On Medical Trauma, Medical Gaslighting, & Doing Better in Chronic Illness Care
Y’all, I’m tired.
There are so many reasons to be exhausted right now: ICE raids and government-sanctioned violence, our rapid descent into fascism, ongoing genocides, and the constant flood of despair-inducing headlines, alongside the usual suspects of racism, sexism, homophobia, ableism, and more.
I’m also exhausted because there’s never a day this isn’t true.
That’s the reality of living with complex chronic illness, where even rest happens inside systems that don’t let up.
For many people in the United States living with chronic illness, the most painful part of their experience isn’t only the symptoms; it’s the American healthcare system meant to help them.
Repeated dismissal, minimization, disbelief, or prolonged and circuitous journeys toward diagnosis can leave lasting psychological harm. Over time, these experiences often accumulate into medical trauma, eroding trust in providers and discouraging people from seeking care at all.
When Healthcare Becomes a Source of Trauma
I’m writing this out of the exhaustion and rage I carry as someone who regularly navigates a fundamentally broken medical system, deep care for my fellow spoonies and what we endure, and because I’m still holding onto a small, stubborn kindling of hope that maybe this can finally be different.
So here it is, my personal plea to American medical professionals to please do better.
And, I also get it. Really. You’re managing an enormous amount.
I have deep empathy for the impossible situation you’re in, because I navigate it with such frequency. I see firsthand how the healthcare system works against doctors as well, with unmanageable caseloads, constant insurance hurdles and denials, unrelenting work hours, and more.
It feels unfair to only critique without offering anything in return. So I want to try to help by sharing therapist-informed guidance for how we might come together to care for people differently, even within broken systems.
In this article, I’ll explore:
medical trauma and medical gaslighting
why people with chronic illness are especially vulnerable and disproportionately impacted
how medical professionals can offer more supportive, ethical, and effective care
Medical Trauma and Chronic Illness
Medical trauma refers to the lasting psychological impact that can occur when healthcare experiences repeatedly feel overwhelming, invalidating, coercive, unsafe, or outside of a person’s control. While medical trauma can result from acute events such as invasive procedures or medical emergencies, for people living with chronic illness it more often develops cumulatively.
How Medical Trauma Develops for People With Chronic Illness
For many patients, medical trauma is not about a single “bad” appointment. It is about years of being dismissed, minimized, or told that “nothing is wrong” despite persistent and debilitating symptoms. It is about having pain reframed as anxiety, stress, noncompliance, or not doing enough. It is about navigating endless referrals, inconclusive tests, and shifting explanations without ever feeling truly heard or believed.
Over time, these experiences do not just take a toll. They cause psychological harm.
When someone spends weeks, months—and in too many cases—years, in severe symptom flares and does all the right things to try to obtain a diagnosis and effective treatment, only to be repeatedly dismissed or minimized, the impact is profound. The pain is not only physical. It is emotional, relational, and deeply destabilizing.
Medical Trauma Symptoms and Their Impact on Health and Care Engagement
From a therapeutic perspective, medical trauma can shape both mental health and medical outcomes. The psychological consequences of repeated invalidation may contribute to increased symptom severity, heightened emotional distress, agitation, and significant changes in how patients engage with care.
Some people avoid medical settings altogether. Others overutilize care in an effort to finally be taken seriously. This can look like leaving appointments shaking, replaying conversations for hours, or deciding it’s easier not to go back at all.
In these moments trust erodes slowly, visit by visit, until even scheduling an appointment feels heavy.
Symptoms of medical trauma may look like hypervigilance before appointments, difficulty trusting clinicians, or shutting down during visits. Some patients become highly rehearsed and overprepared in an attempt to protect themselves from dismissal. Others disengage entirely, deciding that seeking care is not worth the emotional cost and the limited physical energy they can muster.
“For many people in the United States living with chronic illness, the most painful part of their experience isn’t only the symptoms; it’s the American healthcare system meant to help them.”
Medical Trauma Is a Systems Issue, Not an Individual Failure
Importantly, medical trauma does not require any malicious intent.
If you are a medical professional caring for patients who demonstrate symptoms of medical trauma, this does not necessarily mean that you personally caused harm, that you are a bad doctor, or that you do not genuinely care about your patients.
Harm can occur even when well-intentioned providers are required to appear neutral, focus on efficiency, or to prioritize evidence-based treatment over genuine curiosity. Time constraints, productivity pressures, insurance limitations, and fragmented care shape these interactions in ways that can unintentionally reinforce power imbalances and undermine relational safety.
