Abstract
Introduction: Chronic interpersonal abuse in workplace settings may generate trauma-spectrum symptoms that present in acute or crisis contexts. However, such cases are often described using lay terminology and may remain under-recognized in emergency and trauma medicine. This report examines a case of chronic workplace interpersonal trauma conceptualized within trauma-informed frameworks of coercive control and prolonged relational stress.
Methods: This single-patient case study describes the clinical course of an individual exposed to a workplace relational dynamic commonly described in lay discourse as “narcissistic abuse.” Symptoms developed following relational destabilization characterized by emotional withdrawal, unpredictability, and perceived psychological manipulation. Treatment consisted of trauma-focused psychotherapy integrating cognitive-behavioral strategies, psychoeducation, boundary work, and cognitive restructuring. A structured digital reflective tool was used as an adjunct between sessions to support narrative processing and reflective engagement under clinical supervision.
Results: The participant presented with clinically significant symptoms including intrusive recollections, nightmares, avoidance, hyperarousal, affective dysregulation, and functional impairment. Standardized self-report measures indicated severe trauma-related distress. Following occupational disengagement, relocation, and sustained implementation of a no-contact strategy, six-month follow-up demonstrated substantial reduction in self-reported distress and progressive stabilization of psychological functioning.
Discussion: This case illustrates how chronic interpersonal workplace stressors may produce trauma-spectrum symptomatology resembling post-traumatic stress presentations. It also suggests that structured reflective tools may serve as supportive adjuncts within psychotherapy, although causal effects cannot be inferred in a single-case design.
Conclusion: Chronic workplace interpersonal trauma may present with significant psychological symptoms in emergency and trauma contexts without explicit disclosure of relational abuse. Early recognition of trauma-related processes may support differential diagnosis and appropriate referral pathways. Conceptualizing survivor-described experiences within empirically grounded trauma frameworks may improve clinical recognition while avoiding premature diagnostic labeling of third parties.
Keywords
Workplace psychological trauma, Coercive control, Narcissistic abuse (lay term), Gaslighting (interpersonal invalidation), AI-assisted reflection, No-contact strategy