People go to doctors for many reasons, ranging from minor to much more serious. But looking at it from a broad-picture perspective, we go to doctors for help. We've been raised to think of physicians almost as friends or counselors. And, in theory, they're full of medical knowledge that the average person simply doesn't have. That's always been the benefit of doctors. You should be able to trust them with your life... right? Except for many, many patients, that trust just isn't there. Sure, there is the new nuisance of insurance companies wanting a say in absolutely every move you make and every referral, prescription, or diagnosis your doctor gives you. But many patients also worry about and deal with medical gaslighting.
The term "gaslighting" seems like one of those "hot button" issues that has cropped up in the last few years to create controversy. Many people will scoff at the very notion of any kind of gaslighting. But while the term might feel pretty new, the actual act of gaslighting has been happening for centuries. If you're familiar with women being sent to infirmaries and institutions because they were depressed or angry, then you know about medical gaslighting.
While the odds of that type of medical gaslighting occurring today are less than during the last century, medical gaslighting does still exist. It happens every time your doctor brushes off one of your concerns. To better understand this infuriating — and potentially life-endangering — form of microinvalidation, Scary Mommy asked an expert to weigh in.
What is medical gaslighting?
"Medical gas lighting is a term used to describe doctors or healthcare providers who dismiss the complaints or concerns of the patient," says Dr. Kimberly Foley, consulting pulmonologist and ABIM board-certified in Internal Medicine. "Often, patients complain that they are not taken seriously because the physician feels that her illness or symptoms are psychological. Patients are often left feeling like they are being brushed off or it's all in their head and not reality. This can happen quite subtly or blatantly. Medical gaslighting is often seen due to the implicit bias of the physician, which they may not recognize themselves and may not be deliberate. Gaslighting is often seen in women, minorities — especially African Americans and Hispanics — LGBTQ, and the obese. Sometimes symptoms are overlooked and can lead to misdiagnosis or delayed diagnosis."
What are some of the hallmarks of medical gaslighting?
In essence, medical gaslighting looks like someone brushing off your concerns. If you have ovaries, you've seen it your entire life when doctors told you that your terrible cramps and heavy periods were "totally normal" without checking you out to ensure you didn't have endometriosis or PCOS. Or every time you go in for a painful pap smear and your doc tells you that you'll feel "slight discomfort" before they rip off a piece of your body. But Foley has given us some other examples, as well. Foley's examples of medical gaslighting include:
- Being told that symptoms of pain are due to being overweight.
- Being told that symptoms are due to anxiety or depression.
- Being told that you worry too much.
- Being told that symptoms are due to being too old, i.e., joint pain is due to old age.
- Being told that symptoms are not real because you are too young. i.e., chest pain in a young adult.
What might medical gaslighting look like in real life?
It seems no one is immune to medical gaslight — even doctors. Foley has also been medically gaslit, and comes at it from a different perspective, given her medical background.
"I know what it feels like to be in the patient's seat, wanting to be understood and listened to. At age 36 years old, I was diagnosed with cavernous cerebral angioma. I had just returned from a trip overseas and experienced an extreme left-sided electric headache while still at the airport. Maybe it was the pressure from the airplane. I blew my nose for relief to no avail. The pain persisted. As the frequency and intensity of the pain increased, I wondered if this was the worst headache of your life described in textbooks — a subarachnoid hemorrhage and life-threatening — or if it's just an earache. Even with slight numbness and tingling in my left hand and foot, I attributed my symptoms to being tired and stressed. This was not your normal headache, but I'm not a hypochondriac," explains Foley.
When her symptoms persisted for over 24 hours, Foley's husband made her go to urgent care. "The urgent care doctor looked in my ear and said it looked OK, had no infection, and sent me home. Symptoms persisted over the weekend until the start of my shift, and I knew something wasn't right," shares Foley. "I asked a colleague, who happened to be a neurologist, to examine me, and to both our surprise, I was hyperreflexia. I showed signs of transverse myelitis or multiple sclerosis. An MRI was ordered, showing numerous lesions in my brain and an acute brainstem lesion that had just bled."
She continues, "How could I miss this? Had I gaslighted myself? To downplay my symptoms and ignore them, for as a Black female, I have implicit biases and fear of being a hypochondriac and slacking... something to think about. If you have symptoms of numbness, headache, seizures — it could be something more. I encourage everyone to get checked out or seek a second opinion if you don't get the answers you are looking for."
How can you avoid medical gaslighting?
After her own personal experiences, Foley knows how best to avoid being gaslit in the exam room. She suggests a few moves to ensure your best interests are being met.
- Journal all symptoms and details related to your complaint.
- Bring an advocate. (Think of them as your "witness" and emotional support.)
- "Ask the physician about the differential for the symptoms that you are having to rule out," says Foley. "And [ask] what studies, including labs and imaging, have been ordered to rule out all of the differentials before the diagnosis of exclusion is made."
- Ask for a second opinion or for a referral to another provider.
- Ask for a referral to a specialist.
And if you've been told this once, you've been told it 1000 times — trust your gut. You know your body better than anyone. If something feels amiss, even after you visit a doctor and they tell you nothing's wrong, don't be afraid to rattle some cages to get the answers you need.
Dr. Kimberly Foley, consulting pulmonologist and ABIM board-certified in Internal Medicine