Understanding medical trauma is not about assigning blame. It is about recognizing how systems, practices, and patterns of interaction influence disease course, engagement in care, and patient wellbeing, and how care can be delivered differently when relational safety is treated as essential, not optional.
How Disbelief Damages the Care Relationship
Disbelief in healthcare doesn’t just affect whether a patient receives an accurate diagnosis or effective treatment. It changes the relationship itself.
For people with chronic illness, the doctor–patient relationship can slowly become a source of relational injury. When patients are repeatedly questioned, dismissed, or subtly discredited, it’s more than frustrating. It’s destabilizing.
For many people, that erosion shows up as dread before visits, rehearsing what to say in the car, or already feeling defeated before walking through the door.
Epistemic Injustice in Healthcare
Epistemic injustice is a term used to describe harm done to someone in their role as a knower. In other words, harm that happens when a person’s knowledge is treated as less credible or less trustworthy than it should be. One common form is testimonial injustice, which occurs when someone is given less credibility because of prejudice held by the listener, often in relation to marginalized identities.
In medical settings, epistemic injustice shows up when a patient’s account of their own body and symptoms is treated as unreliable, exaggerated, or somehow less legitimate than clinical interpretation or statistical likelihood.
As Rena Alcalay notes in Epistemic Injustice in the Medical Context: Introduction to Special Issue, patients are often seen as lacking credibility when describing their own bodily experiences, because medicine tends to privilege third-person, disembodied expert knowledge over first-person lived experience.
Epistemic injustice is especially likely when symptoms don’t fit neatly into diagnostic boxes, when tests come back inconclusive or “normal,” or when clinicians feel pressure to provide certainty even when the picture is unclear. Instead of uncertainty being held together, the burden is quietly shifted back onto the patient.
For people with chronic illness, this doesn’t happen once. It happens over and over. Eventually, patients are taught, implicitly and explicitly, that their perceptions can’t be trusted. Many start to question themselves: Am I overreacting? Am I imagining this? Am I not trying hard enough? Am I somehow failing at being a patient?
Naturally, I’ve asked myself all of these questions, often in the same appointment!
This is how people come to feel “crazy.” Not because their symptoms are psychological, but because their reality has been repeatedly dismissed and invalidated by people with institutional authority.
If you’ve ever left an appointment feeling confused, ashamed, or like you somehow failed at being a patient, I want to be very clear: that reaction didn’t come out of nowhere.
Let’s be real for a sec. How could you not have debilitating anxiety or pervasive depression when you repeatedly try to recruit the people you need to be on your team to really listen you? To take your distress seriously? To work alongside you and give you access to the care you need? And instead, time and time again, you leave feeling unheard, dismissed, and still—severely unwell.
Relational Injury and the Loss of Trust
Relational injury occurs when trust in the patient–clinician relationship becomes fractured. Each dismissal or minimization makes the relationship feel a little less safe, and it changes how patients show up.
Some arrive guarded, bracing for disbelief. Others (hi, it’s me!) over-explain, over-document, or over-prepare, hoping that if we just say the right thing or bring the right data, we’ll finally be taken seriously. Many of us walk in already exhausted, expecting that getting the care we need will once again be an uphill battle, even when that care is absolutely deserved.
This injury isn’t contained within individual appointments. It shapes future care decisions. It influences whether people seek help at all. It affects how honestly and openly patients can talk about symptoms, concerns, and uncertainty.
What can look to providers like defensiveness, anxiety, or noncompliance is often a very reasonable response to repeated relational harm.
When expecting not to be believed becomes routine, care stops feeling collaborative and starts to feel adversarial. Repairing that damage takes more than reassurance, and even more than finally accessing effective treatment. It requires a shift in how patient knowledge, uncertainty, and power are held within the care relationship.
Medical Gaslighting in Real Life
Medical gaslighting is what happens when a patient’s symptoms, experiences, or concerns are dismissed or reframed in ways that slowly make them doubt their own reality. Sometimes it’s so powerful that a person can start to wonder, Am I actually sick or is it all in my head?
It doesn’t usually look dramatic. It’s rarely someone being cruel on purpose. More often, it shows up in everyday interactions that feel normal on the surface, but deeply unsettling underneath.
What Medical Gaslighting Sounds Like
It sounds like:
“Your labs are normal, so everything looks fine.”
“This is probably just anxiety.”
“Let’s not worry too much about that.”
“Have you tried reducing stress or cutting out sugar, gluten, or dairy?”
“You’re very resilient.” (said right before nothing actually changes)
Or my personal favorite, “You look healthy.”
Individually, these comments might seem harmless. Even kind. But over time, they add up.
