Matthew Sexton, LCSW · NATC — Nassau County, NYC & Telehealth
Therapy for Narcissistic Abuse & Antagonistic Relationships
You're not oversensitive. What happened to you was real.
Recovery from narcissistic abuse requires more than general trauma therapy. It requires a clinician who understands the specific mechanisms of coercive control, identity erosion, and the psychological aftermath of antagonistic relationships.
Telehealth available in New York, Florida, Maine & Delaware
Clinical Definition
Narcissistic Abuse
Narcissistic abuse is a pattern of psychological harm resulting from sustained exposure to a narcissistic or antagonistic individual. It is characterized by deliberate reality distortion (gaslighting), coercive control, identity erosion, and the systematic undermining of the victim's self-trust — producing a clinical presentation that overlaps with but is distinct from single-incident trauma.
The NATC credential (Certified Narcissistic Abuse Treatment Clinician) indicates specialized training in the assessment and treatment of these dynamics — beyond general trauma certification.
Common Signs You May Be Experiencing Narcissistic Abuse
These patterns are deliberate and systematic. Naming them is often the first step toward recovery.
- ◆Persistent self-doubt — you second-guess your own memory, perception, and judgment
- ◆Walking on eggshells to avoid triggering anger or withdrawal
- ◆Feeling responsible for your partner's or family member's emotional state
- ◆Increasing isolation from friends, family, or support systems
- ◆A growing sense that nothing you do is ever enough
- ◆Confusion about what actually happened in arguments or conflicts
- ◆Loss of identity — you no longer know what you want or who you are outside the relationship
Narcissistic Abuse vs. General Trauma: Why the Distinction Matters
| Feature | Narcissistic Abuse | Single-Incident Trauma |
|---|---|---|
| Cause | Sustained relational pattern over months or years | Discrete traumatic event |
| Identity impact | Systematic erosion of self-concept and self-trust | Self-concept typically intact |
| Reality orientation | Deliberately distorted by perpetrator (gaslighting) | Reality perception intact |
| Attachment dynamics | Trauma bonding — love and fear intertwined | No attachment to source of trauma |
| Treatment focus | Reality reconstruction, identity rebuilding, relational recalibration | Event processing, safety restoration |
| Specialist needed | NATC certification or equivalent specialized training | General trauma-trained therapist |
Specialized Certification
Certified Narcissistic Abuse Treatment Clinician (NATC)
Matthew Sexton holds the NATC credential — Certified Narcissistic Abuse Treatment Clinician — a specialized certification in the assessment and treatment of narcissistic abuse and antagonistic relationship dynamics.
Most therapists are trained in general trauma or couples work. The NATC credential means Matthew has undergone specific training in the mechanisms of narcissistic abuse — the patterns, the aftermath, and the clinical protocols for recovery. You don't need to spend sessions explaining what DARVO is or why you stayed.
“Narcissistic abuse leaves a very specific kind of damage — to identity, to reality orientation, to the capacity to trust yourself. That requires very specific clinical work.”
Understanding What Happened
Patterns of Narcissistic Abuse
Naming the patterns is often the first step. These dynamics are deliberate, systematic, and leave a predictable clinical footprint.
Gaslighting
Persistent reality distortion — making you doubt your memory, perception, and judgment — until you no longer trust your own experience. One of the most psychologically damaging forms of manipulation.
Love Bombing & Idealization
Intense early affection, attention, and idealization that creates a powerful attachment — then is systematically withdrawn or made conditional to establish control.
Coercive Control
A pattern of behavior used to dominate and control — restricting autonomy, monitoring movements, undermining relationships, and using emotional leverage to maintain power.
Devaluation & Discard
After idealization, a systematic dismantling of your self-worth — criticism, comparison, contempt — followed by abandonment or threat of abandonment as a control mechanism.
DARVO
Deny, Attack, Reverse Victim and Offender. A predictable defensive response that leaves victims feeling responsible for the harm done to them — and doubting whether harm occurred at all.
Flying Monkeys & Triangulation
Using third parties — mutual friends, family members, colleagues — to gather information, spread narratives, or apply social pressure. Isolation and reputation damage are common consequences.
The Clinical Work
What Recovery Actually Involves
Validate Your Reality
Narcissistic abuse systematically distorts perception. Recovery begins with establishing what actually happened — rebuilding a reliable internal reality that was deliberately undermined.
Process Complex Trauma
Relationships with narcissistic or antagonistic partners create complex PTSD — not a single traumatic event, but accumulated relational trauma that requires specialized clinical processing.
Reconstruct Self-Concept
Prolonged exposure to devaluation and gaslighting erodes identity. Therapy rebuilds a coherent, accurate sense of self that isn't organized around another person's distorted projections.
Rebuild Relational Safety
Antagonistic relationships recalibrate how you relate to others — triggering hypervigilance, fawn responses, or avoidance. Therapy restores the capacity for genuine connection with appropriate discernment.
Who This Practice Serves
Antagonistic Relationships of All Kinds
Narcissistic abuse doesn't only happen in romantic partnerships. It occurs in family systems, workplaces, and friendships — and the psychological aftermath is similar regardless of the relationship type.
Your Therapist
Matthew Sexton, LCSW · NATC
Certified Narcissistic Abuse Treatment Clinician
Matthew Sexton is a Licensed Clinical Social Worker and Certified Narcissistic Abuse Treatment Clinician in private practice in Floral Park, NY. His practice specializes in high-complexity relational trauma — including narcissistic abuse, chronic illness, and the psychological aftermath of antagonistic relationships.
Sessions are available via telehealth in New York, Florida, Maine, and Delaware. Private pay only — $225/session with SuperBill provided for out-of-network reimbursement.
Getting Started
Begin Your Recovery
Reach Out
Use the contact form or send a direct message. Matthew responds personally — no intake coordinators, no answering services.
Free Consultation
A 15-minute call to understand your situation, answer your questions, and confirm we're a good fit before committing to anything.
Start Sessions
Telehealth sessions via secure video. Weekly frequency to start. $225/session — SuperBill provided for out-of-network reimbursement.
Common Questions
Frequently Asked Questions
What are the signs of narcissistic abuse?+
Common signs include persistent self-doubt and second-guessing your own memory, walking on eggshells to avoid triggering a reaction, feeling responsible for your partner's emotions, isolation from friends and family, and a pervasive sense that nothing you do is ever enough. Gaslighting — being told your perceptions are wrong, exaggerated, or imagined — is a hallmark feature.
What is DARVO?+
DARVO stands for Deny, Attack, Reverse Victim and Offender. It is a predictable defensive response used by perpetrators of abuse when confronted: they deny the behavior, attack the person who raised the concern, and reframe themselves as the victim. It is one of the most disorienting manipulation tactics because it leaves survivors feeling responsible for the harm done to them.
Can therapy actually help with narcissistic abuse recovery?+
Yes — but effectiveness depends heavily on the therapist's familiarity with narcissistic abuse dynamics. General trauma therapy often misses the specific mechanisms: identity erosion, reality distortion, and the cognitive after-effects of coercive control. Specialized treatment with a NATC-certified clinician addresses these directly, helping survivors rebuild accurate self-perception, process relational trauma, and develop discernment in future relationships.
Mental Wealth Solutions provides individual psychotherapy and mental health consulting. This page is for informational purposes and does not constitute medical advice. Matthew Sexton, LCSW is licensed in New York, Florida, Maine, and Delaware. Telehealth services are provided to clients located in those states at the time of service.