My name is Sam Vaknin, and I am the author of Malignant Self-Love, Narcissism Revisited.

We know what abuse and torture do to the victim’s soul, to their spirit, to their psychology.

But what are the effects on the victim’s body?

There is one place in which one’s privacy, intimacy, integrity and inviolability are guaranteed, and that is one’s body. The body is a unique temple, it’s a familiar territory of sense and personal history.

The abuser invades, defiles and desecrates this bodily shrine. He does so, usually, publicly, deliberately, repeatedlyand often sadistically and sexually, with undisguised pleasure.

Hence, the orca-vasive, long-lasting and frequently irreversible effects and outcomes of torture and abuse.

In a way, the torture victim’s own body is rendered her worst enemy. It is corporeal bodily agony and pain that compels the sufferer to mutate her identity, to fragment her ideas and principles to crumble.

Very few people can withstand pain. The body becomes the accomplice of the abuser, of the tormentor, an uninterruptible channel of communication of pain, a treasonous, poisoned territory of writhing agony.

This fosters a humiliating dependency of the abused on the perpetrator. Bodily needs denied, such as sleep, toilet, food and water, are wrongly perceived by the victim as the direct causes of her degradation and dehumanization.

As the victim sees it, she is rendered bestial, not by the sadistic bullies around her, but by her own flesh and blood. Beatrice Parlantes described this transmogrification in her Ethics of the Unspeakable, Torture Survivors in Psychoanalytic Treatment.

She says, as the gap between the I and the me deepens, dissociation and alienation increase. The subject that under torture and abuse was forced into the position of pure object has lost her sense of her interiority, intimacy and privacy.

Time is experienced now, in the present only, and perspective, that which allows for a sense of relativity, is foreclosed.

Thoughts and dreams attack the mind and invade the body, as if the protective skin that normally contains our thoughts gives us space to breathe in between the thoughts and the thing being thought about and separates between inside and outside, past and present, me and you.

This skin was as though it were lost.

Repeated abuse has long-lasting, pernicious, traumatic effects, such as panic attacks, hypervigilance, sleep disturbances, flashbacks, intrusive memories and suicidal ideation.

Victims and survivors experience psychosomatic or real bodily symptoms, some of them induced by the secretion of stress hormones, such as cortisol.

So there is increased blood pressure, racing pulse, headaches, excessive sweating, a myriad self-imputed or, as I said, real diseases.

The victims endure shame, depression, anxiety, embarrassment, guilt, humiliation, abandonment and an enhanced sense of vulnerability.

CPTSD, complex post-traumatic stress disorder, has been proposed as a new mental health diagnosis by Dr. Judith Herman of Harvard University to account for the impact of extended periods of trauma and abuse.

In stalking: An Overview of the Problem, authored by Karen Abrams and Gail Ehrlich Robinson in 1998, the authors write,

Initially, there is often much denial by the victim. Over time, however, the stress begins to erode the victim’s life and psychological brutalization results.

Sometimes the victim develops an almost fatal result that, inevitably, one day she will be murdered.

Victims, unable to live a normal life, describe feeling stripped of self-worth and dignity.

Personal control and resources, psychosocial development, social support, premorbid personality traits and the severity of the stress may all influence how the victim experiences and responds to it.

Victims, stalked by ex-lovers, may experience additional guilt and lowered self-esteem for perceived poor judgment in their relationship choices.

Many victims become isolated and deprived of support when employers or friends withdraw after also being subjected to harassment or when they are cut off by the victim in order to protect them.

Other tangible consequences include financial losses from quitting jobs, moving and buying expensive security equipment in an attempt to regain privacy.

Changing homes and jobs results in both material losses and loss of self-respect.

Surprisingly, verbal, psychological and emotional abuse have the same effects as the physical variety.

Abuse of all kinds also interferes with the victim’s ability to work.

Admiral St. Robinson wrote in another article titled Occupational Effects of Stocking in 2002.

Being stalked by a former partner may affect a victim’s ability to work in three ways.

First, the stalking behaviors often interfere directly with the ability to get to work, for example, flattening tires or other methods of preventing leaving the home.

Second, the workplace may become an unsafe location if the offender decides to appear there.

Third, the mental health effects of such trauma may result in forgetfulness, fatigue, lowered concentration and disorganization. These factors may result in the loss of employment, with accompanying loss of income, security and status.

Still, it is hard to generalize.

Victims are not a uniform lot.

In some cultures, abuse is commonplace and accepted as a legitimate mode of communication, a sign of love even, caring and a boost to the abuser’s self-image.

In such circumstances, the victim is likely to adopt the norms of society and avoid serious trauma.

