to quit.

Surprisingly, research confirmed that the reward-seeking behavior continued even after the rewards stop coming! In studies, rats neglected their grooming and other self-care habits but kept pushing the reward lever like a slot machine.

You can get addicted to emotionally unavailable partners because they may periodically want closeness. You become dependent on and addicted to your partner’s attention and validation. You can become addicted to any sign of approval or bits of kindness or closeness that feel all the more poignant (like make-up sex) because you’ve been starved and are relieved to feel loved.

Similarly, the mix of positive and negative feelings toward a Jekyll and Hyde abuser creates confusion and makes it hard to leave. Narcissists might intentionally withhold communication and affection to manipulate and control you with rejection or withholding, only to randomly fulfill your needs later. You become anxious and try even harder to decipher the narcissist and how to please him or her to get what you previously had but to no avail. Like the experimental rats, you get accustomed to long periods of not getting your needs met. This is how you become increasingly childlike and dependent on the narcissist — watching and accommodating to avoid abuse and to receive the occasional reward.

Trauma Bonds and Stockholm Syndrome

The term “Stockholm syndrome” originated from a bank robbery in Stockholm, Sweden in the summer of 1973 when bank robbers held four people hostage for six days. This syndrome describes captives who sympathize with their abuser in life-threatening situations where they are isolated and can’t escape. Prisoners align with their captors. Any act of kindness or even the absence of abuse feels like a sign of friendship and being cared for. The abuser seems less threatening. Prisoners imagine that they’re friends and share common values and goals, believing they’re in it together and may view helpers or the police as the enemy. In the Stockholm robbery, the prisoners sided with their captors against the police who rescued them.

Because of the emotional and psychological bonding, Stockholm syndrome terminology has been expanded to cover intimate relationships that are less perilous than hostage situations. However, this application is controversial. Some people also argue that it’s not even abnormal behavior because it’s normal in the prisoner situation and adaptive. In fact, statistics show that friendliness and empathy for the abuser reduce violence against prisoners.

Signs of Trauma Bonding

Codependents are loyal to a fault. They are often preyed upon by and attracted to narcissists and abusers and feel trapped and hard to leave any relationship. This tendency is exaggerated in trauma bonds. You want to protect the abuser rather than yourself. You make excuses for the abuser or hide or lie about the abuse to other people. You feel guilty when you talk to outsiders or think about leaving the relationship or calling the police. Outsiders who try to help feel threatening. For example, you might see counselors and twelve-step programs as interlopers who want to brainwash and separate you and your partner. This reinforces the toxic bond and isolates you from help, which is exactly what the abuser wants!

Some conditions and signs are:

1. You cover up or conceal the abuser’s behavior to other people.
2. A cycle of behavior that’s hurtful to you, despite your complaints.
3. You feel protective of your partner and feel guilty talking about the abuse.
4. You rationalize the abuse or make excuses for your partner.
5. You don’t want to leave or don’t like the relationship but feel unable to leave. Logic is distorted or is no help.
6. You obsess about the relationship or the abuser.
7. You doubt your feelings and perceptions.
8. You blame yourself and accept blame for the abuser’s behavior.
9. You continue to hope that things will improve, despite evidence to the contrary.
10. You cling to any sign of positive attention from the abuser.

Effects of Trauma Bonding

Over time, trauma bonding increases dependency. You attempt to avoid conflict and become more deferential. Meanwhile, your self-esteem and independence are frequently undermined by emotional abuse. When you object, you’re attacked, intimidated, or confused by manipulation. Consideration from your partner may become rare. Nevertheless, you’re hopeful and accommodating and keep trying to win back crumbs of loving attention. This behavior is common for victims of abuse who become attached to their abuser. You may have been gaslighted and have begun to doubt your perceptions due to blame and lies.

