This is a joint article by Jean Dow and Charmaine Shepherd borne out of a sense of frustration.
We were recently horrified by a letter that was written to one of our patients in which the mother was accused of creating the child’s illness because of her own anxieties despite the child having multiple clinical signs of illness. We see this in practice every day, particularly with women. Many of you will be aware of the term gaslighting whereby a person doubts their own reality and although it refers to abusive relationships, we also see this in the medical industry. The reason why this is common in medicine is because there is a power imbalance between doctors and patients.
Medical gaslighting is a term that describes the phenomenon of patients being made to feel that their physical symptoms are all in their head or are the result of a psychological condition. This is a frustrating and harmful experience for patients who are seeking medical help but instead are made to feel that their concerns are not being taken seriously. Medical gaslighting occurs when doctors cannot work out what the problem is, and instead of continuing to search for a physical cause, they suggest that the patient's symptoms are due to stress, anxiety, or depression.
Gaslighting is a form of emotional abuse that involves making someone question their own perceptions and beliefs. In the context of medicine, gaslighting can be particularly harmful because patients rely on their doctors to provide them with accurate information and treatment. When doctors suggest that a patient's physical symptoms are the result of a psychological condition, it can be incredibly distressing and can cause patients to doubt their own experiences.
We wanted to share some excerpts of a GP’s letter sent to a mother of a young boy who has significant clinical signs. In the letter the GP refuses any further testing that was suggested by a hospital consultant.
“ Continuing a quest for an underlying medical condition and remedy would be fruitless. At the same time, the negative aspects of proceeding this way would be that attention will be deflected from attending to underlying psychological issues. It is a sensitive issue to raise, but I have expressed in the past that your anxiety will be feeding into your child and prolonging or exacerbating his symptoms.”
Although anxiety can always make nearly all conditions worse, refusing to investigate because the provider believes that the issues are caused by anxiety of, in this case the mother, is negligent and arrogant. What the above has done was to undermine the mother’s confidence, but more than that, caused additional distress to the child.
One of the main problems with medical gaslighting is that it can prevent patients from receiving the treatment they need. If doctors dismiss physical symptoms as being psychological, patients may be referred to mental health services rather than being given appropriate medical tests and treatment. This can lead to delays in diagnosis and treatment, which can have serious consequences for the patient's health.
Another issue with medical gaslighting is that it can cause patients to feel ashamed or embarrassed about their symptoms. Patients may begin to doubt their own experiences and may feel that they are not being taken seriously. This can lead to a lack of trust in doctors and the medical system as a whole, which can be a significant barrier to seeking help in the future.
Medical gaslighting is more common in certain groups of patients, such as women, people of colour, and those with chronic illnesses. These patients are often not taken seriously by doctors and may be more likely to be dismissed as being overly emotional or anxious. In fact, over a recent chat with other practitioners, many of us will have encountered patients who had been told they are simply "hysterical" women. This can lead to a delay in diagnosis and treatment and can have serious consequences for their health.
We often see this with parents whose concerns about their children’s health are dismissed and blamed on the parents’ anxieties. Sadly, there have been several recent news reports on this which resulted in the child’s death.
To prevent medical gaslighting, it is essential that doctors take patients' concerns seriously and listen to their experiences. It is important for doctors to be aware of their own biases and to avoid making assumptions about a patient's symptoms based on their gender, race, or medical history. Doctors should also ensure that patients are given appropriate tests and treatment and should not dismiss physical symptoms as being the result of a psychological condition without a thorough investigation.
Here are some tips that may help patients prevent medical gaslighting:
1. Trust your instincts: If something feels wrong, speak up. You know your body and your health better than anyone else.
2. Do your research: Educate yourself about your symptoms, medical conditions, and treatment options. This will help you ask informed questions and advocate for yourself.
3. Keep a journal: Record your symptoms, when they occur, and how they affect you. This can help you track patterns and communicate more effectively with your healthcare provider.
4. Seek a second opinion: If you feel like your concerns are not being taken seriously, consider getting a second opinion from another healthcare provider.
5. Bring a support person: Consider bringing a trusted friend or family member with you to appointments. They can help you remember important details, provide emotional support, and act as a second set of ears.
6. Set boundaries: If you feel like your healthcare provider is dismissive or disrespectful, it's okay to set boundaries and communicate your needs.
7. Find a new healthcare provider: If you've tried everything and still feel like you're being gaslit, consider finding a new healthcare provider who will listen to you and take your concerns seriously.
As Functional Medicine practitioners, we are taught to carefully listen to patients and to investigate every angle that could be contributing to health conditions. We always trust that patients are coming with genuine and valid concerns and do everything in our power to help them find the cause of their symptoms.
Remember, you deserve to be heard and respected by your healthcare provider. Don't let anyone make you feel otherwise.
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