Gaslighting: ALS, anti‐Blackness, and medicine

Abstract

Gaslighting has become a popular term to describe experiences of doubt and manipulation that make individuals or groups feel like their lived realities are not valid. Much of the theoretical work utilizing gaslighting as an analytic can be found in psychology literature or feminist domestic violence discussions. More recently, political scientists, philosophers, and sociologists have noted the structural, political, economic, and social processes that enable gaslighting to move beyond an interpersonal dynamic between women and their abusers. This essay extends these arguments through a Black feminist anthropological lens to examine how anti‐Black medical gaslighting functions structurally within medical systems, individually through implicit biases held by healthcare workers, and collectively through cultural norms. Despite Black patients’ learned mistrust of the medical system and often after multiple failed attempts to receive care or answers, ethnographic vignettes reveal that Black people with amyotrophic lateral sclerosis (ALS) and their caregivers continue to fight to be heard by the medical establishment despite being gaslit.

“I have to fight for them to investigate things”: a qualitative exploration of physical and mental healthcare for women diagnosed with mental illness

“…Health and wellbeing are influenced by genetic, neurobiological, environmental, and social factors. The social category of womanhood is closely linked to sociocultural and institutional milieus that may impact engagement in health services in unique ways for women ( 19 , 20 ). These include adverse experiences such as discrimination and gender inequality which can both lead women to delay access healthcare and diminish the quality of care they receive [( 15 , 21 , 22 ); ( 23 )].…”

“…Health inequities experienced by women in their communities and relationships are compounded by inequities in the health system, such as medical gaslighting ( 15 ), also known as health-related communicative disenfranchisement ( 26–29 ). Medical gaslighting refers to the denial and dismissal of symptoms, invalidation and disregard of patient concerns and wishes, refusal of screening, referral and treatment, gender bias in healthcare, stigmatisation of mental ill health by healthcare professionals, and inadequate care experienced by individuals in medical settings ( 15–17 , 19 , 30–35 ). For example, women may experience being dismissed as lacking credibility when reporting illness symptoms ( 16 , 17 , 26 , 31 , 35 ).…”

“…Women may experience multiple, intersecting discrimination that increase risk of medical gaslighting (i.e., sexism, racism, ableism, ageism, sizeism) ( 16 , 19 , 32 , 34 ). For example, their gender and age leading to perceived lack of credibility, dismissal, and misdiagnosis ( 32 , 34 ), or women’s intersections of gender, race, or weight may lead to stigmatising health experiences based on these characteristics ( 19 , 34 ). Co-diagnosis of a mental and physical health condition can increase the likelihood that women will be stigmatised and dismissed as imagining or fabricating somatic symptoms ( 32 ).…”

Ethnography and ethical life

“…Virtue can be explicitly sought and cultivated (Mahmood, 2005), and it can manifest creatively under challenging circumstances (Mattingly, 2014). Brodwin's (2013, p. 14) Everyday Ethics , for example, tracks “second thoughts and fleeting moments of self‐doubt,” exemplifying the “ethical sensibility of clinicians.” Conversely, there is a long history, from Taussig (1980) to Carter (2022), of showing the ethical damage made possible in clinical encounters. Ethnographers who do not shy away from facing ethical complexity and anxiety include Crapanzano (2010, 2011) and Jackson (2017).…”