You might give up hobbies, interests, and friends and completely lose yourself trying to please and not displease your partner. This pattern may have developed in childhood and is now activated and exacerbated in your current relationship. Trauma bonding is resistant to change. Our brains are wired to attach and before recovery, these bonds aren’t within our conscious control. So don’t judge yourself.

As denial and cognitive dissonance between reality and your beliefs and perceptions grow, you do and allow things you wouldn’t have imagined when you first met. You develop “learned helplessness.” Your shame increases as your self-esteem declines. You feel guilty or responsible for the abuse. You wonder what happened to the happy, self-respecting, confident person you once were. Trauma bonds can harm your mental and physical health and create an increased likelihood of depression. This worsening trend parallels the chronic progression of codependency and makes it harder to leave.

You’re especially susceptible to becoming dependent on an abuser if you have codependency and/or the relationship dynamics are similar to what you experienced with a distant, abusive, or withholding parent. The trauma bond with your partner outweighs the negative aspects of the relationship. You not only fear retaliation but also the loss of the emotional connection with your partner, which seems worse than the abuse. Some common symptoms are:

1. Shame and low self-esteem
2. Depression and anxiety
3. Distrust in yourself and other people
4. Difficulty concentrating and functioning at work
5. Prolonged irrational feelings of guilt, even for leaving the abuser
6. Intimacy issues in new relationships due to shame and fears of abuse and abandonment
7. PTSD or CPTSD as a reaction to abuse even after leaving
8. If you don’t leave the relationship, you may suffer a loss of self, depression, health conditions, and possible addiction.

If you’re experiencing abuse, don’t isolate or hide the fact. Reach out and get support. Seek counseling. It’s essential to seek treatment to leave an abusive relationship and to heal from trauma. There are many modalities available, including CBT coupled with EMDR or Sensory Experiencing (SE). Also, join a 12-Step program such as CoDA or Al-Anon. Additionally, take steps to overcome codependency. Raise Your Self-Esteem, learn How to Be Assertive, and practice self-love. These relationships are very hard to leave. Learn how to handle abusive relationships, restore your self-esteem, and acquire the strength to leave. Get Essential Tools for Improving or Leaving Narcissistic and Abusive Relationships.
© 2022 Darlene Lancer

f you’ve ever watched someone be warm, generous, and magnetic in a room full of people — then cold, critical, and controlling the moment the door closed — you already know why this question gets asked so often. Yes, many people with strong narcissistic traits effectively live a double life: a curated public self and a very different private one. Understanding why it happens (and what it does to your mind and body) is the first step toward protecting yourself.

The Public Self: Image as Oxygen

For people high in narcissistic traits, admiration isn’t a bonus — it’s fuel. Psychologists call this “narcissistic supply”: the steady stream of praise, attention, and status that props up a fragile self-image underneath.

In public, that looks like:

• Charisma that fills the room
• Generosity with an audience — big tips, grand gestures, public favors
• Quick charm with strangers, coworkers, and extended family
• A carefully managed reputation as the helper, the leader, the “great guy” or “amazing woman”

None of this is fake in the sense of being consciously rehearsed every minute. For many, it’s automatic — the self they need to be seen as. That’s an important nuance: not every narcissistic person is a calculating villain in a mask. Some genuinely believe their public self is who they are.

The Private Self: When the Audience Leaves

Behind closed doors, the incentives change. There’s no reputation to protect from you — you’ve already seen too much. What often shows up instead:

• Criticism, contempt, or the silent treatment
• Blame-shifting (“You made me act this way”)
• Control over money, time, friendships, or decisions
• Rage over small slights, followed by zero accountability
• Warmth that returns only when you’re useful again — or when others are watching

This public/private discrepancy is one of the most commonly reported experiences among partners and family members of people with narcissistic personality patterns. It’s also why victims so often aren’t believed: everyone else only ever meets the public self.

Why the Two Selves Exist

Clinically, narcissistic personality disorder involves grandiosity, a need for admiration, and low empathy — but underneath is usually an unstable sense of self-worth that depends on external validation. The public performance protects that self-worth. The private behavior discharges the pressure of maintaining it.

