Neurobiological Entanglement: A Systems-Level Framework for Understanding Narcissistic Abuse in Neurodivergent Populations

Abusive relationships are profoundly shaped by the interaction of distinct neurobiological profiles. This paper proposes a systems-level framework—defined as the interaction between neural, endocrine, and behavioral systems—of neurobiological entanglement to explain the self-perpetuating cycles of exploitation and dependency in relationships involving individuals with covert narcissistic traits and neurodivergent individuals, particularly those with ADHD or autism. The framework integrates research on the neurobiological mechanisms of perpetrators, who exhibit high cognitive but low emotional empathy, with the neurodivergent vulnerabilities of victims, including dopamine dysregulation and heightened oxytocin sensitivity. We conceptualize trauma bonding as a neurochemical process that shares key features with addiction, driven by intermittent reinforcement that exploits these inherent sensitivities. The long-term consequences of this abuse, including alterations to the hippocampus, amygdala, HPA axis, and default mode network, are discussed. Finally, we outline a neurobiologically-tailored recovery approach using the “Six Rs” framework. Given that neurodivergent individuals are significantly more likely to experience intimate partner violence—up to 47% in autistic women—this paper argues that recognizing narcissistic abuse as a neurobiological public health concern is essential for developing specialized, evidence-based interventions and policies to support neurodivergent survivors.