I believe it’s important for both patients and practitioners to recognize gaslighting.
What is Medical Gaslighting?
Gaslighting in general is when someone, generally a person in power, makes another person (their victim) question their memory, their perception of reality or their sanity. The person being gaslit will feel anxious and confused. While gaslighting is part of the dynamics of an abusive relationship, it can happen in the context of the patient-practitioner dynamic in medicine.
Medical gaslighting is when a patient’s symptoms are blown off, dismissed or denied, which invalidates the patient. The practitioner may tell the patient that the symptoms they are experiencing are in their head, that the symptoms aren’t that bad, that their symptoms couldn’t possibly be caused by condition X. Medical gaslighting generally stops the process to get the correct diagnosis and treatment for the patient which, of course, further invalidates them. Medically gaslit patients get scared and confused, can be misdiagnosed or can have a delayed diagnosis.
I believe it’s important for both patients and practitioners to recognize gaslighting. It’s also important for practitioners to learn how to avoid gaslighting in the first place
Who is Most Likely to Be a Victim of Medical Gaslighting?
Gender, race and sexual orientation can make a difference. I almost always see medical gaslighting in women. It’s subtle, but women are much more commonly seen as hysterical and emotional beings who don’t have the ability to discuss their symptoms without dramatizing them. People of color and people in the LGBTQIA community also see higher rates of medical gaslighting.
Those with chronic pain may fall victim. I see a lot of chronic pain in my practice. Folks with chronic pain whose source can’t be pinpointed are commonly subjected to medical gaslighting. I do a lot of regenerative injections like prolotherapy and PRP to address pain and many chronic pain patients’ pain isn’t actually coming from an impinged nerve or an arthritic joint. It’s common that their pain is coming from damage to a ligament or tendon. But imaging often isn’t sensitive to pick up on this microdamage, so these patients can be blown off when they “fail” the conventional treatment or imaging doesn’t show where their pain is coming from. Since pain is subjective, it can be easy to slide into a situation where a practitioner is medically gaslighting their patient. Pain patients are in, well, pain and this can seem overdramatic to a busy practitioner. And treating pain with drugs can be particularly tricky for the practitioner because there are patients who are drug-seeking and overstate their pain to get more pain meds.
The chronically ill can be particularly challenging for medical practitioners. Often, they will present with a collection of symptoms that seem unrelated and there are so many of them that it becomes overwhelming! With these patients, the practitioner gets overwhelmed by the sheer volume of symptoms and blows the patient off because it’s difficult to believe that a patient could possibly have that many symptoms and diagnosis is difficult when a large collection of symptoms is present.
However, a patient with conditions like POTS, long-haul Epstein Barr virus, endometriosis, vaccine injury, dysautonomia, mold toxicity, fibromyalgia or other non-standard condition can have odd symptoms that don’t seem to make any sense. In my experience, this type of medical gaslighting that these chronically ill patients are subject to is really just a lack of knowledge about these conditions on the practitioner’s part. When the practitioner is unfamiliar with a condition, the collection of symptoms can be complex and intimidating. Sometimes, practitioners don’t believe in a medical condition like dysautonomia or chronic Lyme disease and will medically gaslight their patient. But these conditions are there and they impact the patient in a life-changing way.
With more COVID-19 long-haulers being seen, I’m hoping that more practitioners will think outside of the box and recognize that these complex patients have underlying conditions that are present. I have been treating long-haulers of different varieties for well over a decade and they are frequently medically gaslit. Even if the tools to treat are limited, these patients still need to be validated. We can validate our patients by listening, getting labs done, and ordering imaging…even if the labs are ones we need to do a little research to interpret!
I’ll be back next month to talk more about medical gaslighting. FBN
By Amber Belt, ND
Amber Belt, N.D. is a naturopathic physician and co-owner of Aspen Integrative Medical Center where she helps patients get healthy from the inside out. She is also co-owner of Sage Sirona, which focuses on natural first aid and education. Dr. Belt has been practicing naturopathic medicine for more than 15 years and can be contacted via aspenmedcenter.com or sagesirona.com. You can also call her office at 928-213-5828.
