Toxic relationships with narcissists and psychopaths/sociopaths can leave really deep and long lasting effects in victims, to the extent that seeking out the help of a therapist is almost always recommended after getting out of these relationships.
However, not nearly all therapists are suitable for this kind of work. In fact, I would argue that a majority still aren’t. A good number of therapists still have no real concept of Cluster B disorders or Cluster B abuse, or the effects it has on people, which also means they’ll have no idea of how to help you recover.
Therefore, picking not just any therapist, but a good and suitable therapist, is a must for this kind of work, to avoid wasting your time and money. In this article, I’ll give you some tips on how to do this.
Here are some quick boxes that your therapist should tick when trying to recover from toxic relationships with Cluster B disordered people (narcissists/psychopaths/borderlines):
- Good rapport and down to earth
- Warm, empathic, friendly and supportive
- Has good knowledge of Cluster B disorders/abuse
- Has good knowledge of PTSD/C-PTSD
- Has good knowledge of codependency
- Fully validates you regarding the abuse you suffered
- Creates a sense of clarity and focus
- Clearly identifies key issues to work on
- Clearly identifies strategies to resolve issues
- Healing focused (emphasis on moving forward)
- Broad and deep knowledge base and skills set.
- Will challenge views when necessary.
We’ll cover all these points and more in much more detail in this post, detailing what to look for, what to avoid, and how best to proceed with therapy when recovering from Cluster B abusive relationships.
Some Qualities The Therapist Should Have (Brief Overview)
The aftermath of toxic relationships with Cluster B personality disordered people are best worked through with a qualified therapist or counselor.
See the video below for a superb summary by Richard Grannon of exactly the kind of help that will be most effective when recovering from a relationship with a psychopath/narcissist/borderline personality.
Here’s a summary of his main 5 points of qualities your therapist should have to help with recovery:
- Knowledge of Cluster B personality disorders and/or Complex Trauma (C-PTSD), preferably both. This is the crucial factor any therapist you work with must have.
- Healing Focused – willing to talk about the past but also focused on moving forward and moving on from the abuse – build new networks, connections, lifestyle, friends, etc.
- Approaches the therapy with a compassion and humor when appropriate – adds a lightness of touch to the process.
- Down to earth – approachable and treats you like a fellow human and not an object to be studied.
- Will when necessary give negative feedback and challenge your thinking and beliefs when faulty – doesn’t just agree with you 100% of the time.
I’ll cover these and more desirable traits in more detail in a section further below. But this is an excellent brief primer to start with in terms of what to look for in a therapist. And knowledge of Cluster B disorders and Cluster B abuse is a non-negotiable first step. If a therapist doesn’t even pass this test, they’re not suitable. The others are also important, but the knowledge of the therapist is the most important.
Some Resources For Finding A Therapist
Here are some links to follow to find a suitable therapist in your area, broken down by country.
- USA – very wide availability and multiple online search directories. Here are a couple:
- UK – two main accrediting bodies for therapist – UKCP & BACP.
- Canada – See Goodtherapy.org site for a search feature by ZIP code and state.
- Australia – See the APS Search Page or Goodtherapy AU page to find a therapist.
Does The Type Of Therapist Matter?
There are many different types and schools of psychotherapy, in fact so many that it might feel there’s almost too much choice when trying to decide. You can choose between classic psychoanalysis, Gestalt therapy, cognitive behavior therapy (CBT), EMDR Therapy, transactional analysis (TA), Jungian psychotherapy, Parts Therapy, and many more different therapeutic modalities.
EMDR is a particularly interesting modality that people in this space should consider exploring. It doesn’t work for everyone, but when it does work, it can be very powerful and effective. See here for a good account of a victim of narcissistic abuse who used EMDR to recover very effectively.
But does it matter which type of therapist you use when trying to recover from toxic relationships with Cluster B disordered people (narcissists/sociopaths/borderline)?
I would argue that this is a more important question when trying to recover from narcissistic or sociopathic abuse, than it might otherwise be for other mental health issues, because these people can cause such long lasting damage on a such a deep level in victims that using “just any” random therapist, the first one you find in the phone book or online, will not be adequate. You need to be more selective than that.
