PTSD And Depression Comorbidity Increase Risk Of Mortality In Women

PTSD And Depression Comorbidity Increase Risk Of Mortality In Women

POST-TRAUMATIC STRESS DISORDER and major depression comorbidity is linked to psychobiological changes in women that can lead to chronic disease and death. When these two conditions occur in tandem, a comprehensive approach to treatment must be taken to counteract their dangerous and complex emotional, psychological, and physical impact.

This article discusses:

Increased Mortality In Women With PTSD and Depression

A new study shows that post-traumatic stress disorder (PTSD) and major depressive disorder (MDD) comorbidity can lead to physiological changes that cause serious illness and mortality in women.

An estimated 50% of women with PTSD also suffer from MDD. 1 out of every 2 women with this dual diagnosis have an increased risk of mortality.

A study of over 50,000 women were was conducted over 9 years period showed that women who suffer from symptoms of post-traumatic stress disorder (PTSD) and depression have more than twice as likely to die from complications compared to women who had not experienced trauma or depression.

Furthermore, research suggests that the biological impact of PTSD and MDD comorbidity may represent a subtype of PTSD.

Adverse Childhood Experiences Linked To Inflammation In The Body

Adverse childhood experiences (ACEs) are linked to an increased risk of developing PTSD in adulthood. The psychobiology of ACEs can make some adults predisposed to inflammation in the body, putting them at greater risk for certain health conditions.

PTSD Connected To Metabolic Dysfunction

PTSD is linked to physiological changes associated with metabolic dysfunction connected with the development of various diseases, specifically:

  • Changes in hypothalamic-pituitary-adrenal–axis
  • Immune system dysfunction
  • Oxidative stress
  • Sleep disturbances, and
  • Premature aging.

Researchers theorize that an increased discharge of cortisol by the hypothalamic-pituitary-adrenal axis in tandem with disruptions in the sympathetic nervous system can lead to irregularities in neurological and metabolic functioning.

Health Conditions Linked To PTSD

Numerous studies have shown that PTSD is linked to a range of adverse health outcomes, including:

  • Hypertension
  • Cardiovascular Disease
  • Metabolic Syndrome
  • Type 2 Diabetes
  • Obesity
  • Substance Use Disorders

PTSD and Depression Increase Risk of Suicide

Another health risk for women who experience PTSD and MDD is suicide. A 2009 study from Florida State University showed that women who experience both disorders are at greater risk for suicidal ideation and death by suicide.

Prevention Of Health Risks Associated With PTSD and Depression

It is imperative that women with PTSD and depression implement lifestyle changes to decrease the risk of mortality associated with their condition. Some effective actions include:

  • Regular exercise
  • Weight management
  • Smoking abstinence
  • Companionship


1 out of ever 2 women who suffer from cooccurring PTSD and MDD can experience psychobiological changes that cause 380% increase of death. Adverse childhood experiences can lead to inflammation in the body, which makes some people predisposed to illness and disease later in life. PTSD can cause metabolic dysfunction and systemic changes that lead to serious health conditions. Lifestyle changes are an important part of treatment.


