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People with long COVID continue to experience medical gaslighting more than 3 years into the pandemic

<p><em><a href="https://theconversation.com/profiles/simran-purewal-1405366">Simran Purewal</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/kaylee-byers-766226">Kaylee Byers</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/kayli-jamieson-1431392">Kayli Jamieson</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>, and <a href="https://theconversation.com/profiles/neda-zolfaghari-1431577">Neda Zolfaghari</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a></em></p> <p>It’s increasingly clear that the <a href="https://www.worldometers.info/coronavirus/country/canada/">SARS-CoV-2 virus is not going away</a> any time soon. And for some patients, their symptoms haven’t gone away either.</p> <p>In January 2023, our team of researchers at the <a href="https://pipps.ca/">Pacific Institute on Pathogens, Pandemics and Society</a> published a <a href="https://pipps.cdn.prismic.io/pipps/bd160219-3281-4c5d-b8be-57c301e7f99b_Long+Covid+Brief+Feb+2023.pdf">research brief</a> about how people seek out information about long COVID. The brief was based on a scoping review, a type of study that assesses and summarizes available research. Our interdisciplinary team aims to understand the experiences of people with long COVID in order to identify opportunities to support health care and access to information.</p> <h2>Lingering long COVID</h2> <p>Long COVID (also called <a href="https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/symptoms/post-covid-19-condition.html">Post COVID-19 condition</a>) is an illness that occurs after infection with COVID-19, lasting weeks to months, and even years. First coined by a <a href="https://doi.org/10.1016%2Fj.socscimed.2020.113426">patient on Twitter</a>, the term also represents a collective movement of people experiencing the long-term effects of COVID-19 and advocating for care. <a href="https://science.gc.ca/site/science/sites/default/files/attachments/2023/Post-Covid-Condition_Report-2022.pdf">Around 15 per cent</a> of adults who have had COVID still have symptoms after three months or more.</p> <p>Long COVID affects systems <a href="https://doi.org/10.1016/j.socscimed.2021.114619">throughout the body</a>. However, symptom fluctuations and limited diagnostic tools make it challenging for health-care providers to diagnose, especially with <a href="https://doi.org/10.1038/s41579-022-00846-2">over 200 symptoms</a> that may present in patients. Perhaps because long COVID presents itself in many different ways, the illness has <a href="https://doi.org/10.1016/j.socscimed.2021.114619">been contested</a> across the medical field.</p> <p>To identify opportunities to reduce barriers to long COVID care, our team has explored how patients and their caregivers access <a href="https://pipps.cdn.prismic.io/pipps/bd160219-3281-4c5d-b8be-57c301e7f99b_Long+Covid+Brief+Feb+2023.pdf">information about long COVID</a>. We have found that one of the most significant barriers faced by patients is <a href="https://doi.org/10.1177/20552076211059649">medical gaslighting</a> by the people they have turned to for help.</p> <h2>Lack of validation leads to stigma</h2> <p><a href="https://doi.org/10.1136/bmj.o1974">Medical gaslighting</a> occurs when health-care practitioners dismiss or falsely blame patients for their symptoms. While new information about long COVID has become more readily available, some patients continue to face gaslighting and feel that their symptoms are <a href="https://doi.org/10.1016%2Fj.ssmqr.2022.100177">treated less seriously</a> by some health-care professionals.</p> <p>This dismissal can <a href="https://doi.org/10.1111/hex.13602">erode trust</a> in the health-care system and can also lead to <a href="https://doi.org/10.1111/hex.13518">stigma and shame</a>.</p> <p>Preliminary findings from our ongoing study with long COVID patients indicate that, when medical practitioners do not validate a patient’s condition, this extends into community networks of family and friends who may also dismiss their symptoms, contributing to further stigmatization at home.</p> <p>Medical gaslighting can present additional barriers to treatment, such as not being referred to specialists or long COVID clinics. This can, in turn, compound other symptoms such as fatigue, and <a href="https://doi.org/10.1192/bjo.2022.38">exacerbate the psychological symptoms of long COVID</a>, such as depression and anxiety.</p> <p>Medical gaslighting isn’t new. It has been documented by patients with other chronic conditions, such as <a href="https://doi.org/10.5772/intechopen.107936">myalgic encephalomyelitis or chronic fatigue syndrome</a>. And while this is common for patients with <a href="https://doi.org/10.1001/amajethics.2021.512">non-visible illnesses</a>, medical gaslighting is more commonly experienced by <a href="https://doi.org/10.1111/1467-9566.13367">women and racialized people</a>.