When Doctors Don't Have the Answers: The Psychological Impact of Medical Gaslighting

Why taking patients seriously is so important, even when their symptoms remain unexplained. 

"Not having an explanation for someone's symptoms doesn't mean those symptoms aren't real." 

This was one of the points I made recently when contributing to an article for Blavity Health, exploring the announcement of a new research centre at the US National Institutes of Health (NIH).

The centre will investigate serious health problems reported following vaccination, alongside persistent symptoms after infections, including long COVID. Its aim is to improve our understanding of these conditions, identify possible causes and develop better approaches to treatment.

But beyond the medical research itself, the announcement raises an important psychological question: What happens when someone knows that something is wrong with their health, but struggles to get others to believe them? 

For many people living with chronic or unexplained symptoms, the experience of not being heard can become an additional source of distress, sometimes almost as difficult to manage as the symptoms themselves.

What is medical gaslighting?

The term medical gaslighting describes situations in which a person's symptoms or concerns are repeatedly dismissed, minimised or attributed to psychological factors without sufficient consideration or investigation.

For example, someone experiencing persistent fatigue, pain or dizziness may repeatedly be told that their symptoms are simply stress-related, despite feeling that their concerns have not been properly explored.

Of course, not every disagreement between a patient and a healthcare professional constitutes gaslighting. Medicine involves uncertainty, and sometimes investigations genuinely fail to identify a cause. Healthcare professionals also have to make difficult clinical judgements about which tests or treatments are appropriate.

The distinction lies in how that uncertainty is communicated and managed.

There is a considerable difference between saying, "We haven't found an explanation yet, but let's consider what we should do next," and telling someone, "There's nothing wrong with you."

One acknowledges the limits of current knowledge. The other risks invalidating the person's lived experience.

The psychological consequences of not being believed

When someone experiences persistent physical symptoms, they are already dealing with considerable uncertainty.

They may worry about what is causing their difficulties, whether their condition will improve and how their health might affect their work, relationships or everyday activities.

If their attempts to obtain help are repeatedly dismissed, another layer of psychological distress can develop.

1. Losing trust in their own experiences

One of the more damaging consequences of repeated dismissal is that people may begin to question their own judgement.

They may wonder whether they are exaggerating, being overly sensitive or somehow imagining their symptoms.

This can create a difficult internal conflict. On the one hand, they continue to experience genuine physical difficulties. On the other, they have been told that nothing is wrong.

Over time, this disconnect can undermine their confidence in their own perceptions.

2. Increased anxiety and uncertainty

Uncertainty is often harder to tolerate when we feel powerless to do anything about it.

When someone receives no clear explanation for their symptoms, they may become increasingly vigilant about changes in their body, searching for clues or worrying about what might have been missed.

This heightened attention can become exhausting.

It is important, however, not to confuse anxiety about symptoms with evidence that the symptoms are caused by anxiety. Someone can have a physical illness and understandably feel anxious about it.

3. Withdrawal from healthcare

Another potential consequence is the loss of trust in healthcare professionals.

People who repeatedly feel dismissed may become reluctant to seek further medical advice, even when new symptoms develop.

Others may move between different practitioners, seeking somebody who will finally take their concerns seriously.

Neither response necessarily reflects an unwillingness to engage with treatment. It may instead reflect previous experiences in which the person felt unheard or misunderstood.

4. Feelings of isolation and helplessness

Physical health problems can already affect someone's ability to work, socialise or participate in activities they previously enjoyed.

When the condition has no clear diagnosis, explaining these limitations to friends, family members or employers can be particularly difficult.

Someone may find themselves having to justify why they are exhausted, why they need time off or why they cannot manage activities that appear straightforward to others.

The resulting isolation can contribute to low mood, frustration and a sense of helplessness.

Psychosomatic does not mean imaginary

As a clinical psychologist, one misunderstanding I regularly encounter concerns the relationship between psychological distress and physical symptoms.

When people hear that their symptoms might be psychosomatic, they sometimes interpret this as meaning that the symptoms are imaginary, that they are making them up or that they have somehow brought the illness upon themselves.

None of those interpretations is correct.

Psychosomatic processes refer to the ways in which psychological factors can influence physical functioning and symptoms.

For example, stress can contribute to muscle tension, digestive difficulties, headaches or changes in sleep. These physical experiences are genuine, even when psychological processes play a role in their development or intensity.

Importantly, the relationship between physical and psychological health works in both directions.

Living with chronic pain can increase anxiety. Anxiety can, in turn, heighten muscle tension and affect pain perception. Persistent fatigue can contribute to low mood, whilst low mood can make it harder to manage the demands of daily life.

And of course none of this means that the original physical symptoms are unreal.

Psychological factors may influence how symptoms are experienced without necessarily being their underlying cause. 