  1. Roberts AL, Kubzansky LD, Chibnik LB, Rimm EB, Koenen KC. Association of Posttraumatic Stress and Depressive Symptoms With Mortality in WomenJAMA Netw Open. 2020;3(12):e2027935. doi:10.1001/jamanetworkopen.2020.27935
  2. Flory JD, Yehuda R. Comorbidity between post-traumatic stress disorder and major depressive disorder: alternative explanations and treatment considerations. Dialogues Clin Neurosci. 2015 Jun;17(2):141-50. doi: 10.31887/DCNS.2015.17.2/jflory. PMID: 26246789; PMCID: PMC4518698
  3. Masodkar K, Johnson J, Peterson MJ. A Review of Posttraumatic Stress Disorder and Obesity: Exploring the Link. Prim Care Companion CNS Disord. 2016 Jan 7;18(1):10.4088/PCC.15r01848. doi: 10.4088/PCC.15r01848. PMID: 27247845; PMCID: PMC4874765.
  4. Farr OM, Sloan DM, Keane TM, Mantzoros CS. Stress- and PTSD-associated obesity and metabolic dysfunction: a growing problem requiring further research and novel treatments. Metabolism. 2014 Dec;63(12):1463-8. doi: 10.1016/j.metabol.2014.08.009. Epub 2014 Aug 28. PMID: 25267015; PMCID: PMC4459590.
  5. Brown, P. J., Stout, R. L., & Mueller, T. (1999). Substance use disorder and posttraumatic stress disorder comorbidity: Addiction and psychiatric treatment rates. Psychology of Addictive Behaviors, 13(2), 115–122.
  6. Cougle JR, Resnick H, Kilpatrick DG. PTSD, depression, and their comorbidity in relation to suicidality: cross-sectional and prospective analyses of a national probability sample of women. Depress Anxiety. 2009;26(12):1151-7. doi: 10.1002/da.20621. PMID: 19842171.

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      4 Signs of Dysfunctional Narcissism

      4 Signs of Dysfunctional Narcissism, According To Dr. Michael Stokes

      LEARNING TO SPOT the signs of dysfunctional narcissism can help you make more informed in your relationships with friends, family members, and romantic partners. It is a useful skill for anyone seeking to preserve their mental, physical, and emotional health.

      It is easy to get drawn in by the formidable charm of highly narcissistic people, especially when they are telling you everything you want to hear during the love bombing phase of the relationship. People with this personality style form don’t fall in love, they form trauma bonds, and go to great lengths to avoid accountability. To the person on the receiving end, who is being groomed for exploitation, they are manipulated into thinking they’ve met the partner of their dreams.

      It can take months and sometimes years for people to overcome the trauma of narcissistic abuse. Because an ounce of prevention is worth a pound of cure, Narcissistic Abuse Rehab reached out Dr. Michael Stokes, a Licensed Mental Health Counselor, Sex Therapist and the founder of Rhodes Island Sex Therapy. He also provides specialized counseling for pornography- and sex addiction. We asked him to share his picks of the biggest red flags of dysfunctional narcissism.

      1. They Make Everything About Them

      Narcissistic Abuse Rehab: Dr. Stokes, what’s a dead giveaway that you are dealing with a highly narcissistic person?

      Dr. Michael Stokes: They focus everything on them, their accomplishments, and how they are better than those around them. These grandiose behaviors will be a huge red flag.

      Narcissistic Abuse Rehab: Can you please give some examples of what that might look like in practice?

      Dr. Michael Stokes: This can include telling you how amazing he was at school and graduated top of his class. Meanwhile, this can be completely false. 

      2. An Over-Inflated Sense of Entitlement

      Narcissistic Abuse Rehab: What other behaviors should people seeking to avoid relationships with highly narcissistic people look out for?

      Dr. Michael Stokes: They have an over-inflated sense of entitlement. Therefore, they will belittle people without regard. This might not include you yet, but it will.

      Narcissistic Abuse Rehab: That’s such an important observation. During the love bombing phase you are exempt from their aggression, but inevitably it will happen to you, too. Can you share an example of how they might belittle others in your presence.

      Dr. Michael Stokes: This might include screaming at a server because his food is cold. Although not the server’s fault, this will not be a factor for the narcissist.  

      3. A Need For Constant Validation

      Narcissistic Abuse Rehab: What is the first red flag that’s likely to show up in their relationship with the person they are grooming?

      Dr. Michael Stokes: Narcissist have a insatiable need for constant reinforcement.

      Narcissistic Abuse Rehab: Because they are dependent on narcissistic supply or external validation to function. How might this show up in their relationship with someone getting to know them.

      Dr. Michael Stokes: They will frequently ask for praise, acknowledgment, attention, etc. You will find they will tell you about all their accomplishments and embellish them to shift the focus to how wonderful they are.

      Narcissistic Abuse Rehab: How will their demands for constant validation impact the other person in the relationship?

