Medical Gaslighting

      Gaslighting refers to the act of manipulating someone into doubting their own judgment or sanity. Often, the term is used in abusive relationships but has been increasingly more prominent in medical settings. Gaslighting in medicine can happen between doctors and patients, which often compromises the trust in a doctor-patient relationship. Gaslighting is dangerous because it is often subtle and difficult to detect. The victim and those around the victim often don’t realize it is happening, yet it can have lasting effects on the victim’s self-esteem (Fraser, 2021).
   Most often, medical gaslighting occurs when a doctor knowingly or unknowingly dismisses a patient’s symptoms or concerns, causing the patient to question his/her own judgment or self-reporting abilities. For instance, a patient comes into the hospital complaining of a headache. The doctor, at the end of his long shift, runs a couple simple diagnostic tests and does not find anything serious. The doctor tells the patient that it is nothing serious and that it will pass with time. The patient, who is still in pain, has failed to receive the treatment they need and now begins to question their own judgment. They may think, “maybe I was too sensitive and I didn’t need to go to the hospital” or “maybe I failed to give a proper report of my symptoms.” Then, the patient may feel a lowered sense of self-esteem. This is medical gaslighting (Au, 2022).
     Medical gaslighting was particularly prominent among long COVID patients. Long COVID patients are patients that have lingering effects from contracting COVID-19, such as brain fog, difficulty focusing, memory loss and problems with mobility. Because COVID-19 is a relatively recent and under-researched disease, many doctors were unsure of the causes and treatment of long COVID symptoms. Therefore, many long COVID patients reported that their symptoms were dismissed by doctors because doctors didn’t have enough knowledge about the
condition. Not taking seriously the concerns of long COVID patients, who clearly had symptoms, is a form of medical gaslighting (Au, 2022).
     Gaslighting is also common in obstetric medicine. Gaslighting in obstetric medicine consists of making decisions on behalf of the mother, acting without the mother’s consent or blaming the mother for unfavorable outcomes. Gaslighting in this field is especially prevalent due to the general discrimination against women in medicine. Historically, clinical trials and treatment recommendations have been tailored toward men. Also, there is a history of women’s health problems being dismissed because of the false assumption that they are being hysterical or irrational. For such reasons, women are at higher risk of medical gaslighting. One example is traumatic childbirth, which refers to the trauma due to feelings of helplessness and horror during childbirth. In many cases, the traumatic experiences during childbirth can lead to higher risk of postpartum depression and anxiety and detachment from the child. However, to obstetric doctors, these experiences are seen as normal and routine. This can lead mothers to question their own sanity or mental fortitude (Fielding-Singh, 2022).
     One of the key tenets of medicine is trust between doctors and patients and the mutual understanding that the doctor is acting in the best interest of the patient. However, medical gaslighting can completely compromise this trust and lead to mistrust and animosity between doctors and patients. This is why it is crucial that we are able to understand and recognize gaslighting when it happens and intervene. As a patient, it is important to have a friend or family present during check-ups and get second opinions from different doctors to make sure that they are not being manipulated. As a doctor, it is important to treat all patients with the same level of respect and allow them to have autonomy in their decision-making. Doctors and patients must be able to work together to produce the best possible results for the patients.

References

• Au, L., Capotescu, C., Eyal, G., & Finestone, G. (2022). Long covid and medical gaslighting: Dismissal, delayed diagnosis, and deferred treatment. SSM - Qualitative Research in Health, 2, 100167. https://doi.org/10.1016/j.ssmqr.2022.100167
• Fraser, S. (2021). The toxic power dynamics of gaslighting in medicine. Canadian Family Physician, 67(5), 367–368. https://doi.org/10.46747/cfp.6705367
• Fielding-Singh, P., & Dmowska, A. (2022). Obstetric gaslighting and the denial of mothers’ realities. Social Science & Medicine, 301, 114938. https://doi.org/10.1016/j.socscimed.2022.114938
• Watson-Creed, G. (2022). Gaslighting in academic medicine: Where anti-black racism lives. Canadian Medical Association Journal, 194(42). https://doi.org/10.1503/cmaj.212145