What Are the Signs of Gaslighting? with Dr. Warren Ng

Faith: Dr. Warren Ng, thank you so much for joining us today.

Dr. Ng: Thank you so much for inviting me, Faith. I’m really looking forward to our conversation.

Faith: So, today we’re talking about gaslighting. It is, I dare say, a buzzy word these days. From your point of view as a doctor as a psychiatrist, what is the definition of gaslighting in a mental health context?

Dr. Ng: It’s a psychological manipulation of a person that causes that person to question the validity of their own thoughts, perception of realities, or even memories. And this often leads that person to feel confused, or a sense of loss of confidence or self-esteem, and also an uncertainty about that one person’s emotional and mental stability.

Faith: So, how do you go about addressing that with patients? 

Dr. Ng: As a psychiatrist, the things that I think about are what are some of the downstream effects of gaslighting? And some of the downstream effects are really making that person feel confusion, loss of confidence, or that sense of poor self-esteem, or the uncertainty about their emotional and mental stability. So what they’ll do is they’ll come to me and say, Hey, I think I’m going crazy, or I feel like I’m going crazy, or I feel like I don’t know myself, or I feel like I’m forgetting things. Because this person keeps on telling me that they’ve said this,, and I don’t remember it. So is there something wrong with my memory? So those are some of the things that people often come to ask me about, because they think that the problem is with them. 

Dr. Ng: And that’s the core issue with gaslighting is that actually, the problem isn’t with them. It’s actually with the other person, and it is intentional. And my job is really to help them differentiate the kind of what this person is making, the way that they’re making them feel, and to try to make sure that they’re not owning something that is actually not their problem. It’s what this person is Imposing on them.

Faith: I can imagine that someone who is seeing you for a mental health condition who is additionally being gaslighted, that layer of complexity, the person who is gaslighting them can say, you’re only thinking this because you suffer from depression or you have anxiety. The layering of it must be so challenging.

Dr. Ng: Thank you, Faith, for really bringing up that, the idea of layering, because gaslighting may happen to some people more than others. And if we think about different groups of people who might experience this more than others, it’s not surprising that it’s often people who are already mistreated,in different ways. So, and you can think about within our society, um, people who may be living with a mental health condition, or we can even just think of women, or people of color, or older people, or children, or those that are living with chronic conditions, or within our LGBTQ plus communities. The way that we see these wonderful individuals within our communities is that they often are in a position to have to justify how their feelings and thoughts and experiences matter, and they do matter.

Dr. Ng: And that’s really where thinking about this whole experience of gaslighting is so important is really making sure that the individual knows and claims their own power and part of knowing and claiming your own power is to not give that power away. So you know your own mind, you know your own feelings, don’t let someone else tell you how you’re thinking and feeling.

Faith: Tell us a little bit more about how you know if you are being gaslighted.

Dr. Ng: First of all, it’s so important to just pause and reflect. Because oftentimes we don’t know. When you’re in a conversation or a relationship, when you start to doubt your own feelings and emotions, or when you feel like you’re always ending up apologizing for something, or when you’re questioning whether or not your feelings or experiences are accurate or valid, or when you’re often finding that you’re afraid of expressing what your real feelings are.

Faith: It’s so painful to hear you make that list because so many people have had that experience and it just cuts you right down. 

Dr. Ng: This is a very human experience and that’s why it’s so important. So one of the things I often ask people is stop, pause, and think about how that person made you feel. Did they make you feel cared for? Did they make you feel understood or that you mattered? Or did they make you feel the opposite of that?

Faith: It sounds like gaslighting can be very subtle. Like death by a thousand cuts. And I would imagine that when it takes place in really close relationships, like in a couple or in a family, that would be an incredible challenge. So how often is gaslighting a part of intimate relationships?

Dr. Ng: I think that the actual experience of feeling misunderstood, confused, or invalidated can happen frequently in different ways, but it shouldn’t be a pattern of behavior and it shouldn’t be leaving you questioning your own sense of reality, perception, your memory, or your thoughts.