Three things worth knowing:

1. It exists on a spectrum. Plenty of people have narcissistic traits without full NPD. The double-life pattern shows up along that whole spectrum, in milder and harsher forms.
2. It isn’t always conscious. Some people knowingly manipulate; many are running deeply ingrained defenses they’ve never examined.
3. The explanation is not an excuse. Understanding why someone devalues you in private doesn’t obligate you to keep absorbing it.

What Living With the “Private Self” Does to Your Body

This is the part most articles skip — and it matters, because the damage isn’t only emotional.

Living in a relationship where the rules change at the front door keeps your nervous system in a state of chronic vigilance. Over time, that can show up physically:

• Sleep problems — difficulty falling asleep, waking anxious, exhausting dreams
• Chronic muscle tension — jaw clenching, tight shoulders, tension headaches
• Digestive issues — stress and gut function are tightly linked
• Fatigue and brain fog — chronic stress hormones are metabolically expensive
• Getting sick more often — prolonged stress suppresses immune function

If you’ve been told “it’s all in your head,” it isn’t. Chronic relational stress is a whole-body experience — which is why recovery has to be whole-body, too.

How to Protect Yourself: A Mind-and-Body Approach

1. Trust the private version. The person you see when no one’s watching is real data — not a bad mood, not something you caused.

2. Stop debating reality. You won’t win an accountability conversation with someone whose self-image depends on never being wrong. Save your energy.

3. Document and confide. Keep a private record of incidents and tell at least one trusted person. This counters both gaslighting and the isolation the public persona creates.

4. Rebuild your body’s sense of safety. Gentle, rhythmic movement — walking, stretching, somatic exercises, breathwork — helps discharge the stress your nervous system has been holding. Even 10 minutes a day starts to shift it.

5. Get real support. A therapist familiar with narcissistic abuse recovery can help you untangle what happened and rebuild self-trust. If cost or access is a barrier, support groups and hotlines exist too.

6. Set exit-ready boundaries. Whether or not you leave the relationship, know your limits, your resources, and your people.

The Bottom Line

Do narcissists live double lives? Often, yes — a public self built for admiration and a private self where the pressure comes off, usually onto the people closest to them. The pattern varies in severity and self-awareness, but the effect on partners and family is remarkably consistent: confusion, self-doubt, and a body stuck in survival mode.

You can’t control which self they show the world. You can start telling yourself the truth about which one you live with — and begin healing from there.

---

FAQ

Do all narcissists act differently in public and private? Not identically, but a public/private behavioral gap is one of the most widely reported patterns. Severity varies — from mild image management to a dramatic, disorienting split.

Do narcissists know they’re living a double life? It varies. Some are consciously strategic; many are running automatic defenses and genuinely see themselves as the good person their public self projects. Either way, the impact on you is the same.

Why does everyone else think they’re wonderful? Because everyone else only meets the public self. The private behavior is reserved for people whose opinion no longer threatens the image — usually partners, children, and close family.

Can a narcissist change? Meaningful change is possible but uncommon, and it requires the person to want treatment for themselves — not to win you back. Change promised during a breakup rarely holds.

Is the stress from this kind of relationship really physical? Yes. Chronic relational stress affects sleep, digestion, muscle tension, immunity, and energy. Mind-body practices like somatic exercise and breathwork are legitimate parts of recovery, alongside therapy.

---

SOURCES

• American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.) — Narcissistic Personality Disorder criteria
• Mayo Clinic — Narcissistic personality disorder: Symptoms and causes
• Day, N. J. S., et al. (2020). “Living with pathological narcissism: a qualitative study.” Borderline Personality Disorder and Emotion Dysregulation
• American Psychological Association — Stress effects on the body
• Cleveland Clinic — Narcissistic Personality Disorder overview

Dr Samantha Rodden

As your friendly neighborhood blogapist that tackles many non-PC topics in order to help your marriage, I consider it my business to help you actually understand your partner better, even if what I say isn’t politically correct. This post is no different!  Here, I tackle the idea that men should generally try to protect their wives, because this is what most women that I see actually want. And, if the choice is between overprotecting and underprotecting (examples will follow), men who pick overprotecting will end up with happier wives and marriages. How does this play out?

