Understanding Toxic Relationships and their Emotionally Abusive Effects on Mental Health by Dr. Rebecca Wang

A toxic relationship was originally defined by Dr. Lillian Glass in her 1995 book, entitled, Toxic People, as “any relationship which lacks emotional support, has frequent conflict, involves one person having more power than one’s partner, and often feels like a competition, rather than a mutually-supportive partnership.”  Toxic relationships can have extremely detrimental effects upon one’s mental health, due to the following: lack of emotional support, negative communication patterns, jealousy, controlling behaviors, resentment, dishonesty, patterns of disrespect, financial stress, and ignoring or minimizing one’s needs.  The recipient of the emotional abuse often experiences repetitive hope for change which doesn’t happen and a sense of constantly “walking on eggshells.”

Toxic relationships are dominated by emotional abuse which can have long-lasting mental health effects upon the person who is the target of this abuse.  The most obviously-detected effects of emotional abuse are social withdrawal, a diminished or lost sense of self-confidence and overall self-worth, and extreme difficulty focusing on and completing necessary work, personal, and academic tasks.  The more subtle, and often unrecognized, effects of emotional abuse are a desperate need for affection and acceptance from one’s abusive partner and from other significant people in one’s life, lack of daily motivation, pervasive self-defeating thoughts, and a tendency to experience depressive moods.  Lastly, many people seek therapy for help with managing uncontrollable emotional responses to various current events in one’s life and the generalized anxiety which have resulted from the emotional abuse.

Traits of an Emotionally Abusive Partner

An emotionally abusive partner may not be obvious to the recipient of this abuse, because this type of personality can be very charming, manipulative, and intelligent.  During or after an emotionally abusive relationship, it is important to recognize the following major traits of the abuser: (1) hyper-critical, judgmental statements, (2) possessiveness, (3) controlling behaviors (such as with money, children, and/or work schedule), (4) dismissive of partner’s needs, thoughts, and feelings, (5) repeated attempts to isolate one’s partner from family and friends, and (6) constant disrespect of one’s partner’s boundaries in the relationship.

Many emotional abusers have narcissistic qualities.  If you believe that you have experienced emotional abuse, please review this checklist for the narcissistic personality:

  1. Grandiosity
  2. Arrogant and domineering role in relationships
  3. Preoccupation with success and power
  4. Lack of empathy
  5. Belief of being unique and/or “always right”
  6. Sense of entitlement
  7. Requires excessive admiration
  8. Exploitative behaviors when one feels insecure or threatened

Understanding Emotional Abuse through 4 Main Types of Narcissism

Grandiose narcissists are extroverted, charming, enjoy adventuresome activities, and exhibit a high level of self-esteem and life satisfaction.  However, they are also very attention-seeking, self-absorbed, exploitative, entitled, stubborn, and prone to verbal and/or physical aggression.  Many grandiose narcissists rationalize their abusive behaviors as caused by perceived mistreatment or disrespect from others.

Malignant narcissists are more aggressive and emotionally cold, as represented by the tendency to obtain pleasure by humiliating others or by creating chaos in others’ lives.  They can also exhibit paranoid and sadistic thoughts and behaviors, which often categorizes them as sociopaths or psychopaths and is diagnosed in the DSM-5 as Antisocial Personality Disorder.

Communal narcissists are warm, agreeable, outgoing, and want others to view them as trustworthy and supportive.  However, they also make repeated attempts to manipulate others through their kindness.  They tend to love publicity, to seek power positions in all settings, to take a grandiose stance toward any person in their daily lives, and to gain self-esteem through being perceived as a caretaker or helper.

Vulnerable narcissists are introverted, self-absorbed, manipulative, exploitative, and prone to verbal and/or physical aggression.  They lack self-confidence, have an intense fear of criticism, and often behave in a superficial and self-serving manner toward anyone from whom they can benefit.  They experience strong discontent with their lives, which results in shame, guilt, and anxiety.  This form of narcissism is the most likely to be diagnosed as an anxiety or depressive disorder.  These narcissists often feel threatened by others, so they remain in a continual defensive stance in their thought and behavioral patterns.

How to Heal from an Emotionally Abusive Relationship

Cognitive behavioral therapy (CBT):  I have found the cognitive behavioral therapeutic (CBT) approach to be extremely effective in the healing process from emotional abuse in a relationship.  This approach requires time and commitment to the cognitive and behavioral goals which are identified during the first and second therapy sessions.  I support and assist my clients throughout the process of participating in weekly in-session cognitive clarification and empowerment exercises.  I also encourage my clients to keep a daily journal between therapy sessions, as a tool for gaining self-awareness, monitoring behaviors, and releasing emotions.  The ability to recognize and to learn from one’s disturbing thoughts and emotions is a key factor in the healing process from an emotionally abusive relationship.  The human survival tendency is to deny or fear disturbing thoughts and emotions.  However, this only worsens one’s overall life satisfaction and daily functioning abilities.

In CBT, the client’s behavioral modification plan serves as a valuable starting point and an ongoing source of monitoring the client’s progress.  It is an inspiring process for a client to create and achieve behavioral goals which are present-oriented and serve as catalysts for strength and confidence.  By adhering to a weekly, structured behavioral plan, the client learns that the past can be overcome through intentional actions and thoughts.  While I continue to help the client through past dysfunctional emotional, cognitive, and behavioral patterns during therapy sessions, the behavioral plan provides a daily sense of control over one’s life between our therapy sessions.

Humanistic therapy:  I also use humanistic therapeutic techniques with clients who are healing from emotionally abusive relationships.  The two most important goals of humanistic therapy are (1) to help the client with making decisions about specific current life situations and (2) to help the client with creating and adhering to a goals list aimed at personal growth.  I use in-session interview-style exercises which address the client’s holistic needs.  These holistic needs include the emotional, spiritual, physical, interpersonal, and career aspects of one’s life.  I also encourage the client to stay in the here-and-now, both in and out of therapy sessions, when ruminating and self-defeating thoughts and emotions occur.  Through this process, the client can gradually become who one envisions to be and to let go of current negative perceptions about oneself, others, and life in general.  Most importantly, the humanistic approach focuses on the development of personal strengths, such as hope, wisdom, creativity, courage, spirituality, and responsibility, thus directing one’s energy away from past emotional pain and self-doubt.


Glass, Lillian. Toxic People. Simon and Schuster, 1995.

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