‘Gaslighting’ – or, why women are just too darned emotional during their heart attacks

by Carolyn Thomas  ♥  @HeartSisters

If you’re familiar with the term gaslighting , you’ll immediately grasp its practical application to everyday life. (Very similar reaction, in fact, to first hearing the word mansplaining!   But I digress). The concept of gaslighting may ring bells for any woman who has been misdiagnosed in mid-heart attack, patted on the head and sent home from the E.R. in abject embarrassment.

I liked what I read about gaslighting from   Yashar Ali, a Los Angeles-based columnist and author of the book A Message To Women From A Man: You Are Not Crazy.  Here’s an excerpt:

“This mental health term comes from the 1944 MGM film, Gaslight, starring Ingrid Bergman. Bergman’s husband in the film, played by Charles Boyer, wants to get his hands on her jewelry. He realizes he can accomplish this by having her certified as insane and committed to a mental institution. To pull off this task, he intentionally sets the gaslights in their home to flicker on and off, and every time Bergman’s character reacts to it, he tells her she’s just seeing things.”

Charles Boyer’s dastardly attempts at gaslighting poor Ingrid were both deliberate and pre-meditated.

But gaslighting is not always so, which – according to Ali – just makes it worse. And all of us, especially women, have dealt with gaslighting at one time or another.

“Those who engage in gaslighting create a reaction – whether it’s anger, frustration, embarrassment –  in the person they are speaking to. Then, when that person reacts, the gaslighter makes them feel uncomfortable and insecure by behaving as if their feelings are not rational or normal.”

Gaslighting can be as simple as someone smirking at you and saying something like:

  • “You’re too sensitive!”
  • You’re so emotional!”
  • “You’re defensive!”
  • “You’re overreacting!”
  • “Calm down!”
  • “Just relax!”

Such responses, writes Ali, may seem innocuous enough, but in that moment, the speaker is making a judgment about how someone else should feel. And, worse, that judgement can render some women emotionally mute.

When women receive pushback like this to our own reactions, we might just brush it off:  Forget it!

But that Forget it! isn’t just about dismissing a thought, warns Ali. It is about self-dismissal.

You too might be doing the Gaslight Tango (as described by Dr. Robin Stern, author of The Gaslight Effect: Don’t Be Afraid To Speak Your Truth) if:

1. you are constantly second-guessing yourself
2. you frequently ask yourself: “Am I too sensitive?”
3. you often feel confused and even crazy
4. you apologize – a lot
5. you can’t understand why, with so many apparently good things in your life, you aren’t happier
6. you frequently make excuses for the comments or behaviour of others
7. you find yourself withholding information so you don’t have to explain or make excuses
8. you know something is terribly wrong, but you can never quite express what it is, even to yourself
9. you have trouble making simple decisions
10. you have the sense that you used to be a very different person.

Now consider, for example, the disturbingly common scenario of women who are misdiagnosed and sent home from the E.R. in mid-heart attack.

This, by the way, happened to me, and it happens far more frequently than you might ever guess: when the New England Journal of Medicine reported on a study of over 10,000 heart patients, 48% of them women, findings suggested that women under age 55 are SEVEN TIMES more likely than their male counterparts to be misdiagnosed in mid-heart attack and sent home.  The consequences of this were enormous: being sent away from the hospital doubled the chances of dying.(1)

Anyway, back to the E.R.

So you show up at the hospital, overwhelmed by frightening physical symptoms that may (Oh, no, please God, no!) be related to a heart attack.  It’s actually taken a lot just to get you this far, after trying for much too long already to ignore or deny your increasingly debilitating symptoms.

But the E.R. physician tells you that your cardiac tests are all fine, that you’re merely just experiencing ____ (fill in the blank here: anxiety, stress, menopause,  indigestion) and that your symptoms are clearly NOT heart-related at all. Goodbye and have a nice life!

What do you do?  If you stand up to the doc’s confident dismissal, then you surely run the risk of reinforcing that anxiety misdiagnosis. Patient is anxious.

When you politely question his diagnosis, the doctor sighs, one of those quietly exasperated oh-no-not-another-one-here-we-go-again-let’s-just-get-this-over-with sighs.

