Medical and Mental Health Gaslighting and Iatrogenic Injury

You are a woman and go to the emergency room with a severe cough and the ER doctor listens intently at first and acts nice. However, the physician sees on your record that you have a mental health condition or that you have complained about this same problem before.

Suddenly, the physician begins to act differently perhaps growing curt with you or telling you nonsense such as you need to drink more water or lose weight and the cough will go away.

You leave the hospital feeling ashamed and embarrassed with your self-esteem badly bruised. You feel deeply frustrated and a fool for ever approaching a medical person for help in the first place. You also may question yourself and your perceptions asking yourself, “Is it all in my head?”

You have been medically gaslighted and the doctor has committed iatrogenesis.

This article will focus on the definitions of gaslighting and iatrogenesis and how mental health and medical personnel can harm their patients.

What is Medical Gaslighting?

Medical Gaslighting takes many forms including someone telling another person they are imaging that they are ill or questions their sanity.

Unfortunately, gaslighting is also performed by therapists and psychiatrists. Both can bring devastating results.

The problem of gaslighting is that it can have dire consequences leading to further harm or even the death of patients. The possibility of being embarrassed or feeling ashamed overwhelms clients and they may ignore their good sense and decide to never darken the door of a doctor again.

Once a person has been gaslighted they may not trust physicians any longer behavior that can be deadly if their condition, the reason you went to a doctor in the first place, is dangerous.

Who Gets Medically Gaslighted?

Women are by far the group that is gaslighted the most. Medical professionals tend to see women as hysterics and do not heed a woman’s complaints or take them as seriously as men. Interestingly, this is true whether the physician is female or male.

Women are more likely than men to hear from their attending physician that their pain is emotional and more likely to receive anti-anxiety medication than men. They are also more likely to be diagnosed as mentally ill (Pagan 2018).

Also, even with diagnoses that affect only women the diagnosis may be prolonged or delayed. For instance, conditions such as endometriosis may take around seven to eight years to diagnose. The result is that women suffer needlessly because they are not heeded by their doctor.

Methods to Defeat Medical Gaslighting

The humiliation and possible physical harm from gaslighting by a physician are horrendous side-effects to a biased or prejudiced approach.

However, there is no need to lay down and take medical gaslighting, you can fight back. Below are a few suggestions as to how you can defeat medical gaslighting.

Find a healthcare provider you can connect with. The greatest weapon someone who gaslights has is to make vague statements to pacify you. Find a new physician who is honest and frank with you.

Be a Self-Advocate. You can fire your doctor and do not have to put up with someone who is condescending or rude. If you are not satisfied with the doctor’s treatment of you or their diagnosis seek out someone else who will listen to you and takes you seriously.

Report a Negligent Doctor. You are not without recourse against a doctor who is continuously gaslighting you and others. Go over his or her head to the clinic supervisor or the board if it is a not for profit clinic or hospital. Tell them frankly and honestly how you were treated by the physician and demand action. There is always the option of legal action as well if you are harmed physically and mentally by the egregious actions of a gaslighting doctor.  

Gaslighting by Mental Health Professionals

Being gaslighted by a mental health professional is not something anyone should take lightly. The biggest reason not to ignore the possibility of being gaslighted by a therapist or a psychiatrist is that it is probably intentional.

There are two possible reasons for a mental health professional to gaslight a client. One is that the clinician has a different idea than the client about what their diagnosis should be and thus gaslights you to get you to go along with their chosen treatment.

The other possible reason a therapist might have for gaslighting a client is that the therapist is unethical and is gaslighting to make their patient into a long-term client.

In either case, it is useful to ask for clients to ask for their file to see what is written to make certain the therapy being performed is what they expect. After reading the file, if a client feels gaslighted, they should leave that therapist and seek out one who will listen to and be honest with them.

Medical Iatrogenesis

Hippocrates formed the one of the most basic principles of treatment of patients by physicians, “First do no harm.” However, treatment by physicians can be more harmful than healing. Such treatments may involve diagnostic procedures, medications, surgery, hospitalization, or psychotherapy. Such mistakes are known as iatrogenic harm.

The term iatrogenesis is from the Greek “brought forth by the healer” and refers to any effect on a person from the actions of a healthcare professional that negatively impact their patients. These professionals include physicians, surgeons, psychiatrists, psychologists, therapists, and many more. 

Iatrogenesis might occur as a direct or indirect result of their treatment or lack thereof. An example would be if a person entered treatment with a therapist complaining of feeling deeply depressed and receives treatment for an anxiety disorder. The therapist has made an iatrogenic error and may wholeheartedly be unaware or biased to believe their diagnosis is correct. Sometimes the treating physician may himself be guilty of harming his patients and bringing about an iatrogenic disorder.

