Study on Medical Gaslighting

wabi-sabi

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I was so excited to see this in PubMed today. Medical Gaslighting has reached the literature!

Not sure if there's another research thread where this would go better, so feel free to move.

https://pubmed.ncbi.nlm.nih.gov/34432297/

Towards a sociological understanding of medical gaslighting in western health care
Jennifer C H Sebring 1
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Abstract
In recent years, the term 'medical gaslighting' and accompanying accounts of self-identified women experiencing invalidation, dismissal and inadequate care have proliferated in the media. Gaslighting has primarily been conceptualized in the field of psychology as a phenomenon within interpersonal relationships. Following the work of Paige Sweet (American Sociological Review, 84, 2019, 851), I argue that a sociological explanation is necessary. Such an explanation illustrates how medical gaslighting is not simply an interpersonal exchange, but the result of deeply embedded and largely unchallenged ideologies underpinning health-care services. Through an intersectional feminist and Foucauldian analysis, I illuminate the ideological structures of western medicine that allow for medical gaslighting to be commonplace in the lives of women, transgender, intersex, queer and racialized individuals seeking health care. Importantly, these are not mutually exclusive groups, and I use the term bio-Others to highlight and connect how those with embodied differences are treated in medicine. This article indicates the importance of opening a robust discussion about the sociology of medical gaslighting, so that we might better understand what structural barriers people of marginalized social locations face in accessing quality health care and develop creative solutions to challenge health-care inequities.
Keywords: epistemic injustice; institutional gaslighting; intersectionality; medical gaslighting.
© 2021 Foundation for the Sociology of Health & Illness.
 

Pyrrhus

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It's truly great that more people are acknowledging medical gaslighting.

It's also a bit weird that the term 'gaslighting' has recently become so mainstream that it is beginning to be used as a synonym for "invalidating symptoms", rather than the narrower original definition of "convincing someone they are mentally ill when they are not"...
 

wabi-sabi

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It's also a bit weird that the term 'gaslighting' has recently become so mainstream that it is beginning to be used as a synonym for "invalidating symptoms", rather than the narrower original definition of "convincing someone they are mentally ill when they are not"...
Yes, that's true. But I'm not sure I care as long as attention is coming to the issue. I was searching for stuff on the historical psychologization of illness, especially for women, and this was what I found.

I continue to be surprised at the way medicine attributes illness to psych causes until the real, biological cause is found. Surely medical historians have noticed this and discuss it?
 
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I continue to be surprised at the way medicine attributes illness to psych causes until the real, biological cause is found
Even when there is an obvious physical cause some will still look for (and invent) a psychological reason for the patients symptoms. Take TB for instance. If we go back to the 1930s one of the reason for some not making a recovery from TB was due to them having a "Tubercular personality".
 
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this study from Japan is interesting....

https://bpsmedicine.biomedcentral.com/articles/10.1186/s13030-018-0122-3

they looked at some new patients at the psychosomatic medicine dept and eventually almost every one of them had an actual physical impairment, their psychosomatic diagnoses being wrong.

this paper examines some shortcomings in their system, contributing to this problem in diagnosing.

a table in this paper is uses a very formal approach to compare the system used in psychosomatic, wiht the system used in more rigorous medical diagnoses. Could not paste it in here.

from the article, here are how they describe Provider Issues (the problems your doctor is having)

Anchoring is the tendency to be affected by an initial impression that is not adjusted by later information. This was seen in cases 1, 2, and 7.

Availability is the tendency to judge diagnosis by recent experience and the memory of diseases. This was seen in cases 2, 5, 6, 7, 17, 20.

Confirmation bias is the tendency to seek data/evidence to support a diagnosis and to cast away data/evidence that refutes it. This was seen in cases 3, 8, 9, 16, and19.

Delayed diagnosis means that long-term observation is necessary until a true diagnosis is made. This was seen in cases 3, 4, 9, 10, 12, and 20.

Representativeness is the tendency to look for prototypical manifestations of diseases and to miss atypical variants. This was seen in cases 8, 11, and 13–19.
 

Pyrrhus

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personally gas lit....