But you know your body. You know when something is just not right. You know what anxiety or stress or menopause or indigestion feel like – and you know that this is none of those. Do you repeat your insistence that your symptoms must be taken seriously?  Patient is agitated.

The E.R. doc now begins to repeat what he’s already told you, often very s-l-o-w-l-y this time as if you are a difficult or dull-witted child. You realize as he’s talking, of course, that the more you try to stand your ground, the more your affect will actually reinforce what he’s already written on your chart. You do know how this looks. Patient is uncooperative.

Besides, by now you are acutely aware that the E.R. waiting room is filled with bleeding-crying-injured-vomiting sick people, and this doctor has many far more urgent cases to see tonight. He is ready to snap your chart shut right now and move on to the needy person in the next bed. You can sense this. Patient is attention-seeking.

Maybe this doctor is right.

Maybe you are just feeling a bit anxious after all.

Maybe you are indeed overreacting, just as the doctor has implied.

Maybe you should just climb down off that gurney, thank the E.R. staff, and go straight home now, albeit embarrassed and humiliated that you have made such a big fuss over nothing.

Earth to all those working in emergency medicine:

Many people who fear they are having a heart attack may very well appear anxious, agitated, uncooperative and attention-seeking – particularly when faced with a response that sounds something like: There’s nothing wrong with you, dear.

Nothing – allow me to repeat that – NOTHING is more anxiety-producing than fearing you might be in the middle of a cardiac event.

Ingrid Bergman got off easy with her gaslighting. At least she wasn’t having a heart attack . . .


©Carolyn Thomas – Heart Sisters  www.myheartsisters.org

NOTE FROM CAROLYN:   I wrote much more about why women are significantly more likely than our male counterparts to be misdiagnosed and sent home from Emergency in my book, A Woman’s Guide to Living with Heart Disease”. You can ask for it at your nearest library or local bookshop or order it online (paperback, hardcover or e-book) at Amazon,  or order it directly from my publisher, Johns Hopkins University Press (use the code HTWN to save 30% off the list price).


(1) Pope JH, Aufderheide TP, Ruthazer R, et al. Missed diagnoses of acute cardiac ischemia in the emergency department. N Engl J Med. 2000;342:1163-1170.


See also:

The Concept of ‘Mansplaining’ Explained for You

When you fear being labelled a “difficult” patient

Six personality coping patterns that influence how you handle heart disease

Do you think you’re a “somebody”?

When you know more than your doctors about your diagnosis


10 thoughts on “‘Gaslighting’ – or, why women are just too darned emotional during their heart attacks

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  3. I have used the term “gaslighting” for 40 years. I discovered your article while doing research on medical gaslighting, as the plan is to write about this ever-expanding problem. Medical gaslighting, which is a form of collusion in which medical and administrative staff solely support each other to the detriment of patients, and, to the point where the patient begins to think she – it’s always “she” – is going mad.

    They are correct in one respect: the lack of attention to objective findings indicating physical problems, and the constant anxiety associated with not knowing what is wrong, when you have reports stating something IS amiss, wears a body and mind down like nothing else. After all, these are the professional, yet, by definition, these professional gaslighters have enormous power, and it is the institution that must prevail.

    As it is increasingly impossible to find an independent physician, any medical practitioner seen within the system is vested in supporting whatever approach, or lack thereof, or patient bias that has, historically, been “decided” about a patient.

    Carolyn’s article should be submitted to medical journals, in the U.S., and abroad, as well as to international women’s health advocacy groups.

    Liked by 2 people

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    1. Great recommendation, Laura – I once worked with someone my doctor friends had unofficially described as having BPD: a true nightmare.


  6. Stellar stellar article Carolyn! Substantiated powerfully….including the New England Journal of Medicine study.

    “I believe in the greatness of science….and the weakness of man”. H.G.Wells

    21st century women are caught in this terrible limbo now. What technology there is remains too often withheld from women…because of these pervasive belief systems that should have begun imploding long ago from the sheer accrual of devastation they cause.

    I am going to post this on WomenHeart.

    Liked by 2 people

    1. Thanks Jaynie. I like to believe (or is this just wishful thinking?) that diagnostic research and med school education will evolve to prove that, as Dr. Nieca Goldberg says, “Women are not just small men!”


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