In Episode 9 of Unseen but Not Untold: Overcoming Covert Narcissistic Abuse, Dr. Christine C. Zacharia MD, integrative covert narcissistic abuse recovery expert and board certified endocrinologist, shifts the focus to something many survivors feel but often struggle to explain: the physical impact of covert narcissistic abuse. She explores this topic across Episodes 9 and 10 in this two-part mini-series within the podcast.
Before she dives into the episode, Dr. Zacharia shares an important message about the material presented:
"This discussion is not a substitute for medical evaluation or treatment. The framework I’m sharing in this episode and the next episode is intended to be supplemental to the care you are already receiving from a licensed medical provider. As always, before starting any new physical activity or practice discussed here, please check in with your healthcare provider to make sure it’s safe for you."
The Body Under Siege: Covert Narcissistic Abuse and Its Detrimental Impact on Your Health
"One of the most consistent and clinically observable consequences of covert narcissistic abuse is its physical impact on the body."
What many dismiss as stress is actually prolonged physiological activation. Living in a constant state of high alert keeps the body locked in survival mode.
"Living in a constant state of high alert exposes your body to chronic physiologic elevations in cortisol and adrenaline levels."
This is not temporary stress. This is chronic dysregulation.
Chronic Cortisol Elevation: The Silent Disruptor
Cortisol plays a central role in how the body responds to stress.
"Cortisol is a hormone produced by the adrenal gland, a small triangular shaped gland that sits on top of the kidney. This hormone is designed to regulate blood pressure, sleep, body weight, sugar levels and inflammation in the body."
Under normal conditions, cortisol follows a predictable rhythm throughout the day.
"It typically follows a diurnal rhythm where levels are highest in the morning, with a second boost in levels in the afternoon hours before subsiding into the overnight hours."
In the presence of chronic stress—especially the kind created by covert narcissistic abuse—that rhythm becomes disrupted.
Although this does not result in Cushing syndrome or Cushing disease, conditions characterized by pathologically elevated cortisol levels, the effects of chronically elevated cortisol on the body can still be significant.
"For instance, you may notice weight gain or an inability to lose weight despite diet and exercise efforts."
Sleep disturbances, elevated blood pressure and changes in blood sugar regulation often follow. For premenopausal women, menstrual irregularities also develop.
The effects are not limited to metabolism. They extend into brain function and immune health as well.
"In states of prolonged exposure to high cortisol, the hippocampus, the memory center of our brain, becomes impaired, leading to memory loss."
At the same time, immune defenses weaken, increasing vulnerability to infections.
Adrenaline and the Hypervigilant State
Alongside cortisol, adrenaline remains persistently elevated in survivors of covert narcissistic abuse.
Dr. Zacharia explains the "fight or flight" system of the body is designed for short-term survival—not long-term living.
"Normally adrenaline is released when there is a perceived threat or danger - that’s why it is labeled our 'fight or flight' hormone."
It prepares the body to respond quickly by increasing heart rate, blood pressure, breathing and energy availability.
However, with covert narcissistic abuse, the threat is not a single moment—it is ongoing.
"In covert narcissistic abuse, adrenaline is chronically elevated due to the constant 'push and pull' dynamics of the relationship."
Dr. Zacharia explains that the unpredictability, the emotional volatility and the constant anticipation of the next shift keep the body in a state of hypervigilance.
"The constant walking on eggshells... the chronic invalidation…the continuous anticipation of their next move and reaction to something good happening in your life."
Over time, this creates a persistent internal state of danger. This internal state begins to manifest physically.
"Physically, this manifests as anxiety, sweating and palpitations. Also you may develop shallow, rapid breathing and a sensation of being unable to fully catch your breath."
This is not just anxiety. This is a body conditioned to expect harm.
Stored Trauma in the Body
"Outside of hormonal aberrations, prolonged covert narcissistic abuse also leads to stored trauma in various parts of our body."
Dr. Zacharia explains this trauma often settles in the lower back and hips, particularly within the psoas muscle.
The psoas plays a key role in the body’s protective response.
"When the amygdala perceives a threat—whether physical or emotional—it activates a primitive survival reflex designed to protect the body from impact."
Part of that reflex involves bracing—curling inward to protect vital organs.
"One of the body’s instinctive responses is to brace and curl inward, engaging the core and hip flexors to shield vital organs. The psoas is a key muscle in this protective response."
In chronic trauma, this response never fully turns off. As a result, the psoas stays chronically contracted, holding the body in a subtle but persistent state of bracing.
Over time, this leads to pain, stiffness and restricted movement.
"Fun fact: the psoas muscle in cows is where filet mignon comes from—it’s one of the most tender cuts of meat. So, as you can imagine, for a muscle designed for flexibility and responsiveness to become chronically tight in the human body is a powerful indicator of the amount of stored stress, unprocessed trauma and repressed anger that is present."
