Patient advocacy
A joint article by Jean Dow and Charmaine Shepherd, written out of frustration after reading a letter that left them horrified.
Jean Dow & Charmaine Shepherd
Medical Herbalists
This is a joint article by Jean Dow and Charmaine Shepherd, borne out of a sense of frustration.
We were recently horrified by a letter written to one of our patients, in which the mother was accused of creating her child’s illness because of her own anxieties, despite the child having multiple official diagnoses. We see this in practice every day, particularly with women.
Many of you will be aware of the term gaslighting, where a person is made to doubt their own reality. Although it mainly refers to abusive relationships, we also see it in medicine, largely because of the power imbalance between doctors and patients.
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Medical gaslighting describes patients being made to feel that their physical symptoms are all in their head, or the result of a psychological condition. It often happens when doctors cannot work out what the problem is and, instead of continuing to search for a physical cause, suggest that the symptoms are due to stress, anxiety or depression.
In medicine this can be particularly harmful, because patients rely on their doctors for accurate information and treatment. Being told your physical symptoms are psychological can be incredibly distressing and cause you to doubt your own experiences.
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Here is an excerpt from a GP’s letter to the mother of a young boy with a chronic condition, refusing further testing that a hospital consultant had suggested:
“Continuing a quest for an underlying medical condition and remedy would be fruitless. At the same time, the negative aspects of proceeding this way would be that attention will be deflected from attending to underlying psychological issues. It is a sensitive issue to raise, but I have expressed in the past that your anxiety will be feeding into your child and prolonging or exacerbating his symptoms.”
Anxiety can make nearly all conditions worse. But refusing to investigate because the provider believes the issues are caused by anxiety (in this case, the mother’s) is negligent and arrogant. It undermined the mother’s confidence and caused additional distress to the child.
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If physical symptoms are dismissed as psychological, patients may be referred to mental health services instead of receiving appropriate tests and treatment. Delays like this can have serious consequences.
Patients may feel ashamed or embarrassed about their symptoms and begin to doubt themselves. This can lead to a lack of trust in doctors and the medical system, which becomes a barrier to seeking help in future.
Medical gaslighting is more common among women, people of colour and those with chronic illnesses, who are more likely to be dismissed as overly emotional or anxious. In a recent conversation with other practitioners, many of us had encountered patients who had been told they were simply “hysterical women”.
We also often see parents whose concerns about their children’s health are dismissed and blamed on their own anxieties. Sadly, several recent news reports describe cases like this that ended in a child’s death.
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Doctors need to take patients’ concerns seriously and listen to their experiences. They must be aware of their own biases, avoid assumptions based on gender, race or medical history, and never dismiss physical symptoms as psychological without a thorough investigation.
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As functional medicine practitioners, we are taught to listen carefully to patients and to investigate every angle that could be contributing to their health. We trust that patients come with genuine, valid concerns, and we do everything in our power to help find the cause of their symptoms.
Remember: you deserve to be heard and respected by your healthcare provider. Don’t let anyone make you feel otherwise.
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This article is for general information and isn’t a substitute for personal medical advice. Please don’t start or stop any medication without speaking to a qualified practitioner.
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