The cruelest, vilest, most horrific form of psychological abuse and gaslighting is to tell someone that an involuntary state is voluntary.
When someone has something wrong that they have no control over whatsoever, something that makes life difficult or even tortuous, the accusation that they are doing it on purpose hurts the most. What sane person would choose whatever condition they are in? But so many think it is perfectly fine to accuse someone of “being dramatic” or seeking attention for something they have no choice in.
Best case scenario – bad enough – is to say that if the person would “just choose not to do it” or be it, whatever the “it” is, that the problem would go away. Worse still is to punish for conditions the person has no control over and cannot change. Even worse is for the issue or issues to be medical, and dismissed as a psychiatric problem to be “treated” like anxiety, depression, delusions, or hallucinations instead. The underlying medical or congenital issue never being dealt with means the problem and its sequelae remain and often worsen with time.
But the worst of all is that the accuser ends up “vindicated” no matter what the outcome: If the condition changes (again, without input or control by the sufferer), the accuser simply says “see, I told you it would go away if you simply chose to stop”. If it doesn’t, or if it worsens, the accuser dismisses it, continues the accusations, and perhaps even gets a complicit psychiatrist or psychologist to affirm their “diagnosis” of attention-seeking, dramatic behavior. Either way, the accuser wins and the sufferer loses. There is no case in which the sufferer wins.
The only vindication a sufferer might someday see is if an outside force confronts the issue and proves that the suffering was involuntary – and for many this never happens.