Women frequently tell me that they don’t feel their husband “has their back.”  This can manifest in a million small and large ways, but some common ones are:

• He is not on her side in arguments with the kids or inlaws
• He doesn’t watch out for her and try to help her when she is tired, overwhelmed, depressed, or sick
• He sits by and watches while she makes unhealthy choices (e.g., stay up too late, drink too much, work too hard, get involved in arguments with family members that won’t lead to anything good) even though she tries to stop HIM from doing these same things
• He is nonconfrontational to a fault and does not lead the family in a direction that would be overall positive because he is terrified of her short term frustration or disapproval

Women may say they want to be independent, and they certainly do want to make their own choices about many things, as does any human being.  But most women also yearn for a partner who takes charge, especially when they feel tapped out or overburdened.  The problem comes when they criticize their husbands for any attempt at taking charge, which makes men feel scared to do so, because then they are jerks or bad feminists.  This idea is why I wrote my post Stop Caring So Much What Your Wife Thinks.

What are examples of protecting and underprotecting?

Protecting (which maybe you see as overprotecting if you never do these things):

• Making the decision about where to go to dinner because she is too stressed to deal
• Telling your mom that your wife will be taking a nap during their afternoon visit because she is wiped out from being up with the baby
• Telling your kids to respect their mother and giving them a time-out for being rude
• Telling your wife she needs to get more sleep and turning off Game of Thrones after this episode
• Not buying the snack foods that she says over and over that she gets addicted to and doesn’t want in the house
• Telling her to go take a nap because you have the kids and the house handled and she is exhausted

Underprotecting:

• Letting your wife make all the decisions because she criticized your choice of Mexican food when you were dating
• Saying nothing as your mom makes comments about how your wife should sleep train the baby
• Saying nothing when your kids are rude to your wife because this one time she told you not to invalidate them
• Figuring that your wife’s sleep, exercise, food and drink intake and whatever else is her business because she is an adult and not helping her with moderation even when she says that would be helpful
• Not checking on her during the day at all, even via text, and then saying it’s because you don’t want to bother her at work because she says she’s busy (as if a text is going to jump out of her phone and dance on the table during her meetings)

If you try some of the protecting ones and your wife says, “Don’t patronize me!” then you can openly share that you’re trying to make more decisions because she has said she wants you to make decisions/be involved/whatever she has said.  But I can assure you that this reaction is better than the sobbing anger that you will get from a wife that feels that you never protect her or back her up.

If you are uncomfortable making decisions for your wife’s benefit because this seems chauvinistic, think of it as caretaking plain and simple. I have said before to treat your partner as well as you treat your kids.  If your child said “But I don’t want to brush my teeth!” you would still make sure they brushed their teeth. Yet when your exhausted wife says, “But I have to watch one more episode to wind down,” you say, “Okay” and go back into the world of your phone.  What if you said, “Come to bed and I will rub your back and then you can get the sleep you need?”  This would be loving, caretaking, and protecting.  If you do it for your kids, why not for your wife?

Sometimes women are uncomfortable being cared for because they never got cared for as children. Then, they usually secretly want to be taken care of and protected, but they think this isn’t an option for them.  Then, they will say things like:

• “I do everything myself around here”
• “My husband acts like a child“
• “My husband is so irresponsible“

You may say that these particular men in the linked posts are actually all of these bad things that their wives call them.  But how did these men get this way and why did the woman choose to stay when their selfish traits became evident (almost never late in marriage, almost always red flags early on)?  It takes two to tango. Often, women who are very anxious and codependent find an irresponsible partner very familiar on a subconscious level.  Growing up, they saw one parent who was a “problem person” (e.g. alcoholic, anger issues, depressive), and one who devoted their life to “helping” or enabling this person.  When women stay in situations where a man cannot protect them and then say this is why they HAVE TO do everything themselves instead of getting out and finding a partner who would care for them, this is due to unexamined codependency and feeling like they don’t deserve and could never find anything better.