      Dr. Michael Stokes: You will feel drained often by telling this person how amazing they are.  

      4. An Absence of Remorse

      Narcissistic Abuse Rehab: You are describing a personality that is highly self-focused, combative, and demanding. How do narcissistic people reconcile being so overbearing and emotionally needy?

      Dr. Michael Stokes: They have no remorse. This person will talk down to other people, become verbally aggressive, and show no signs of remorse for these feelings.

      Narcissistic Abuse Rehab: How do these maladaptive behaviors affect highly narcissistic people?

      Dr. Michael Stokes: This person will likely not apologize or own their behaviors. This is a huge factor why marriages fail with narcissists. They cannot own their part within the marriage and will blame their partner. 

      Narcissistic Abuse Rehab: Thank you for sharing your insight on signs of dysfunctional narcissism.

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      What Is Blame-Shifting And Why Is It Harmful?

      What is blame-shifting?

      BLAME-SHIFTING is the redirection of responsibility for one person’s actions, behavior, or mistakes onto another person, group, or thing. It is a destructive act of deception that shirks personal responsibility and destroys trust in relationships. It is a tactic commonly used in the context of narcissistic abuse.

      What Is Blame-Shifting?

      • Blame-shifting is a form of deflection
      • It is a practice people use individually and collectively to avoid accepting responsibility for their actions. 
      • It is a learned behavior used to cover up mistakes through deceit. 
      • Blame-shifting is one of the stages in the process of scapegoating.
      • It can devastate relationships, diminishing friendships, families, and communities because it erodes trust.

      What Are Some Examples?

      Here are some of the ways blame-shifting can show up:

      • A CEO blames their staff for poor performance rather than take responsibility for poor management choices. 
      • A politician who blames the opposition party for their errors rather than take accountability.
      • A student who blames their academic failure on a teacher rather than taking responsibility for their lack of motivation.
      • An unfaithful spouse blames their infidelity on their partner instead of admitting it was their own decision.

      How Might It Sound?

      Some of the ways people may try to redirect responsibility for an outcome by blame-shifting are:

      You made me lash out at you!Person A is blame-shifting their anger management issues on to Person B to avoid taking responsibility and learning to control their emotions.
      You’re the reason why I drink.Person A is blame-shifting their choice to use alcohol on to Person B to liberate themselves from responsibility for their actions and facing their substance abuse issues.
      My family/friends don’t like you so I am divesting from our relationship.Person A is blame-shifting their loss of interest in their relationship with Person B on to their family/friends. This is a combination of two psychological defense tactics: blame-shifting and triangulation.
      It’s your fault I was unfaithful because you let yourself go.Person A is blame-shifting their lack of integrity and restraint on to Person B by justifying their betrayal through fault-finding.
      I was perfectly happy until you came along.Person A is evading responsibility for their mental state by blame-shifting on to Person B instead of recognizing that they alone are responsible for their happiness.
      I’m too busy with my job to make time for our relationship.Person A is blame-shifting their emotional neglect of Person B on to their job instead of acknowledging that they choose their priorities.
      It’s your fault I run out of money because your standards are too high.Person A is blame-shift their financial problems on to Person B instead of working on their boundaries and communication skills.

      Why Do People Blame Shift?

      • Blame-shifting is a strategy used to maintain power and control while avoiding responsibility. 
      • People and organizations often avoid criticism and scrutiny by blame-shifting.
      • Authority figures are often prone to blame-shifting to retain their status and escape accountability for their errors.


      In conclusion, blame-shifting is the transfer of responsibility from one person or group to another person or group. It is a toxic behavior as it diminishes trust between individuals, collectives, and institutions. It’s wise to confront the behavior and resolve it to cultivate trust and accountability.

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      Recognizing the Signs of Narcissistic Cheating with Nicole Artz

      Recognizing Signs of Narcissistic Cheating With Nicole Artz

      BECAUSE MANIPULATIVE PEOPLE use tactics like gaslighting and blame-shifting to evade being held accountable when they are caught out, their partners may have difficulty recognizing the signs of narcissistic cheating.