</p> <p>Long COVID patients also note gender biases, as women with prolonged symptoms feel they are not believed. This is particularly worrisome, as studies have found that <a href="https://doi.org/10.1001/jama.2020.17709">women are disproportionately more likely to experience long COVID</a>.</p> <h2>Where do we go from here?</h2> <p>While long COVID information is constantly shifting, it’s clear that patients face many barriers, the first of which is having their illness minimized or disregarded by others. To ensure that patients have access to compassionate care, we suggest:</p> <p><strong>1. Educating physicians on long COVID</strong></p> <p>Because definitions of long COVID, and its presentation, vary widely, primary care physicians need support to recognize and acknowledge the condition. General practitioners (GPs) must also provide patients with information to help manage their symptoms. This requires actively listening to patients, documenting symptoms and <a href="https://doi.org/10.1136/bmj.m3489">paying close attention to symptoms that need further attention</a>.</p> <p>Training physicians on the full range of symptoms and referring patients to available supports would reduce stigma and assist physicians by reducing their need to gather information themselves.</p> <p><strong>2. Raise awareness about long COVID</strong></p> <p>To increase awareness of long COVID and reduce stigma, public health and community-based organizations must work collaboratively. This may include a public awareness and information campaign about long COVID symptoms, and making support available. Doing so has the potential to foster community support for patients and improve the mental health of patients and their caregivers.</p> <p><strong>3. Ensure information is accessible</strong></p> <p>In many health systems, GPs are <a href="https://doi.org/10.1186/s12913-019-4419-0">gatekeepers to specialists</a> and are considered trusted information sources. However, without established diagnostic guidelines, patients are left to <a href="https://doi.org/10.2196/37984">self-advocate</a> and prove their condition exists.</p> <p>Because of negative encounters with health-care professionals, patients turn to social media platforms, including long COVID <a href="https://doi.org/10.7861%2Fclinmed.2020-0962">online communities</a> on Facebook. While these platforms allow patients to validate experiences and discuss management strategies, patients should not rely only on social media given the <a href="https://doi.org/10.3389/fpubh.2022.937100">potential for misinformation</a>. As a result, it is crucial to ensure information about long COVID is multi-lingual and available in a wide range of formats such as videos, online media and physical printouts.</p> <p>The <a href="https://science.gc.ca/site/science/en/office-chief-science-advisor/initiatives-covid-19/post-covid-19-condition-canada-what-we-know-what-we-dont-know-and-framework-action">recent recommendations of the Chief Science Advisor of Canada</a> to establish diagnostic criteria, care pathways and a research framework for long COVID are a positive development, but we know patients need support now. Improving long COVID education and awareness won’t resolve all of the issues faced by patients, but they’re foundational to compassionate and evidence-based care.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/203744/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/simran-purewal-1405366">Simran Purewal</a>, Research Associate, Health Sciences, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/kaylee-byers-766226">Kaylee Byers</a>, Regional Deputy Director, BC Node of the Canadian Wildlife Health Cooperative; Senior Scientist, Pacific Institute on Pathogens, Pandemics and Society, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/kayli-jamieson-1431392">Kayli Jamieson</a>, Master's Student in Communication, Research Assistant for Pacific Institute on Pathogens, Pandemics and Society, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>, and <a href="https://theconversation.com/profiles/neda-zolfaghari-1431577">Neda Zolfaghari</a>, Project Coordinator, Pacific Institute on Pathogens, Pandemics and Society, and the Pandemics &amp; Borders Project, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/people-with-long-covid-continue-to-experience-medical-gaslighting-more-than-3-years-into-the-pandemic-203744">original article</a>.</em></p>

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6 warning signs that you’re being gaslighted