You may also ask, “Why is this post targeted toward men? I thought both partners are supposed to care for each other?” My answer is simple.  I see many, many women in couples counseling who say they wish their partner protected them, and I have never heard this from a man.  Men certainly want to be taken care of, and most frequently this is with physical affection and words of love.  I take an equity approach to couples work vs equality.  Everyone needs similar things, such as to feel loved and secure, but not everyone needs the exact same partner behaviors to achieve this.  Women who want to care for their male partners can read other posts of mine like this, this or this.

Try to protect your wife and see if she starts to feel more secure, which would manifest as more smiles, less anxiety, less irritability and less anger (and more physical touch).  People who feel vulnerable to attack (even in ways that you don’t consider “attacks,” e.g. your mom making comments) act angry and defensive.  When they know someone is there for them, actively trying to care for and protect them, they frequently calm down because they feel more secure and loved.  Share this article with your partner as well, because more communication on this topic may help you further understand how your spouse feels about this idea of protection.  And till we meet again, I remain, The Blogapist Who Says, Everyone Wants To Be Securely Reparented, But This Can Look Very Different To Different People.

Navigating relationships can often be tricky, and it’s crucial to identify when someone might not have genuine intentions. Here’s a straightforward guide to help you determine if a guy is using you.

Signs That He May Be Using You

1.Lack of Consistent Communication

1. Infrequent Contact: If he only reaches out when he needs something, it may indicate his lack of genuine interest.
2. One-sided Conversations: If your interactions revolve solely around his needs or interests, it’s a red flag.

2.Minimal Emotional Investment

• Avoids Deeper Conversations: If he steers clear of discussing feelings or future plans, he may not be invested.
• Limited Support: Observe whether he supports you during tough times or if he disappears when you need him.

3.Unbalanced Efforts

• You Do All the Work: If you find yourself planning most of the dates or initiating conversations, this imbalance can be telling.
• Only Engages When It’s Convenient: If he only wants to hang out on his terms, it suggests a selfish approach.

4.Focus on Physical Relationship

• Rushing Intimacy: If he seems more interested in physical aspects rather than forming a deeper connection, this may indicate ulterior motives.
• Disregard for Your Boundaries: Respect for your personal boundaries is critical; a lack of it may signal that he’s only interested for personal gain.

How to Address Your Concerns?

1.Open Communication

• Express Your Feelings: Share your observations and feelings with him. A direct conversation can clarify misunderstandings.
• Ask for Clarity: Inquire about his intentions and see how he responds. Genuine individuals will engage earnestly.

2.Set Boundaries

1. Establish Expectations: Clearly outline what you want from the relationship and observe his reaction.
2. Maintain Personal Space: Don’t hesitate to take a step back if you feel uncomfortable or undervalued.

3.Trust Your Instincts

1. Listen to Your Gut: If something feels off, pay attention to those feelings. Your intuition often knows more than you realize.
2. Be Aware of Red Flags: Keep an eye out for consistent behaviors that align with the signs mentioned above.

Conclusion

Recognizing when a guy is using you is essential to maintaining healthy boundaries in any relationship. Always remember:

1. Trust your instincts.
2. Prioritize your value and well-being.
3. Don’t be afraid to walk away from situations that don’t serve you.

Being informed and vigilant can empower you to build relationships based on mutual respect and genuine interest.

If you find yourself in a situation where you are unsure, seeking advice from friends or a professional can provide additional perspective and support.

The surprising revelation on the effect of narcissism on relationships.

