Medical gaslighting as a mechanism for medical trauma: case studies and analysis

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Abstract
Being dismissed or disparaged by medical professionals can be shocking and demoralizing for patients, leading to unnecessary harms (e.g., avoidance of medical treatment; depression; shame). This difficulty is further compounded when patients are also the target of wide-ranging stigmatization due to the nature of the medical and behavioral diagnoses they carry, and/or the social identities attributed to them by medical providers. Incorporating both clinical psychology and medical ethics perspectives, two clinical cases are presented demonstrating the insidious nature of the harms incurred to patients from traumatic medical experiences like those described above. Both cases are shown to illustrate the role that a particular form of gaslighting– medical gaslighting– plays in creating the conditions that result in a form of medical trauma. The term “medical gaslighting” currently lacks a clear and stable definition in the larger literature; the authors develop and establish a definition here. The case of Alex is offered, illustrating a standard form of medical trauma recognized in the literature, and the significance of epistemic injustice in preparing the grounds for medical gaslighting. Next, the case of Kiara is considered, in order to demonstrate how medical gaslighting becomes the vehicle for a more subtle form of medical trauma, not currently captured in standard diagnostic criteria. The claims presented here are testable, and the authors suggest that further work expanding the conceptual reach of medical trauma, and incorporating the concept of medical gaslighting into standard practice, is warranted.

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