I have considerable medical aversion, likely stemming from childhood. some not good things happening near doctors, etc.

I don't really go to them willingly.

And I had HMO type medicine for a long term, they don't want to provide you with anything. So if the doctor is not pushing me into tests and physicals etc, well I certainly wont push my own self.

The game with HMO is to avoid ever covering a procedure and drag it all out. Every referral was denied, usually related to an error. This keeps the $$ in their bank account. This is how they want it.

So I did a Physicians Assistant for about eight years. And she'd wear this white coat, stare at me, type things into her lap top, and never help me in any way. Then, she'd go on and on plying me with antidepressants and I'm there because my mouth, teeth, throat and palette swell up so much my teeth want to fall out.

I can't even explain how this transpired. Why did I Let this happen? How could I let that woman bully me like this? Just that part is really upsetting.

Well the actual doctors in that office, give 15 minute appointments and its four months to see one.

At some point, the office manager sat me down one day as I was leaving and gave me a little spiel. More or less, do I understand I am not seeing a real doctor? (answer, well Yes)




***
I was finally saved , when I dropped that insurance, and by accident, my new doctor gives me an SEID diagnosis in 5 minutes.

No gaslighting there, at all. Its like two worlds.
 
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I continue to be surprised at the way medicine attributes illness to psych causes until the real, biological cause is found.
I know that I'm something of a broken record on this subject, but .... well, here goes again ....

A sadly large representative number of Drs are fairly clueless about, well, pretty much everything that isn't incredibly obvious, or treatable by anything that Pharma rewards them for bigly.

What could be a more beneficial gift to them than their standard default diagnosis of " ...it's isn;t my fault that I can;t figure this out, because IT'S ALL IN THEIR HEAD ...." ....

Surely medical historians have noticed this and discuss it?
Not if they want to keep their status and reputations within the medical community ....
 
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It's also a bit weird that the term 'gaslighting' has recently become so mainstream that it is beginning to be used as a synonym for "invalidating symptoms", rather than the narrower original definition of "convincing someone they are mentally ill when they are not"...
I agree. The 'bastardizing' of words and phrases to mean anything that the user wants them to mean is the slippery slope into the Slimy Pit of Meaninglessness, until finally, nothing means anything at all ....
 
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Even when there is an obvious physical cause some will still look for (and invent) a psychological reason for the patients symptoms.
There's a very real, very practical (at least for the Drs and hospitals involved) reason for this, as well as the over-prescribing of psyhoactive drugs ...

Once any psychological basis for an illness is established, or any prescriptions are written for psych drugs, it slashes the possibility of any successful malpractice lawsuit into thready rags, and has been described by attys as an active intention to "pre-impeach" the witness ...
 
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It was very strange, the phone call my Doctor made, in an attempt to 1) get my insurance to OK Provigil; and 2) show me how he will never be making such calls again.

His time completely wasted. Six transfers, to six parties. The final authority- my doctor listed all the Drugs I'd tried...none of which was true. And had virtually nothing to do with: ok Provigil.

(oh like he said Lyrica)....I've never taken Lyrica....

Denied, they said. Referenced some secret Medicare document, that can't be publicly accessed. It costs 100s of dollars to have access to: the book that says you can't Have Provigil.
 

hapl808

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It was very strange, the phone call my Doctor made, in an attempt to 1) get my insurance to OK Provigil; and 2) show me how he will never be making such calls again.

His time completely wasted. Six transfers, to six parties. The final authority- my doctor listed all the Drugs I'd tried...none of which was true. And had virtually nothing to do with: ok Provigil.

(oh like he said Lyrica)....I've never taken Lyrica....

Denied, they said. Referenced some secret Medicare document, that can't be publicly accessed. It costs 100s of dollars to have access to: the book that says you can't Have Provigil.
I've heard people say some version of, "I wouldn't wish this illness on my worst enemy." Well, they're better people than I am, as I hope every single one of those people come down with severe ME/CFS and get to experience that same gaslighting, ostracism, and loss of respect.

It's truly cruel and dehumanizing, and so entrenched that I don't expect it to change in my lifetime.
 
