Yolanda Sims, JD, MHA
Loss Prevention and Risk Management Advisor

What is gaslighting?

Generally speaking, gaslighting occurs when a person uses manipulative tactics to make another person doubt their own judgment. For providers practicing in the mental health world, gaslighting has been documented for decades. The term has since acquired a medical meaning beyond psychological studies and is considered mainstream in today’s lexicon.

What is “medical” gaslighting?

Medical gaslighting is rooted in bias and occurs when a medical professional dismisses a person’s symptoms, making them think it’s all in their heads. Unlike the movie, medical gaslighting can lead to serious consequences for the patient, such as a missed or delayed diagnosis, improper treatment, and even medical trauma. Research has shown that it can happen to anyone, but women, people of color, older people, non-heterosexual people, and individuals with “stigmatized” conditions–like being overweight or having a mental illness–are more frequently misdiagnosed, and their symptoms are more frequently dismissed.

Patients also report the long-term negative consequences of gaslighting, including:

• Anxiety and depression
• Symptoms of post-traumatic stress disorder such as intense stress, guilt, or shame
• Severe self-doubt
• Feeling insecure and unsafe

What can providers do?

In many cases, what may be perceived as medical gaslighting is really a breakdown in communication. Providers should be more intentional during patient encounters to show concern and avoid the use of the following dismissive phrases:

• “You have a great imagination.”
• “You’ve got to expect this at your age.”
• “You’re not that sick.”
• “You’re being too sensitive.”
• “Why are you getting so emotional about this?”
• “We’ve talked about this many times, and there’s nothing new to discuss.”

Risk Recommendations

In addition to avoiding the red flags above, here are a few risk recommendations to incorporate into your clinical interactions while remaining committed to treating patients with dignity and respect:

• Set expectations during the visit. From the outset, welcome a dialogue exchange with your patient and ask questions like “What do you hope to accomplish today?” and “Can you tell me your concerns?” We live in the information age, so asking a question like “What did you Google?” is very acceptable.

• Check your bias at the door. Utilize bias interrupting techniques. Slow down your thinking, pause or halt your responses, and be intentional when engaging with patients.

• Adopt a new philosophy. Practice the philosophical principle of charitable thinking, meaning treat people like they are intelligent to better understand their viewpoint. Instead of dismissing a patient’s lived experience, take it at face value and focus on finding solutions to their concerns.

• Second opinions are valuable. Second opinions are worth exploring because they bring a fresh perspective, and often, both parties gain additional insight. The more information patients have, the better the outcomes.

• Encourage and empower patients. Many patients are their own best advocates and health historians, but they may lack the methods to collect data on themselves properly. With guidance, patients should be encouraged to write down symptoms when they occur, their frequency, and what makes them better or worse and report it during the encounter.

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References
Fraser S. The toxic power dynamics of gaslighting in medicine. Can Fam Physician. 2021 May;67(5):367-368. doi: 10.46747/cfp.6705367. PMID: 33980633; PMCID: PMC8115954.

Mendaris, Anna. ‘6 tips to deal with medical gaslighting according to doctors,’. Business Insider. Dec 23 2022. https://www.insider.com/6-tips-to-deal-with-medical-gaslighting-according-to-doctors-2022-11

Hilton-Anderson, Charlotte. ‘What is Medical Gaslighting: 9 doctor’s statements that are red flags’. The Healthy: A Reader’s Digest Brand. May 26 2023 https://www.thehealthy.com/healthcare/here-is-what-medical-gaslighting-means-plus-signs/

Witten, Beth Jan 2020, ‘Stop medical gaslighting to empowering your patients’, Home Dialysis Central. January 15 2020. https://homedialysis.org/news-and-research/blog/342-stop-medical-gaslighting-to-empower-your-patients