Gaslighting in academic medicine: where anti-Black racism lives.

Citation metadata

Date: Oct. 31, 2022
From: CMAJ: Canadian Medical Association Journal(Vol. 194, Issue 42)
Publisher: CMA Impact Inc.
Document Type: Viewpoint essay
Length: 3,351 words
Lexile Measure: 1790L

Document controls

Main content

Article Preview :

In the 1938 play Gaslight, a man attempts to negatively alter his wife's mental state by frequently changing or moving items in their home without her knowledge; when she questions the changes, he insists that no changes have been made, and that something must therefore be wrong with her mind. (1) The term gaslighting is commonly understood to refer to the intentional manipulation of someone else's account of reality and is considered a form of psychological abuse. (2) How gaslighting can manifest is less commonly described at a group or organizational level, where, when confronted with the idea that a problem exists (e.g., pervasive anti-Black racism), people within the organization distort or dismiss the idea altogether through obfuscation, misdirection, confabulation, dismissive incomprehension (claiming to have no knowledge of the alleged problem) (3) or mockery, even if subtle, of the claimants alleging that there is a problem. This then leads the organization to conclude that there is no problem. Gaslighting furthers anti-Black racism in organizations, including academic and health care organizations. This article explores the individual and organizational damage created by such gaslighting behaviours, and considers ways to address the problem.

How does gaslighting relate to institutional betrayal of equity-deserving groups?

The anti-racism work being undertaken by many medical schools across Canada may be regarded by many as culture-changing. Organizational culture is defined by Edgar Schein as, "the pattern of basic assumptions which a given group has invented, discovered or developed in learning to cope with its problems of external adaptation and internal integration ... ". (4) These patterns are implicitly and explicitly taught to incoming group members. However, when behaviours promised by the organization fail to materialize, members, and especially new members, of the organization experience harm. Institutional betrayal is the term used to describe the negative experiences of members of an organization that fails to act according to its values or rules (e.g., values of "intolerance toward racism," or values of "equity, diversity and inclusion"). (5) What is exposed by such failure may be the actual (hidden) culture of the organization. Peoples' sense of betrayal deepens when the mechanisms meant to protect them from harm fail, or worse, act to cause harm against those in need of protection.

Within the realm of institutional betrayal, gaslighting behaviour signals organizational willingness to protect those who hold the balance of power to act on damaging beliefs regarding equity-deserving groups, so as to protect their unearned privilege. In the case of racism, unearned privilege refers to privilege that is the result of colonial and white supremacist design of societal institutions, such as systems of education, justice and wealth, with the resulting privileges conferred to a whole class of people (in the case of racism, people who identify as white) at the expense of others (e.g., Black or Indigenous people). (6) People engaging in gaslighting behaviour may not be aware that they are acting to protect such privilege and power imbalance. As such, gaslighting can be a substantial threat to anti-Black racism work, and,...

Source Citation

Source Citation   

Gale Document Number: GALE|A724594741