Volume 39 Number 5 | October 2025
Summary
Darby Naheedy examines gaslighting in clinical laboratories, describing how subtle dismissal and manipulation erode confidence, morale, and psychological safety. Often unintentional, gaslighting undermines communication, isolates staff, and can harm patient care. Naheedy outlines warning signs, coping strategies, and the need for leadership to foster respectful, transparent environments—emphasizing that protecting employee well-being is inseparable from ensuring patient safety.
Recognizing the Subtle Behaviors that Undermine Confidence and Trust
Darby Naheedy, DO, MLS(ASCP)CM, ASCLS Patient Safety and Diagnostic Stewardship Committee Chair
Note to Readers: This article contains discussion of gaslighting and psychological abuse in professional environments. Please use discretion as you read.
The term “gaslighting” comes from the 1938 play Gas Light, later adapted into two films. In the story, a man tries to make his wife doubt her sanity by subtly dimming the gas lights and then insisting nothing has changed. His continual denial and manipulation slowly undermine her trust in herself.
Gaslighting is a form of psychological manipulation that causes someone to doubt their own thoughts, memories, or perception of reality. While it’s often discussed in the context of personal relationships, gaslighting is increasingly recognized as a serious problem in workplaces—including healthcare settings like clinical laboratories. Whether intentional or not, it breaks down confidence and judgment, giving the manipulator more control or a way to deflect responsibility.
Everyday Gaslighting and How it Appears in the Laboratory
Gaslighting can be intentional, but more often it’s subtle and unintentional—embedded in daily workplace interactions. Several systemic factors make clinical laboratories prone to gaslighting: hierarchical structures, high stress, ambiguous roles, and an emphasis on unquestioned compliance.
Activist Tessa Watkins highlights how privilege and marginalization shape participation in our workplaces. In the lab, power imbalances can mean that concerns raised by newer staff, career switchers, or professionals from underrepresented backgrounds are more easily dismissed. Legitimate questions may be labeled as overreactions or incompetence. In labs, gaslighting may be masked as mentorship, tradition, or harmless “teasing.”
“In laboratories where precision, accountability, and collaboration are essential, a culture rooted in respect and transparency benefits both employee well-being and patient care.”
A Realistic Scenario: Gaslighting without Malice
Consider this scenario: A recent master’s graduate in their 30s, embarking on a second career in medical laboratory science, starts in a hospital lab. Their trainer, a senior technologist in their 60s, insists on using their old MT (medical technologist) credentials. When the trainee asks detailed questions about lab workflow and policies (like vacation time), the trainer becomes frustrated, replying, “Vacation is earned, not handed out,” and comments disparagingly on the work ethic of younger generations.
Later, the trainer tells coworkers the new technologist is too focused on time off and may not be a team player. The trainee, once enthusiastic and inquisitive, begins to doubt themselves, feeling self-conscious and hesitant to speak up. Withdrawn from team interactions, their confidence starts to erode.
Although the trainer may not intend harm, their dismissiveness and criticism can have real consequences. The trainee feels marginalized, socially isolated, and worried about their reputation and career prospects.
The Cost of Gaslighting
Gaslighting erodes psychological safety, lowers morale, and damages self-worth. Over time, these effects can become disabling—impacting job performance, retention, and ultimately, patient care. Experiencing repeated dismissal or mischaracterization leads to disengagement, high turnover, and loss of valuable team members.
Prolonged gaslighting is linked to increased anxiety and emotional distress, heightening the risk of symptoms associated with depression and anxiety disorders. Victims may stop sharing ideas, avoid clarifying important issues, or hesitate to challenge unsafe practices—putting both staff and patients at risk. The toll often spills into personal life, affecting self-esteem, relationships, and overall well-being. Psychological harm in the laboratory isn’t just a private battle; it’s a systemic workplace issue.
Common Phrases and Behaviors to Watch For
Gaslighting often hides in plain sight, showing up gradually through patterns of manipulation. The Cleveland Clinic notes, “Gaslighting often happens subtly or in fits and starts. So, it’s common not to realize that you’re experiencing it … That’s why gaslighting is so sinister.”[1] Look for recurring phrases and tactics, such as:
- “You’re too sensitive/emotional,” or “You’re overreacting.”
- “I never said that,” or “You’re imagining things.”
- Refusing to apologize or accept responsibility for mistakes.
- Using past incidents or insecurities against you.
Red Flags: When to Suspect Gaslighting at Work
Gaslighting can be hard to spot, especially when it’s subtle or unintentional. Common warning signs include:
- Being excluded from important communications or meetings.
- Frequent feelings of confusion, shame, or inadequacy, especially after routine interactions.
- Regularly second-guessing your own perceptions and decisions.
- Noticeable loss of confidence or enthusiasm for work, becoming withdrawn or hesitant.
These aren’t signs of weakness, they’re signs that your work environment may be unhealthy.
Standing Your Ground
Addressing gaslighting starts with awareness and small, practical steps:
- Trust your instincts and keep a private, detailed record of troubling interactions.
- Seek support from a colleague, mentor, mental health professional, or someone outside your workplace if necessary.
- Practice self-care, define your boundaries, and consider working with a therapist to rebuild confidence.
- If you feel safe, call out gaslighting behaviors calmly and directly.
- If you lack supportive leadership or reporting pathways in your lab, you can take concerns directly to your institution’s human resources department or professional practice office.
Most importantly, remember that your perceptions are valid, and you deserve a respectful workplace.
Leadership Matters in Creating a Psychologically Safe Lab
While individual strategies are important, lasting change requires organizational commitment. Leaders must:
- Create transparent pathways for confidential reporting.
- Foster respectful, open communication.
- Provide training to recognize and address gaslighting.
- Prioritize psychological safety at every level.
Psychological Safety Is Patient Safety
Psychological safety isn’t just a buzzword—it’s the foundation of a healthy and ethical workplace. In laboratories where precision, accountability, and collaboration are essential, a culture rooted in respect and transparency benefits both employee well-being and patient care. When staff feel safe to speak up, contribute, and learn, it isn’t just good workplace practice, it directly supports the quality and safety of patient outcomes.
References
- Cleveland Clinic. (2025, July 14). What Is Gaslighting? Here’s What To Do if You Think It’s Happening to You. Cleveland Clinic. https://health.clevelandclinic.org/gaslighting
- Nash, J. (2018, January 5). How to set healthy boundaries & build positive relationships. Com. https://positivepsychology.com/great-self-care-setting-healthy-boundaries/
- Sweet, P. L. (2019). The sociology of gaslighting. American Sociological Review, 84(5), 851–875. https://doi.org/10.1177/0003122419874843
- Watkins, T. (they/them). (2020, August 19). Wheel of privilege and power. Just 1 Voice. https://just1voice.com/advocacy/wheel-of-privilege/
Darby Naheedy is Resident Physician, Anatomic and Clinical Pathology|PGY-1 at the University of Vermont Medical Center in Burlington, Vermont.