How to tell if you’re being gaslighted

We throw the term “gaslighting” around a lot these days when it comes to health care, but I wonder how many people know the origination of the term.

The play “Gaslight” — and then the 1944 movie with Ingrid Bergman and Charles Boyer — is about an unfaithful and ruthless husband who tries to convince his wife she’s going insane by creating noises in the attic and making the gaslights in their home flicker. Spooky. Then he would say, “I didn’t hear anything. It must be your imagination.”

It took Ingrid practically the whole movie to figure out that Charles was “gaslighting” her. After all, he was her husband and she trusted him.

And it may be hard to figure out if your health care provider is gaslighting you. Presumably, you like them and trust them — otherwise why stay? But if you feel like your concerns or symptoms are being ignored or dismissed, “gaslighting” may be the reason.

The doctor, nurse practitioner or physician assistant may be doing it unintentionally, or they may even be unaware of their behavior. The effect is the same: You’re not being listened to.

Studies have shown that women and people of color experience gaslighting more frequently. There’s something called “unconscious bias,” which leads some to make assumptions and draw conclusions about people without realizing that their assumptions and conclusions are rooted in deep-seated beliefs and biases. Medical professionals are humans who, even with all of their education and experience, may bring their existing beliefs and biases into the exam room with them.

That’s not the only thing at play. The health care system itself, which sometimes leaves only a precious few minutes for a doctor to spend with a patient, is part of the problem. The thing about making assumptions is that it does save a lot of time — but at what cost?

What are some of the signs of medical gaslighting? They’re not all that different from what someone may experience in a personal relationship.

• Shifting blame: “It’s not me, it’s you.” In a medical setting, this may look like the health care provider telling you that you’d feel better if only you did … something (sleep better, eat better, exercise more). While those things may be true, it doesn’t mean you’re to blame for your condition.

• Interrupting: This is one of those things that happens during rushed appointments. On average, doctors spend between 12 and 15 minutes with a patient. In an effort to speed things along, the provider interrupts what you’re saying to ask questions.

• Dismissing symptoms: It’s maddening when someone tells you you’re not feeling something that you’re feeling, right? Or worse, “it’s all in your head.” That’s what Charles Boyer told Ingrid Bergman.

What can you do if you suspect your health care provider is gaslighting you? Not surprisingly, these are some of the same recommendations I make for you to get the most out of a doctor appointment.

• Call them out: Being direct is the best approach, but use “I” language: “You know, I don’t feel like you’re listening to me.” It may be uncomfortable, but if the provider is unaware of how they’re coming across, you may be helping them improve their bedside manner.

• Keep a record of your symptoms: It can be very helpful to keep a log of the symptoms you want to discuss. For example, if you get dizzy periodically, it would help the doctor to know how frequently it happens, how long it lasts and how you feel afterward.

• Write everything down: Come to your appointment prepared with a written list of things you want to discuss, and move through your list efficiently. Write down what the provider says, including if they’re prescribing a new medication or ordering a test.

• Take someone with you: An advocate, whether it’s a family member or a private patient advocate, is a valuable resource at any medical appointment, but especially those where you’re dealing with a potential case of gaslighting. They can confirm what you and the doctor are saying and (not incidentally) witness the provider’s behavior.

• Find a new doctor: As a last resort, find someone you trust who listens to you. Ask friends and neighbors for recommendations and look at their social media reviews on Yelp and Google. But don’t leave without telling the provider why you’re going.

Gaslighting is troubling behavior, but if Ingrid Bergman could figure it out, so can you. Next week, I’ll take a look at another behavior that’s fitting to discuss during the spooky season: Ghosting. What does it mean when your doctor “ghosts” you, or you “ghost” your doctor?

• Teri (Dreher) Frykenberg is a board-certified patient advocate. A critical care registered nurse for 30+ years, she is founder of NShore Patient Advocates (www.NorthShoreRN.com). Her book, “How to Be a Healthcare Advocate for Yourself & Your Loved Ones,” is available on Amazon. She is offering a free phone consultation to Daily Herald readers; email her at teri@northshorern.com.