Gaslighting in Pediatric Mental Health

If you have ever had an unexplained medical problem you have probably experienced medical gaslighting. “Gaslighting” is when you go to the doctor so they can determine what is wrong and they attribute it to a mental health problem or otherwise dismiss your symptoms as not being serious when the symptoms are real and significant to you. It’s a way of blaming the victim for their own symptoms and ultimately dismissing (and disrespecting) you.

An Example of Medical Gaslighting

I’m sure I could share many personal examples, but years ago I had extreme fatigue. It was debilitating and unexplained. Routine tests pointed to no cause. At one point, I was referred to a sleep clinic. As a thin woman in my 30s, I did not fit the typical profile of someone with sleep apnea, and the medical professional made it clear that she believed I was malingering or that it was somehow my fault I was so exhausted. This is not an uncommon experience for many people, especially women. It was really insulting.  (There’s much more to this story, but long story short is that I had the resources to continue to get other opinions and was ultimately helped by a naturopath.) 

Are You Guilty of Gaslighting Your Clients?

Have you ever considered whether you do the same thing to clients? I have certainly heard educators and other therapists make comments about parents and children that might leave them in a situation that has them doubting their lived experience. 

Some possible ways we may gaslight parents/caregivers:

1. Attribute a child’s behavior to poor parenting. Parents may be blamed for not having enough discipline or boundaries with their children.
2. Dismissing concerns. A parent may give an example about a situation in which they were concerned and we take that at face value, as though it was an isolated incident when it may be just a recent example that was on their mind. 
3. Invalidate their experience or observations. We may attribute their concerns to being a first time parent or because they mention that they Googled the concern. 

I’d like to think that mental health professionals would not gaslight children, but unfortunately I have witnessed it myself. 

Some possible ways we may gaslight children:

1. Minimize their feelings. “It’s not that big of a deal.” (This is why I’m not a fan of Size of the Problem in the way it can often be presented…a topic for a future blog!)
   
2. Focus on behavior instead of their perception of the situation or emotions. For example, we may tell them that they are overreacting to a situation. And while their reaction may not fit the size of the problem as we perceive it, it doesn’t mean that it is not distressing to them.
   
3. Dismiss what they say as not being true. “My teacher wouldn’t let me go to the bathroom when I raised my hand” and we respond with, “I’m sure your teacher wouldn’t do that.”

How can we ensure we aren’t gaslighting our clients?

1. We can do a comprehensive evaluation, or at the very least, ask clarifying questions. 
2. Remind ourselves that parents know their child best. We have some training and expertise from which they may benefit, but they are the expert when it comes to their child. 
3. Validate their feelings, concerns, and ask clarifying questions. 
4. Always assume that their perceptions and reports are real and accurate until proven otherwise. 

As therapists and educators we need to monitor our own biases and assumptions. We must also trust that when a parent is seeking our help that they really feel they need support. To help children feel supported we need to try to understand their experience and be empathetic. We may not always be the best person to help them, but we can listen to help them find someone who is. We can also make sure that we aren’t dismissing their concerns. Unfortunately some people stop seeking help after they are gaslit and continue to live with their difficulties thinking they are responsible for them, but not knowing how to do anything about it.