• Narcissistic admiration is different from narcissistic rivalry.
• Narcissistic admiration can be linked with positive traits, especially early in a relationship.
• Narcissism does not always moderate a decline in relationship satisfaction.

We all know someone involved with a person who is self-centered and self-absorbed. We are always hesitant to jump to conclusions and diagnose someone as a “narcissist.” But there are a variety of negative traits that value self over others, that affect romantic relationships in different ways.

Source: Image by Daniil Kondrashin from Pixabay

Narcissistic Admiration and Rivalry

Gwendolyn Seidman and William J. Chopik (2026) examined how narcissistic admiration and rivalry affect changes in relationship satisfaction over time.[i] They adopt the narcissistic admiration and rivalry concept, definitions of narcissistic admiration as “seeking admiration from others by being charming and asserting one’s unique and special status,” and narcissistic rivalry as a strategy that is more antagonistic and destructive within interpersonal relationships, including demonstrating superiority and devaluing others. They explain that narcissistic admiration is linked with positive traits such as higher self-esteem and constructive conflict strategies; narcissistic rivalry is associated with lower self-esteem, hostility, and reduced communal behavior and forgiveness. They acknowledge prior research suggesting that narcissistic individuals may initially prompt enjoyable and satisfying relationships due to their charming tendencies, but experience steep declines in satisfaction over time due to narcissistic antagonistic tendencies.

Narcissism and Relationship Satisfaction

In their own research, Seidman and Chopik sought to delve further. They studied a sample of over 5000 romantic couples and a subset of couples in new relationships of one year or less, over six years, examining changes in relationship satisfaction as linked with narcissistic admiration and narcissistic rivalry. They found that narcissistic rivalry was linked with lower relationship satisfaction, consistent with past research. They note that these effects were stronger for an individual’s own amount of narcissistic rivalry than for one’s partner. Contrary to predictions and prior research, however, they found no association between narcissistic admiration and satisfaction or how it changes over time. In addition, Seidman and Chopik found that neither partner’s narcissism moderated the degree to which relationship satisfaction changed in either of their samples.

In discussing limitations and future directions, Seidman and Chopik point out that relationship satisfaction is only one factor related to relationship quality, and the only one included within their study. They note that some evidence indicates people with high levels of narcissism are less relationally invested and may have a positive view of relational alternatives. They also note that even though less relational commitment and satisfaction combined with high quality alternatives are linked with higher rates of dissolution, these risk factors are more pronounced within people who have higher levels of narcissism.

Romance and Self-Love: How to Navigate Narcissistic Traits

Couples, where one or both parties acknowledge a tendency to put self first, can learn from research in this area to maximize relationship satisfaction, as well as quality and commitment. Recognizing selfish tendencies in oneself or a prospective partner in the early stages of a relationship can prompt objective analysis of compatibility issues before either partner invests in the partnership. Engaging in this reflection before trading in reading glasses for rose colored glasses also allows individuals to spot red flags before they become pleasantly muted. And of course, even when a relationship is already underway, narcissistic traits and all, counseling is available and can be of assistance to both partners.

References

[i] Seidman, Gwendolyn, and William J. Chopik. “From Spark to Strain? Changes in Relationship Satisfaction as a Function of Narcissistic Admiration and Rivalry.” Journal of Personality, March 26, 2026.

Wendy L. Patrick, J.D., Ph.D., is a career trial attorney, behavioral analyst, author of Why Bad Looks Good, Red Flags, and co-author of the revised New York Times bestseller Reading People.

Online:

 wendypatrickphd.com, Facebook, X, LinkedIn, Instagram

Grief shows us the value of what we have lost.

Key points

• We see the tragedy our clients experience but cannot be flooded by it, or we wouldn’t be able to do our work.
• Meaning-making is a stage of grief that helps us integrate grief into life purposefully.
• Grief and depression may coincide but may be mutually exclusive; clinicians need to be sensitive to this.

