Being Gaslit in your Body*
By Jennifer L. Gaudiani, MD, CEDS-S, FAED
Many people are familiar with the concept of “gaslighting.” For those who aren’t, it comes from the 1944 Academy Award-winning movie “Gaslight” starring Ingrid Bergman, in which a husband slowly manipulates his wife into going insane. She sees, among other things, the gaslights in the house flicker and dim, but her husband tells her she’s imagining it…while he is the one deliberately causing the lights to flicker. These days, we use the term “gaslight” to describe someone invalidating another’s perceptions, whether deliberately or not, making the other question themselves and their insight in ways that are really psychologically harmful.
So, let’s apply this to the experiences of individuals with eating disorders in the doctor’s office. So many of my patients have been gaslit in their own lived experiences, their physical symptoms. They are told, “You couldn’t have that much nausea. Your scope was normal.” “You can’t be restricting like you say; your weight isn’t that low/your labs are normal.” “You can’t have that much pain; your CAT scan was normal.” “You must be secretly bingeing; your weight is high.” “There’s nothing wrong with you that we can find on tests; you must just be really sensitive/psychosomatic.” Unlike Charles Boyer’s character in the movie, the doctors likely are not delivering these proclamations with an intention to make the patient question their sanity… but as we know, impact matters more than intent. Where the eating disorder already taunts and torments the person’s recovery-oriented voice, questioning everything, having a medical professional do the same thing can be desperately awful and severely impact recovery work.
Being gaslit in your body can make you avoid medical care because, “They said there’s nothing wrong; what can they do anyway?” It can significantly strengthen the eating disorder, which grabs that powerful professional’s words and says, “See? You were exaggerating your suffering the whole time. Feel shame.” And it can further disconnect you from listening to your body’s signals down the road. This is heightened when your particular symptoms are hard for Western medicine to measure. The person whose irritable bowel syndrome (IBS), postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), migraines, breathlessness, low energy, dizziness, fatigue, etc. are getting worse may stay detached from these worsening symptoms rather than paying attention to them with compassion and warmth. This leads to a worse quality of life and misses the vital opportunity to seek help, slow down, and practice self-care.
If you are one of the people who has been gaslit in your body by the medical system, I want to offer an apology to you on behalf of my profession. I’ve done it too; I’ve caused harm. As a provider, it’s not about being perfect or getting the right diagnosis every time, it’s about staying curious, humble, and open to patient suggestions and research. It’s about acknowledging when you as the provider were wrong and the patient was right. It’s about flexibility and being willing to change course. It’s about witnessing even when one cannot in the moment find a way to ease suffering. I’ve learned so much from my patients who send me an article or blog they’ve read and ask me to check it out. Or from a dietitian or therapist who says, “Hey, what about this?”
In addition to my heartfelt apology for what you have experienced in the medical system, I want to encourage you to reconnect with what your body is telling you, as long as you can do so safely (some with a trauma history may need a skilled trauma therapist to begin reconnecting with their bodies). Use body suffering as a reminder that you deserve rest, nourishment, connection, and joy. (And take it from this health-privileged doctor: one need not suffer to deserve those human rights as well!) Try to keep a glimmer of hope that your research, persistence, advocacy, and voice may lead to a provider who happens to have the right knowledge base and soul to help you feel better. And while eating disorder behaviors may temporarily ease some symptoms in the moment, they will always do more harm in the long run.
*In January 2021, I recorded a really fun video talking more about this topic with the amazing Sondra Kronberg, MS, RD, CEDRD-S, which will be posted on www.chatsinthelivingroom.com. (In the meantime, there are SO many amazing videos already archived with Sondra and incredible eating disorder providers, so you can find lovely words and support there.)