<h2>What is gaslighting?</h2> <p>In a way, it’s psychological brainwashing. Gaslighting is a type of emotional or mental abuse when someone uses manipulation and distraction tactics to distort the truth, making their victim question their own reality. It can happen in any type of close relationship, including romantic relationships but also between family members, friends and coworkers.</p> <p>It may not be as visible as other types of abuse but gaslighting can be just as damaging, says Robin Stern, PhD, a licensed psychoanalyst and author of The Gaslight Effect: How to Spot and Survive the Hidden Manipulation Others Use to Control Your Life. “When a loved one undermines your sense of reality, you become trapped in a never-never land, where you feel bad, inadequate and crazy all the time,” she says.</p> <h2>Why gaslighting is harmful</h2> <p>Lying to someone about what’s really happening is hurtful in the short-term. “Wondering why someone you love is trying to deceive you can make you question the relationship and yourself,” Stern says.</p> <p>But gaslighting can have terrible consequences in the long-term, destroying the victim’s self-esteem and confidence and either trapping them in a dysfunctional relationship or blowing up the relationship.</p> <p>It can have broader implications, as well. Over time, the person being gaslighted becomes conditioned to trust others’ perceptions more than their own, leading to a feeling of helplessness, brain fog, an inability to make decisions, memory problems, PTSD, depression, and anxiety – and these may not end even if the person leaves the relationship, Stern says.</p> <h2>How gaslighting happens</h2> <p>Abusers generally don’t start off at full force, or else their victim would immediately leave; rather, they start slowly, which adds to the sense of confusion and unreality the victim experiences, says Stephanie Sarkis, PhD, a psychotherapist and author of Gaslighting: Recognize Manipulative and Emotionally Abusive People – and Break Free. In fact, gaslighting examples often start as a fairytale romance.</p> <p>“Gaslighters will ‘love bomb‘ you with affection, attention and gifts, as a way to gain control and make you trust them,” Sarkis says. “Then once you love them, little by little, the gaslighter will start to pick you apart and criticise you.” This red flag shows up as early as the first date, with the gaslighter asking a lot of personal questions, pressing for intimacy very quickly, and giving lots of gifts or declarations of love, she says.</p> <p>Once in the relationship, there are three main phases that a victim goes through during the gaslighting process, Stern explains.</p> <p>Disbelief. The first few times someone tries to change your reality, you will likely not believe them and may tell them that they’re wrong or they have misunderstood the situation.</p> <p>Defence. The more someone gaslights you, the more you begin to question whether the gaslighter has a point, but you will still try to defend yourself. You will try to disprove their statements with logic or try to reason with them, but you will try to “be fair” and see it from their point of view as well.</p> <p>Depression. After a while, you believe them, particularly if their criticisms stem from a fear you have. The more the gaslighter can keep you feeling insecure and questioning your reality, the more you’ll believe their explanations. Over time, you reach a point where your self-confidence is destroyed, and you no longer trust yourself.</p> <p>The gaslighter’s ultimate goal is to make you doubt yourself so much that you will become totally dependent on them and only them, allowing them to control you, she says.</p> <h2>Gaslighting examples</h2> <p>Due to its deceptive nature, gaslighting examples can be uniquely difficult to identify, especially when you’re in the middle of it, Sarkis says. “It is a type of brainwashing and coercive control. It can be so subtle that you may not even be aware it’s happening,” Sarkis says. “Part of gaslighting is training the victim not to question it; it depends on you believing that your experiences and your feelings are wrong.”</p> <p>To help you better understand and spot gaslighting, we’ve asked our experts to share some common gaslighting examples and gaslighting phrases.</p> <h2>Flickering gaslights: The example that started it all</h2> <p>This phenomenon has likely existed forever, but the term “gaslighting” didn’t become recognised until the 1944 movie Gaslight. In the movie, a husband convinces his wife she’s going insane in order to cover up a murder and steal some jewels. He subtly manipulates things in her environment, including changing the gas lights, and then denies the reality, eventually making her think that she is mentally ill and shouldn’t go out of her home. The gaslighting example resonated with many viewers, and today the term has taken on a broader meaning, Sarkis says.