What Medical Gaslighting Actually Is (and Isn’t)
Medical gaslighting also isn’t about never considering psychological factors. It’s about premature dismissal. Gaslighting happens when genuine clinical concerns are brushed aside without adequate evaluation, especially in patients with complex, chronic, or nonspecific symptoms.
For example, assuming a symptom is “just psychological” without doing the appropriate medical workup isn’t reassurance. It’s a failure of care. And when this happens repeatedly, particularly to patients with chronic illness or psychiatric histories, it teaches them that their symptoms won’t be taken seriously no matter what they say.
Medical gaslighting teaches a very specific lesson: your experience is questionable. Your pain is suspect. Your body is unreliable. And if you keep pushing, you might be seen as difficult, dramatic, or noncompliant.
This is how people end up replaying appointments in their heads, wondering if they didn’t share the “right” information. This is how people stop bringing up symptoms altogether. This is how people leave visits feeling smaller, quieter, and strangely ashamed, when they did nothing wrong.
So many times I’ve walked out of appointments having nodded politely, only to sit in my car afterward and think, Wait. What just happened? My symptoms were still there. My questions weren’t answered. But somehow I’d been momentarily convinced I should feel reassured.
Why Medical Gaslighting Causes Real Harm
And here’s the thing worth naming clearly: medical gaslighting doesn’t require bad intent.
Research backs this up. In medical settings, gaslighting is often less about cruelty and more about a mix of blind spots: limited knowledge about certain (often complex) conditions, rigid expectations of how illness is “supposed” to look, unexamined bias toward certain patients, and the quiet assumption that the clinician’s interpretation matters more than the patient’s lived experience.
In other words, medical gaslighting is frequently driven by systems and training that reward certainty and authority, not by intentional harm. But the impact on patients is very real.
When gaslighting becomes routine, it reinforces the relational injuries already present in healthcare. It deepens medical trauma. It makes trust harder to rebuild. And it turns what should be a collaborative process into one that feels unsafe and unsupportive.
My hope in naming medical gaslighting is not at all to place blame on individual providers, but to make these patterns visible so they can be interrupted.
“This is how people come to feel ‘crazy’ — not because their symptoms are psychological, but because their reality has been repeatedly dismissed.”
How Medical Professionals Can Show Up Differently
Okay, I know, I know. This all feels pretty bleak.
At the risk of sounding redundant, I want to reiterate that I’m not interested in placing blame on individual medical professionals. I’m far more concerned with the system that makes it nearly impossible to slow down, lead with curiosity, or tolerate professional uncertainty without placing significant strain on providers themselves.
Doing better doesn’t require perfect knowledge, unlimited time, or never making mistakes (and yes, I know the healthcare system rarely supports any of that). What it does require is a shift in approach: moving from certainty to curiosity, from control to collaboration, from skepticism to trust, and from defensiveness to repair.
Below are some concrete ways to reduce harm and rebuild trust, informed by my therapist brain and my lived experience with chronic illness.
I also want to name something important about my own position here. While I spent much of my life coping with mystery symptoms without a diagnosis or effective treatment, I now carry enormous privilege in having eventually received a diagnosis and in being able to assemble a care team that slows down, listens, and treats me with genuine respect. I have also had the financial ability to access care outside of the insurance system in moments when it was necessary or helpful.
That access has made a profound difference in my quality of life and my ability to heal.
But it shouldn’t be a privilege. It should be the baseline.
Too many people with chronic illness are denied this kind of care not because they didn’t advocate hard enough, but because our healthcare system makes thoughtful, relational care scarce and expensive. I write this with deep awareness of how unevenly access to diagnosis, time, and humane care is distributed.
Start With Belief, Not Proof
You don’t need to have all the answers to meet patients with genuine belief that they’re telling the truth.
Believing a patient doesn’t mean you immediately know what’s happening or how to fix it. It simply means you trust that something is happening, and that the person sitting in front of you is the expert on their own experience.
Even if you feel confused, unsure, or genuinely stuck trying to make sense of what they’re describing, it helps to remember just how vulnerable this moment is for them. Living with frequent, complex symptoms is physically exhausting and emotionally destabilizing. Talking openly about it can feel risky, especially when past experiences have taught them that being met with disbelief is likely.
Add in the power differential here. This is someone who needs you in order to access care. That alone raises the stakes.
Simple, clear, affirming language has a powerful impact:
“I believe you’re experiencing this.”
“Something is clearly going on, even if we don’t fully understand it yet.”
“Your symptoms make sense given what you’re describing.”
“I don’t know what’s going on yet, but I know it’s very real.”