As a general rule, the school or type of therapist does not matter so much as rapport with the client, and the knowledge base and skills set of the therapist, when trying to recover from Cluster B abuse. The therapist must be well versed in Cluster B disorders and Cluster B abuse patterns, as well as trauma and complex trauma. The humanistic school of psychotherapy is generally not recommended for this kind of work, but any other type of therapist is suitable as long as they have the correct knowledge of personality disorders and toxic abuse patterns.
In other words, make sure your therapist knows what they need to know in order to help validate you and help you heal, and that the rapport between you is good, rather than focusing too much on the “school” of therapy they come from. Make sure all the criteria in the section above are ticked off (especially knowledge of Cluster B disorders and abuse), and also make sure you feel safe, comfortable and validated in sessions, and move on from any therapist where you don’t feel this.
However, from personal experience, one exception I would make to this rule is the humanistic school of psychotherapy. I’ve experienced myself (and heard other reports as well) that there’s too much naivety and lack of “streetwise-ness” to this school of therapy for it to be effective with this kind of work. I would stay way from this type of therapy for recovery from relationships with narcissists and sociopaths (narcissistic abuse).
I personally spent 18 (very conscientious and committed) months with a humanistic therapist after Cluster B abuse, and little or no core issues were actually addressed and resolved by the therapist, or even adequately labelled or acknowledged, with the result that the same experiences played out all over again in my life.
Looking back now, with additional knowledge I’ve gained since then, I am not at all impressed with their work, and can see that therapy was never going to be successful with them in my situation. I should have been a lot more picky with my therapist in the initial stages. Perhaps it was just my therapist, but given that I’ve heard other reports of this about humanistic psychotherapists as well, I think it’s important to put this out there.
The problem with using a humanistic framework for this kind of work starts off with the fact that one of the fundamental tenets of humanistic psychology is that all people are innately good. Anyone who’s seen the real nature of narcissists and sociopaths, once the masks comes off, and seen how relentlessly vicious and cruel they can be, unfortunately knows how incorrect and naive this assumption about humanity is.
“Our default understanding of humanity is going to be that everybody has some good in them. The research that Dr Robert Hare and Dr Martha Stout have done have really turned that around to say that 4% of human beings don’t have a conscience, they have no remorse for their behavior, and they actually look for opportunities to cause harm to others”
Jackson Mackenzie – see here.
I am open to hearing about successful experiences with humanistic psychotherapists (contact me with any differing accounts you have), but for now, I’m NOT recommending humanistic therapists for this kind of work. Moreover, the way they’d deal with sociopaths/narcissists themselves (as well as victims of narcissists/sociopaths) because of their somewhat naive views on humanity, is also misguided:
“Some (victims of narcissistic abuse) have been set up (by their narcissistic abuser) to go to a therapist and then be diagnosed by the therapist as a narcissist, and the (actual abuser) told them to do it. And (the narcissist) was smart enough to know what type of therapist he needed to get, even the background of the school of therapy he needed to go to.
There is a psycho-therapeutic school called humanism. Humanistic psychotherapy teaches that the therapist must validate the narcissist’s every belief about themself, because the narcissist was in denial as a child, was not given what they needed as a child. So they train the therapist (so that) if they have a narcissist in front of them, to let them say whatever they want, and to believe whatever they believe, and just give them more validation.
Yes, (why not just) take fuel on a open fire and just chuck it on. And that’s actually the way (humanists) are trained to do therapy”.
Richard Grannon, Spartan Life Coach
It should go without saying that you should not go near any therapist that looks at Cluster B personality disorders this way, for this kind of work. Therefore I’m out if they’re a humanistic psychotherapist. The only exception I can find is Elan Golomb, who is a humanistic therapist, and wrote a great book on narcissism, but that’s because her own father was one, so she had the life experience to really know that disorder inside out.
If you put all your energy into an unsuitable therapist for this kind of work, it can also exhaust your motivation to start all over again with someone else. This is what’s happened with me, and I don’t want others to be in that position as well. Therefore I’ve made this post with the intention to help others get this process right the first time, so they don’t end up wasting their time and money.
The school of therapist needn’t matter too much overall (other than my warning about the humanists), but make sure they have the right knowledge base and skills set and that you feel comfortable and validated with them.
Signs You’ve Found A Good Therapist
Let’s first look at some positive signs that you’ve found a good therapist that you can make some good progress with in recovering from sociopathic/narcissistic abusive relationships:
Rapport – You feel a good connection with your therapist; you seem to relate to each other very well. Conversation flows naturally and smoothly, you feel comfortable being open with them. You might sometimes find them finishing your sentences because they relate very well to what you’re describing in terms of your experiences.