</p> <div> </div> <h2>“You’re not hungry, you just ate”: Gaslighting as a parenting tactic</h2> <p>“Parents undermine their kids’ reality in the most innocent ways, usually as a way to get the child to obey, but the consequences are very damaging,” Stern says. She cites a time where she saw a father and a young boy playing in a park. The dad told his son not to run away, but the child ran anyhow, eventually tripping and hurting himself. Instead of comforting him, the father yelled, “What have you done to yourself now? Look at this mess you’ve made!” as if the boy did it on purpose.</p> <p>“The problem wasn’t that the boy disobeyed and was hurt as a consequence, it’s that the father made him feel that his feelings of being hurt were wrong and invalidated his experience,” she says. “Instead of learning a lesson about being careful, he learned that there was something inherently wrong with him.”</p> <h2>“I only did it because I love you”: Gaslighting as a way to show love</h2> <p>Some gaslighters believe that they are manipulating their victim because they love them and “only want what is best,” presuming that they know what is better than the person themselves, Sarkis says.</p> <p>For instance, a woman applied for a job that she very much wanted and was excited to get very far in the interview process when the company suddenly stopped responding to her. Her husband told her that she wasn’t right for the job, wasn’t good enough for that position, and probably didn’t interview well.</p> <p>Eventually, after several weeks, she asked the hiring manager why she was dropped so suddenly, only to hear that her husband had called and told them that she was no longer interested and to take her name out of consideration. She confronted her husband, he said it was for her own good, that he knew she would be happier not working and staying at home.</p> <p>“The victim then has to choose whether they believe that their loved one really does know what they need more than they do,” she says. “Eventually, they may stop trying to make decisions for themselves, which allows their partner to control them.”</p> <h2>“I’m not cheating, you’re just paranoid”: Gaslighting as a way of deflecting blame</h2> <p>One of the most common reasons for gaslighting is that by changing reality, the gaslighter can make the problem the victim instead of their own bad behaviour, Stern says. “We see this a lot in infidelity, like when a man will tell his wife that she’s being ‘too sensitive’ or is ‘just jealous’ when she questions an inappropriate relationship with his coworker,” she says. “Then, if she catches him having an affair, he may tell her that he had to cheat because she is too frigid and doesn’t give him enough sex,” she says.</p> <p>Then, instead of talking about how he’s emotionally checked out of his marriage or is sleeping with another woman, suddenly the argument is about the wife’s personal failings. “It’s a way to get her to blame herself, instead of him,” she says.</p> <h2>“No one will ever love you but me”: Gaslighting as a way to isolate</h2> <p>Isolating the victim from friends and family is a hallmark of all types of domestic abuse, and gaslighting is one way to accomplish this, Sarkis says. A person’s loved ones are those who could give them a reality check, proving the abuser wrong, so the gaslighter may try to separate them by bending reality.</p> <p>One gaslighting example she cites is of a boyfriend who forbade his girlfriend from going out to gatherings like a girls’ night out, saying that her friends hated him and that they talked badly about her behind her back. He went so far as to take her phone and delete texts and calls from her friends as “evidence” that they really didn’t care about her and that he was the only one who truly loved her.</p> <p>“They don’t just want to be the primary relationship in your life, they want to be the only relationship in your life,” she says, adding that it’s often a double standard, and they will maintain many outside relationships.</p> <h2>“You made me do this”: Gaslighting as punishment</h2> <p>The silent treatment or angry rages (or alternating between the two) are the main ways gaslighters use to punish their victims and regain control over them, Sarkis says.</p> <p>For example, one woman says she went on a holiday with her family, but the first night she and her husband got into an argument about where their baby would sleep. Her husband became so enraged that he left the hotel room all night. When he returned the next morning, he acted normally with the kids but pretended that she didn’t exist, refusing to talk to or even acknowledge her – for the entire week. By the end, she was so desperate to make the silent treatment end that she apologised for anything and everything she could think of, begging for his forgiveness.</p> <p>“The silent treatment is the ultimate gaslighting because it denies the reality of you, of your humanity,” Sarkis says.