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

[De8934]

Re: NLP or CBT

Hello again, To make me feel comfortable, the relationship with the dentist should be sincere and honest as well as professional and caring. I am the kind of person that needs to talk alot in situations that I feel nervous about and I do probably ask too many questions. I suppose there are boundaries to what and how things are said but my old dentist seemed to feel relaxed with me and that must be good when he's doing the drilling and stuff.


Talking about things helps me think things through and make it right in my head. I think thats what CBT is about by the sounds of it. Just being able to express my scary feelings on here and getting feed back on this forum is my CBT


Now iv'e made the decision not to return to my family dentist I feel like a lamb alone in the woods but also liberated. I get the impression there are some 'wolves' out there in the form of uncaring dentists but I have one good lead which i'll try.

A good friend of mine is also nervous she dosn't trust any dentist, something to do with the dentist not stopping when she raised her hand, she really lost the plot apparently, but rather than apologize to her he made it her fault and told her he didn't feel comfortable treating her any more and to find a dentist some where else. She stays away altogether now. I have told her about this website and I think she'll find it helpful.

I feel that a dentist plays a big part in helping the patient feel safe and comfortable but also dentists can make a patient feel uncomfortable. I suppose when they don't want to see a patient any more, it must be easy to scare them off. Reading other threads on here of peoples experiences it seem that dentists indeed do.

I'm so glad Iv'e found this forum. I think I have been a bit clueless as a patient. I'm certainly more informed now which is quite empowering and helps me to be in control of which dentist I see, what treatment I have and how I allow the experience to affect me. Thank you

 

[gettingthere]

Re: NLP or CBT

This thread has taken an interesting turn and hope you don’t mind me weighing in again with my own thoughts.

I have actually recently been having a similar conversation about doctor-patient relationships with a medical doctor whom I have been seeing for a particular issue in recent months. Given that there are situations in both medicine and dentistry which can make me very anxious, we have spoken about the imbalance of power and the necessary distance between doctor and patient as having both positive and negative influences on the control of anxiety and ability to trust the doctor. Trust is key and by focussing more on the “patient experience” and allowing them to be a partner in their own care plan, the patient should be able to (eventually) work with the doctor to a successful outcome but the fact remains that no matter how well a relationship develops, there is always going to be an element of distance in play as it is the doctor who ultimately has responsibility for the patients well-being rather than this being a two-way relationship of looking out for each other. Whilst this can mean that there is a constant risk of intimidation, it should also allow the patient to feel safe in discussing certain issues or allowing procedures to take place in the knowledge that these actions are being done in order to address their own needs rather for any benefit to the doctor and avoids the situation where patients may start to feel “too close” to allow these events to take place. As my doctor says however – such focus on the patient and developing interpersonal relationships rather than taking a dictatorial stance is a relatively new concept for the NHS.

Going back to my linguistic sensibilities, there is a famous study by Brown and Levinson (1978), upon which I happen to have based my dissertation. The theory includes a formula of “weightiness” to calculate and explain that all utterances in everyday interactions may be perceived as “face threatening acts” and the effect of distance and power between two speakers in an interaction is vital to their levels of perception of and deference to the other. The formula also demonstrates how patterns of speech generally associated with politeness must consider various factors including age, gender, social class etc and how attempts at politeness often fall down when these variables are altered. It has struck me that this model can be applied to the doctor or dentist/patient relationship to explain why some anxieties are reduced in conversation with the dentist whilst others may be magnified much to the confusion of both parties who may think they are behaving in the correct manner befitting the situation. (If anyone is inclined to read further details - https://en.wikipedia.org/wiki/Politeness_theory provides a good overview.) . It is true what Letsconnect says about power-distance being ever reduced and Brit’s noting measured distance can vary around the world so it is clear that the way we interact is constantly changing to accommodate such variables. As I have mentioned before, I think a linguistic study into the effects of language patterns on phobias is one that is greatly overdue.

That being said, I think it is dangerous to make claims such as “the dentist is not your friend” on a site like this where many people do feel particularly vulnerable in the relationship with their dentist. Although I generally agree with the points Dr Daniel has made, I can’t help feeling that someone who genuinely feels that their dentist may be irritated by their displays of anxiety may see this as supporting these negative thoughts.

