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When I first heard the term “gaslighting,” I had to look it up. The term’s origin goes back to a play from 1938, Gas Light. In the show, a husband wants to convince his wife that she is going crazy, so he manipulates things to make it appear so. When the husband goes into the apartment above them, which is empty, he turns on the gas lights, which makes the lights in the rest of the building dim. His wife hears his footsteps but doesn’t know it’s him, so she thinks she is hearing things.
Now, gaslighting means manipulating someone by making them believe that what they think or remember isn’t true. For example, someone might tell you that you’re being dramatic or overreacting, they didn’t say something you remember them saying, or blame you for something they did (“If you’d only done ABC, I wouldn’t have done XYZ.”) In other words, you are the problem, not something they said or did. It’s abusive. A common example is saying, “I was only joking,” if something they said made you cry. What they don’t get is a joke is only funny if both sides think it is. The fact that it made you feel bad is not your fault; it’s theirs.
Medical gaslighting
Given what gaslighting means, I was surprised to read that something called medical gaslighting exists. I remember thinking, no way. I acknowledge, with sadness, that not every patient is treated as well as they deserve, but gaslighting? That’s a bit much, isn’t it? So, I did some digging. I was wrong. There is medical gaslighting.
“Gaslighting is real; it happens all the time.”
The New York Times published an article last year discussing how to spot medical gaslighting and what to do about it. In it, Dr. Jennifer H. Mieres, a professor of cardiology at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, said, “Gaslighting is real; it happens all the time.” The author relates a story of a woman who had fallen off her bike and hurt her arm. She sought help from her doctor, and he just brushed her off, blaming her pain on the fact that she was overweight. For arm pain. Later, an urgent care clinic X-ray showed that the woman had chipped a bone.
Like many types of mistreatment, gaslighting affects certain groups of people more than others. According to a Psychology Today article, also from 2022, “People of color and women are most likely to experience medical gaslighting.”
Of course, medical gaslighting isn’t like the examples I used above, but the frightening thing (to me) is that most of the time, healthcare professionals may not realize they are even doing it.
The most common example of gaslighting is when a medical professional suggests that a woman’s complaints are not taken as seriously as a man’s or – worse – are considered psychological. Look at how women are often treated when they present with pain. Period pain – cramping during a menstrual cycle – can be very severe. But I remember a female gynecologist telling me to stop acting like it’s so bad, because she had some cramping and she managed to get through it.
These studies are a bit older than I usually like to share, but I think they’re still valid. This one, published in 2008, found that women who went to the emergency department complaining of acute abdominal pain waited much longer than men to get pain relief and were 25% less likely to be given an opioid for that relief. This one, published in 2009, found that middle-aged women who sought care for symptoms of heart disease were twice as likely to be diagnosed with a mental health issue than men with the same symptoms: “Middle-aged female patients were diagnosed with the least confidence, whether for CHD [coronary heart disease] or non-CHD conditions, indicating that their gender and age combination misled physicians, particularly toward mental health alternative diagnoses,” the authors wrote.
Did you know that some white medical students still, to this day, believe that Black patients don’t feel as much pain as their white peers? So not only do these patients have to deal with racial bias, but they also have to deal with gaslighting. I remember caring for a young Black man, many years ago, who lived with sickle cell anemia. While I’ve never experienced the pain associated with the disease, I know it’s agonizing. But I know he went through a lot just to have someone listen to him and acknowledge that he needed help during a sickle cell crisis.
So how do we prevent medical gaslighting?
My Decipher Your Health cofounder Karin Molander and I started the project because we want people to become their own patient advocates or advocates for the people they care about. This helps reduce, if not eliminate, medical gaslighting.
Here are some tips we frequently mention:
Bring someone with you to your appointments. They don’t have to be physically in the room during the physical examination if you don’t want, but they can be with you during your conversations with your PCP or specialist. Having someone with you helps you catch things you might miss and helps back you up if you feel your concerns are being dismissed. What does this look like?
Suppose your doctor tells you that your headaches are likely related to stress. Your advocate can say, “I’m her sister/mother/friend, and I don’t see her get headaches when stressed.” Or if the doctor says, “I think you should exercise more to see if the problem will resolve itself.” Your advocate can say, “As she mentioned, she already runs three times a week and swims the other days.”
Ask questions. If your doctor says, “It’s probably related to stress, maybe you should see a counselor,” ask for more information. Why does the doctor believe it’s related to stress? Why is that the first choice before sending for tests to see if it’s a physical problem?
Document everything. Have a journal where you document your visits, list test results, medications, side effects, symptoms, and anything related to your complaint. If your doctor dismisses your concerns, you have them in writing. It’s harder to ignore a well-documented, dated list than to ignore someone trying to remember things in a conversation. At the same time, if your doctor is dismissing your concern, ask that they clearly note it in your health record.
Listen to your gut. If you need a second opinion, get one. (Read Getting a Second Opinion; Is That Insulting to Your Doctor?, which I wrote over at Decipher Your Health) You are your body’s expert. While you didn’t go to medical school and don’t know all the ins and outs of your body’s function, you are the expert on how you feel. If you are uncomfortable with your PCP or specialist’s diagnosis or treatment plan, get a second opinion. You may even need to switch physicians if it’s possible.
What do you think? Leave a comment below. Let’s get a conversation started.
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