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Is the dentist your friend? (was: NLP or CBT)

D

De8934

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Does any one know the difference between NLP and CBT? These have been mentioned in conversation as an alternative treatment for dental phobia, not that i'm saying i have a phobia but i thought i'd ask on here and would appreciate any feed back on how it can help people with dental anxiety/phobia. I'm not exactly sure what they mean either.

Thank you
 
letsconnect

letsconnect

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Re: NLP or CBT

Or Vicki... (if you happen to read this ;)).

A few people on here have mentioned that CBT (cognitive-behavioural therapy) has helped them. On the other hand, I can't say I recall anyone saying that NLP (neuro-linguistic programming) has helped them (even though it's often touted as a miracle cure of sorts).

You can read more about NLP in this wikipedia article:

http://en.wikipedia.org/wiki/Neuro-linguistic_programming

It's got a very good critical section on NLP in it (I was quite impressed).

Many qualified hypnotherapists do an NLP qualification, because it can help with one's CV (if everyone else offers it, it's best to have the letters after your name so that you don't loose out on potential clients). That does not necessarily mean that they buy into it.

You can become an NLP practitioner by just doing some weekend courses - the impressive-sounding strings of letters don't actually mean very much.

Personally I don't like NLP because I think it can be a bit disingenious (sp?), and techniques such as consciously mirroring someone almost strike me as cynical. I also have concerns about techniques such as the "fast phobia cure" being able to induce flashbacks and making matters worse rather than better.

CBT on the other hand may be well worth looking into, depending on the nature of your fears. For some people, just having the right dentist can make all the difference, but CBT can be hugely beneficial if your own perceptions and thoughts contribute markedly to your fears.
 
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De8934

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Re: NLP or CBT

Thanks for getting back to me about this. I had 'googled' both but got a bit confused with what I was reading.

It seems to me that CBT is to help with the way we think and interprete information and NLP is to do with thinking yourself happy or something similar. I wish my dentist was more understanding it would make life so much easier, I like him but i don't think I trust him. My dentist could have CBT to help him be more understanding but I don't think it works like that some how.

Thank you letsconnect for the effort and time you took to look into this.
 
letsconnect

letsconnect

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Re: NLP or CBT

If you like him, maybe you can try and explain to him how you feel. I think most dentists would prefer to know how their patients feel, rather than be left in the dark and trying to second-guess. So as long as you can voice your feelings in a non-confrontational way, he might even take them on board and make changes to the way he interacts with his patients.

Not sure though if this would be any help with trusting him. When I think of the word "trust", it seems to refer more to a basic instinct.

If you do have difficulties with trusting people more generally, then CBT would be useful.

But unless you are consistently distrustful of other people in everyday life or in many situations, I would be inclined to take any feelings of distrust quite seriously - and trust your instincts.
 
vicki

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Re: NLP or CBT

Hi

Sorry, I’m a bit late in seeing this (still drooling from seeing Derren Brown’s new show ‘Svengali’ !!).

To answer your original question, CBT is all about changing the way that you feel by changing the way that you think. We all have beliefs about ourselves, other people and situations; sometimes these beliefs are helpful and based on real evidence and/or experience, but sometimes they’re not helpful and are quite often the result of assumptions or over generalisations.

To give a very basic example, someone who is not very confident in social situations may feel very self conscious and anxious when at parties, meetings or public speaking. After looking at all the thoughts that go through their mind when in this sort of situation, the one thought or belief that underpins all the rest (also known as the ‘hot thought’ in CBT lingo) might be something like “they’ll think I’m stupid”. Once this thought has been identified, it can then be examined in more detail to see whether there is any actual evidence that supports it (e.g. what has happened before in this sort of situation, has anyone actually said anything that supports it, etc). Most of the time, these hot thoughts are the result of assumptions rather than anything that someone has actually said, done or experienced. It’s then a question of finding an alternative, more helpful way of viewing the situation and replacing the ‘hot thought’ with an alternative, more helpful one. There are many other techniques that are used in CBT and this is just one example.

NLP is more about looking at the way that we receive information, process it and then form thoughts, beliefs and behaviours which then ultimately affect our feelings. It was developed in the 1970s and has its roots in hypnotherapy and also various forms of therapy (including family therapy and gestalt therapy – there are loads of articles on Wikipedia and other websites that go into this in more detail). The theories, ideas and techniques that NLP originally grew from, were mostly effective and so the creators of NLP wanted to form a system that would combine all of these ideas and techniques into something that could be used to help people with a variety of problems or issues.