      For answers we turned to Licensed Marriage and Family Therapist Nicole Arzt. She serves on the advisory board for Family Enthusiast and she’s also the author of the book Sometimes Therapy Is Awkward: A Collection of Life-Changing Insights for the Modern Clinician.

      Manya Wakefield: Nicole, please share the biggest red flag of narcissistic cheating.

      Nicole Artz: The biggest dead giveaway is withdrawal. This doesn’t inherently mean the person is cheating, but almost all partners look back and recognize that their partner was pulling back at some point in the relationship.

      Manya Wakefield: Can you describe what withdrawal looks like when a narcissistic partner is engaging in an extramarital affair?

      Nicole Artz: Withdrawal can be physical. For example, spending less quality time with you, avoiding sex, kissing, even holding hands or cuddling. It can be financial. Examples of this are they become less willing to spend money on you, and hesitate to open up a new credit card or bank account.

      It can also be emotional. For example, they may seem more distant, act defensively, spend more time going out with friends, etcetera.

      Manya Wakefield: Can a highly narcissistic partner’s withdrawal extend to other aspects of the relationship as well?

      Nicole Artz: Your partner may also start withdrawing from your children, other family members – especially if they’re relatives on your side – and mutual friends. They may no longer have as much interest in the same shared hobbies or interests.

      Manya Wakefield: Can you talk a bit about what drives the withdrawal process?

      Nicole Artz: The withdrawal comes from a place of shame and guilt. On a fundamental level, people know cheating is wrong, and they want to separate themselves from the act. Additionally, most unfaithful partners don’t want to hurt their loved ones with their actions. Subconsciously or not, they start pulling away. They don’t want their loved one to find out what’s going on. They think they might be able to maintain the facade. 

      Nicole’s book Sometimes Therapy Is Awkward: A Collection of Life-Changing Insights for the Modern Clinician,’ is available on Amazon.

      Learn More About Recognizing The Signs Of Narcissistic Cheating

      UK Recognizes Children Born From Rape As Crime Victims

      UK Recognizes Children Born From Rape As Crime Victims

      On January 19, 2023, the Ministry of Justice announced England and Wales are to become the first countries in the world to give legal status to children born from rape as crime victims.

      The new legislation will take the form of an amendment to the Victims Bill, ensuring that children born from sexual violence receive support from the criminal justice system. 

      A recommendation from the Justice Select Committee catalyzed the government’s decision to acknowledge and meet the unique needs of children born from a felony crime. 

      Victims-survivors are often horrified to discover that in addition to rape, they are also victims of reproductive coercion. According to a report by Dr. Kate Butterby for The Center for Women’s Justice (CWJ), “between 2,080 and 3,356, children could have been conceived in rape” in 2021. The numbers are conservative, as 2 out of 3 victim-survivors do not report rape due to threats, stigma, and the appalling fact that less than 1% of sexual assault reports lead to a conviction.

      “No child born in these horrific circumstances should be left to suffer alone,” said Deputy Prime Minister, Lord Chancellor, and Justice Secretary Dominic Raab MP, “Which is why we must ensure they can access vital support whenever they may need it.”

      Since 2010, the government has increased funding to cover the damage caused by men’s sexual violence against women. The new amendment will help children born from rape access mental health support. The new law will apply to children born from rape at any age.

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      Harvard Students Protest Return of Professor Guilty of Sexual Harassment

      Harvard Students Protest Return of Professor Guilty of Sexual Harassment

      AUSTIN SIEBOLD was browsing through Harvard University’s course catalogue when an intriguing subject caught her eye.

      “I saw this class, it was on colonialism, post-colonialism and de-colonialism, and I thought that sounded really interesting,” she recalls, “And then I clicked on it and it was taught by John Comaroff and I was like, ‘Holy…'”

      John Comaroff is a professor of African and African American studies who was accused of sexually harassing and assaulting several graduate students. The university conducted an internal investigation into the 78-year-old’s behavior and found him guilty of verbal misconduct in violation of its guidelines on sexual and gender-based harassment and professional conduct.