Warmth – Relates to the rapport issue. The therapist needs to create a warm, safe, welcoming environment, where you get that feeling that you can shut out the stresses of the outside world and safely open up about issues for an hour. Feeling safe is crucial in recovering from Cluster B abuse, and the therapist plays a crucial role in this with the environment and feeling they create for clients in sessions. If you’re feeling this, then it’s a great start (but not everything – see the Direction point below).
Correct Knowledge – A huge one. They need to know about Cluster B disorders (narcissism, psychopathy/sociopathy, borderline), the common abuse patterns (gas-lighting, triangulation, smear campaigns, projection, devalue-discard etc), and also common issues from the victim’s side (codependency, weak boundaries, attachment issues, PTSD and complex PTSD etc) that need working on. More generally, their knowledge base and skills set needs to be broad and deep for this kind of work. Make sure they’re good, and know their stuff, with broad emotional and therapeutic literacy. If you’re clearly seeing this, then great!
Validation – They fully validate what happened to you. They understand the viciousness and cruelty of what was done to you. They understand that people without a conscience exist, who actively seek to harm others, and this is what you encountered. A sense that they will hold you accountable when needed, but are also fully on your side, understand and believe what happened, and you are working as a team to help recover and rebuild.
Accountability – Perfect balance to the validation point. Your therapist needs to be a supportive presence who 100% validates that you went through abuse, but also can’t be agreeing with you 100% of the time if it wouldn’t serve your healing to do so. Therefore a good therapist will challenge your thinking (with delicacy and empathy) when appropriate, and also encourage accountability down the line, once trust and rapport is firmly established. By accountability, I mean owning your side of the toxic relationship (how/why you let them in, mistakes you made) and working on boundary and codependence issues, and unresolved trauma from your side that the psychopath/narcissist may have exploited, but wasn’t originally responsible for. As horrible as Cluster B relationships are, it’s never a one way street and there are mistakes the victim made as well that need to be acknowledged.
Direction – You can see very early on that there’s a clear sense of direction and focus with the therapy. This needs to complement the warmth point above. You’ve both established a clear path moving forward on what happened, what issues clearly need addressing from your side, plus a broad plan of how to work on them. The process is focused and gives you a sense of clarity moving forward and doesn’t feel “aimless”, wandering or random.
See here for another excellent article from Psychology Today on finding a good therapist and recognizing good therapy.
Trust and rapport is essential. You need to get on with your therapist and find them relatable
Signs You Need To Find Another Therapist
Perhaps more importantly though, I want to give some pointers from personal experience on when it might be time to move on to another therapist instead.
Lacking Key Knowledge – The most important factor by far. If your therapist has no idea about Cluster B disorders or Cluster B abuse, move on right away. In fact, it’s best to weed these ones out before even meeting in person, via phone calls and emails. A therapist not knowing about Cluster B disorders and narcissistic/sociopath abuse in today’s world, with all the literature that is out there, is inexcusable. If they don’t have this knowledge, save your time and money and move on to another therapist immediately. Same thing if you’re bringing up key terms like gas-lighting, triangulation, codependence, smear campaigns etc, or citing key books and authors in the Cluster B/recovery space, and they’re just looking at you with a blank stare. It’s not going to work; find someone who has the correct knowledge instead.
Lack of Rapport – Another huge one. The therapeutic profession (ironically) has quite a lot of weirdos in it, who aren’t exactly relatable or good at building rapport. If you’re finding a therapist cold, aloof, unfriendly, not down to earth and just generally not building good rapport with them, move on to someone else right away. Rapport and trust is crucial with this kind of work; many of us lose faith and trust in others after narcissistic/sociopathic abuse, and building a good relationship with a therapist can be a key way of restoring this. If you’re not “vibing” with your therapist here, find someone else instead.
