Examining Character Assassination in Patient-Clinician Interactions About Chronic Pain

Female chronic pain patients often report perceiving that their character (i.e. credibility, reputation) has been attacked by clinicians during healthcare interactions. Although initially developed to examine political communication, we argue that character assassination (CA) is an inherently communicative phenomenon that also occurs within patient-clinician interactions. Utilizing CA as a sensitizing concept, this study examined experiences of CA among a racially, socioeconomically, and globally diverse sample of 450 female chronic pain patients during their interactions with clinicians. Our findings illuminate specific tactics employed by clinicians to attack patients' character, including making false attributions, lying and misquoting, triggering stereotypes, bullying, and emphasizing alleged flaws. Our findings also illustrate how CA might catalyze other deleterious outcomes, including fueling self-doubt, delaying further help-seeking and diagnosis, intensifying physical and mental health conditions, and turning relationally close others against the patient. We offer theoretical implications for utilizing CA as a conceptual lens and practical implications for patients and clinicians.