Yet, the absence of a clear medical diagnosis is not, by itself, evidence that symptoms are psychosomatic.

Good healthcare should recognise the complex relationship between mind and body without using psychological explanations as a substitute for appropriate medical investigation.

Why the NIH announcement matters

In October 2026, the US National Institutes of Health announced the establishment of its Vaccinology and Immunology Center, which will investigate serious health problems reported after vaccination and persistent symptoms following infections.

An important part of this research will be determining whether particular symptoms are associated with vaccination, infection, another medical condition or a combination of factors.

There's a very important distinction to be made here: The fact that symptoms develop after a particular event does not automatically mean that the event caused them. Establishing causation requires careful scientific investigation.

At the same time, uncertainty about causation should not prevent patients from receiving compassionate care or appropriate clinical assessment.

Vaccination remains an important means of preventing serious infectious diseases, and rare adverse reactions, like those associated with other medical interventions, deserve rigorous investigation.

It's also important to remember that these positions are not contradictory.

What I find particularly valuable about the wider discussion is the recognition that patients can experience genuine suffering even when medicine has not yet established precisely why.

Research may eventually provide answers. In the meantime, people still need to be listened to, supported and treated with respect.

Medical gaslighting and healthcare inequalities

The Blavity Health article also highlighted another important issue: not everybody has the same experience when seeking medical help.

Research has identified racial biases in how symptoms, particularly pain, are assessed and treated.

A 2016 study published in the Proceedings of the National Academy of Sciences found that some white medical students and residents held inaccurate beliefs about biological differences between Black and white patients. These beliefs were associated with biased pain assessments and treatment recommendations.

Although the research was conducted in the United States, it highlights a wider concern about the influence of assumptions and unconscious biases on healthcare decisions.

Other factors, including gender, disability, age and previous mental health diagnoses, may also affect how someone's symptoms are interpreted.

This is particularly important when a patient already has a history of anxiety or depression.

A pre-existing mental health difficulty does not exclude the possibility of a separate physical condition, and both deserve appropriate attention.

What can you do if you feel your symptoms aren't being taken seriously?

If you are experiencing persistent or unexplained symptoms, there are practical steps you can take to help communicate your concerns and remain involved in decisions about your care.

Keep a record of your symptoms. Note when they occur, their duration, severity and any patterns you have noticed. It can also be helpful to record how they affect your everyday functioning.

Prepare for medical appointments. Identify your main concerns in advance. This can help ensure that important information is communicated, particularly when appointments are brief.

Ask about the next steps. If investigations have not identified a cause, ask what other explanations are being considered, whether further assessment might be appropriate and when your symptoms should be reviewed.

Seek clarification. If a particular investigation or referral is not recommended, it is reasonable to ask why. Understanding the clinical reasoning may help you feel more involved in your care.

Consider a second opinion. If you remain concerned that your symptoms have not been adequately assessed, discussing them with another suitably qualified healthcare professional may be helpful.

Pay attention to your psychological wellbeing. Living with persistent symptoms and uncertainty can be emotionally demanding. Psychological support may help with managing distress, coping with limitations and maintaining quality of life, whether or not a medical explanation has been found.

Seeking psychological support does not mean accepting that your symptoms are purely psychological. Physical investigation and psychological care can take place alongside one another.

The importance of being heard

When I spoke to Blavity Health, I emphasised that people should understand what happens next in their care, even if a diagnosis has not yet been established.

For me, this is an important part of the therapeutic relationship between healthcare professionals and the people they support.

Patients do not necessarily expect clinicians to have every answer. What they reasonably hope for is that their concerns will be considered carefully, that uncertainty will be communicated honestly and that they will be involved in decisions about their care.

Sometimes, simply acknowledging that someone's symptoms are real and distressing, even when their cause remains unclear, can make a meaningful difference.

It can reduce the sense of isolation, help preserve trust and create opportunities for collaborative problem-solving.

Ultimately, good healthcare is not simply about identifying disease or providing treatment. It is also about recognising the person experiencing the symptoms.

Not knowing what is wrong is not the same as knowing that nothing is wrong. 

Until answers are found, compassion, curiosity and a willingness to listen remain essential.

Further reading

I was pleased to contribute to TylerChris Daniels' article for Blavity Health, "Key Takeaways From The NIH's New Vaccine Research Center Announcement", published on 26 October 2026.

Read the full article on Blavity Health.

Research references: 

• Hoffman, K. M., et al. (2016). Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. Proceedings of the National Academy of Sciences. https://doi.org/10.1073/pnas.1516047113
• Au, L., et al. (2022). Long COVID and medical gaslighting: Dismissal, delayed diagnosis, and deferred treatment. SSM – Qualitative Research in Health. https://doi.org/10.1016/j.ssmqr.2022.100167