Communicating belief, even in the absence of certainty, can significantly reduce harm. Sometimes it’s the thing that makes the rest of care possible at all.
Be With Uncertainty Together
Uncertainty is unavoidable in medicine, especially when someone is living with a complex condition and a long list of symptoms. What is avoidable is making that uncertainty feel like the patient’s fault, or something they have to carry alone.
Living with chronic illness is already deeply isolating. It’s even lonelier when it feels like the people meant to help you aren’t really with you in it.
Instead of:
“There’s nothing wrong.”
“All the tests are normal.”
“I can’t help you. Have you seen another specialist?”
Try:
“Our current tests don’t explain this yet.”
“Medicine doesn’t have great tools to understand everything you’re experiencing.”
“I don’t have a clear answer right now, but I want to keep thinking about this with you.”
Or, sometimes even more powerful:
“I don’t fully know what’s going on yet, but I’m not giving up.”
You don’t have to know what’s happening or what to do right away. Being with someone matters. Holding uncertainty together can be one of the most supportive things you offer a person who has been living in uncertainty on their own for a very long time.
Be Careful With Mental health Explanations
Mental health and physical health are deeply intertwined. Of course doctors know this, and patients do too. What feels particularly minimizing is when psychological explanations are viewed as a stopping point instead of one part of a larger picture.
Before suggesting just anxiety, stress, or trauma:
Ask what explanations the patient has already been given.
Acknowledge any past dismissals.
Make it clear that suggesting support for mental health and emotional distress does not mean physical symptoms are imagined or less real.
A helpful frame sounds like:
“Mind and body affect each other, but that doesn’t mean what you’re experiencing is imagined or ‘just stress.’ We can keep multiple possibilities on the table.”
Watch for Advocacy Fatigue
A significant part of managing chronic illness within the American healthcare system is having to advocate for yourself, over and over again. So much of the limited energy people have goes toward fighting to be taken seriously, doing their own research to understand symptoms or diagnoses, and trying to access treatments that might actually help.
Patients with chronic illness are often labeled “difficult” when they are actually just worn down. (Turns out exhaustion can look like a lot of things.)
Advocacy fatigue can show up in a lot of ways. It might look like:
Flat affect or withdrawal
Anger or frustration
Over-preparation or hypervigilance
Hesitation to speak up
Understandably, it can feel challenging to collaborate with a patient who shows up this way. You might feel impatient, overwhelmed, or unsure how to move forward. That reaction makes sense.
What helps is noticing it before it enters the room.
Instead of unintentionally conveying impatience, try language that names what’s really happening:
“You’ve had to work really hard to be taken seriously.”
“It makes sense that you’re tired of explaining this.”
“I understand you’ve had to share your story so many times already. How can I make this feel a little easier today?”
Often, taking a small moment to slow things down changes everything. When people feel seen, they don’t have to fight as hard to be heard.
“You don’t need all the answers to start with belief.”
Decrease the Power Differential Where You Can
Small relational shifts matter more than you think.
This can include:
Sitting down instead of standing over a patient
Explaining why you’re recommending a test or treatment
Asking permission before exams or sensitive questions
Inviting questions and actually leaving space for them
Trauma-informed care doesn’t have to be about adding time. It’s about changing how time is used.
Slow Down to Hear What Actually Matters
In a healthcare system that constantly demands speed, slowing down can feel impossible, or even irresponsible. But for patients with chronic illness, pace matters just as much as protocol.
Rushing through appointments often means missing patterns, flattening complex stories, and defaulting to the most familiar explanations. When visits feel hurried, patients learn quickly what not to say. (Ask me how I know.) They truncate their stories, skip details, or stop mentioning symptoms altogether in an effort to be “easy” or not take up too much time.
Slowing down does not have to mean dramatically longer appointments. Often it’s about how time is used.
This can look like:
Letting a patient finish a thought without interrupting
Asking one follow-up question that invites clarification
Pausing before responding instead of rushing to reassurance
Reflecting back what you heard to make sure you got it right
When patients feel genuinely heard, something important shifts. They offer more accurate information. They correct misunderstandings early. They are more likely to share symptoms that feel embarrassing, confusing, or hard to explain.
This doesn’t just benefit patients. It helps clinicians too.
Taking a moment to slow down can reduce miscommunication, decrease repeated visits driven by unresolved concerns, and support more accurate clinical reasoning. It can also ease the pressure to appear certain when certainty isn’t available.
Most importantly, slowing down supports relational safety. It turns the visit from something that feels transactional into something that feels collaborative.
When people feel heard, they don’t need to push as hard to be understood. And when clinicians aren’t constantly rushing, they have more room to think, to notice, and to practice medicine in a way that feels more sustainable.
