Long COVID patients’ reconstruction of medical gaslighting discourse in online epistemic communities, 2025, Plastina

https://www.sciencedirect.com/science/article/abs/pii/S0738399125000321

Highlights

• Long COVID patients narrate medical gaslighting experiences in online communities
• Corpus‑based critical discourse analysis is used as a new method of investigation
• Accounts reveal a range of gaslighting strategies and their ideological root causes
• Sites of contention are disclosed, showing how epistemic communities strike back
• Respectful knowledge-sharing is called for to close epistemic healthcare gaps

Abstract

Objective
To analyse long COVID patients’ reconstruction of medical gaslighting (MG) discourse in online epistemic communities in order to identify the MG types experienced and unfold root causes.

Method:
The mixed-methods of corpus‑based critical discourse analysis was applied to an ad hoc corpus of 18 threads (n=1,176 posts) from two sub-communities on the social media site Reddit. Comparative concordance analyses were performed on the two sub-corpora to semantically code concordance lines as MG types. Critical discourse analysis was conducted to uncover power/ideological drivers of MG discourse.

Results:
Keyness log‑likelihood statistical measures displayed higher values for the pronouns I, me, you, it, they and the noun doctor(s). KWIC (Key Word in Context) output for these items exhibited seven main MG types: scapegoating, downplay, treatment refusal, psychosomatic disorder, disbelief, denial and dismissal. Concordance lines revealed three major sites of contention – epistemic knowledge, epistemic authority, long COVID indeterminacy – where MG tactics operate through epistemic injustice, ignorance, discrimination and lack of epistemic humility.

Conclusion:
MG discourse is triggered by deep-seated ideologies rather than by mere doctor-patient interaction as a face-saving strategy which faults patients as epistemic agents.

Practical Implications:
Patients’ social media mobilisation helps unmask MG tactics, raising providers’ awareness of the need for perspective-taking to build collaborative doctor-patient relationships.

 

Unfortunately, the same reaction would greet this study. We have seen this before, it's met with derision and lots of huffing and puffing and DARVOing. The ideological construct is imagined to be flawless, and the institutions supposed to protect from this all enable it. Every last one of them. Sometimes they even say the same thing but with a fake smile instead of a frowny face.

No one seems able to question the deep-seated ideologies, precisely because they are faith-based and must be flawless otherwise holy crap this is all so extremely harmful, so it can't be that. Must be the TikToks, or whatever. Or just vibes. Or newspapers. Or bicycles. Or youth's eternal disrespect for their elders. Always anything but the people responsible.

 

This paper is a polite way of telling them that they are terrible at the very basics of their job.

 

«I want to help, therefore anything I do is «to help»».

IMO this is probably the most common logical fallacy for your regular Joe. There are probably other ones in play for the BPS researchers and the main people.

 

The worst part is that it's not even unique or particular to psychosomatic ideology. Medicine used to be exactly like that, an unregulated free-for-all where physicians experimented all sorts of things and many made long careers treating people with useless, even harmful, nonsense. This was the whole point behind doing rigorous pharmaceutical trials, the lesson from which being that no matter how rigorous you think you are, you're not even close to be enough, because everyone wants what they do to work, and if they are free to determine whether the stuff they made up works, without surprise most people assume so, otherwise why would they bother?

Every single physician who has either harmed, or not helped, people by performing useless treatments, drugs, procedures or techniques have been absolutely certain that it either works, or can't harm, and ultimately does more good than bad. And the vast majority of those have been revealed to be a sham. Because figuring things out is extremely difficult and almost no one manages it.

But in the field of non-pharmaceutical evidence-based medicine, almost every intervention shows some kind of benefit. It's like an entire educational program where everyone gets a gold star for every answer they give, no matter how silly. Which is so absurd that it must be questioned. And yet, literally the opposite. In fact most proponents literally use the same backwards arguments as science deniers, entirely oblivious to it. It would look bad enough on its own, but they're basically repeating the exact same set of mistakes, with the same fallacies, fraudulent claims and egomaniac beliefs about having superior knowledge out of very little information that they did in biomedicine, the only part of medicine that actually works because it's based on actual scientific facts, and not self-serving delusional fantasies.