Dr. Kübler-Ross, in her 1969 book, On Death and Dying, offered for the first time a framework for understanding grief, based on her research with terminal patients. Her model is not linear, and individuals may cycle through or revisit as needed.

Kübler-Ross, a psychiatrist, describes denial, the first stage of grief, as a defense mechanism where our minds numb us to the immediacy of the loss. The next stage is anger, where the denial gives way to feelings of anger at the pain experienced from the loss or at external circumstances brought about by the loss. The third stage is bargaining, where we might try to negotiate the pain of the loss away by perhaps imagining different outcomes. Then we may experience feelings of depression characterized by the weight of what has occurred, expressed with sadness, isolation, or hopelessness. The final stage is acceptance, which might be best described as learning to live with the permanent pain and changes it brings to how life was.

Dr. David Kessler, a grief expert, has added another stage he describes as meaning, which allows a person to move forward, honor the loss in some way, and find a way to integrate the experience into a purposeful life.

The DSM-5-TR pathologizes grief by calling it Prolonged Grief Disorder, and it adheres to a caveat of more days than not and over a month of intense yearning and preoccupation with thoughts or memories of the deceased person. A person must exhibit marked disbelief about death and avoidance of reminders of the deceased, and experience three symptoms from a laundry list that includes identity disturbance, reminders of loss, intense emotional pain, and more.

This historical development is presented as a long-term process culminating in the inclusion of valid, clinically relevant prolonged grief disorder criteria in diagnostic handbooks. Yet there are challenges to this dominant narrative. As stated in a 2023 article (Eisma, 2023): “[T]he developmental history of prolonged grief disorder has been nonlinear and…this yields questions on generalizability and problems with measurement.” Grief and depression may certainly coincide, but they also may be mutually exclusive, and we as clinicians need to be sensitive to this.

Grief may also tell us we lost something important that may not be a person, but something else. Grief informs us of the value of something we have received. As I work with individuals who suffer from severe and persistent mental illness, I witness loss often. The person who hears voices marching through their head or believes they are being followed may grieve the absence of quiet and safety.

Individuals who have been sexually or physically abused as children, those who lack loving and committed parents, homeless or hungry persons, or those who suffer from a pervasive life-changing mental illness grieve for those losses they have experienced, yet they don’t have the luxury to grieve because their lives are filled with instincts to survive.

article continues after advertisement

Illegal immigrants who live in fear of being deported at any moment cannot grieve their loss of hope about the lives they believed they would have had. It is ever-present grief about the immediacy of impending loss.

I believe grief also takes us to a darker side of life we would rather not see. For those of us in mental health care, we see the tragedy our clients have experienced routinely, but we cannot be flooded with grieving, or we would be unable to do our work.

Grief is a multidimensional experience that all of us will experience or have experienced in our lives. Perhaps it is the experience that has allowed us to go deeper inside ourselves to serve others. It is a common occurrence that we don’t speak enough about.

I had a client I worked with for 20 years. She suffered not only severe and persistent mental illness but also borderline personality disorder. I met her in a clinic I was working in and was able to accommodate her in my private practice following my leaving the clinic.

She was a unique human being, but she had spent her life cutting her arms and pushing people away and hearing voices when no one was around. She was a pacifist and often went to marches to proclaim nonviolence.

Over time, she abandoned her cutting behaviors in favor of developing relationships with others and expressing her deep feelings openly and with less fear and intensity. Her favorite method of being pampered was being psychiatrically hospitalized at a few chosen sites. Not only a particular hospital but a designated floor.

article continues after advertisement

When she was 51 years old, she was diagnosed with lung cancer. When oxygen became necessary, she could not visit my office, so I decided to have our sessions at her house.

She became less able to care for herself and did not have any care providers, so she moved into a nursing home where she would be able to be transported to a hospital for her chemotherapy and radiation. The rides became very painful. She needed to be wheeled into an ambulance and take the bumpy ride to treatment. After a few treatments, she elected to discontinue both. She was going to die.