According to one study, the harm that a doctor can do is not limited to the negligent use of medicine or medical procedures but may also include unjustified remarks and misinterpretations of the data. The end result, either way, is a patient who is harmed emotionally and physically and may not recover (Krishnan & Kasthuri 2005).

The Effects of Medical Iatrogenesis of Those in Mental Health Treatment

Receiving the wrong diagnosis and being treated with the wrong methods can be extremely devastating. This is especially true for those who have a mental illness who are more likely than the general population to not be treated appropriately.

To better understand how iatrogenic treatment for those who have a mental health problem seriously affects them, read the following information put out by the National Mental Health Consumer & Carer Forum.

“People living with persistent mental health issues can often expect to:

  • have significantly reduced life expectancy
  • experience a greater burden of ill health
  • suffer delayed diagnosis, non-existent or inadequate preventative screening, and deferred commencement of treatment of many avoidable disorders or diseases.

Studies have shown that:

  • people living with mental illness are 30 percent more likely to die from cancer, despite having no higher occurrence of the disease than the wider population
  • people living with mental illness have an overall death rate 2.5 times that of the general population
  • forty-four percent of all hepatitis C cases occur in people living with mental illness
  • people living with mental illness have life expectancy reduced by between 15 to 25 years
  • people living with mental illness who also have alcohol and drug-related disorders have the worst survival rate.”

Obviously, iatrogenic treatment is devastating to the health and welfare of those living with a mental health condition.

The Effects of Psychological Iatrogenesis on Mental Health Clients

Mental health treatment by professionals can sometimes have negative consequences. Some of these possible effects are psychiatric labeling or misleading information about their client’s diagnosis. To be clear, there are few mental health professionals who would commit iatrogenesis on purpose, but that does not stop it from happening.

The therapeutic alliance between the professional and their client is a deep relationship that aids in the healing of the patient. But, sometimes this alliance means that the patient becomes completely reliant on their therapist and may act the way they believe the therapist wants them to.

This iatrogenic affect can lead to misdiagnosis and lead to inappropriate treatment by therapists who should not make hasty decisions on a diagnosis until they know their client well (Boisvert & Faust 2002).

Methods to Fight Iatrogenesis

The best method to fight iatrogenesis and keep it from happening is to be alert to the possibility that it can happen. Both clinicians and patients need to be aware of what iatrogenesis is and how it can affect their overall outcome of their treatment.

Medical clinicians must watch for biases that may lead them to prescribe or treat their patients with inappropriate treatments. One way to fight these problems is to listen to your patients and do not blow off what they are telling you. Listening to your patient closely and accepting them as an ally in their treatment can go a long way in mitigating the chance of a misdiagnosis.

Because some clients will want to please them, mental health professionals can prevent iatrogenesis from happening by taking time to get to know their client well before diagnosing. Also, watch for signs your diagnosis is wrong and admit to yourself and your client that you have made an error. Only honesty can help prevent or reverse iatrogenesis.

Patients can help keep iatrogenesis from happening through awareness that it could occur in their relationship with their therapist or doctor.     

In Closing

Gaslighting and iatrogenesis are both very harmful to those who seek out treatment for physical and mental health issues. However, there are many methods to prevent either gaslighting or iatrogenesis from harming you and for physicians and therapists to help their clients to heal.

“Though either choice was good, one was truer to myself… Ultimately, I reflected on Geothe’s invocation to ‘make a commitment and the forces of the universe will conspire to make it happen’ and chose the uncharted path.” ~ Jacqueline Novogratz

“Never be afraid to raise your voice for honesty and truth and compassion against injustice and lying and greed. If people all over the world…would do this, it would change the earth.” ~ William Faulkner

References

Boisvert, C. M., & Faust, D. (2002). Iatrogenic symptoms in psychotherapy: A theoretical exploration of the potential impact of labels, language, and belief systems. American Journal of Psychotherapy, 56(2), 244-259.

Krishnan, N. R., & Kasthuri, A. S. (2005). Iatrogenic disorders. Medical journal, Armed Forces India, 61(1), 2.

Pagan, Camille Noe. 2018. “When Doctors Downplay Women’s Health Concerns.” The New York Times

Physical Health Impacts of Mental Illness and its Treatments (2016).

National Mental Health Consumer & Carer Forum

Schopen, Fay. 2017. “The healthcare gender bias: do men get better medical treatment?” The Guardian

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