Since that time, Sarah has developed nightmares about being raped or killed. In most days, she has suffered from flashbacks of her being attacked. Each time she watches TV shows that remind her of incident, she gets scared, overwhelmed, and becomes agitated. At times, she develops anxiety attacks, palpitations, sweating, and restlessness.

Since attack, Sarah can hardly trust people. As a result, her relationships have profoundly suffered. More recently, she’s been depressed and feeling hopeless. She hasn’t been sleeping and eating well. Her inattention has negatively impacted her work.

Based on above symptoms, Sarah is most likely suffering from Posttraumatic Stress Disorder (PTSD). What exactly is PTSD?

These two terms bear clarification:

Narcissistic injury

Any threat (real or imagined) to narcissist's grandiose and fantastic self-perception (False Self) as perfect, omnipotent, omniscient, and entitled to special treatment and recognition, regardless of his actual accomplishments (or lack thereof).

The narcissist actively solicits narcissistic supply - adulation, compliments, admiration, subservience, attention, being feared - from others in order to sustain his fragile and dysfunctional ego. Thus, he constantly courts possible rejection, criticism, disagreement, and even mockery.

The narcissist is, therefore, dependent on other people. He is aware of risks associated with such all-pervasive and essential dependence. He resents his weakness and dreads possible disruptions in flow of his drug - narcissistic supply. He is caught between rock of his habit and hard place of his frustration. No wonder he is prone to raging, lashing and acting out, and to pathological, all-consuming envy (all expressions of pent-up aggression).

The narcissist is constantly on lookout for slights. He is hypervigilant. He perceives every disagreement as criticism and every critical remark as complete and humiliating rejection – nothing short of a threat. Gradually, his mind turns into a chaotic battlefield of paranoia and ideas of reference.

Most narcissists react defensively. They become conspicuously indignant, aggressive, and cold. They detach emotionally for fear of yet another (narcissistic) injury. They devalue person who made disparaging remark, critical comment, unflattering observation, innocuous joke at narcissist's expense.

By holding critic in contempt, by diminishing stature of discordant conversant – narcissist minimises impact of disagreement or criticism on himself. This is a defence mechanism known as cognitive dissonance.

Narcissistic Rage

Narcissists can be imperturbable, resilient to stress, and sangfroid. Narcissistic rage is not a reaction to stress - it is a reaction to a perceived slight, insult, criticism, or disagreement (in other words, to narcissistic injury). It is intense and disproportional to "offence". Raging narcissists usually perceive their reaction to have been triggered by an intentional provocation with a hostile purpose. Their targets, on other hand, invariably regard raging narcissists as incoherent, unjust, and arbitrary.

Narcissistic rage should not be confused with anger, though they have many things in common.

It is not clear whether action diminishes anger or anger is used up in action - but anger in healthy persons is diminished through action and expression. It is an aversive, unpleasant emotion. It is intended to generate action in order to reduce frustration. Anger is coupled with physiological arousal.

Another enigma is:

Do we become angry because we say that we are angry, thus identifying anger and capturing it – or do we say that we are angry because we are angry to begin with?

Anger is provoked by adverse treatment, deliberately or unintentionally inflicted. Such treatment must violate either prevailing conventions regarding social interactions or some otherwise a deeply ingrained sense of what is fair and what is just. The judgment of fairness or justice is a cognitive function impaired in narcissist.

Anger is induced by numerous factors. It is almost a universal reaction. Any threat to one's welfare (physical, emotional, social, financial, or mental) is met with anger. So are threats to one's affiliates, nearest, dearest, nation, favourite football club, pet and so on. The territory of anger includes not only angry person himself, but also his real and perceived environment and social milieu.