Narcissistic relationship dynamics can have a profound impact on sexuality, intimacy, and emotional wellbeing. They may undermine safety, trust, vulnerability, and authentic connection, while sexuality itself can sometimes become a means of seeking validation, exercising power or control, or causing harm.
For therapists, working in this area can be complex. Service Users may present with experiences of trauma, coercive control, disrupted attachment, difficulties with boundaries and a diminished sense of self. The therapeutic relationship can also evoke powerful responses, including rescue dynamics, idealisation, devaluation, and challenging countertransference.
This training offers a trauma-informed framework for understanding narcissistic relationship dynamics and how they may present in clinical practice. Participants will explore how narcissistic personality characteristics can affect sexual behaviour, intimacy, attachment and relationship functioning, including associations with infidelity, compulsive sexual behaviour, problematic pornography use, coercive control and interpersonal abuse.
Using clinical examples, the session will support participants to develop practical assessment and formulation skills and consider therapeutic approaches that promote safety, agency, relational recovery and sexual wellbeing.
The training will also explore therapeutic boundaries, countertransference and practitioner self-awareness, helping clinicians to navigate this complex area of practice with greater confidence and clarity.
Learning Outcomes
By the end of the session, participants will be able to:
- Understand narcissism and narcissistic relationship dynamics through both diagnostic and complex trauma perspectives.
- Explore how narcissistic personality characteristics can influence sexuality, desire, intimacy, consent, and relational safety.
- Recognise common relational patterns, including coercive control, abuse and the impact on attachment and identity.
- Apply trauma-informed principles to assessment and clinical formulation.
- Consider practical therapeutic approaches for supporting people affected by narcissistic relationship dynamics.
- Reflect on therapeutic boundaries, countertransference, and practitioner self-awareness.
Session Outline
9.30–9.45am | Introduction
- Defining narcissism and narcissistic relationship dynamics
- Diagnostic and complex trauma perspectives
- Common myths and misconceptions
- Why this topic matters in trauma-informed and sexual health practice
9.45–10.20am | Understanding Narcissism and Sexual Behaviour
- How narcissistic personality characteristics can influence sexuality and intimacy
- The impact on desire, arousal, pleasure, embodiment and relational safety
- Sexual coercion, validation seeking, infidelity, compulsive sexual behaviour and problematic pornography use
- Shame, consent and power within sexual relationships
10.20–10.55am | Narcissism and Intimate Relationships
- An attachment-informed perspective
- Common relational patterns and dynamics
- Narcissistic abuse and coercive control
- The impact on attachment, identity and relational safety
10.55–11.10am | Break
11.10–11.50am | Assessment, Formulation and Case Study
- Trauma-informed assessment considerations
- Developing a comprehensive clinical formulation
- Clinical case study and formulation discussion
- Interdisciplinary assessment and referral pathways
11.50am–12.20pm | Therapeutic Intervention and Clinician Reflections
- Practical therapeutic strategies for supporting people affected by narcissistic abuse
- Clinical considerations when working with clients presenting with narcissistic personality characteristics
- Therapeutic boundaries and countertransference
- Practitioner self-awareness
- Maintaining therapeutic safety and containment when working with complexity
12.20–12.30pm | Questions, Discussion and Key Take-Home Messages
About the Trainer
Dr Sarah Ashton (She/her)
Sexual health psychologist, board-approved supervisor, educator, and founder of SHIPS (Sexual Health and Intimacy Psychological Services) and the Institute of Sexual Health Psychology Australia (ISHPA)
With over 17 years of clinical experience, she has dedicated her career to advancing the integration of sexual wellbeing into mainstream psychological practice through clinical work, education, supervision, research translation, and advocacy.
Dr Ashton has lectured at universities across Australia, delivered professional development workshops nationally and internationally, advised organisations including the Australian Psychological Society (APS), the Society of Australian Sexologists (SAS), and Labia Library, and developed more than 28 professional training programs in sexual health psychology.
Sarah is the author of the book When Trauma Affects Sex, which introduces the SHIFT Model -an integrative framework for understanding and treating the impact of trauma on sexual wellbeing. Her work is recognised for translating complex theory into practical, compassionate, evidence-informed frameworks that clinicians can confidently apply in everyday practice.
