I got in the car feeling… discombobulated… confused, and flat-out terrified. What the hell just happened? She nodded, smiled, even complimented my ridiculous fabric bag with crazy dog faces on it. She seemed… well, nice. I had been desperate for the appointment, after three months of painful hell I can’t talk about, all that worrying she’d shut me down but….she was lovely.
And then she wasn’t.
“No, I’m not running any other tests.”
“No, it’s all a coincidence.”
“No, that’s not my area—see your GP.”
“No, no, no, no…”
And now…nothing. The same treatment I had told her made things worse—treatment the emergency doctor had told me to stop using. But apparently, it was my fault. I must have been using it wrong. All the rest? “Not her area.”
That was the first time I broke down and sobbed, I’d been clinging on to this appointment with hope and relief as it approached, finally – help, hope and now… overwhelmed by the crushing realisation that there was nothing else… No end now, no appointment to look forward to… Now I had to smile, function, and work, all the while drowning in pain that left me wondering how much longer I could go on.
I stared at the snow falling on the windscreen, and realisation started to dawn on me… What had happened in there? My mind raced through the appointment, replaying the words, the moments and…
It was all an act. A performance.
I grabbed my phone… That’s when my research began.
I’d only recently retaken the training. Active Listening Skills. Only acted out with tick box effficacy and disingenuity. An Oscar-worthy performance—faux empathy played out with exaggerated non-verbal cues and empty gestures. Beneath it all? A dismissive, superior attitude…..where my voice was never being heard at all.
So what is Performative Empathy?
…it’s when empathy is acted out—performed—without any genuine intention of hearing you in any meaningful way or acting on what you’re saying. Rogers’ active listening skills—attentive listening, reflecting and paraphrasing, clarification through questions, summarising what’s been said, and even eye contact and body language—so easily distorted into empty gestures and a tick box exercise.
You leave feeling utterly discombobulated. Baffled that they appeared to listen, you witnessed the nods, the smiles, the paraphrasing back what you were saying….and now you’re doubting yourself because somehow…while it felt like you were heard and understood… somehow, you weren’t.
To me this is the most cruel institutional betrayal. A false hope that violates your trust, not just a fleeting moment of discomfort and with shocking impact on your mental and emotional health never mind the physical illness that may be left undiagnosed and untreated from which you suffer daily. Tick box empathy leaves you…
Realising your voice is meaningless. You feel powerless, with nowhere to turn.
The result is a cascade of confusion, anger, anxiety, self-doubt, and trauma. You’ve been led into believing you were heard, only to be dismissed and invalidated once again.
That betrayal becomes a permanent scar. You start questioning yourself, your perception of what just happened, and the cold reality sets in: You have nowhere else to turn.
How Can You Advocate for Yourself When You’re Not Truly Heard?
We are told to advocate for ourselves. Not only is this a blatant shift of responsibility I’ll come to in another piece…. Here’s the question:
How can you advocate for yourself when the reality is, in many cases, you are not being listened to in any meaningful way?
In this scenario, advocacy isn’t just difficult; it’s impossible. Rather like trying to play chess without knowing the rules while the other side does… Or maybe it’s more like a game where you play by the rules and the other side does not while simultaneously presenting a false image of virtue.
Tick-box empathy is one of the cruelest, most insidious forms of institutional betrayal, especially for patients desperate for help and trying to advocate for themselves. It’s a dehumanising disempowering tactic that leaves us invisible and without recourse.
Little wonder so many of us are left suffering serious illness without diagnosis…
If you have experienced this, I hope understanding what has happened validates your experience. It was not you.. You were gaslit only not in the most obvious way so often talked out.
If you have an experience of this you want to share you can get in touch with me directly by email (at the top of the website) or leave a message in the comments..