Unfortunately, although some of the ideas behind NLP are quite sound when used appropriately and perhaps in conjunction with other techniques, over the years since it was developed, it has become a mass-market thing with literally hundreds of courses popping up all over the place. These courses allow people to call themselves NLP Practitioners – sometimes after only a couple of days at a seminar, or even just an internet course with no assessment or supervision. One of the problems with this is that it can be very prescriptive and encourages certain techniques to be used in certain situations rather than looking at the bigger picture and the person as an individual. Some of the techniques (such as the ‘Fast Phobia Cure’ which letsconnect mentioned) really should only be used by people who are experienced enough to deal with any issues or reactions that may happen as a result of it (in other words, not someone who has been on a one-week ‘fast track’ course).
Many hypnotherapists (including myself) also have an NLP Practitioner qualification, partly because it’s a sort of natural progression (seeing as NLP has some of it’s roots in hypnotherapy), partly because it expands the range of skills we have and also, as letsconnect said, it looks impressive on your website and lets you put even more letters after your name.

Having said of all that, it does depend on the person I’m seeing and their fear or phobia, but generally I tend to stay away from NLP for dealing with phobias and instead look at more practical solutions such as hypnosis combined with desensitisation (in other words, gradually facing your fears in manageable steps) as well a combination of other techniques. Depending on the person and their progress, I do sometimes use an NLP technique called ‘Anchoring’ to help them produce a more confident and relaxed feeling when in the phobia situation, but again this isn’t always appropriate for everyone and so depends on the individual.

If you like your dentist, but don’t feel able to trust him and you wish that he was more understanding, perhaps it would help both you and him if you were able to talk about what it is that worries you. From my own experience, as a ‘dental phobe’, even the nicest dentist in the world (they do exist – honest!) can only guess at what might help, unless you’re able to tell them. If you don’t feel able to say anything or can’t bring it up in conversation, then writing it all out beforehand and then just handing it over at your appointment (and maybe explaining in your letter that you feel too nervous or tongue-tied to talk about it), can be a great way to start the ball rolling. I did this – although I’d been seeing the dentist for a couple of years and he was really nice anyway, I never managed to tell him what I was scared of or what might help. Then at one appointment, when I had to have a filling, after injecting the local anaesthetic, he was making such an effort to provide reassurance about what he was going to do, I felt able to hand over the letter that I had in my handbag ‘just in case’. After handing it over (I didn’t tell him what it was), I then went back to the waiting room to wait for it to go numb, whilst he saw another patient. When I went back in to have the filling, things were totally different – it was the best thing I ever did.
 
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De8934

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Re: NLP or CBT

Thank you all for getting back. Your reply has made things alot clearer now Vicki.

The thing about trust and me is really only with dentists. I am generally a trusting person and see good in most people but when i have to have the numbing injection and drilling and things i loose the plot. I have tried to tell the dentist so many times. rehearsed it over and over in my head, but i'm scared he will laugh at me and not want to see me anymore. I dont trust what he will do if i tell him. Ive heard that people have been kicked off their dentist practice list because they take too much time and the numbing injection fails alot. I don't want to go any where else, it's really local to where I live.

I have a letter to give to the dentist to explain things. iv'e had this for 2 years but i can't bring myself to give it. I think now because it's been too long the dentist is fed up with me and wont care. I just want to be a good patient that doesnt cause any problems. I don't want to be the unpopular patient that the dentist dreads seeing on the appointment list :redface: .

You are so brave Vicki giving the letter to the dentist. I wish I had some of your courage. How would you have felt if it didn't make a difference or the dentist didn't acknowledge you fears? It scares me more to be ignored.


Thankyou:)
 
vicki

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Re: NLP or CBT

The thing is, you don’t really know how your dentist will react unless you are able to discuss things with him or you can hand the letter over (or post it to them before your next appointment).

Yes, he might react negatively and decide that he doesn’t want to see you – but based on all your previous experiences with him, especially as you like him, how likely do you think it is that this will happen? If it doesn’t go the way that you hope it will, then at worst you’ve maybe had a few embarrassing moments in the company of someone who probably isn’t cut out to deal with nervous people anyway. If this were to happen, then at least you’d know that he perhaps isn’t the best person for you and you’d be able to look at visiting another dentist/dental practice.

I know you’ve said that you don’t want to go anywhere else because it’s local to where you live, but sometimes if you can find a dentist who is willing to take time to listen to your fears and work with you to overcome them, then travelling a little further afield can make a lot of difference.

