The Harm of Pathologizing Abuse Survivors

At The MEND Project, we often hear stories from survivors whose emotional pain was mislabeled as abnormal behavior or unhealthy behavior. This experience has a name: pathologizing — and it causes deep, lasting harm. This blog explores how pathologizing survivors of emotional and covert abuse undermines healing, why it happens, and how we can move toward a narrative grounded in compassion, truth, and trauma-informed awareness of mental health.

Misunderstanding Trauma Responses

When emotional harm is subtle—as covert emotional abuse often is—pathologizing becomes a way to avoid accountability. Survivors are blamed for their understandable reactions, while their coping and self-protection are interpreted as dysfunction, rather than strength and courage. This injustice distorts the truth that trauma does not make someone unstable; it reveals what they’ve had to survive.

In an age where mental health conversations are increasing, survivors may even begin to self-diagnose, trying to make sense of their overwhelming symptoms and anxiety. Too often, persons suffering from prolonged emotional abuse believe it is somehow their fault. When licensed therapists give an incorrect diagnosis or minimize the abuse, treatment can exacerbate Post Traumatic Stress Disorder. Unfortunately, this can lead to internalizing false beliefs that their trauma responses and internal thoughts are signs of a life being lived thus far with a pathological character defect that relegates the person on the receiving end of abuse, somehow responsible.

Even worse, the presence of distress may reinforce a preconceived notion held by those who don’t understand trauma, leading to misjudgment and stigma. What appears as instability to the outside world is often the survivor's attempt to seek to manage internal chaos created by prolonged abuse.

For instance, a cultural problem in many courts is revealed when survivors cry or involuntarily shake, compromising their cognitive functioning during a custody hearing, while their abuser appears calm and calculated. Too often, these visible emotional expressions are viewed as weakness or instability instead of a sign of the intense stress and suffering they are enduring. Survivors and their children deserve courts to be accurate in their determinations. Uneducated judges are often inaccurate, unable to establish a positive custodial arrangement that benefits the children's lives.

Recognizing Trauma, Not Disorder

Pathologizing Is a Form of Covert Abuse

At The MEND Project, we affirm that covert emotional abusers often project pathologizing tactics to portray the survivor as having a mental disorder. One of the most insidious is gaslighting — invalidating a survivor’s experience under the pretense of concern for her mental health condition. This form of pathologizing not only distorts reality — it fractures the survivor’s ability to trust her own perceptions. If the abuser slanders the victim in this way to other persons it can create adverse consequences and assumptions rather than acceptance.

Blame-shifting, deflection, and pathologizing behavior convert the abuser’s harmful actions into a distorted image of the survivor being the one at fault. Over time, people surrounding the survivor — including professionals — may be led to believe that their patient, friend or family member's trauma responses are symptoms of a mental illness, instead of the natural result of sustained emotional harm.

At MEND, our trauma-informed approach works to dismantle these false narratives. We do not frame trauma symptoms as signs of inherent instability. We acknowledge them as evidence of emotional survival under conditions that no one should have to endure.

Avoid Pathologizing Normal Trauma Responses

How Society and Professionals Can Reduce Harm

Professionals without specific training in covert abuse or domestic violence often default to observable cues like calmness, composure, or logic when deciding who is “credible.” This approach can be dangerously misleading. Abusers are often skilled in manipulation and appear in control because they are not living in fear and trauma. Survivors, by contrast, may appear emotional, confused, or even disoriented—because they are actively being harmed. Their cognitive thinking becomes fragmented and compromised in numerous ways. The prolonged stress produces surges in toxic hormones that often lead to autoimmune issues and other health problems, overwhelming them with illness and exhaustion, and in some cases, premature death from immunological collapse. When the victim reaches out for help and, rather than receiving support, is instead criticized, judged, or not believed, it exacerbates their trauma symptoms. It can lead victims to a place of hopelessness and despair, and, in some cases, result in suicidal ideation.

When professionals respond to these signs by pathologizing the survivor, they unintentionally protect and embolden the abuser. This happens in therapy, legal contexts, custody proceedings, and even in spiritual or community environments. Assigning mental health disorder labels to survivors not only misrepresents their pain — it undermines their credibility and reinforces the abuser’s control.

