What Gaslighting Is, How to Recognize It, and What Next to Do
I’m sorry, but I can’t find anything wrong with you. Are you sure about all these symptoms? It’s probably just your body’s reaction to the stress from these years of the pandemic?"
Well, I really don’t think there’s anything that I or anyone else can do for you. You might consider getting some counseling from a psychologist.
Guess what – you have just been gaslighted!
It’s possible to have missed the movie and/or series called “Gaslight” where a person has dismissed what someone else has said with a result that the dismissed person begins to doubt themselves. When this happens, it’s called “gaslighting.” Gaslighting In a medical setting is when your doctor or other healthcare professional dismisses your symptoms, complaints, or even feelings, making you believe that they are not taking any of these seriously. As a result, you’ll begin to 2nd guess that your problem even exists. This is called “medical gaslighting.”
When medical gaslighting occurs, it can be traumatic, but the consequences can even be worse: a delay in diagnosis with its associated delay in proper treatment or a missed diagnosis. While often not intentional, there are those healthcare professionals that are unaware of harboring personal bias — like gender, racial bias, or social bias. Unfortunately, women and minority groups most often the victims of medical gaslighting.
Some Examples of Medical Gaslighting
For women who are more commonly gaslighted than men, examples include being told that their symptoms are “in their head” and not real, or for those women who remain menstruating, that their symptoms are premenstrual. An uncommon but not rare condition called endometriosis where the lining of the uterus, called “endometrium,” grows outside the uterus and causes scars between the organs that are not normally present and results in abdominal and/or pelvic pain. Heart disease is more often misdiagnosed in women especially since their presentation differs from that of men – like pain in their back or jaw. Even waiting times in the emergency room have been shown to be longer for women than men for the same condition (1).
For people of color, certain myths persist like they have thicker skin as well as nerve endings that are less sensitive, or that they biology is different from that of white people. (2,3) Worse yet, negative descriptors are found more often in their charting compared to that of a white person. (4)
How Do I Know If I’ve Been Medically Gaslighted?
Similar to when you know that your healthcare professional will not be a good partner in your care, a common sign is when there is lack of eye contact and apparent disregard when providing your story – your signs and symptoms. This may be in the form of interrupting you so you can’t even tell your medical history. Other signs include questioning how accurate you have been in telling your medical story and/or rushing you out of the exam room.
If your doctor is not a true partner in your care, they will not take the time to discuss their findings or initial impressions and even what treatment options might be available with you. This is a form of medical gaslighting. It means that you will walk out of the exam room with little understanding of your condition and your treatment plan. In this instance, the result can be either a delay in a proper diagnosis and it’s attendant treatment plan, or even a missed diagnosis. The bottom line is that medial gaslighting is harmful to your mental and physical health.
What Can I do If I Have Been Gaslighted by My Healthcare Professional?
The good news is that there are ways to prevent and/or overcome medical gaslighting once it’s recognized. In 2 words: Be Prepared! That means having an accurate journal of your health with you in which you have recorded signs and symptoms beyond what’s in your electronic medical records. It’s important to describe your symptoms are. Are they constant or come and go? Do they migrate (sometimes called “radiate”) to different parts of your body? If you have pain, where is it located, what’s its character – constant, throbbing, burning, sharp, etc.? When do the symptoms occur? What makes them better or worse? Was there an activity that preceded their onset? All these things are important to have in your journal.
For each and every visit, have a list of your questions written out. Don’t be afraid to ask and ask and ask until you understand the health professional’s response. Bring a trusted friend along or a family member to support you and be a second set of ears. A friend or family member can act as your advocate. A professional health advocate can also be a great help, especially as a neutral party in the event there is tension or conflict that may be present.
Do I Need a Personal Patient Advocate?
Doing your own research can be overwhelming and confusing. A personal patient advocate can save you time, help you find the right information, and explain everything so you feel confident talking with your doctors and making good decisions. There is a range of services that advocates can provide and therefore are an important resource for anyone who’s struggling to understand everything doctors say, figure out what questions to ask, and what information may be important to tell them. While some speak of advocates only as “guides,” they can do much more than this. The range of support includes setting up appointments, reviewing medical bills for accuracy, resolving conflicts between patients and their healthcare professionals and/or their health insurer, attending medical visits and taking notes, aiding completion of medical forms and applications, identifying areas where care can be improved, finding trusted information on healthcare conditions, and explaining medical conditions and treatment plans. Some patient advocates may provide all of the above, or a narrowing form of support.
Should I Consider a 2nd Opinion?
Sometimes a personal advocate may not be right for you. If that’s the case, don’t be afraid to obtain a 2nd opinion. Think of a 2nd opinion as a consultation with another independent healthcare professional that’s generally the same type of healthcare professional – like a specialist — to confirm, refine, revise, or disprove the initial diagnosis and/or recommended treatment plan. Since no healthcare professional can be expert in every aspect of a person’s health, and especially in situations where more information is needed when the results of testing are confusing or conflicting, a 2nd opinion may be your best next step. It’s important to know that most healthcare professionals try to be objective and practice honestly, but in the practice of medicine, many gray areas exist leaving a lot of room for differing opinions. That’s why it’s called the “practice” of medicine. The good news is that most healthplans will pay for, and in some instances require, 2nd opinions, especially when a surgical procedure or a type of treatment that may be considered experimental is recommended. Don’t worry about offending your initial healthcare professional since they want you to be comfortable with the diagnosis, treatment, or procedure and confident that you have made the right decision. In fact, given the same circumstances where further clarity is needed, they would do the same. If they are not in agreement with your 2nd opinion request, it’s time to look elsewhere.
Some of the most common reasons for a 2nd opinion include:
- You have an uncommon medical condition, cancer, or your condition is life-threatening
- A surgical procedure recommended
- You’re not responding to your prescribed treatment plan
- Your doctor seems unsure of your diagnosis and/or treatment plan
- Your healthcare professional tells you that there’s nothing further to be done
In a study from the Mayo Clinic in 2017 found that only 12%of patients in their study had the same diagnosis after getting a 2nd opinion and in fact, the 2nd opinion resulted in getting further information that helped in establishing the correct diagnosis.(5) When both healthcare professionals agree on a diagnosis and treatment plan, you’ll feel more confident moving forward. If there is disagreement, you may find alternatives that better meet your needs or even find another healthcare professional to whom you relate better. Further, you will be more in control and empowered – called being an “activated” patient.
Having an experienced empathetic patient advocate by your side can help ensure better decision-making which often leads to better clinical outcomes along with greater clarity and less stress. Greater National Advocates is among the best resources at your disposal to identify the patient advocate that best meets your personal needs.
1. Esther H. Chen MD, Frances S. Shofer PhD, Anthony J. Dean MD, Judd E. Hollander MD, William G. Baxt MD, Jennifer L. Robey RN, Keara L. Sease MaEd, Angela M. Mills MD Academic Emergency MedicineVolume 15, Issue 5
4. Health Affairs Vol. 41 No,2 Racism and Health