On the other hand, he might be really glad that you’ve told him what worries you and maybe what could help. He may have realised that you’re nervous but without any further information from you, he can only guess at what you’re scared of and what to do about it.

When I handed the letter over, I’d already been seeing this dentist for a couple of years and although I’d been able to tell him that I was scared and that I took beta blockers before appointments, I couldn’t tell him what I was scared of because I was too terrified of how he’d react and also I find it very difficult to talk about it face to face (yes I know, whoever heard of a hypnotherapist with a phobia?!). Throughout most appointments I would usually be shaking like a leaf and wouldn’t really say much, so even though I never really said anything, my anxiety was probably very obvious. Luckily for me, he was really nice and never made me feel bad about being scared.

Like you, I was worried that even though he’d been OK for a couple of years, he might get really irritated if I said anything, so I decided it was better to say nothing and leave things as they were. Then at one appointment, he told me that the root canal I’d been trying to avoid was probably the only option left to get rid of the pain and that he could do the first part that day if I didn’t mind going back to the waiting room whilst the injections took effect. The thought of this absolutely terrified me and the look on my face maybe said it all, but because he was making such an effort to provide reassurance that it would be totally numb (I’ve never managed to get totally numb for fillings and so this just makes the fear even worse) and was explaining what would happen, my gut instinct told me that it might be OK to hand the letter over, so I did. I just whipped it out of my bag and said, something like “Oh, you might as well read this…” as though it was nothing out of the ordinary.

The next ten minutes were awful sat in the waiting room – going through all the ‘what ifs’. I nearly ran out because I had started to regret handing the letter over. But then I told myself that if he reacted badly, I could just walk out because I was actually the customer and I didn’t have to be there if I didn’t want to be.

When I was called, I just wanted to run, but thankfully I didn’t. He never made any reference to the letter at all (which I was glad about because I wouldn’t have been able to find the words), he just asked if I’d hoped that it had disappeared whilst I was waiting, so I said yes. For the rest of the appointment, he did everything that I had asked in the letter and was totally fine about it; I couldn’t have asked for better.

Try it - you might be pleasantly surprised.
 
D

De8934

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Re: NLP or CBT

I don't think I could give my dentist the letter with confidence that I would get a response as positive as you have Vicki. Letsconnect's suggestion I 'trust my instinct' and thinking alot about it, trusting this dentist is a real issue for me.

I may like the dentist but then again I like and trust most people unless they give me a really good reason not too. I have thought about what to do over the last few days and it has been suggested to me that I make alist of good and bad things about this dentist and really there are not enough good reason for me to go back.

All the help and support from this forum has helped me understand that a dentist should help me feel comfortable. I know I haven't told him about my fears but he could ask if i feel comfortable or say something that would give me an excuse to tell him how i feel when i'm having treatment. I dont trust he cares enough to want to know about the information in the letter. The letter contains a personal experience that happened along time ago but is very relevant to dentistry, If he didn't respond in a way that helped me to feel comfortable about it I would be devastated.

I will try to find another dentist. There are a few not to far away, one particularly Iv'e been told is 'really nice'. My whole family go to our local dentist and have done for 20 years so it will be sad not to go as a family, but recently there was a change in owership and the new dentists seem alot more short of time some how.

My really old dentist use to ask about things, talk about the allotement or tell me he sees me walking my dog or we talk about things he'd been up to. It just made the visit so much more relaxing. I trusted him.

The experience in my letter was never an issue until recently. All the memories came flooding back and thinking about it thats when the gagging and stuff started when I go to the dentist. I just need to put the memories away again and find a 'nice caring' dentist. It might be something as simple as we just don't get on with each other. A personality class maybe. :(

Thank you Vicki and everyone for all your support. :grouphug:
 
brit

brit

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Re: NLP or CBT

I think you've made the right decision....you know you are in the right place when you talk about non-dental things alongside, a rushed dentist however nice is not going to be a relaxing experience. Make that alternative appointment asap...I knew something was wrong as soon as you said he seemed irritated. :grouphug:
 
letsconnect

letsconnect

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Re: NLP or CBT

Great to hear that you've already got a lead for a really nice dentist :thumbsup: - I hope it all works out for you! Let us know how you get on :grouphug:
 