Over diagnosis is common in these situations. Survivors are misdiagnosed at alarming rates, often with serious mental disorders, simply for exhibiting trauma-related emotions and reactions. Without being knowledgeable about the dynamics of covert abuse, even well-meaning professionals can cause lasting damage.

Instead of assuming the problem lies with the survivor’s psyche, professional therapists, psychiatry professionals, and support networks must begin with curiosity and compassion. It's critical to pause and ask: “What happened to this person?” not “What’s wrong with them?” That small shift opens the door from pathologizing to understanding, and from mislabeling to meaningful support. We, at The MEND Project, believe it is essential that professional providers and those support staff working in their practice be trained to understand the dynamics of covert emotional abuse, as well as learning the evidentiary signs of trauma.

The Internal Impact on Survivors

Pathologizing doesn’t just influence how survivors are treated — it alters how they see themselves.

When the message repeated to them — directly or subtly — is that their distress justifies being diagnosed with a mental illness, many begin to question whether they are broken, not normal, or an intrinsically flawed human being. This can lead to toxic self-blame, rumination, and identity confusion, as well as not trusting their gut instincts and emotions. Instead of recognizing that their emotional reactions are signs of trauma, they come to believe that something is inherently wrong with them.

In today’s culture, where emotional distress is often misunderstood, it’s easy for these symptoms to lead people to question a survivor’s stability rather than recognize their resilience. The implications are far-reaching. Confusion is not dysfunction. Feeling deep sadness, loneliness, emotional exhaustion, or hypervigilance in the wake of abuse is not evidence of a flaw. These conditions are examples of what prolonged states of high stress and confusion, which have not yet been met with clarity, safety, and support, cause.

Rewriting the Narrative

It’s time to reshape the way we understand survivors’ emotional responses:

Survivors are not inherently unstable. They are often highly resilient, deeply intuitive people who have learned to live in unsafe environments while trying to protect themselves and those they love.

Sensitivity is not dysfunction — it’s a marker of lived experience and emotional depth.

Anger is not a symptom of a mental illness — it is an appropriate response to injustice, oppression, and betrayal.

At The MEND Project, we are committed to shifting the conversation. We do not reduce survivors’ responses to a mental health label. We resist pathologizing and instead recognize emotional responses as the language of survival. We encourage survivors to educate themselves to gain accurate clarity, choose to disengage from those who speak false narratives, and reframe their story through the lens of truth.

While other publications may focus solely on symptom reduction, our approach invites survivors to address the root causes of their pain and to walk through their healing with compassion, education, and empowerment.

Many survivors report feeling like their entire life has been defined by what others think of them — by therapists, courts, or even family members. These perceptions are often shaped by behaviors that seem unusual to those without context. That’s why education is essential: to dismantle judgment and replace it with understanding. The person with pathological or characterological flaws is the one causing harm. Offenders are those who will say and do almost anything to avoid accountability and responsibility, and professionals need to understand this.

Steps Toward Healing

If you're in the process of healing, we want you to know this: you are not alone.

Healing is possible. And treatment begins by surrounding yourself with support that is rooted in trauma education and compassion — not in pathologizing, criticism, or judgment.

If you haven’t yet, consider taking The MEND Project’s Finding Clarity and Healing in Difficult, Confusing, or Abusive Relationships course. This course was created for situations just like yours and has been life-changing for so many. Graduates often report that it saves them a year of traditional therapy by providing language, tools, and insights regarding the nuances of abusive relationships that reduce confusion and fast-track the healing process.

Participants have shared how the course helped them differentiate between trauma responses and internalized shame. It reframed their experience, helping them see that the problem was never their personality — it was the pattern of abuse by a perpetrator and the mislabeling of their pain and grief.

MEND advocates for survivors through education, empowerment, and clarity. Pathologizing takes power away from survivors. Education, truth, and supportive community restore it.

In Closing

It’s essential to acknowledge that not everyone will comprehend the intricacies of covert abuse. Some may respond with judgment or pathologizing. But their misunderstanding is not your truth to carry.

You don’t need to fix their perceptions — your task is to stay rooted in what you know to be true.

Find people who affirm your story, who respect your process, and who validate the depth and strength of your survival.

If you have been pathologized, know this:

• You are not to blame.
• Your emotional responses are valid.
• Healing is possible — one day, one truth, one new beginning at a time.
• You are worthy of respect, safety, and care — exactly as you are.