We often discuss how uniquely challenging, yet incredibly rewarding, rural and remote health work can be. However, a psychological risk within the workplace that often goes unnamed is gaslighting. Here, CRANAplus Bush Support Line Senior Psychologist, Dr Nicole Jeffery-Dawes, helps us to understand gaslighting in the context of rural and remote health workplaces, and provides strategies for recognising the signs, protecting yourself, and supporting psychologically safe teams.
Gaslighting can be defined as a pattern of psychologically manipulative behaviour that causes another person to doubt their own memory, judgement or perceptions.
Gaslighting can be unintentional, subtle, malicious, or systematic, and can occur between individuals, or embedded within
a workplace’s culture.
Gaslighting is not the same as feedback or a disagreement and is more about the impact it has on someone, rather than the intent. For example, you may be trying a new procedure and having some issues. Constructive feedback would be someone saying, “I noticed you’re having difficulties. Perhaps you could try (x) next time. We can practice on the dummy later if you like?” Examples of gaslighting could be “Are you sure that’s how you want to do that? Everyone else seems to be able to get it right. If you weren’t so insecure, this wouldn’t be an issue,” or “You are so bad at that. Maybe this isn’t the right job for you. Next time ask (x) to do it.” Gaslighting can leave you feeling confused, unsupported and doubtful of your abilities.
Interestingly, gaslighting can thrive in rural and remote health workplaces for several reasons. These include limited human resources access, power imbalances between managers, visiting specialists or senior clinicians, a reliance on short-term contracts, dual relationships, high workloads that can blur the line between stress and mistreatment, a culture of ‘this is how it’s always been done’, and a reluctance to speak up and be labelled as ‘a troublemaker’. All these factors can become normalised, and unfortunately, so too can our distress.
Whilst these factors don’t cause gaslighting, they can make it more challenging to identify when it is happening to you or a colleague, and more difficult to challenge and report a gaslighter’s behaviour.
Below are examples of what gaslighting can look like at work, taking into consideration that such examples occur as a pattern of behaviour when deemed gaslighting. As you read each of these, reflect on whether you have experienced these or similar in your career, either directed at you or towards colleagues.
- Raising concerns about someone’s behaviour, such as medication inaccuracies, and being told, “You must have recorded that wrong.”
- Minimising or dismissing concerns raised by junior or new staff, e.g. “I’ve been working here for 20 years, and if there was a problem, I would know about it,” or “That’s just the way it happens out here.”
- New staff or locums being blamed for systemic failures, e.g. “You’re too anxious. It’s all in your head,” or being labelled as
- “not adaptable enough.”
- Having concerns about Cultural Safety dismissed, e.g. “We don’t see race; everyone gets treated the same here.”
- Being excluded from information, then criticised for not knowing, e.g. “You should have known – this was discussed.”
- People having selective memories around incidents or concerns, e.g. “That never happened. You must be remembering it wrong.”
- Goalposts being moved, e.g. KPIs, shift expectations, on-call demands, etc. and then being told “If you can’t cope, maybe rural and remote work isn’t for you.”
In the context of gaslighting, these sorts of incidents can occur in isolation as single events, such as an honest mistake or one-off conflicts.
However, if a pattern of behaviours emerges over time by the same person and you have a growing sense of self-doubt with no resolution in sight, it could be gaslighting behaviour.
Gaslighting often becomes evident through warning signs experienced by the person being gaslit, rather than from obvious behaviours displayed by the gaslighter. These might look like:
- Feeling anxious before interacting with
- a specific person
- Feeling unsettled or confused after conversations
- Frequently second-guessing yourself, including your memory or perception of reality
- Questioning yourself if you are ‘the problem’, despite having a strong work ethic and history
- Constantly seeking reassurance from others
Some people often feel like they are “going crazy” and begin to gaslight themselves, telling themselves things such as, “Maybe I am being overly sensitive,” “Perhaps if I had acted/asked differently, they wouldn’t have responded like that,” or “I can’t trust my own judgement anymore.” Please know that these are normal responses to repeatedly being invalidated and are not signs of weakness on your part. Instead of self-blame, try practising self-compassion and self-kindness. Speak to yourself as you would give advice to a friend. Ask yourself, “Is this actually a ‘me’ issue, or a ‘them’ issue?”
