'A devastating place to be': N.S. doctor speaks about racist gaslighting in academic medicine

A Nova Scotia doctor is highlighting how gaslighting in academic medicine can perpetuate institutional racism in a new paper published by the Canadian Medical Association Journal last month.

The paper, Gaslighting in academic medicine: where anti-Black racism lives, was written by former deputy chief medical officer of health, Dr. Gaynor Watson-Creed.

Published in the Focus on Black Health issue of the CMAJ on Oct. 31, it explores how institutions can identify and stop instances of gaslighting, and how that could help address anti-Black racism in medicine.

Watson-Creed, who is also the assistant dean of serving and engaging society at Dalhousie University's faculty of medicine, spoke with CBC Radio's Portia Clark on Information Morning Nova Scotia about racist gaslighting in medicine on Thursday.

Their conversation has been edited for clarity and length.

Listen to Watson-Creed's full interview here:

What is gaslighting for people who are unfamiliar with the term?

Gaslighting is a really interesting phenomenon where somebody might describe to you or to a close friend something that's happened to them and the reaction from the person who's hearing the description is one of dismissal. 

So the person who's hearing the description might say, "No, you're overreacting," or "No, that didn't happen the way you think it did," or "No, I know that's what you think happened, but actually when you look at it, it was actually something completely different."

And if it's been a significant experience, like racism, then what that person actually needed was to be heard in their experience, and so that dismissal from the person that they're sharing it with — something so personal — can be damaging. It can be really painful.

How does it come up in academia or institutions?

In institutions, what can happen is that same gaslighting phenomenon can occur, but what's happening is the person is reporting it to the institution because the institution says that they are interested in reports of unfair treatment, racism, sexual harassment, you know, that long list of policies institutions will often have. 

So somebody might report their negative experiences they've had, for example, of racism in the institution to the institution through the proper channels, only to be met with that same response from the institution — "I know you think this was racism, but actually when we look at your claim, we're deciding that it's not racism for the following reasons," or "We know that you think that this happened in the following way, but honestly, we think you may be misinterpreting what happened" — that type of response. 

And the challenge with gaslighting is it's bad enough to share something personal and have that kind of response to it, but the real challenge is that when you get that back, especially from an institution that you've trusted — you work there, you believe in the policies, in some cases, people have helped write the policies — and so you get that response back, you don't doubt the institution.

What happens is people start to doubt themselves, and that's a devastating place to be because now all of a sudden you're questioning your own version of reality. It's really a hideous outcome to have when folks are looking to deal with something in good faith.

What compelled you to explore and write about this topic?

My work at the faculty of medicine includes a lot of work around equity, diversity, inclusion and accessibility, and as part of that, we have been exploring policies that could be in place to better support faculty members who are experiencing multiple forms of intimidation and harassment. 

In doing that exploration of what those policies could look like, I heard from so many faculty members — not just here, but actually across the country as I met with other schools of medicine — who have had these experiences, and what I love about the work that I'm able to do now is that when I hear about these things, I'm usually able to go into the social science literature, outside of medicine, and see if somebody has come up with a description of this before.

It almost always has a name, and so in this case, I uncovered the literature that's already been written about gaslighting and institutional betrayal — that idea that the institution betrays somebody who's acting in good faith according to these policies. 

And so I brought it forward in part because I understood that it would be helpful for my colleagues who were experiencing this to be able to give it a name, so that institutions can see it and then think about how they might remedy those things, and certainly what's happening is I'm hearing from colleagues now across North America [that they are] grateful for the opportunity to give this phenomenon a name and actually have these discussions in their home base.

It sounds like institutions themselves need to understand gaslighting, how institutional betrayal works, and acknowledge that there is racism or anti-Black racism within the places that people are working.

Yeah. I think it's exactly that, and so I think one of the things that comes with that is that when the institutions claim that they have these policies, then they do need to be prepared to sort of respond to each complaint with sort of a fulsome response. 

So really taking all the complaints at face value and working them up appropriately, but also looking for the power differentials that are likely at play is key, and so one of the things I heard from several faculty members as I was doing this writing, is the way in which they may be the underpowered person in the relationship, so they're making a complaint against somebody who has a higher status than their organization or doesn't have the same disadvantage that they may have culturally or with respect to sexual and gender orientation or whatever it is, and so they're already working at a disadvantage. They're still bringing the claim forward. 

The courage that it takes to do that is incredible, and so institutions really need to look to support the person who is in that lower power position because they're going to need it. They're going to need that extra support as they work through these claims.

For more stories about the experiences of Black Canadians — from anti-Black racism to success stories within the Black community — check out Being Black in Canada, a CBC project Black Canadians can be proud of.