      No wonder Austin was shocked to see that Harvard had quietly let the fox back into the hen house.

      Rape Culture At Harvard University

      “The reality is that our campus promotes a culture of sexual abuse, a culture of misogyny and harassment and discrimination,” explains student activist Rosalie Couture.

      Couture’s view is supported by the fact that in February 2022, 38 faculty members including Henry Louis Gates Jr. and Jamaica Kincaid signed a letter questioning the findings of the Comaroff investigation. Its closing paragraph states, “We the undersigned know John Comaroff to be an excellent colleague, advisor and committed university citizen […]”

      This is a typical example of the bystander betrayal that marginalizes victim-survivors of sexual assault. The self-serving arguments usually sound like:

      • (S)he’s nice to me so (s)he deserves a pass.
      • (S)he makes money for the company/institution so (s)he deserves a pass.
      • Their work is good so they deserves a pass.
      • Their songs/movies are good so they deserves a pass.

      It is also an example of how manipulators excel at grooming their social circles into blindly supporting them, even in the face of glaring evidence of their wrong-doing and convictions.

      However, when the facts about Comaroff came to light, the faculty members who supported him were left red faced. A week after the publication of the letter, 34 of the signatories withdrew their support.

      Did Rejection Trigger A Rant About Corrective Rape?

      Lilia Kilburn told The New York Times that Comaroff kissed her lips without her consent. She informed him that she was in a same-sex partnership to repel further advances from the professor. Instead of backing off, she says Comaroff began ranting that in some parts of Africa she and her parter would be targets for so-called corrective rape or femicide.

      For his part, Comaroff’s attorney say that he “categorically denies ever harassing or retaliating against any student.” He acknowledged that he discussed rape with Kilburn but claims to have done so in a paternal way to warn her of the dangers women in same-sex couples might face in Cameroon.

      Unsurprisingly, Kilburn and two other graduate students, Margaret Czerwienski and Amulya Mandava are suing Harvard University for dismissing repeated allegations that Comaroff was harassing students and ignoring claims that he leveraged his position of power to frighten the students with threats of sabotaging their careers if they report his aggression.

      Students Do Not Feel Safe With Comaroff On Campus

      Students were horrified to learn that Comaroff was allowed to return to teach at Harvard for the fall 2022 semester. They launched a protest over his present on campus which Harvard ignored because they welcomed Comaroff back to teach for the Spring 2023 semester.

      Harvard is sending a clear message that, when it comes to sexual harassment and assault, the institution will protect itself and its faculty but students are on their own. Ultimately, the student uprising is a demand for the right to study in peace without fear of sexual harassment or assault from those in positions of power.

      Student activist Rebecca Araten says, “This man is not safe to interact with undergraduate students.”

      Is Harvard University An Abuse Enabler?

      Austin spearheaded the second demonstration against Comaroff on February 25, 2023. After she saw his course in the catalogue, she says, “I enrolled in the class and used information I was able to gather from that to help me plan this.”

      She alerted Our Harvard Can Do Better, a student association that aims to dismantle rape culture at the school. They collaborated with Harvard Graduate Students Union-United Auto Workers’ Feminist Working Group. The action received support from Fossil Fuel Divest Harvard and the Student Labor Action Movement.

      In their official statement, Our Harvard Can Do Better, repudiated Harvard for hiring Comaroff in 2012 despite allegations of sexual misconduct that stretched back to the 1970s. They described the school’s enabling of the disgraced professor as “shameful.” Furthermore, they are accusing Harvard University of being “systematically biased in favor of abusers.”

      Taking Matters In To Their Own Hards

      Per The Harvard Crimson, over 100 students attended Comaroff’s Colonialism and its Postcolonial/Decolonial Afterlives: Critical Readings class on January 25. As soon as the professor started to speak, the students stood up and shouted in unison, “Justice for survivors!”

      As the protesters exited the classroom, Comanoff responded to their demonstration with a smirk. One of the students confronted him and said, “Smile in hell, asshole!”