Experiencing gaslighting can have significant professional, emotional and ethical consequences. Being gaslit can lead to distrust of others, hypervigilance or anxiety, reduced confidence and self-doubt, low self-esteem, low mood and depression, and emotional exhaustion. In rural and remote areas where alternative employment opportunities are often limited, people can feel trapped and concerned about negative consequences to their employment or reputation for raising the issues of gaslighting. So they suffer in silence. The professional impacts also include hesitation in clinical decision-making, withdrawal from team discussions, and disengagement or burnout.
The impacts spread beyond the individual or teams involved. When health workers stop trusting their judgement and feel unsafe raising concerns, risks may go unspoken and unaddressed, leading to negative implications for patient safety.
Although every situation is different, there are practical strategies you can use to support yourself when you suspect gaslighting behaviour within your workplace.
Document. As stated earlier, gaslighting is a pattern of behaviour.
Document any incidents, no matter how small or insignificant you think they are, keeping records non-emotive and factual to help identify patterns over time.
Behaviour, not intent. We don’t know what someone’s intent is behind their behaviour, so don’t debate their possible motives. Name the observable behaviours and the impact they are having on you (both directly and indirectly); your thoughts, your feelings, your behaviour that is affected (sleep patterns, questioning your judgement, feeling unsafe to speak out, etc.). You can document this separately from the incidents if you prefer, as journalling is often helpful for processing, along with having a record of incidents.
Prioritise safety. Depending on the situation, protecting your personal and professional safety and wellbeing might include strategies such as limiting engagement with the person, asking to be moved to a different department or clinic, or planning an exit strategy.
External perspective. Talk to a trusted peer, mentor or supervisor about what you are experiencing. Often, getting a fresh perspective, particularly outside of the workplace, helps provide a reality check on this situation.
Professional support. Consider speaking to someone from your Employee Assistance Program or contact the Bush Support Line on 1800 805 391 for external, confidential support and guidance.
Responding to a gaslighter. Assertive phrases such as “We remember things differently,” “I know what I experienced,” or “My feelings are valid,” are often solid responses to someone’s gaslighting and help to ground us in our reality. To disengage from an unhelpful discussion or argument, try, “I’m not going to keep debating this,” or “I’m done discussing this,” and walk away. Remember to trust your own perceptions and instincts, as this self-trust and self-validation of your own reality will help ground you and disempower the gaslighter.
Whilst an individual may take steps to protect themselves against this behaviour, gaslighting is ultimately an issue for the organisation to address. If you are in a leadership role within an organisation, ensure the following is in place:
- Implement clear policies and create safe reporting channels for employees to report concerns. Provide education and training on topics such as respectful communication, healthy conflict resolution, and recognising the signs of gaslighting for all levels of employees and leadership.
- Provide psychological safety for those who raise concerns, e.g. by believing and validating their feelings, helping them connect with their sense of reality, and supporting their boundaries and self-care.
- Investigate complaints impartially and promptly. Protect and support the person who came forward and take appropriate disciplinary action against those who found to have enacted the behaviour.
- Lead by example and model healthy communication, behaviour, empathy and inclusion. Demonstrate the organisation’s expected standard of behaviour.
- Create and foster a workplace culture that encourages open feedback and where challenging decisions or voicing concerns are safe and welcomed. This helps correct power imbalances that enable gaslighting.
Gaslighting thrives in environments where there is silence and self-doubt, yet what does staying silent truly preserve? The best thing you can do is gently and contextually call out the behaviour or inconsistencies when they occur, and document them if you notice any of those internal warning signs.
A tree can only fall if it has no roots; stay grounded and true to your values.
Our remote workforce is incredibly skilled and resilient, with a deep commitment to helping some of our most disadvantaged communities. We deserve workplaces that respect our judgement, reality and wellbeing.