In terms of the dentist being friendly whilst still maintaining professional distance, I think it is up to the dentist as most powerful player in eh interaction to be able to blur the lines of distance whilst still maintaining control over the relationship in a way that may not even be recognisable to the patient. By this I mean that a more sympathetic and anxiety-friendly dentist is likely to be more willing to have a “chat” about non-dental subjects as described by Brit in order to put his patient at ease and make the environment more akin to that of visiting a friend whilst still ensuring that certain subjects are “out of bounds” – for example, it would not be appropriate for him to say, “hey, let’s get a coffee later so we can continue talking about your holiday!” or even to some extent talk in great detail about his own family or personal life – although there is value is mentioning some more generalised aspects of this in order to establish that even dentists are human. “I’ve got a baby at home too” is different from “here, look at this photo of my child, whose name is x, and birthday is y…” From my own point of view, this two-way interaction has been invaluable in decreasing my anxiety. I am aware that the dental staff are not my “friends” but often on the approach to an appointment may be thinking along the lines of “looking forward to seeing my hygienist and finding out about her holiday – I wonder if she visited that restaurant I recommended” rather than focussing and worrying about the dental content of the appointment. Obviously it stands to reason that those in the dental profession who are more open and personable in general are probably best suited to working with anxious and phobic patients for this reason.

 

[Dr. Daniel]

Re: NLP or CBT

I think it is dangerous to make claims such as “the dentist is not your friend” on a site like this where many people do feel particularly vulnerable in the relationship with their dentist.

I was (and still am) totally aware that this sentence is a very provoking sentence, that might even trigger fear among readers, especially when it is coming from a dentist, but still, this provoking sentence refers to a very fundamental concept in treating people. The concept is: the course of the treatment is determined by the patinet's needs.
I think that this concept should be applied in treating patients who are afraid of the dental treatment, that means that the patient raises the issue of his own fear as an issue to be attended and treated by the dentist, and the dentist must go according to the patient's needs.

 

[letsconnect]

Re: NLP or CBT

Definitions of friend:

noun /frend/
friends, plural

1. A person whom one knows and with whom one has a bond of mutual affection, typically exclusive of sexual or family relations
2. A person who acts as a supporter of a cause, organization, or country by giving financial or other help
   • - join the Friends of Guilford Free Library
3. A person who is not an enemy or who is on the same side
   • - she was unsure whether he was friend or foe
4. A familiar or helpful thing
   • - he settled for that old friend the compensation grant
5. (often as a polite form of address or in ironic reference) An acquaintance or a stranger one comes across
   • - my friends, let me introduce myself
6. A contact associated with a social networking website
   • - all of a sudden you've got 50 friends online who need to stay connected
7. A member of the Religious Society of Friends; a Quaker

 

[gettingthere]

Re: NLP or CBT

I was (and still am) totally aware that this sentence is a very provoking sentence, that might even trigger fear among readers, especially when it is coming from a dentist, but still, this provoking sentence refers to a very fundamental concept in treating people. The concept is: the course of the treatment is determined by the patinet's needs.
I think that this concept should be applied in treating patients who are afraid of the dental treatment, that means that the patient raises the issue of his own fear as an issue to be attended and treated by the dentist, and the dentist must go according to the patient's needs.

I do agree with you 100%. I believe that boundaries are important for both the dentist and patient and allow the patient to gain the most benefit from dental appointments. I was just a little concerned about the wording of this statement. It seems clear that "what the dentist may think of me" is a major issue of concern for many users of this forum and certainly if I had read this statement 5-6 years ago, I probably would have stopped reading right there with the belief that this was evidential of my worst fears which would have increased my anxiety about impending dental appointments and ability to openly discuss my fears with my dentist. I also think that the abililty to "be friendly" whilst upholding boundaries is one which is greatly overlooked but vital in dentist-patient relationships. In all honesty, I beleive it is more a personality trait than a skill which can be learned and one which is probably held by all the dentists who either visit or are recommended on this site - this is why they are so good with anxious patients. Someone who is generally good at interpersonal relationships will know which boundaries to set, and when these can be moved according to individual patient needs. Certainly as time develops there may well be a more friendly tone to the relationship where checking teeth may appear to come second to a friendly catch-up chat but never compromising the dentist's professional integrity. I have recently been reading about the nature of boundaries in counselling relationships and am aware that whilst some respected members of the field strongly argue for the rigid placing of boundaries in order to create a secure environment for the client to disclose and be helped to overcome his concerns, others believe that the very nature of the counselling process means that some degree of boundary crossing must be permitted or at least made variable in order to "reach" individual clients and that boundary rigidness can promote "aloofness" which is potentially dangerous to the client and relationship (Hermansson, 1997). I don't think it is a huge stretch to impose these thoughts onto the dentist-patient relationship to show that whilst a degree of power-distance will always exist, those dentists who seek to visibly reduce this inequality will have better success in gaining the trust of an anxious patient.