      The students then marched to the Baker Center where Comaroff’s office is located. They taped pages from Kilburn, Czerwienski and Mandava’s lawsuit to his door.

      The student activists are demanding Comaroff’s resignation and calling for an end to Harvard’s “cultures of harassment, misogyny, and discrimination.”

      Will their calls for justice continue to fall on deaf ears? And, if so, should Harvard University retain it’s status as an elite institution when it is failing to keep students safe and many of its most esteemed faculty members are so barbarously ignorant about rape?


      • Boit, D.A.C., Hamid R.D., and Schisgall E.J. (2023, January 25) ‘More than 100 Students Walk Out of Embattled Harvard Professor Comaroff’s First Class of Semester.’ The Harvard Crimson. 
      • Alaimo, K. (2022, February 14) ‘Harvard professors’ initial letter of support for John Comaroff sends a disturbing message.’ Think – Opinion, Analysis, Essays. NBC News.
      • Hartocollis, A. (2022, February 8) ‘A Lawsuit Accuses Harvard of Ignoring Sexual Harassment by a Professor.’ The New York Times.
      • Kim, A.H., Xu, M. (2022, February 10) ’35 Harvard Professors Retract Support For Letter Questioning Results of Comaroff Investigations.’ The Harvard Crimson. 
      • Our Harvard Can Do Better. PRESS RELEASE: 100s of Students Shut Down Abuser’s Class. January 24, 2023.

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      Rape Culture In Numbers: Why Most Sexual Assaults Go Unreported

      Rape Culture In Numbers: Why Most Sexual Assaults Go Unreported

      WHY DIDN’T YOU REPORT IT BEFORE? is the go-to chorus of rape culture. These are often the first words people are told when they find the courage to disclose that someone sexually assaulted them. Victim survivors face a barrage of questions, accusations, and criticisms, whether it’s been years or even decades after the fact. Society is quick to accuse them of attention-seeking, making it up, and – when they are believed – of having no one to blame for themselves because they did not report.

      What is especially cruel about this stance toward victim-survivors is that even when they do file a police report, the criminal justice system is hard-wired to fail them. There is little hope for any rectitude when statistics show that out of every 1000 cases of sexual assault, only 25 perpetrators go to jail. Social attitudes toward victim-survivors of sexual assault reflect a grotesque degree of willful ignorance.

      Sexual Assault In Numbers

      Per The Rape, Abuse, and Incest National Network (RAINN), 2 out of 3 sexual assaults are never formally disclosed to law enforcement, making it one of the most underreported crimes.

      In addition to the traumatic nature of sexual assault and rape, there are many prohibitive reasons why victim-survivors may opt out of reporting. 

      5.7%Sexual assault reports lead to arrest
      0.7%Sexual assault reports lead to conviction
      0.6%Sexual assault reports lead to incarceration

      In the United States, the chances that victim-survivors of sexual assault will see justice is slim.

      In 8 out of 10 sexual assaults, the perpetrator is someone the victim-survivor knows, which usually mean that they have groomed their mutual social circle prior to the sexual assault. For example, the perpetrator may hold a position of power affording them greater social capital than the person they target.

      82%Girls under age 18
      90%Adult victims are women
      1 in 6US women have experienced attempted/completed rape

      Nota bene: The low incidence of justice is not an American phenomenon. The conviction rate is equally dismal in the United Kingdom.

      The Reality of Rape Culture

      As it stands, society is turns a blind eye to sexual assault and rape. The criminal justice system rarely holds perpetrators of these crimes to account. In most cases they walk free while the victim-survivor is left to pick up the pieces without support.

      In the rare instances when sexual assault cases make it before a court of law, the victim-survivor becomes the de facto defendant as they are on trial. They will usually be publicly subjected to DARVO tactics in public which can re-traumatize them.

      Asking people why they don’t report sexual assault is the wrong question. What we should be asking is why people don’t feel safe to report sexual assault.

