NHS Gaslighting – what to look out for

Medical gaslighting is term used to describe doctors or medical practitioners who wrongly deny a patient’s illness entirely, for example wrongly telling patients that they are not really sick, or blame a patient’s physical illness or symptoms on psychological factors

Medipedia

This is going to be a difficult one to write about. Even though I’ve been going through this for well over two years, I never spoke about it to anyone.

This is just because, in spite of my emotional maturity, it triggers a lot of my fears about so much more than health. Although of course that is a concern. It is the sheer wall of ignorance and arrogance made to stand with nothing more than confirmation bias. No science. No reason. No intellect.

Over the course of the past 2 years, I have learnt many of the strategies that doctors and professionals use to gaslight patients. Both to our faces, and behind our backs. 

This post will point out some clues that can give you a warning that you are being a victim of gaslighting.

I have found that the battle against gaslighting becomes a toxic power struggle that if it does not kill you it will seriously compromise both your health and mental health.

Speaking to others who have had similar experiences, most just give up eventually. However, not everyone can do that. There are many patients that end up dead. Late stage of ignored cancer, terminal, or chronic illnesses are often mentioned by other gaslighting victims.

If anything in this post resonates with you, please fill in the form to help me gather data on the issue. For a diverse range of opinions on medical gaslighting, please see the References at the bottom of this page.

1. How it works
2. Entrapment
3. Problems with making appointments
4. Repeating the same tests unnecessarily
5. The wild goose chase of referrals
6. What do you think is wrong with you?
7. What do you want me to do
8. We can’t help you
9. They sound like somatic symptoms
10. That is not what happens/that’s not what the medication does
11. That is normal
12. Are you refusing anti-anxiety medication?
13. Ignore medication side effects
14. Ignore anything you say and only looks at notes
15. It was a pleasure to see …
16. The patient believes …
17. This is a complex case …
18. Kindly refer this patient …
19. Reassured the patient
    
20. Psychiatric diagnosis
    
21. Lies, lies, lies ...
    
22. Research
    
23. References
    

How it works

In my experience it starts at the GP surgery or the dentist. Likely because of someone usually rather ignorant, not particularly smart, arrogant, a little narcissistic. Some may have their own mental health issues.

If you present someone that fits this profile with symptoms that they cannot understand, they tend to become defensive. When we, as mere patients, dare question their “professional opinion” they will go on the attack and start a campaign of disinformation and even defamation to protect their status.

After this, then it spreads like a virus because of things like comradery and other petty “professionals” that think that a PhD is enough to be respected. Personal accountability is just an idea that only few old people like me know of.

Confirmation bias then takes hold. When professionals see you, they won’t see a patient. They will see a “problem” that needs to be dealt with. Ignoring all evidence in front of them they will seek, and provoke reactions if necessary to achieve this result, to prove the unreasonableness of a patient.

And I have seen it happen.

Doctors deny what is in front of them because it doesn’t fit their confirmation bias. Even mental health workers will do exactly the same.

Effectively, the patient will feel not only discriminated, but also persecuted. Because that is that patient’s reality. As you will see below, the steps taken by professional do amount to a widespread, systemic, and institutional legitimisation of psychological abuse by doctors and professionals.

They will use phrases like “it was a pleasure to see …” (means “this patient is difficult”) , or “kindly refer this patient” (taken to mean “can you believe how crazy this patient is wanting to be referred there?”), or “declare a complex case” (which means that they officially consider a patient to be a “crazy”). Read below for further details.

While reading them we may think that the doctor is helping us, they are sending a coded message that perpetuates the gaslighting between departments and service providers.

Entrapment

We trust doctors. We are taught to trust them from a young age. But they don’t trust us. They will try and always accumulate information that will display them as having been diligent and competent, while portraying the patient as being difficult and unreasonable.

It may take a while before becoming aware of this as it can be very subtle. But eventually it will feel like something is out of place and you won’t be able to ignore it.

Read on to see some examples of how this entrapment takes place. I have experienced all of these, but if you are lucky, you may not. Usually, you will not be aware of them unless you review the referrals to consultants and the responses.

Problems with making appointments

Suddenly, the doctor will not give you face to face appointments. Either that, or they will take up to or even in excess of, 2 weeks to get one.