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gettingthere

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Re: NLP or CBT

Hi

I've come a bit late to this and can't really add extra value to what has already been advised or comment on the specific situation but for what it is worth, wanted to give my two cents regarding the original question as I did go through a CBT programme for my dental phobia a few years ago and can honestly say it is one of the best things I have ever done. Funnily enough my dentist had recommended NLP to me as a way of conquering my fears and I had pretty much dismissed this as an option based on two things: I have a degree in Linguistics, during which I took a (fascinating) module in Neuro-Linguistics. I recall one day in class, someone asking the lecturer about NLP to which she responded quite badly. Well she hit the roof really, ranting about how those people were taking the name of a serious and worthwhile study of how the brain acquires and holds language functions and instead using it for unsubstantiated, new-age practices. and that, although there can a lot of value to NLP practices if done properly, quite often these are practiced by those who (as mentioned here) have not undergone lengthy or supervised study and therefore do not fully understand the mechanics and consequences of the practices which only serves to confuse the public and bring into disrepute, the academic study of this branch of Linguistics. I hadn’t thought much about this episode until NLP was brought to my attention for the second time whilst reading Derren Brown’s Tricks of the Mind book in which he displays a certain amount of scepticism for the practice for many of the same reasons. Btw, Vicki – I have tickets to see Svengali later this month and am hyper-excited. You have just made me even more so now. Love DB! :respect::-*

I was referred for CBT by my gp on the NHS but if you, or anyone else does decide to go down this route however, please be aware that the waiting list – at least in my area – is long (around 6 months from referral). I won’t go into too much detail about what happens in the sessions as both letsconnect and Vicki have covered this and provided excellent links and I have also written about this in my journal if you want to take a look. What I will say is that CBT is not a passive therapy where you tell a therapist what scares you and they come up with solutions. The whole point is that you come up with the answers from within and although I thought this was an impossible task at first, once I did start paying attention to and challenging my thoughts and beliefs about dentistry and my relationship with dentistry, things did start to fall into place. It did require a lot of motivation and discipline and I’m not going to pretend that it was all plain sailing. At times some answers truly did seem unattainable but with patience and perseverance, I was able to achieve these. I kept a “thought diary” to note all the negative and upsetting thoughts about dentistry that would play on my mind in everyday life and we would use this as a basis for each session. Interspersed with these “thought challenging” exercises was a programme of sensitisation and also breathing and relaxation exercises. As I have said, this is one of the best things I have ever done as the skills learned have not only helped enormously with the dental phobia but in so may other times of stress and overwhelming situations in other areas of my life. Recently I have been working in a support role and have been studying Counselling courses to help in my career – it has been extremely interesting to see CBT from the “other side” and my own experiences have made me a passionate supporter of this style of therapy. :)

One thing I cannot emphasise enough however is that although I could not have conquered my dental fears without the aid of CBT, it is also very true that I don’t think the CBT would have worked, had I not found an extremely supportive and understanding dentist to support the skills I was acquiring. This really is key as without being able to both trust him and talk to him about the issues affecting me, all the skills – the relaxation and changing thought processes – may well have fallen down in the face of the old sheer panic. Likewise, I had been seeing this dentist for a year before beginning CBT and although I was developing trust in the relationship, still could not cope with many aspects of dental treatment and needed the external help to do this. Both the therapy and the individual dentist played important parts in my recovery but I would maintain that it was the dentist more so because it was his empathy to my situation and the realisation that I wanted to work with him which pushed me into seeking further assistance in the first place.

Have just realised I have waffled on for a considerable amount of time only to say what Letsconnect has so succinctly summed up in a few sentences at the end of her post. :oops:

CBT on the other hand may be well worth looking into, depending on the nature of your fears. For some people, just having the right dentist can make all the difference, but CBT can be hugely beneficial if your own perceptions and thoughts contribute markedly to your fears.

Thanks for reading anyway. :grouphug:
 
Dr. Daniel

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Re: NLP or CBT

Hey
I sounds to me that you took the right decision. I think also that the dentist should make sure during the treatment that the patient is comfortable (physically and mentally).
The dental situation is a very intimate one. After all, the patient allows the dentist into his/her body. Sometimes it simply does not work out.
However, the dentist is not supposed to be your friend. :censored:
Sounds non politicly correct but it is true. The relationship between a dentist and a patient is fundamentally different from a relationship between two friends.
How? In a "normal" friendship there is a kind or symmetrical balance, each person is the friend of the other. However, the dentist is the one which is providing the treatment and the patient is the one receiving the treatment and that is totally different from friendship. When you meet a friend, the focus of the conversation can shift between you and your friend, but during treatment the focus stays constantly on the patient! The person who provides the treatment (a dentist, a therapist or a pilots teacher) can use examples from his own experience and from his personal world, but with the intention of helping the patient (the receiver) with his needs, the treatment provider chooses what examples to say according to the patient's needs. I think that the threads Vicki wrote are a good example for that concept.
By the way, it does not mean that the dentist can not be friendly of course...:D
In order that the dentist will be able to provide what is needed to a specific patient, it is essential that this patient will share what are his needs, to guide the dentist in this path. So the idea of giving a letter can serve this purpose well.:D
 
brit

brit

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Re: NLP or CBT

By the way, it does not mean that the dentist can not be friendly of course...:D
I:D
Yes of course just like with a teacher - you want them to be 'friendly' i.e. 'like a friend' but they are not truly your friend unless you see them socially as well.
 