Behavior/Attitude Issues – If you see any red flags from your therapist, such as rudeness, aloofness, “moodyness“, impatience, or just a bad attitude in general, don’t tolerate this – just move on. Same thing if you catch any sense of a disrespectful or invalidating tone of voice or non verbal expressions (rolled eyes etc). The wrong word or “sigh” or facial expression at the wrong time can ruin trust in this process. Also watch out for a sense of arrogance and superiority, a patronizing tone, or the sense of there being an ego-battle between you and them. You might get a sense they feel threatened or annoyed by you having your own opinions on things, having done your own reading (victims of Cluster B abuse often have read lots of books on the topic, because they do want to understand and get better. The therapist should respect and value this). Or where they feel they have nothing left to learn and already know everything, especially if it’s clear to you they don’t know anything about Cluster B disorders/abuse. Look instead for clarity, maturity, humbleness and openness in your therapist. Good therapists know that they don’t know everything, and treat every new exploration in therapy as an opportunity to learn more.
Invalidation – Another very important one. If you sense even the slightest hint of invalidation from the therapist, a sense of them siding with the abuser(s), or trying to blame you entirely, or implying this is all “in your head”, then move onto another therapist immediately. This may tie in with the lack of knowledge point mentioned above (they don’t know what they don’t know), but it doesn’t matter. Accountability is very important down the line for recovering from Cluster B abuse, but being fully validated in what happened is also a key foundational core of recovery from Cluster B abuse that needs to be put in place first. If the therapist can’t or won’t do this because of limitations in their knowledge and skills, move on immediately to someone that can.
Gas-lighting From The Therapist (Do NOT Tolerate It)
Moral Relativism – A huge one to immediately reject and move on from. If there’s strong undercurrent of moral relativism in your therapist – a sense of “there’s no right or wrong” or “there’s no objective truth, only interpretation” or “there’s only your perception, not reality”, and other such post-modernist nonsense, then I would strongly advise rejecting this right away.
No. Abuse is abuse, malignance is malignance, evil is evil, gas-lighting is gas-lighting. If your therapist won’t acknowledge that what was done to you was wrong and unacceptable (or give you the validating space in which you can acknowledge this), and instead leaves you swimming in a morally relativistic soup of “interpretation” and “perception”, you’ll never heal. They might be a great therapist for someone else, but not for recovering from Cluster B abuse with psychopaths and narcissists. Move on to someone else.
Bias From The Therapist – This is another factor that’s surprisingly common. If you suspect you’re encountering any kind of ideological bias from the therapist, move on immediately. This could be gender bias, or political bias in particular. If it becomes clear that you and the therapist have radically diverging political views, or just diametrically opposing values in general, then they might not be the best one for you. Therapists are trained to filter out this bias in their work, but some are much better at it than others, and values differences still often contaminate the therapeutic process if the therapist allows it. If you suspect this is happening, regardless of what your values are (I’m not taking sides between male/female and left/right), move on to a more neutral therapist.
“Skilled therapists — psychologists in particular — have no difficulty keeping their political opinions out of the therapy room. Why? Because they know how to do their job, and they are proud of it. Activists, on the other hand, are more invested in their belief systems than their clinical skills.”
Shawn T Smith, clinical psychologist
A good test for this is simply to ask your therapist “what values will you bring into the therapeutic process?”. It’s of course a trick question, because the ONLY acceptable answer to this question is “I don’t bring any of my values into the therapeutic process. I’m here to work with you on your issues.”
If you receive any other answer than that, or some close equivalent, then move on to another therapist right away. A good therapist will NEVER contaminate the process with their own ideology or values, so this is a non-negotiable requirement.
Core Issues Not Improving – This is another double edged sword, since successful therapy almost always requires patience and takes time, especially with the damage narcissists and sociopaths cause. But by the same token, if you’re not seeing at least some progress on key core issues (boundaries, letting go, self esteem, enjoying life again, choosing better partners, feeling more secure and stable) at least around the 6 month mark, consider moving onto another therapist. Does require careful, balanced judgment, but if you get a sense several months in that the therapeutic process is just a bit aimless, unfocused and not really identifying or addressing core issues, then it’s probably time to re-evaluate your therapist and consider moving on. Be very careful with this though, as recovery from Cluster B abuse does require patience.
See here for a great article on how to choose a therapist well. Here is a great summary quote on what to look for:
“Many therapists speak of the “therapeutic alliance” but fewer seem to understand what a therapeutic alliance entails…..It has three elements:
- There is a connection.
- There is mutual agreement about the purpose of therapy.
- There is mutual agreement about the methods you will use to achieve this purpose.
All three elements are necessary. I often see the first without the other two. That makes for a warm and supportive relationship but not for meaningful psychological change.”
Jonathan Shedler, PhD.
