The Projection Problem: When You Live Beyond Other People’s Imaginations

Humans interpret other people's experiences through the only template they reliably have: their own. When someone cannot imagine what you're describing, they quietly, even subconsciously, substitute something they can imagine. The substitution feels obvious to them, but it produces a distorted version of your reality—one that often becomes the narrative they act on.

For medically complex or neurodivergent people, this happens routinely. It is usually unintentional, often confident, and almost always inaccurate.  The effects can range from annoyingly unhelpful to outright life-endangering.

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Projection as Substitution

Projection is rarely dramatic. More often, it is ordinary and unexamined:

• "He must not be in that much pain."
• "He probably has a low pain threshold."
• "He's overthinking this."
• "Maybe he just read something online."
• "If it were serious, someone would have found it."
• "He must be lonely."

None of these statements come from data. They come from the speaker's limits of imagination. When someone lacks a personal model for your symptoms, they replace them with whatever familiar category feels closest.

You describe your experience. They hear theirs.

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Family Projection: The First and Loudest Layer

Family members often project long before clinicians or coworkers do. If you behave outside the character model they've carried in their minds for you, they fill the gap with assumptions:

• "She wouldn't travel alone unless she was struggling."
• "She must be isolated."
• "She doesn't seem that sick to me."
• "She's always been sensitive."
• "She must be avoiding people because she's shy."

Sometimes the projection is more direct:

• "You're a weenie."
• "Other people handle pain better."
• "I don't see why this is a big deal."

This is not analysis. It is outdated memory mixed with personal preference, and presented as insight with a side of emotion.

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Medical Projection: Training as a Filter

Clinicians also project, but their projection is shaped by training, diagnostic habits, and the boundaries of clinical experience:

• "Young men don't get conditions like this."
• "Your labs are normal, so it's probably anxiety."
• "This doesn't look severe to me."
• "Your explanation sounds too detailed."
• "You're reading too much online."

When a clinician cannot map your symptoms to their internal library, symptom reports are often treated as incorrect rather than incomplete. The mismatch between your lived pattern and their mental model gets resolved in their direction.

Projection becomes protocol.

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Casual Projection: Everyone Else

Outside of family or medicine, projection takes simpler forms:

• "You look fine."
• "You don't seem tired."
• "I had something like that once."
• "I'd still go to work."

These interpretations depend entirely on the observer's imagination. If they cannot picture your reality, your reality is discarded.

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When You Live Outside Other People's Imaginations

Before others fail to imagine your experience, it is worth noting that you may not have been able to imagine it either before these symptoms arrived. Many medically complex patterns—autonomic crashes, MCAS flares, neuropathic pain, system-wide fatigue—are difficult to conceptualize until you live through them. Have you ever remarked "I never knew one could have this symptom," never mind knowing what it would feel like? The impossibility of imagining your own symptoms ahead of time underscores how unrealistic it is to expect others to construct an accurate internal model.

This does not excuse projection, but it helps explain its unavoidability: if even the person affected couldn't picture the experience before encountering it, someone without the condition has almost no chance. Realistic empathy requires a model, and most people simply don't have one.

The core issue is not disbelief—it is substitution. People aren't rejecting your symptoms; they are overwriting them with a simpler version that fits their world.

Your experience ends up filtered through:

• personal experience,
• misremembered history,
• discomfort with uncertainty,
• training bias,
• emotional bias,
• and cognitive shortcuts.

Often, for anyone with a complex condition, this results in:

• minimized symptoms,
• incorrect assumptions,
• delayed care,
• pressure to "push through," and
• repeated misinterpretation of limits.

Not because the symptoms are unclear, but because the other person's internal model cannot accommodate them.

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Relevance to Sympa

Sympa does not rely on other people's imaginations. It helps you track your patterns, at the resolution they actually occur, without collapsing your experience into simplified or misleading categories.

The Projection Problem illustrates why so many medically complex people struggle to be taken seriously: most interpretations begin inside someone else's head, not yours.

Naming the pattern gives it boundaries. Once you can see projection as a structure—not a personal slight—you can recognize when a conversation is no longer about your experience at all.

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Practical Note

If you consistently live outside other people's imaginations, the problem is not your communication. It is the size of their model.  For tips on dealing with this, see our other field note @@communicating-with-constraints.

How Sympa Can Help

Sympa's vision is to bring clarity, pattern-awareness, and grounded logic to personal health—especially for people navigating complex or poorly explained experiences. We are building tools that help individuals find clearer direction by reflecting on their lived data, developing pattern awareness, and making sense of what their bodies are telling them. Field Notes share perspectives that support this process and reflect the rigorous and independent systems-level reasoning that guides Sympa's evolution.