You will notice that you will be passed on to locum doctors, instead of dealing with your usual doctor.

You may even be asked to see the out of hours doctor.

This how the gaslighting can begin and it will be followed by a period of intense entrapment. Read on to read the signs of how doctors give up on patients.

Repeating the same tests unnecessarily

You don’t feel well. You are sent to do some tests, and these come back negative. The doctor probably tries and ignore it. Tries to avoid you. And then gets you to conduct the same test again, and again.

This is a typical case of entrapment. Instead of thinking of different tests and options, the doc tries to present a case that they do everything possible, but you are being unreasonable in asking for further tests.

As well as making a case for them, this instils doubt in the patient’s mind and perpetuates the emotional and mental abuse.

The wild goose chase of referrals

You may find that you are referred to strange specialists, or that you are being asked who you want to be referred to.

Remember, this is part of the entrapment tactic that doctors use to cover their backs in case someone might complain. If they made a number of referrals, no matter how irrelevant, it will look good on paper and show that they went “above and beyond” the call of duty.

Again, this will also cause you, the patient, to doubt yourself.

What do you think is wrong with you?

I think it is just wrong that a doctor would ask that of a patient. If I knew what was wrong with me I'd probably not go to the doctor and just manage it myself. However, I must admit I did fall into the trap, and started researching my illness myself. Unfortunately, that backfired because it triggered the "the patient believes ..." stage of entrapment.

When they ask questions like this, they are definitely trying to prove how “crazy” you are.

Patients should not be asked questions like this as this clearly indicates that the doctor has no intention of taking responsibility.

From this point on, it will be a battle of wills where they will purposefully target a patient and promote both internally and externally the message: “this patient is unreasonable, possibly crazy and delusional”. Some may even say it outright.

What do you want me to do

Just like above, this is meant not only to make patient doubt themselves.  It begins the process of identifying a person as a mental health patient.

This is also an unfair question because a patient wants simply to be healed. The doctor should know what to do to achieve this.

We can’t help you

Your doctor might not say this directly to you, but someone else in the surgery might. Maybe even a locum, or a mental health practitioner.

This does make you question why you are being singled out and refused treatment. You see other patients getting treatment, yet you are being singled out. This epitomises abuse.

They sound like somatic symptoms

This is something that is often said without even looking at the symptoms themselves. It is a judgement based on utter ignorance.

I have never been told which of my symptoms were somatic. And I have not been offered a psychiatric diagnosis. That is because my symptoms are accompanied by pictures and data from my Fitbit.

However, because the doctors don’t know how to identify and diagnose what is wrong, they prefer to deny that the symptoms even exist.

That is not what happens/that’s not what the medication does

When describing symptoms, I have been told on a number of occasions that the symptoms do not exist. Similarly, when describing the effect of a medication I have been told that “it’s not what the medication does”.

This kind of behaviour epitomises gaslighting in that it invalidates the experiential element of the illness and of the medication.

It is also rather insulting. How dares a “professional” deny the reality of my experience?

That is normal

You show them blisters and infections and they say: “this is normal” and refuse to hand out medication or to provide any kind of help.

When I ask them, if it’s normal, do you have it? They hang up the phone on me.

Have you had similar experiences?

Are you refusing anti-anxiety medication?

I have had one mental health nurse being very aggressive in wanting me to take anti-anxiety medication. However, he refused to provide any kind of mental health diagnosis or support.

That is another sign of gaslighting. They don’t even take a patient seriously enough to provide the help that they, the “doctors” claim is needed.

Ignore medication side effects

This is another very upsetting symptom of gaslighting. When explaining the side effects of medication these are completely ignored, and more medication is prescribed. A doctor may eventually agree to change the medication but they will make the patient feel they are being "difficult",

Ignore anything you say and only looks at notes

This is particularly true with second opinion, although I have seen it happen a lot in other circumstances too. You try and explain your symptoms, they barely say “ah-ha” but clearly ignore everything you say.

It was a pleasure to see …

If you read a specialist letter and you see this, you may be a little perplexed. I have seen “professionals” start a letter with this sentence on occasions when the appointment had been fraught with difficulties.

