this post was submitted on 19 Sep 2023
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I think gaslighting is a really bad term for this phenomenon. It's real, and something that needs to be addressed, but it seems to me that gaslighting is intentional, and a way to manipulate someone else. I don't think that's what is usually happening when a doctor dismisses symptoms as psychosomatic. They're wrong, and their biases play a role in being wrong, but I don't think they are generally manipulating someone to get the desired outcome from them.
From Psychology Today (https://www.psychologytoday.com/us/basics/gaslighting) "Victims of gaslighting are deliberately and systematically fed false information that leads them to question what they know to be true, often about themselves. "
That's different than the doctor thinking they are exaggerating, or that there are psychosomatic causes behind their stated symptoms, primarily becuase of the "deliberate and systematic" part.
I’ve witnessed this second-hand with a family member and I’d say gaslighting is an adequate term for what happens to some patients.
Through some combination of weeks/months for a specialist availability, days to weeks for a primary care opening (with a group, not necessarily your specific doctor), and emergency rooms being at capacity, it’s seemingly impossible to get good care for chronic health problems.
ERs and urgent care facilities are not great options for chronic issues, but they’re often all that’s available. And because they aren’t the specialists and they have a narrow charter of work, they can’t really do anything aside from maybe steroids and morphine every once in a while. I do believe that these institutions are being brought down by the sheer volume of work presented to them and are trying to do their best to keep people alive… but it’s disheartening for everybody
I didn't say it isn't a problem, but that the doctors aren't doing it on purpose. They aren't manipulating people for their own ends. "Gaslighting" implies they are.
It is a real issue that needs to be addressed, as is the issue of the wrong kinds of systems and institutions being used (ER for chronic conditions, like you said, for example).
But the doctors aren't doing this on purpose like an abuser who wants to keep someone under their thumb.
I think I would agree. The behavior seems to be more dismissive than gaslighting (manipulative). I think a patient doubting their own knowledge or experience definitely happens, but it is a secondary effect from the dismissiveness from the medical provider and not usually the intention.
Unless, we consider it intentional so they need to do less work. Considering a person’s subjective information to be fully true and including that in the plan of care takes more effort, versus following the script you know.
This is part of a larger discussion that one of my classes is covering: “Traditional versus Collaborative Care.” Personally, I think the word collaborative gets tossed around too much and English needs more synonyms for it, but the theories kind of make sense. Traditional approach is basically “I’m the doctor, so I know what is best. If you don’t take these meds, you’re being non-compliant.” While the Collaborative approach is more like “What are the goals for your care?”
Some people don’t care what the provider thinks they care about, or aren’t communicating in a way that connects to the patient enough. A relevant podcast I listened to a while ago mentioned that most disagreements are caused by a difference in expectations. If the medical provider is expecting a “compliant” patient with no questions, they are going to be upset when someone is disagreeing with them. And if a patient is expecting a medical provider to listen to them, but the provider ignores them, they will probably be frustrated, belittled, etc.