Repair When Harm Happens (Because It Will)
You will miss things. You will say something that lands wrong. You may contribute to harm without ever meaning to.
This isn’t a failure. It’s part of being human in a system that asks too much, moves too fast, and rarely leaves room for reflection.
What matters most is what happens next.
Repair doesn’t have to be dramatic or perfectly worded. In fact, it’s often most powerful when it’s simple and sincere:
“I realize that may have sounded dismissive.”
“I’m sorry I didn’t listen as closely as I should have.”
“Thank you for telling me. Let’s slow down and revisit this.”
For patients with medical trauma, repair is not just a nice gesture. It can be transformative. It interrupts the expectation of defensiveness or dismissal. It signals that this relationship is flexible, responsive, and safe enough to hold mistakes.
Repair also models something important: that care can adapt. That power doesn’t have to be rigid. That being heard can change the course of an interaction, even mid-visit.
You don’t have to get it right the first time to do real healing work. You just have to be willing to notice, respond, and try again.
“The relationship is not separate from care. It is care.”
Remember That the Relationship Is Part of the Treatment
For people living with chronic illness, the care relationship itself is never neutral. It can either deepen existing trauma or actively support healing.
When patients feel believed, respected, and collaborated with, meaningful things happen:
Engagement improves
Communication becomes clearer
Trust becomes possible again
And yes, outcomes improve too.
Relational safety makes it easier for patients to share symptoms fully, to ask questions, and to return for follow-up care instead of avoiding it out of fear or exhaustion. It also makes it easier for clinicians to think clearly, tolerate uncertainty, and work collaboratively rather than defensively.
You don’t need all the answers to offer this kind of safety. You don’t need to fix everything. What patients often need most is to feel that they are not navigating this alone. This matters so much more than we often admit.
For many people with chronic illness, that sense of being accompanied, believed, and taken seriously is the difference between continuing to seek care and quietly giving up.
A Closing Thought
Caring for people with chronic illness is hard work in a system that makes it harder than it needs to be. And still, how you show up matters.
Small moments of belief, curiosity, slowing down, and repair can interrupt cycles of harm that patients have often been carrying for years. They can make care feel a little less lonely, a little more humane, and a little more possible.
For medical professionals, this isn’t about doing everything perfectly or fixing what the system refuses to fix. It’s about remembering that relationship is not separate from care. It is care.
And for people living with chronic illness, you are not imagining this. Your exhaustion makes sense. Your distrust has a history. You deserve care that treats you as a reliable narrator of your own body, and as a full human being worthy of being taken seriously.
None of this will change the healthcare system overnight. But it can change the experience of care in a single room, on a single day. And that’s a very powerful start.
Want Support Navigating All of This?
Whether you’re living with chronic illness or caring for others inside a healthcare system that can feel exhausting and misaligned with your values, you don’t have to hold all of this alone.
At Kindman & Co., our therapists support:
People living with chronic illness who are carrying medical trauma, exhaustion, grief, anger, or self-doubt, and who want space to process what they’ve been through in a way that feels affirming, grounded, and human.
Medical professionals who care deeply and are navigating burnout, moral injury, chronic stress, and the emotional weight of practicing within a broken system, and who want support that doesn’t minimize or rush their experience.
Our work is relational, trauma-informed, and rooted in the belief that care should feel collaborative, respectful, and humane.
If you’re looking for a place to slow down, reflect, and feel supported, we’re here.
👉 Book a free info session to see if working together feels like a fit.
Resources:
International Society for Traumatic Stress Studies (ISTSS): Medical Trauma
ISTSS Healthcare Provider Fact Sheet
Medical Gaslighting: A New Colloquialism Ng, Isaac KS et al. The American Journal of Medicine, Volume 137, Issue 10, 920 - 922
Alcalay, R. (2025). Epistemic Injustice in the Medical Context: Introduction to Special Issue. Social Epistemology, 39(2), 115–120.
Featured therapist author:
Kaitlin Kindman, is a co-founder of Kindman & Co., is disabled, an activist, and a feminist. Her purpose is to help her clients come to believe that they are not alone, they belong, AND they inspire—they have the power to bring about change. She works with her clients to feel more connected, so that they take actions that improve their relationships and the world.
Kaitlin is deeply committed to providing socially just and anti-oppressive therapy. She really loves working with couples to improve their relationships and deepen intimacy, with other therapists and healers, as well as entrepreneurs and other business owners. Kaitlin finds true enjoyment in cuddling with animals, a just-right temperature cup of tea, feeling the sun on her face, and dancing in supermarket aisles.
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