      How To Tell When A Narcissist Is Cheating With Rachel Coffey

      How To Tell When A Narcissist Is Cheating With Rachel Coffey

      PEOPLE IN TOXIC RELATIONSHIPS often struggle with how to tell when a narcissist is cheating. This is because when a partner is highly narcissistic, they use a variety of manipulation tactics to deceive others, making it challenging for their partners to spot the red flags of infidelity. 

      We reached out to life coach Rachel Coffey to explore some of the dead giveaways she has seen in her coaching practice when highly narcissistic partners are unfaithful. 

      Manya Wakefield:  In your experience, Rachel, what is the first sign that a highly narcissistic person may be cheating on their partner?

      Rachel Coffey:  Never ignore that gut feeling that things are not quite right. Our subconscious is brilliant at picking up tiny clues that our conscious brain tries to filter out and rationalize. If you feel like something is up, there probably is.

      Manya Wakefield: What is the most likely think to ping the alarm bell of our gut instinct.

      Rachel Coffey:  Little lies. You know when you notice that what someone is saying isn’t quite true, but you don’t know why they’d bother lying about it? For example, you ask what time a parcel was delivered – they say the courier handed it over at 4.00 pm, but you find out they actually left it on the doorstep at noon. Or you casually ask what your partner had for lunch, they say they had a Subway, but then you find a random receipt showing they had a sit down meal elsewhere. Someone who is having an affair lies constantly.  

      Manya Wakefield: Right, and when you express the concern to a narcissistic partner, they respond with denial, gaslighting, and blame-shifting tactics. This is why it’s important people learn how to tell when a narcissist is cheating. So how do you catch them out?

      Rachel Coffey: The big lies, their main cover, is usually water tight. The small ones that they don’t even notice they are telling? They are the tell tale lies they lose track of – and can be their downfall. 

      Manya Wakefield: Are there any observable behavioral signs of infidelity to look for in your partner? 

      Rachel Coffey:  If your partner’s appearance has dramatically improved or their grooming routine has gone into overdrive for no apparent reason – especially if you’ve been feeling a bit unkempt recently – it can be a red flag. It’s easy to explain away – but there’s many a partner that rues the day they did! 

      Manya Wakefield: Can you share another behavioral sign that a narcissistic person is cheating on their partner? Can you give some clear examples of they style of deception?

      Rachel Coffey: Grand gestures that aren’t warranted. For example, you might receive a random bouquet of flowers or a surprise romantic getaway out of the blue? Watch out! The person having an affair tries to overcompensate. Sometimes out of guilt, and, in other instances, they mirror what they are doing with the person they are cheating with to convince you how much they care! 

      Manya Wakefield: Rachel, thank you for sharing your advice on how to tell when a narcissist is cheating, manipulation tactics, and tips on what signs of infidelity to look for.

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      What Is Parental Alienation Syndrome?

      parental alienation syndrome

      The controversial theory of parental alienation syndrome (PAS) was conceptualized in the 1980s by clinical psychologist Richard A. Gardener, who defined it as follows:

      “The parental alienation syndrome is a childhood disorder that arises almost exclusively in the context of child-custody disputes. Its primary manifestation is the child’s campaign of denigration against a parent, a campaign that has no justification. It results from the combination of a programming or brainwashing parent’s indoctrination and the child’s own contributions to the vilification of the target parent.”

      The American Psychological Association rejects parental alienation syndrome as a legitimate diagnosis. It is not included in two important books that mental health professionals use to diagnose psychological issues. These books are the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) and the International Classification of Diseases, Eleventh Edition (ICD-11). Studies have shown that the theory behind this diagnosis is not true and it is not supported by science.

      Why is Parental Alienation A Rejected Theory?

      The American Bar Association published an article clearly stating, “there remains no test, no data, or any experiment to support claims made concerning PAS. Because of this lack of scientific credibility, many organizations—scientific, medical, and legal—continue to reject its use and acceptance.”

      It included reports from the Presidential Task Force of the American Psychological Association on Violence in the Family, The National Council of Juvenile and Family Court Judges (NCJFCJ), The American Prosecutors’ Research Institute and the National District Attorney’s Association.