Autoimmune Consequences: When the Body Turns on Itself
Dr. Zacharia also notes that prolonged exposure to covert narcissistic abuse impacts the immune system in profound ways.
In the setting of covert narcissistic abuse, the immune system can become dysregulated and lose its ability to distinguish between "self" and "non-self."
"In the setting of chronic trauma and prolonged abuse, the immune system becomes dysregulated and develops an impaired sense of self-tolerance where it begins to misidentify its own cells as foreign."
This leads to an autoimmune response—where the body begins attacking its own tissues.
"The result is a cascade of immune-mediated processes that culminate in an autoimmune response, in which the body mounts an attack against its own tissues."
East Meets West: Integrating Mind, Body and Spirit Through the Chakra Framework
From a clinical standpoint, Dr. Zacharia explains that the effects of covert narcissistic abuse are clear, impacting the nervous, endocrine and immune systems. At this stage in the episode, she transitions into a deeper framework for understanding the physical effects of covert narcissistic abuse on the body.
"Now let’s integrate this medical understanding with an eastern philosophy framework to help interpret how and where trauma from covert narcissistic abuse can become stored in the body—a framework that focuses on chakras, or energy centers."
The concept of chakras originated in ancient India between approximately 1500 and 500 BC. Each chakra, or energy center, represents a different aspect of one's body. They encompass emotions, communication, personal power and spiritual connection.
The chakra system offers a way to understand how emotional and spiritual experiences manifest physically.
"You can think of chakras like a series of checkpoints along a river flowing through your body: when the flow is smooth, energy moves freely. But when it becomes blocked or held up, tension builds in one area until it is released."
Dr. Zacharia takes this moment in the episode to reinforce an important truth about covert narcissistic abuse.
"And even though the covert narcissistic abuse you experienced may have been invisible to others, your body carries the evidence of what happened to you."
"If you ever question whether what you endured was really abuse, look at the physical symptoms you are dealing with today. They are not imagined. They are not exaggerated. They are undeniable proof of the impact this prolonged trauma had on your body, your nervous system and your sense of self."
The Throat Chakra: The Silencing of Your Voice
One of the most impacted chakras in covert narcissistic abuse is the throat chakra—the center of communication, truth and self-expression.
"In covert narcissistic abuse, victims are silenced, invalidated, gaslit and punished for expressing their needs and emotions."
Over time, this suppression creates a blockage that shows up both emotionally and physically.
"When the throat chakra is blocked, expressing your anger or frustration in words can feel impossible."
That suppression doesn’t disappear—it finds other ways to surface.
"Sometimes, that energy comes out in other ways—like crying when you’re angry or feeling a huge lump in your throat."
"Your body is trying to release what your voice has learned not to express."
Dr. Zacharia discusses how her throat chakra was impacted as a result of covert narcissistic abuse.
"Before I began the healing work on my throat chakra, I remember what it felt like when I got angry—I would start crying instead of voicing the anger I was actually feeling."
"I couldn’t express my frustration, set boundaries or say what needed to be said."
"That lump in my throat, the tears, the inability to speak up—they were all signs that my throat chakra was blocked and that energy was stuck there."
The Thyroid Connection: Clinical and Energetic Overlap
Clinically, the throat chakra corresponds to the thyroid gland, a critical organ in the body that regulates metabolism, energy levels, heart rate, blood pressure, body temperature, memory, concentration and bowel function.
Chronic emotional suppression and stress in this region may manifest as: Hashimoto’s thyroiditis, an autoimmune cause of hypothyroidism or Graves’ disease, an autoimmune cause of hyperthyroidism.
"If you’ve been following me for some time, you know I live with Graves’ disease."
This connection between emotional suppression, spiritual targeting and physical manifestation is not coincidental. It reflects the depth of what the body has been carrying as a result of covert narcissistic abuse.
Reclaiming the Voice: Healing Through Expression
Dr. Zacharia's voice has been targeted since her formative years.
"My voice has been the target of repeated spiritual warfare since my birth, beginning within my own family. That pattern of suppression did not end in childhood—it recurred across relationships and environments. In hindsight, it makes sense: when your God-given assignment is to speak truth, expose darkness and help others reclaim their voice, that voice naturally becomes a primary target."
What was once attacked becomes the very place restoration begins.
"Hosting this podcast and sharing my experience with covert narcissistic abuse is not a coincidence. It reflects the restoration of what was once attacked."
Dr. Zacharia shares this restoration didn’t happen all at once. It started in smaller, quieter ways.
"One of the first ways I began releasing the energetic blockage in this area was through singing."
What once felt like a simple interest revealed itself as something deeper.
"Growing up, Sister Act and Sister Act 2 were two of my favorite movies."
Looking back, that connection carried meaning.
"I realize I was subconsciously drawn to the power of vocal expression I saw there—the way the nuns’ singing transformed their community and the way the high school kids in Sister Act 2 found their voice through song."