letsconnect

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Re: NLP or CBT

However, the dentist is not supposed to be your friend. :censored:
Well... stranger things have happened, but I shall refrain from naming names :whistle:

:ROFLMAO:

Actually, I'm not sure if I quite agree with the general gist of this (and especially what it says about power relations)... but one can dream :)
 
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brit

brit

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Re: NLP or CBT

Well... stranger things have happened, but I shall refrain from naming names :whistle:

:ROFLMAO:

Actually, I'm not sure if I quite agree with the general gist of this (and especially what it says about power relations)... but one can dream :)
Well of course there's also that research about generalised differences in the amount of 'professional distance' actively maintained by medical/dental practitioners around the world....funnily enough the latin countries were in general worse for maintaining distance than the nordic.

I have noticed variations in desire for professional distance a bit in my travels...but obviously it varies from individual to individual and I think it is easier to 'connect quickly' with someone of a similar age to you.

I suppose Drdaniel is right though in the sense that whilst we lucky patients might be enjoying a 'relaxing chatty appointment' :cloud9: the professional is in fact at work, at risk of being sued (arguably) and so has to
be aware of the likely effect what they say/do has on the patient, especially a nervous patient.
I think with long-standing patients who are comfortable in the environment, this risk probably lessens and the professional probably does just feel more relaxed and therefore come over as genuinely friendly and interested.
Sorry if this is not helping Letsconnect ...I do think 'naturally friendly caring people' tend to make 'friendly whatever profession' they take up - so finding a nice kind friendly dentist is still key.
 
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brit

brit

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Re: NLP or CBT

When you meet a friend, the focus of the conversation can shift between you and your friend, but during treatment the focus stays constantly on the patient!
Actually this bit I take issue with, whilst I realise the focus is still kind of 'on me' (in that the dentist would wish to avoid making controversial remarks about say politics and still has to concentrate on the job in hand), the thing I like about my current situation is that conversation is two-way with personal info being shared...chatty people tend to be happy to do this.

In other situations in other locations, I could re-analyse and say although people were friendly, I was setting the agenda and no personal info
was coming from the other side, it was all strictly professional.

I know which situation I prefer ;).
Is that better Letsconnect? BTW I am not the person she is referring to lol but my situation does feel like 'visiting friends' who happen to 'look in my mouth' Actually politics has come up too before lol.
 
letsconnect

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Re: NLP or CBT

Well, I think what I really meant to say is that over the last hundred years, we have witnessed a massive change in power distance (which has only been accelerated by the existence of the internet), and personally I believe that there's still some "give" there to reduce this power distance further. It's a social construct after all.

That's just my wishful thinking though and the world might be turning more conservative for all I know :).

Very interesting discussion BTW - a big thanks to gettingthere for adding so much valuable info about CBT!!
 
Dr. Daniel

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Re: NLP or CBT

the professional is in fact at work, at risk of being sued (arguably) and so has to
be aware of the likely effect what they say/do has on the patient, especially a nervous patient.
What I wrote earlier had nothing to do with authority or legal liability. I was talking about the goal of the treatment, the purpose of two people coming together. The idea is answering the patient's needs. That is the direction.
I think that the phobic patient should raise the fear issue as a goal of the treatment and state to his dentist: "I am afraid from the dental treatment, I want you to take that under consideration in your treatment", or "I do not want to feel pain". An appropriate reaction should addressing this issue in a constructive way, maybe by enquiring about the fear, reassuring, finding practical solutions, or maybe telling the patient that this clinic is not the best suitable place for him and to address him to another dentist, that is a legitimate answer, because it goes according to the patient's need.
A non-suitable reaction would be: ignoring what the patient said, to dismiss what he said, making an insulting remark, blaming or threatening. These actions are not suitable not because of their lack of kindness but because they are not helpful to the patient's needs.
I myself as a dentist like to talk about myself and even joke about myself, but I would not do with every one. If I feel that the patient is used to a distanced relationship with the dentist, I will adjust myself to him.
 
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