Deliberate, complicated and premeditated torture has worse and long-lasting effects than abuse meted out by the abuser in rage and loss of self-control.

The existence of a loving and accepting social support network is another mitigating factor.

And finally, the ability to express negative emotions safely and to cope with them constructively is crucial to healing.

Typically, by the time the abused person has already, spider-like, isolated his victim from family, friends and colleagues. She is catapulted into a Netherlands, cult-like setting, where reality itself dissolves into a continuing nightmare.

When the victim emerges on the other end of this wormhole, the abused woman, or more rarely, men, feels helpless, self-doubting, worthless, stupid and a guilty failure for having botched her relationship and abandoned the family.

In an effort to regain perspective and avoid embarrassment, the victim denies the abuse or minimizes it.

Small wonder that survivors of abuse tend to be clinically depressed, neglect their health and personal appearance and succumb to boredom, rage and impatience.

Many end up abusing prescription drugs or drinking or otherwise behaving recklessly. Some victims even develop full-scale post-traumatic stress disorder.

Contrary to popular misconceptions, post-traumatic stress disorder, PTSD and acute stress disorder or acute stress reaction are not typical responses to prolonged abuse. They are the outcomes of sudden exposure to severe and extreme stressors, stressful events.

Yet some victims, whose life or body have been directly and unequivocally threatened by an abuser, react by developing these symptoms.

PTSD is therefore typically associated with the aftermath of physical and sexual abuse in both children and adults.

And this is precisely why Dr. Herman suggested the diagnosis of C PTSD, complex PTSD, as we discussed earlier.

So, to summarize, victims are affected by abuse in a variety of ways.

Ones or someone else’s looming death, violation, personal injury or powerful pain are sufficient to provoke the behaviors, cognitions and emotions that together are known as PTSD.

Even learning about such mishaps may be enough to trigger massive anxiety responses.

The first phase of PTSD involves incapacitating and overwhelming fear. The victim feels like she has been thrust into a nightmare or a horror movie.

We sometimes call it gaslighting. She is rendered helpless by her own terror. She keeps relieving the experience through recurrent and intrusive visual and auditory hallucinations, known as flashbacks, or in sleep, while she sleeps in dreams.

In some flashbacks, the victim completely lapses into a dissociative state and physically reenacts the event while being thoroughly oblivious to her whereabouts and surroundings.

In an attempt to suppress this constant playback and the attendant exaggerated startled response, jumpiness, the victim tries to avoid all stimuli associated, however indirectly, with the traumatic event.

Many develop full-scale phobias, agoraphobia, claustrophobia, fear of heights, aversion to specific animals, objects, modes of transportation, neighborhoods, buildings, occupations, weather and evil people.

Most post-traumatic stress disorder victims are especially vulnerable on the anniversaries of their abuse.

They try to avoid thoughts, feelings, conversations, activities, situations, locations or people who remind them of the traumatic occurs.

These are known as triggers.

It is this constant hypervigilance and arousal, the sleep disorders, mainly insomnia.

The irritability, short fuse, and the inability to concentrate and complete even relatively simple tasks, these erode the victim’s resilience.

Utterly fatigued, exhausted, most patients manifest protracted periods of numbness, automatism, and in radical cases near catatonic posture.

Response times to verbal cues increase dramatically.

Awareness of the environment decreases, sometimes dangerously so.

The victims are described by their nearest and nearest as zombies, machines, robots or automata.

The victims appear to be sleepwalking, depressed, dysphoric, unmedonic, not interested in anything or they can find pleasure in nothing.

The victims report feeling detached, emotionally absent, estranged and alienated.

Many victims say that their life is over and expect to have no career, family or otherwise meaningful future.

The victim’s family and friends complain that she is no longer capable of showing intimacy, tenderness, compassion, empathy and of having sex due to her post-traumatic frigidity.

Many victims become paranoid, impulsive, reckless, self-destructive. Others somatize their mental problems and complain of numerous physical ailments.

All of them feel guilty, shameful, humiliated, desperate, hopeless, helpless and hostile.

PTSD need not appear immediately after the harrowing experience. It can, and often does, delay by days or even months. It lasts more than one month, usually much longer.

Sufferers of PTSD report subjective distress.

The manifestations of PTSD are egodystonic. They don’t like it.

Their functioning in various settings, job performance, grades, school, social ability deteriorate markedly.

The DSM, Diagnostic and Statistical Manual criteria for diagnosing PTSD are far too restrictive.

PTSD seems to also develop in the wake of verbal and emotional abuse, in the aftermath of drawn-out traumatic situations such as domestic divorce.

Hopefully, the text will be adopted to reflect this sad and ubiquitous reality.