When doctors dismiss or minimize patients’ symptoms, the consequences can be severe, leading to psychological distress and long-term avoidance of medical care. A review by Rutgers Health researchers, published in Psychological Bulletin, examined 151 studies involving over 11,000 individuals with conditions like fibromyalgia, long COVID, and endometriosis. The findings highlight the widespread impact of “symptom invalidation,” a phenomenon patients often describe as “medical gaslighting.”
The study identified four key areas of harm caused by symptom invalidation: emotional effects like self-doubt and shame, loss of trust in clinicians, behavioral changes such as avoiding medical care, and diagnostic delays that exacerbate health conditions. Lead author Allyson Bontempo, a postdoctoral fellow at Rutgers, noted that patients often question their reality, asking, “Am I making this up? Is this all in my head?” These experiences are linked to depression, suicidality, and trauma-like anxiety.
Bontempo explained that many patients alter their behavior after such encounters, downplaying symptoms or avoiding health care altogether. For example, one patient with endometriosis refused to seek care even for unrelated issues. The rise in complex conditions like long COVID has further highlighted the challenges doctors face when diagnoses aren’t straightforward.
The researchers attribute symptom invalidation to medical training and workflows that prioritize algorithmic approaches over listening to patients’ nuanced stories. To address this, Bontempo recommends clinicians validate patients’ experiences, even when a clear diagnosis is elusive, and avoid dismissive reassurances like “it’s probably nothing serious.”
“Patients appreciate clinicians communicating their uncertainty and admitting they don’t know something,” said Bontempo.
The study underscores the need for systemic changes in health care to prevent symptom invalidation and improve patient outcomes. For those affected, self-advocacy, such as researching clinicians or bringing a supportive companion to appointments, can help, though Bontempo acknowledges these steps are often difficult. The team hopes their findings will inspire interventions to foster better patient-provider communication.
Add comment