Dr. Ng: And If you’re starting to dread needing to see that person, or if you’re wanting to avoid seeing that person, that might be a red flag to say, hey, maybe I need to think about what this relationship means to me. And ideally, if that relationship doesn’t give you a sense that there’s love, that they’re there for you, that they

Faith: you are believed?

Dr. Ng: yes, that you matter, then you need to also maybe ask yourself, do I need to be in this relationship? Is this healthy for me? 

Faith: Can you talk about how gaslighting might show up in the workplace?

Dr. Ng: I think in the workplace, gaslighting can show up when there isn’t clear and transparent communication..Dr. Ng: It can also happen when you have a supervisor or boss, who may invalidate or not recognize, what you’re saying or what you contribute and may take that credit, may give that credit to someone else and say, I don’t know why you’re saying that it’s all in your head. That’s not my understanding. And so you might feel confused about it. But that was my project, and that was actually my contribution.

Faith: Oh, that’s a very tough one to push on when someone says that’s not my understanding, especially if you are lower status in the workplace. What should someone do in a particular instance like that?

Dr. Ng: I think we would use the same words that, say, the person who is doing the gaslighting is trying to convey to try to create a sense of confusion. You can say, my understanding of our conversation or my understanding and recollection of that event is different, and this is what I understand and remember.

Dr. Ng: And the important thing there is not to leave it as a question. You’re not giving the opportunity for there to be another version of that experience. It’s your experience. And the important thing here is not to give up what you understand. You’re willing to hear if there’s something else that could add to that reality. But it shouldn’t replace or question your own.

Dr. Ng: One thing is to always be clear and communicate what your understanding is. There should be some witnesses, there should be some documentation. The other thing not only in the workplace, but also individual relationships, is that it can be helpful to write a journal.

Dr. Ng: And you can also get support from your friends, from your co workers, from your family, people who care and who can actually give you that support that is important in situations where you’re feeling and made to feel disempowered.

Dr. Ng: The interesting thing is that for the person who is doing the gaslighting, when they see that you’re doing these things, it may actually stop them from gaslighting you, because then what they see is that, oh, you’re making me accountable.

Faith: All of this kind of abusive behavior thrives in secrecy, in, in moments that other people don’t clock. And so when you, when you make something clear or transparent, right, you reveal it, you memorialize it, then it makes bullies or gaslighters back down.

Dr. Ng: Secrecy, isolation, and shame are exactly the places that someone who’s gaslighting you wants you to be. They want you to be there. Because when you’re there, then they have more control over you, they can manipulate the situation, but when you see the light of day and you’re not in the shadows and you’re not isolated and alone and ashamed, that’s when you can actually be who you are and also not let someone else dictate that. 

Faith: So we’ve talked about gaslighting in personal relationships, and in the workplace. We’d also like to spend a little time talking about medical gaslighting. Can you define that for us?

Dr. Ng: Medical gaslighting refers to how people feel about the concerns that they’re bringing to their doctors or their medical or health providers. And sometimes they feel that when they do bring things up, they’re not taken seriously or  sometimes they’re blamed for what the symptoms are, or they’re made to question how they’re experiencing their symptoms. 

Dr. Ng: Now this can happen, say, at the early part of, a medical condition and the symptoms are very mild, or have not really progressed to the point where it meets, say, a diagnostic criteria for something. And in that gray area sort of early onset or early phase, that is a tricky time to actually have a diagnosis. The important thing there is not to dismiss what the person is feeling, but to say, if this continues, or if it gets worse, please come back to me, because then we may be able to understand more of what you’re going through.

Dr. Ng: And as a psychiatrist, this is acutely concerning for me because, if you’re coming in for your health or medical care and someone is dismissing what you’re experiencing, you may not get the proper tests or the further evaluation or the assessments that might lead to a proper diagnosis. 

