“Whenever a doctor cannot do good, he must be kept from doing harm” — Hippocrates
Physical symptoms like fever, aches, pain, insomnia and indigestion are usually indicative of some ailment in the body. In response, the patient consults a physician to either rule out a disease and to provide appropriate treatment so that the body can return to its healthy state. Now sometimes, it just so happens that after examining a patient, doctors may, for whatever reason best known to them, conclude that the patient is merely raising false alarms. The symptoms such patients may be complaining about actually do not exist despite their insistence. There are occasions when patients honestly feel a particular irritation, but are unable to express their ailment clearly leading to the doctors waiving them aside as myth and that is exactly where medical gaslighting comes into play.
Paige Sweet, PhD and assistant professor of sociology at Michigan University, says in quite simple words: “I think of gaslighting as trying to associate someone with the label ‘crazy’. It’s making someone seem or feel unstable, irrational and not credible, making them feel like what they’re seeing or experiencing isn’t real, that they’re making it up, that no one else will believe them”.
Those who are at a greater risk of falling victims to the effects of gaslighting are usually women, elderly and people of color in the West.
When patients refer themselves to a doctor, they do so with the confidence that they are specialists in their field, have the necessary knowledge and experience and will know how to find a remedy that would cure them. On the contrary, if those doctors are taking things lightly, dismissing the symptoms as insignificant, showing apathy and trying to prove the patients wrong, this would be a case of gaslighting. Besides, patients may start casting doubts on their own understanding that could end up increasing their sufferings.
According to Dr. Carolyn Rubenstein, a licensed clinical psychologist based in the United States: “It is a form of emotional manipulation that can be extremely harmful to patients, particularly those with chronic or rare conditions or ‘invisible’ illnesses.”
Those who are at a greater risk of falling victims to the effects of gaslighting are usually women, elderly and people of color in the West. No doubt that in countries where free medical treatment is a citizen’s prerogative but they are not permitted access to their record or test reports, gaslighting can be an easy ploy to discourage patients’ from seeking medical aid.
In Pakistan, although this term may not be in use right now, but many patients, especially the elderly and the under-privileged, do complain that their doctors refuse to accept that anything is physically wrong with them, attributing their symptoms to psychological problems. They believe that in order to gain attention, patients make up stories related to their medical condition, therefore there is no point in treating them. This approach is quite frustrating for genuine patients resulting in further disintegration of their health.
Good doctors would actually delve into patients’ problems to check out whatever is causing them discomfort leading to the symptoms they are complaining about. Instead of ignoring their predicaments they are likely to work with them to understand and resolve their issues. Where doctors have to put up with stubborn patients who remain undeterred even though they are given sufficient evidence, there are chances that they may prescribe supplements to get them off their back. Even to this extent it may be fine, but matters take a wrong turn where the behavior of health providers is less empathetic.
Such medical practitioners assume a vicious façade whereby they use language that can hurt the sentiments of the patients who may be at a loss to argue their case amid so much suspicion. For example:
In Pakistan, although this term may not be in use right now, but many patients, especially the elderly and the under-privileged, do complain that their doctors refuse to accept that anything is physically wrong with them, attributing their symptoms to psychological problems.
“It’s all in your head,” or “It’s not a big deal. Others too have similar conditions but they are doing well,” or “You are just being too sensitive,” or “You are certainly not sick, if that is what you want us all to believe,” or one that can really shut the patients up is when they are told by an expert, “Don’t you trust me? In any case, I know better than you.” These are quite straight forward statements although there could be subtle ways and means to convince patients about their illusive state of mind.
The question is, how can one recognize that one is being medically gaslit? The telltale signs are plentiful. These include the health worker, continuously interrupting while being told the symptoms; reluctant to pay heed to details; hesitant in prescribing tests or other investigative techniques; being rude or offensive; blaming the patient’s mental health for illness;
Dr. Nicole Mitchell, Keck School of Medicine, University of Southern California says: “I always tell my patients that they are the expert of their body. We work together to figure out what’s happening and what we can do about it. It really should be a shared decision”.
Some examples of medical gaslighting from real life could help people to understand this malaise. In January, 2023, it was reported that a 25 year old Canadian resident complained about severe electric shock-like sensations throughout her body which the doctors attributed to anxiety and was suggested some relaxation exercise. As these progressed to multiple times a day, she went for a second opinion to a rheumatologist who diagnosed that she was suffering from fibromyalgia.
In another case, a 56 year old having a hard time coordinating her hands while performing ordinary chores was also brushed off by her doctor who told her that at her age this was quite normal but two years later she was diagnosed with Parkinson’s disease.
To prevent being gaslit by medical experts it is advised that vulnerable patients should keep a thorough record and notes with respect to their symptoms whenever they occur in addition to test reports, if any, conducted during this period. Besides, a support person taken along when visiting the doctor can be useful to act as witness, to second the patient’s statement or to remind of anything that could be left out due to a possible brain freeze when faced with an onslaught of questions.