Therefore, I would recommend that once you’ve established clear rapport and trust, it’s also important to:
- Nail down the crucial issues as to why you’re in therapy, what the key issues are you are struggling with because of the toxic relationship, or what contributed towards it (unprocessed trauma, attachment issues, anger, codependency, weak boundaries, gaslighting, joylessness, anxiety, depression etc)
- Identify with your therapist clear strategies for what needs fixing, and also a clear plan on how to fix them.
Codependence & Therapy
This is an additional point I wanted to add, since codependence is a common issue with those who get exploited and used by disordered individuals like psychopaths and narcissists.
It’s important to make sure that the entire relationship you have with your therapist does not resemble a re-playing of your general codependent patterns.
In other words, instead of the therapy identifying and resolving your codependence, it merely provides another setting for it to play itself out all over again in the way you interact with your therapist. Codependence can often be a very deeply rooted state of being, to the point that codependents approach literally everything they do, including therapy, codependently.
I emphasize this because I made this mistake myself. It’s also an additional reason to support you thoroughly vetting your therapist, making sure you find a good one, because a good therapist will know about codependence and spot if this is happening, whereas a mediocre therapist may not.
Here are some typical patterns of codependents; they typically:
- Struggle to know who they are.
- Struggle to formulate firm principles on things, and then stick to their principles consistently.
- Struggle to properly make decisions.
- Very easily hand their power over to others, especially “authority figures” – of which a therapist can be one.
- Tolerate unacceptable or unsatisfactory situations (including the therapist not being up to scratch)
- Struggle to stand up for themselves, especially if that means sticking to your own convictions and disagreeing with an authority figure like a therapist.
- Struggle to see unacceptable behavior (transgressions of their boundaries) for what they are and call it out right away.
If any of these things are happening in therapy, then your therapist should be spotting this and encouraging you to work on it. If they carry on unacknowledged, then your codependence won’t be healed, because it’s being reinforced by the therapeutic process.
Therefore make sure your therapist has a strong grasp of the concept of codependence, and can develop a clear, strong plan with you to work through it. If they don’t even have a concept of what codependency is, or don’t think it’s a legitimate term, move on to another therapist right away.
Some Good Resources To Help With Therapy
Here are some resources that might prove useful in therapy, either to provide an overall framework for the problems and how to fix them, or to specifically work through with the therapist in a step-by-step way.
Links to all books cited can be found on our Resources Page:
- On finding and selecting a therapist – “What Every Therapist Needs To Know” by Michael Karson.
- Pete Walker – “Complex PTSD: From Surviving To Thriving” – an excellent book for understanding and dealing with the Complex PTSD that narcissistic/sociopathic abusive relationships can leave you with.
- Amy Marlow MaCoy – “The Gaslighting Recovery Workbook” – has some great exercises to help work through the aftereffects of gas-lighting and get confidence in your own perception back.
- Tim/Jane McGregor – “The Empathy Trap” – a great, validating resources that can be a good basis for understanding what happened and working through issues.
- Elan Golomb – “Trapped in the Mirror – Adult Children of Narcissists and Their Struggle For Self” – another great resources that’s written by a therapist.
- See here for a great video from Richard Grannon on the intersection between Cluster B disorders and codependence as a key framework for understanding how toxic relationships with narcissists and psychopaths unfold in a toxic “hand in glove” dynamic. The narc/sociopath likes to exploit people with weak boundaries, and codependents have these weak boundaries because of unresolved trauma in their own lives. As he puts it, the “invisible emotional wounds that leave you open to abuse“
- See also here for an excellent resource on educating therapists on Cluster B disorders and abuse if they are unaware of these things, but are open minded to learn.
In closing, I want to emphasize that you have the absolute right to have standards and requirements of your therapist, and also to interview and ask them questions to make sure they are going to be suitable for you.
Remember, the therapist doesn’t lose out if the process is unsuccessful; they still get paid. It’s YOU, the client, who loses out if the therapeutic process is unsuccessful – you lose your time, your money, and possibly your motivation to even try again if it doesn’t work out. The risk is borne by you, not them.
Therefore you have the absolute right to demand certain (reasonable) things of the therapist and the process, and have certain minimum standards, and move on if you’re not getting them. I hope this guide helps people avoid the mistake I made, and get their choice of therapist right the first time, so they get healed and recovered more quickly.