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"I wouldn't wish this illness on my worst enemy." Well, they're better people than I am, as I hope every single one of those people come down with severe ME/CFS and get to experience that same gaslighting, ostracism, and loss of respect.
uuhhhhgaaaa

My highly informed husband (he actually read The Puzzle Solver)...informs me " us sick ME folks" should be getting electroshock treatments for our depression.

Oh? yes for the fatigue and depression, he tells me. (he is reading New Yorkers)

OK: I spend 5 minutes finding AGAIN the most recent Chang et al 2021 (do any of you know how hard that was to find? ) Can't be found in a PR search a Google search or an OMF web site search.

I show my husband that chart, AGAIN. Depressed, and fatigued- is not us. We fall into some other category.

STOP THIS. I inform my husband it is unacceptable for him to fail to grasp PEM.
 
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I've heard people say some version of, "I wouldn't wish this illness on my worst enemy." Well, they're better people than I am, as I hope every single one of those people come down with severe ME/CFS and get to experience that same gaslighting, ostracism, and loss of respect.
Totally and completely and absolutely right there with you.

I wish I were a bigger person, but there it is :):):).
 
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My highly informed husband (he actually read The Puzzle Solver)...informs me " us sick ME folks" should be getting electroshock treatments for our depression.
Tell hub that he's behind the times. They've developed a brain pacemaker for extreme depression which seems to work exceptionally well. But only if you're actually depressed about nothing in particular, not if you're unhappy because you have a soul-sucking, life-changing and inhibiting illness that, at its worst, limits your world to the size of the slice of bed you inhabit 7/24/365 .....

It's too bad that they cant develop one for empathy, sales to the medical community alone would be astronomical ....
 

hapl808

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My highly informed husband (he actually read The Puzzle Solver)...informs me " us sick ME folks" should be getting electroshock treatments for our depression.

Oh? yes for the fatigue and depression, he tells me. (he is reading New Yorkers)

OK: I spend 5 minutes finding AGAIN the most recent Chang et al 2021 (do any of you know how hard that was to find? ) Can't be found in a PR search a Google search or an OMF web site search.

I show my husband that chart, AGAIN. Depressed, and fatigued- is not us. We fall into some other category.

STOP THIS. I inform my husband it is unacceptable for him to fail to grasp PEM.
You should tell him that they should stop invasive surgery for people with cancer. A lot of those people seem upset at having cancer, so maybe some good old fashioned electroshock therapy would solve their problems?

I do remind myself that when I was moderate, I thought that people who were severe were doing something wrong because I had managed to keep going and manage my illness for many years. So if someone with mild or moderate ME/CFS can't understand severe, then what hope do we have for healthy people being understanding? Not a whole lot.
 

wabi-sabi

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They've developed a brain pacemaker for extreme depression which seems to work exceptionally well. But only if you're actually depressed about nothing in particular, not if you're unhappy because you have a soul-sucking, life-changing and inhibiting illness that, at its worst, limits your world to the size of the slice of bed you inhabit 7/24/365 .....
I read that article in the NYT too! It was really fascinating.

But I think we need to be careful in thinking about depression. I was watching a youtube of a neuroscientist saying if you stimulate a person's brain in the right spot during surgery they will get soul crushing, suicidal depression and when you stop it goes away and they go back to normal. This is in people with no mental illness.

Some other people have depression because something awful has happened to them. But what I'm wondering is, are these too experiences the same? The woman in the article, was she so horribly depressed about nothing, really? Just a brain imbalance? Or had something happened that was beyond human bearing and brain stimulation the only thing that made it better?
 
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A lot of those people seem upset at having cancer, so maybe some good old fashioned electroshock therapy would solve their problems?
Finally. A cure for cancer :D:D.

Now, that wasnt so hard, was it :cautious::cautious::cautious::cautious: ?
So if someone with mild or moderate ME/CFS can't understand severe, then what hope do we have for healthy people being understanding? Not a whole lot.
Sadly, humanity is fatally .... human. We understand only what we've experienced first hand, and even in that understanding we differ in degree and depth :):):).