This sentence likely means one or both of:

1. This patient is really difficult
2. I gave this patient a hard time because they are difficult

Let me give you an example.

One day I went to see a specialist. I explained that the medication they gave me was having disturbing side effects. This is what she did:

1. Wrote to GP saying a didn’t want to take that medication “orally”, whatever this means
2. Prescribed me a lot of alternative medication, against my wishes
3. Prescribed medication that had been discontinued for a number of years
4. Called me obese under her breath
5. Was clearly annoyed by the fact that I did not want that medication

Yet, she wrote: “I was a pleasure to see Mr. X”. Clearly an indication of manipulation of evidence to suit the doctor’s narrative and continue the campaign of entrapment.

And I am not basing my judgement on one single instance. On another occasion a "doctor" said it was a pleasure to see me just a few lines above saying I was delusional because I didn't use medical terminology in describing my symptoms.

The patient believes …

Clearly an accusation of madness. The doctor that writes these sentences has no intention of taking the patient seriously.

It is really interesting to see how the doctors spread these rumours of “madness”, however they do not offer any mental health diagnosis or support.

This is another way in which the gaslighting spreads between departments and health providers.

This is also very fluid in the way it is used. In my case it always ignored 90% of what I said, and then expressed something in words that are clearly indended to pass a negative judgement rather than expressing a patient's concerns. 

This is a complex case …

I have had one doctor “declare a complex case” and I have to question what this means.

Aside from the fact that the GP did not do anything, which is again another sign of gaslighting (see kindly refer this patient), I doubt that one can consider a complex case. Also, we are talking about medicine. Is there really a thing as a “complex” case?

When associating this statement with the all the experiences listed above, it becomes clear that this is another way that doctors use to spread the malignant tumour of entrapment by defamation.

Kindly refer this patient …

This is very unsettling. When they talk to you, they tell you that you need to be referred to some other specialist. Yet, they don’t refer you. Instead, they write to your GP asking to refer you.

This has the dual purpose of causing uncertainty, sowing doubt, and it is a kind of code for doctors to gaslight you.

They are passing each other information of how unreasonable and demanding you are and further piling up “evidence” in their entrapment case.

In my own GP's words: "why did they not refer you themselves?"

Reassured the patient

Another clear and distinct sign of gaslighting. If someone says they reassured the patient it means they believe the patient for over-reacting.

If they believe the patient is over-reacting, they are obviously not taking the patient seriously enough. Which is gaslighting.

Let's be honest. We don't reassure people when there is nothing to worry about. We reassure someone when either they have good reason to be worried, or when we are annoyed that they keep banging on about something.

Psychiatric Diagnosis => Confirmation Bias

I have read in the references that patient who are gaslighted tend to get a psychiatric diagnosis. In my case, they are even refusing to do that. My assumption is that my symptoms are so well documented that they would never be able to get away with a "somatic symptoms" diagnosis. 

But you will find that whenever referred to a psychiatrist or psychologist, they will not be interested in healing you. They will only be looking at confirmation of what the referring doctor indicated. Hence the name confirmation bias.

Lies, Lies, Lies ...

Whatever form gaslighting takes, it is all based on lies. Doctors will "modify" the truth. Sometimes it will be a consequence of confirmation bias. Others, however, it will simply be malicious.

Research

In the meantime, if you experienced medical gaslighting yourself, please share your experience.

References

1. https://me-pedia.org/wiki/Medical_gaslighting
2. https://www.medicalnewstoday.com/ – What is gaslighting?
3. https://www.ncbi.nlm.nih.gov/ – The toxic power dynamics of gaslighting in medicine
4. Interesting info at the beginning of the article Are You A Victim Of Medical Gaslighting?
5. Have you been a victim of medical gaslighting?
6. https://www.ingelathuneboyle.com/ Medical gaslighting in chronic illness: when doctors cause harm
7. https://www.womenshealthmag.com/ Medical Gaslighting
8. https://www.today.com/ How to navigate ‘medical gaslighting’ when doctors dismiss your symptoms
9. https://www.miphealth.org.uk/ – Are you being gaslighted?
10. Don't trust me i'm a doctor 
11. Don't Trust Me, I'm a Doctor: Medical Regulation and the 1999 NHS Reforms