</p> <h2>“You’re too sensitive”: Gaslighting as narcissism</h2> <p>Some people gaslight because that’s how they were raised and continue to use this dysfunctional tool to meet their needs in a relationship. But for many gaslighters, manipulating and hurting others is intentional and gives them a “high” and brings them pleasure, Sarkis says. This can manifest in many different ways, but a typical gaslighting example is in close friendships where one person requires a constant stream of love, gifts, adoration and attention and will gaslight their “best friend” into providing these things.</p> <p>One man shares that his best friend since childhood often disparaged him, telling him that he wasn’t good at anything he tried, he was ugly and he had poor social skills. “I realised after I went to college that none of those things were true, but he wanted me to believe they were so I would continue being his best friend,” he says. “He was actually jealous of me in many ways and put me down to feel better about himself.”</p> <p>“Gaslighters are often narcissists and need a constant supply of attention. However, even if you devote 100 percent of yourself to loving and taking care of them, it will never be enough. They will make you feel like you will never be good enough for them,” Sarkis says.</p> <h2>What to do if you think you’re being gaslighted</h2> <p>Gaslighting may be more common than most people think. It’s one sign of emotional abuse, which more than 43 million women and 38 million men will experience by an intimate partner in their lifetime, according to data from the Centers For Disease Control and Prevention.</p> <p>The first step to ending gaslighting is to be able to recognise it when it’s happening, Stern says. You may come to see it on your own, but many gaslighting victims need help from family, friends, and/or a therapist to detangle all the lies and twisted memories, she says.</p> <p>“I tell people to focus on how they feel during a conversation rather than what is ‘right,’” she says. “It’s OK to say, ‘I don’t care who is right or wrong, but the way you are talking to me is aggressive and abusive, and I won’t continue this conversation’.”</p> <p>Unfortunately, many gaslighters do not respond well to their victims standing up for themselves as it takes away their ability to control them, Sarkis says. “Often, the only way to stop the gaslighting is to walk away from the relationship,” she says.</p> <p>Once you decide to leave, you need to do it very carefully as it’s not uncommon for gaslighting to escalate to physical violence, Sarkis says. “Talk to your loved ones or a therapist and make a plan to leave safely,” she says. “Once you’ve left, you need to go full no-contact because they will try to ‘hoover’ you back in with promises and gifts.”</p> <p><strong>This article originally appeared on <a href="https://www.readersdigest.com.au/uncategorized/6-warning-signs-that-youre-being-gaslighted?pages=1" target="_blank" rel="noopener">Reader's Digest</a>.</strong></p> <p><em>Image: Shutterstock</em></p>

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Three warning signs you’re gaslighting yourself

<p dir="ltr">A psychologist has shared the three signs that suggest you could be gaslighting yourself. </p><p dir="ltr">Dr Julie Smith, a clinical psychologist from Hampshire, has listed the top three self-sabotaging behaviours, which range from blaming yourself to not acknowledging your feelings. </p><p dir="ltr">Gaslighting is a form of emotional abuse and manipulation that is often linked with toxic relationships with others. </p><p dir="ltr">The term refers to someone making another person question their own thoughts, feelings, and perception of reality.</p><p dir="ltr">She said the main sign of self-sabotaging gaslighting is constantly blaming yourself for things out of your control. </p><p dir="ltr">“You make excuses for other people’s behaviour - but if you make a mistake, you believe it says something fundamental about who you are as a person,” Dr Smith explained in her now-viral Tik Tok video.</p><p dir="ltr">Another sign is never trusting your own judgement, or ignoring your gut instinct. </p><p dir="ltr">“But you see the opinions of other people as much more credible source so you live in an almost constant state of self-doubt and you look at other people for clarity,” she said.</p><p dir="ltr">The final sign, according to Dr Smith, is invalidating or ignoring your own feelings. </p><p dir="ltr">“You come to believe that you’re oversensitive or you overreact so you don’t know which emotions you listen to anymore,” she said.</p><p dir="ltr">Her video has struck a chord with many viewers, with thousands of people commenting that her examples are “painfully relatable”.</p><p dir="ltr">“Oh wow that hit me. How would someone stop doing this? It feels like it’s just second nature for me,” one woman wrote.</p><p dir="ltr">According to Dr Smith, finding time to meet your own physical and emotional needs through self-care practises can help to reclaim your energy, and hold onto your sense of self. </p><p dir="ltr"><em>Image credits: Getty Images</em></p>

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