I once again decided that I would conduct therapy where she was living, in a private room, which she was wheeled into. This continued for months as she weakened, but she was still committed to working in therapy.

This process forced me to consider the purpose of psychotherapy and the surroundings in which it occurs.

She had requested my attendance at her bedside as death approached. I remained one day when she passed. Having received verbal permission to speak at her funeral, I gave the eulogy.

My grief was not like it was for other deaths I had previously experienced. It was a deep-felt awareness of my connection to someone with whom I had passed through different stages of her life. I felt a gratitude, a joy, a sadness, and privilege to have known someone who changed my life and helped me become a deeper, more compassionate, more skilled practitioner. It was David Kessler’s stage of meaning.

Fifteen years later, her calligraphy hangs in my home, and her dream catcher hangs in a window.

References

Eisma, Maarten C. Aust N Z J Psychiatry. 2023 Feb 6;57(7):944–951.

What are they ??

Ghosting, simmering, and icing are colloquial terms that describe the practice of suddenly ending all communication, avoiding contact with another person without any apparent warning or explanation, and ignoring any subsequent attempts to communicate.

“When a person is ghosted, even if they try to reach out to the other person to either reconnect or receive closure, they are typically met with silence.”

Source: Navarro R, Larrañaga E, Yubero S, Víllora B. Psychological Correlates of Ghosting and Breadcrumbing Experiences: A Preliminary Study among Adults. Int J Environ Res Public Health. 2020;17(3):1116. doi:10.3390/ijerph1

 As you can see, it’s called ghosting because it involves someone essentially “vanishing” into thin air as if they were a ghost.

The term “ghosting” typically refers to a romantic relationship where contact unexpectedly ceases, but it can also apply to friendships and family relationships.

Signs of Ghosting

Ghosting is often apparent, but it can also be a gradual process. The other person might start by ‘soft ghosting,’ where they progressively minimize contact over some time. Some early signs that someone might be ghosting you include:

• “They frequently cancel plans to hang out, have a hard time committing, avoid sharing personal details, don’t want you to meet their loved ones, disappear from social media, seldom reply to your texts or calls, and their conversations lack depth, making them seem uninterested.”

Ghosting is a trait that can also happen on social media platforms. It refers to the act of cutting off all social media contact with another person without offering an explanation. This may involve unfriending, unfollowing, or even blocking the person on all social media platforms. In some instances, the person may even go as far as deactivating or deleting their social media accounts to prevent any form of contact

Though a new term, ghosting existed well before the digital age. “I think references of ‘going for a loaf of bread and never coming back’ are examples of ghosting,” says Bree Jenkins, LMFT, a dating coach in Los Angeles, Calif. “Ghosting used to be leaving a person and moving away or not leaving [them with] your contact information—its earlier origins are even the simple act of leaving a party or social gathering without notice and goodbyes.”

Why Do Some People Choose to Ghost?

Ghosting is often viewed as an immature or passive-aggressive way to end a relationship, and in some cases, it may even constitute emotional abuse.

There are two primary reasons why a person ghosts another, and often it’s a combination of the two.

It’s the Easy Route

The first reason why some people choose to ghost others is that they find it easier to avoid uncomfortable conversations about ending the relationship.

The person doing the ghosting often wants to avoid confrontation or dealing with someone else’s hurt feelings, so they simply cease all communication and hope the hint is delivered.

Option Overload and Fatigue

“Margaret Seide, MD, a board-certified psychiatrist based in New York City, explains that with internet dating, there are seemingly infinite choices as opposed to walking into a bar with limited options. Due to the large number of choices, online daters tend to quickly move on to the next potential match with an “OK, next” or “Yeah, but what else?” mindset. Although the person they are interacting with may be nice, they may not make the cut due to the fact that they are juggling multiple other people.

There are various reasons why people ghost, including fear of the other person’s reaction to rejection.