That desire to express had always been there. It just needed a safe space to emerge.
"In my 20s, I was drawn to karaoke—not because I was a great singer, but because singing felt instinctively restorative."
After going no contact, that connection to voice returned again—but differently.
"After going no contact with Levi and Jessie, I reconnected with singing—but in the privacy of my car."
There, something shifted in that space for her during her commutes to work.
"During my morning commutes, I sang along to Catholic songs I had grown up with as well as modern Christian worship music that resonated deeply with me."
The difference wasn’t just musical preference. It was evidence of God's presence in Dr. Zacharia's life. She didn't experience the same sense of peace singing her favorite 80s or 90s songs—even ones she had memorized by Madonna or Whitney Houston.
"Singing Christian music created a space for God to meet me in that moment."
"Singing wasn’t about performance—it was about permission. Permission to express, to breathe and to begin reclaiming my voice again."
The Physiology Behind Vocal Healing
Dr. Zacharia delves into the physiological impacts of singing in this next segment of the episode.
"Singing, chanting and humming is powerful therapy for a blocked throat chakra and the phenomenon we experience in these moments can be explained physiologically. They stimulate the vagus nerve which is part of our parasympathetic system - also known as the 'rest and digest' part of our body."
This is the system responsible for calming the body. When your body shifts into the parasympathetic system, it moves out of the sympathetic system’s “fight or flight” mode. There is also an increase in the neurotransmitter serotonin.
"These vocal activities also increase serotonin, a neurotransmitter important for supporting mood regulation, emotional stability, calm and focus."
Together, these responses create space for emotional release, nervous system regulation and energetic flow in the throat chakra.
Dr. Zacharia explains that breathwork deepens this process even further.
"Along with singing, another simple but powerful practice is deep, intentional breathing… it works well with vocal expression to release tension and restore flow."
When you breathe deeply, especially diaphragmatically, you engage the muscles around your throat and chest, helping release tension and allowing energy to move more freely. Like vocal expression, breathwork also regulates the nervous system.
"Deep breathing, like singing, also stimulates the vagus nerve, which shifts your body out of fight-or-flight mode, promotes calm and creates space for emotional and energetic flow."
Dr. Zacharia explains these practices can also be combined.
"You can even pair your breathwork with chanting or speaking affirmations—where the vibration of your voice works together with your breath."
This creates a powerful feedback loop of regulation and release. This powerful combination strengthens your ability to express yourself, reclaim your voice and restore flow in your throat chakra.
Healing from Covert Narcissistic Abuse: From Suppression to Power
Dr. Zacharia reflects on how these practices not only impacted her throat chakra, but her internal sense of well-being as well.
"The daily practice of singing and deep breathing didn’t just release tension in my throat chakra—it opened a pathway for deeper awareness and personal empowerment."
With that shift came change in behavior, expression and identity.
"I started taking up space again, speaking my truth and I became more comfortable expressing my needs, setting boundaries and standing firm even when my words made others uncomfortable."
"I stopped crying when I was angry and started using my voice to express what I truly felt."
At first, it felt unfamiliar. But over time, that discomfort gave way to alignment.
"This is what happens when the throat chakra is restored: your voice aligns fully with your authenticity, your light and your essence. You no longer shrink to avoid conflict or appease others—you stand in your God-given truth and embrace your spiritual purpose.”
She discusses that one's vocal expression is deeply connected to purpose and identity.
“God didn’t put you here to go with the flow—you were created to shake things up.”
“If you were targeted by a covert narcissist, it wasn’t by accident. Darkness seeks to silence the light, but your voice carries purpose.”
In this framework, reclaiming one’s voice is an essential part of healing and fulfilling personal purpose. Dr. Zacharia describes practices such as singing, chanting and humming as powerful tools for releasing stagnant energy and restoring internal flow.
“Singing, chanting or humming is more than a recreational or meditative practice—it’s a powerful tool. It helps move stagnant energy, release trauma, expand consciousness and reclaim your voice.”
She then reflects on the broader message of the episode, emphasizing the connection between the body and stored trauma.
“Your body holds the story of your trauma—even when your mind tries to release it.”
She encourages listeners to become aware of where tension manifests physically, viewing this awareness as the first step toward reclaiming personal power and autonomy.
“The tension, stiffness or discomfort you feel isn’t random; it’s your body signaling where energy has been blocked.”
Dr. Zacharia highlights the throat chakra specifically, encouraging daily practices that support vocal expression and nervous system release, such as breathwork, singing, humming or chanting.
“Even if you don’t have an autoimmune condition affecting your thyroid, your voice has likely been suppressed by the covert narcissist.”
Ultimately, she frames these practices as acts of reclamation—ways of restoring voice, truth and embodied identity.
“Let that blocked energy move and release—it’s your body’s way of reclaiming your voice, your truth and your essence.”