Dr. Ng: We need to do less of that compartmentalization of body and mind, because they are not separate. And so one of the things that’s so important, and when we think about medical gaslighting, you know, there are certain groups of us who may experience that more frequently than others,  women, people of color, older folks, younger folks, children included, and those living with chronic conditions, and chronic pain is one of them, as well as the LGBTQ plus communities. Those individuals may experience medical gaslighting more frequently.

Faith: That’s a lot of people you just listed…

Dr. Ng: Yes, and that’s why it’s so important. I think that the more that we actually have diversity among the people providing the care, or the more that we have real sensitivity, understanding, and cultural humility towards the people we’re serving, it puts us in a position of greater curiosity so that as health or medical providers we can learn more because we may be limited by our own experience and by being able to listen, learn from the people we’re taking care of, we can actually provide better care for them.

Dr. Ng: Some of the things that can be helpful in that is as, and we talked about this earlier in terms of the workplace, if you can keep actually a written diary, if you can keep a list of when you started feeling this or that, and when it started, and what it felt like, the more that we can be informed with what we’re experiencing, and articulate it and convey it to someone who’s taking care of us, the more that they actually have information to help us.

Dr. Ng: And so sometimes by writing it down, and also sharing with the medical or health provider. I think you’re missing something because I think as a physician or doctor, the last thing we want to do is to miss something. By saying that you might be missing something or you might be not getting the whole picture.

Dr. Ng: Those are things that trigger for a health or mental health provider to say, I don’t want to miss something because then that might lead to the wrong diagnosis and that might lead to you not getting the right care. 

Dr. Ng: And you can even say, are there other resources that you would suggest for me? Because I want to, I want to be most helpful in this process. And I think from, a health perspective, it’s about the partnership about the health that’s important.

Faith: And Dr. Ng, if you don’t feel like you are seen or heard as a patient repeatedly, even after employing these suggestions…

Dr. Ng: Mm hmm.

Faith: I think patients also should know that they are empowered to find another doctor. It’s a relationship, right? Some relationships don’t work out.

Dr. Ng: That is so important. And you centered on the principle that is most important about gas lighting. Once again, it’s the power. And knowing that you have the power to make the decisions. You have the power to own your own experience. And if you’re not getting what you need, and if you’re identifying gaslighting, or the experience of not being heard, being dismissed, being minimized, or any of those things, particularly as it relates to your health, then you can seek a second opinion or another provider.

Dr. Ng: And similarly, if you’re experiencing this in your personal life or any other part of your life, you can also choose to exit that relationship or pause that relationship.

Dr. Ng: And the important thing is, is also to pay attention to not what the gaslighter that person is saying, but what are they doing? What are their actions? Because what a gaslighter often does is they use words but they actually speak through their actions because they’re making you feel a certain way.

Dr. Ng: The other thing is that if they are affecting you in this way, then you can also have that option, like of getting a second opinion on your doctor, you can also get a second opinion on that relationship. The important thing is not to give up what your understanding of the situation is, and also to avoid sometimes arguments with someone who’s gaslighting you, because they will find every other way of trying to make you feel like you’re the person to blame.

Dr. Ng: And sometimes when you have a second opinion or a good friend or someone you trust and care about, they may say, Hey, this is like the third time you’re bringing this up, or that person always makes you feel this way.

Dr. Ng: Take that seriously, because the people who really care about you who are really in your corner, are also people who notice some of the things that you’re saying and doing and the way that other people make you feel that you may not necessarily catch yourself

Faith: Dr. Ng, I can’t thank you enough. Your words are very powerful and we’re very grateful to have you join us today.

Dr. Ng: Thank you.

Our many thanks to Dr. Warren Ng. I’m Faith Salie.

Health Matters is a production of New York Presbyterian. The views shared on this podcast solely reflect the expertise and experience of our guests. NewYork-Presbyterian is here to help you stay amazing at every stage of your life. 

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