      For several decades, parental alienation has repeated failed to stand the test of scientific scrutiny.

      Child Withdrawal Is A Relationship Issue Not A Pathology

      One of the reasons the theory of parental alienation syndrome is considered problematic is because it pathologizes children who have relational issues with a parent. Relationship breakdowns are not necessarily indicative of psychological disorders. In order words, withdrawing from a relationship with a parent may occur without any impairment of a child’s healthy psychological functioning. Moreover, mental health treatment is not always a prerequisite for resolving the issue of a child’s withdrawal from a parent.

      As painful as the situation is, it can be helpful to develop an understand of the child’s perspective. Parent-child attachment specialist Dr. Michael Kinsey, explains, “If a child is forced to choose, they might choose the person that they feel they are most like or they’ll also choose the person who they feel is safer or who they feel is the more desirable one to follow. In the case of the kind of scenario you’re discussing, it’s really a matter of survival.” Being in the ‘in-group’ of the narcissist is so essential to survival.”

      It can also help to read evidence-based research into the some of the reasons why some children withdraw from parents in high-conflict relationships.


      Many people searching for answers to an excruciatingly painful question relate to the theory of parental alienation syndrome. It can resonate deeply with parents who are grieving the absence of a beloved child. However, attributing the child’s withdrawal to a discredited mental health construct will not solve the problem. Children do not have to be afflicted with cognitive, affective, or behavioral problems in order to distance themselves from a parent. There are many reasons why a perfectly healthy child might take such a painful decision that merit further exploration.


      • Gardner, Richard A. “Recent trends in divorce and custody litigation.” In Academy forum, vol. 29, no. 2, pp. 3-7. 1985.
      • Thomas, R.M., Richardson, J.T. (2015, July 1) “Parental Alienation Syndrome: 30 Years On and Still Junk Science,” American Bar Association.
      • Vilalta, R., Winberg Nodal, M. “On The Myth of Parental Alienation Syndrome (PAS) and the DSM-5,” Psychologist Papers, 2017. Vol. 38(3), pp. 224-231.

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      Can Narcissistic Abuse Cause Narcissism?

      can narcissistic abuse cause narcissism?

      A COMMON QUESTION asked by people learning about abusive power and control in interpersonal relationships is whether narcissistic abuse can cause narcissism? The short answer is no. Narcissism is one of many personality traits all people possess that is necessary for healthy human functioning. Given that it is something all people are endowed with, narcissism is not caused by narcissistic abuse.

      With that said, let’s look at the question from another angle: can the experience of narcissistic abuse lead to narcissism impairments such as excessive or extreme narcissism? The answer to that question is a definitive yes.

      How Might Narcissistic Abuse Cause Excessive Narcissism?

      The reason for this is that psycho-emotional abuse is generally is a highly stressful experience. Narcissistic abuse is particular can be traumatic. Excessive of extreme narcissism is a post-traumatic stress adaptation that occurs in some people.

      Let’s turn to Dr. Gabor Maté for more insight on this topic. He describes trauma as, “a psychic wound that hardens you psychologically that then interferes with your ability to grow and develop.”

      In this sense, excessive or extreme narcissism represent different levels of arrested development, which is why they share the same defense mechanisms seen in early childhood.

      Narcissism Impairments As A Traumatic Stress Response

      Dr. Maté goes on to explain the affects of trauma, “It pains you and now you’re acting out of pain. It induces fear and now you’re acting out of fear. Trauma is not what happens to you, it’s what happens inside you as a result of what happened to you.”

      A great deal of what happens inside of people happens at a subconscious level. In this way, we can think of excessive narcissism as a balm to soothe a wounded ego. However, the effects of trauma are far more pervasive and can lead to a severing of the self. It is in these cases that various manifestations of extreme narcissism occur to protect a fragmented and, in some cases, annihilated ego.

      Confidential support is available 24/7/365 to anyone experiencing abuse.
      Book a one-on-one consultation or coaching session.

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