Reading back through this thread, I do think we are all arguing for the same thing - just coming at it from different angles. At the end of the day, I would not want my best friend practicing dentistry on me, even if she were hugely skilled in the field - that would be too close and too weird. Equally however, I need to know that the dentist treating me does view me in a friendly manner and has a personal interest in me beyond me being just a set of teeth. Perhaps we need to stop talking about the notion of "friends" and instead replace this with the idea of the dentist and patient being "equals": deep down there is an undisputable truth that the dentist-patient relationship is not equal but both parties can go some way to disregarding this in order to create a safe environment where the patient feels equal to, and not intimated by, the dentist.

 

[brit]

Re: NLP or CBT

Drdaniel's actual original quote was 'the dentist is not supposed to be your friend' and whilst not disputing the cold hard reality of this, on balance I am not comfortable with this in this arena.
The power relations in dentistry are just too 'out of kilter' and uneven compared to any other situation (including medical doctor) for this to be a helpful construct for the patient and to posters on a 'dental phobia forum'.

The reason I think this is, the invasion of the oral cavity, the fact that this impedes your ability to speak and express yourself....medical doctors invade less often and usually in places where you can still 'easily speak out to defend yourself'....add that to the relative frequency of anaesthesia failure in dentistry compared to the medical field and you have a scary concept that is extremely unhelpful to those people that have historically been 'on the receiving end' of distorted power relations including restraint (even abuse - still going on in kids dentistry in USA on a wide scale in the dental arena).

UK TV programmes for pre-schoolers often state 'x is off to visit y their friend the dentist'.....it's just words, we are adults here but given that you admit, like a teacher, the dentist 'can be friendly' whilst not technically a 'true friend because you do not socialise', what is the point of raising this here?
To get care after bad experiences, people need to see the dentist in a different non-authoritarian light and 'friendly...like a friend' is shorthand for that.

I also wonder if you are possibly running the risk of not sufficiently catering to all your patient's needs by seeking to observe more professional distance with those who seem like older more conservative people...maybe what these people need to change their impression, is a dentist who says, 'Hi I'm Daniel...you must be John, is it ok for me to call you that?'....the first chance ever for them to be more like an equal with a dental/medical professional...this approach may be just what they need although they are not aware of it yet. If you incorrectly gauge the patient's desire for increased professional distance you have potentially done them a great disservice.

Also in some places on the planet, dentists are short of work (not the case in the Netherlands I know) because they are 'fee for service' rather than 'insurance based' and people can't afford the care they need and for these dentists making their 'more affluent patients' feel valued and welcome and making appointments sociable and enjoyable(and painless lol) so they will refer their friends is kind of a given...your business will likely die if you carry on the old-fashioned traditional constructs of the dentist as an authority figure.

 

[brit]

Re: NLP or CBT

At the end of the day, I would not want my best friend practicing dentistry on me, even if she were hugely skilled in the field -

Well we are all different and I for one would; and if I had any relative including a parent skilled in the field who I trusted, I would want them to work on me as well. You would at least know from the 'get go' that they would have your best interests at heart...which is certainly not a given otherwise.

I have a few medical doctors amongst my personal friends and they are all people who I would judge as being extremely kind and friendly with their patients, I highly doubt anyone is scared of seeing them. This may be because I only make friends with nice people. Their patients are not their friends (well some are actually) but the key to the success of the professional relationship is their medical knowledge coupled with good friendly communication skills. One is in small village and he is known for 'hanging out over a cuppa to hear the gossip' on home calls and he is essentially a 'friend of the family' for many long-term patients. He would socialise with anyone with shared interests if he gelled with them, whether they were a patient or not. Life's too short and in some cases too remote for all this professional distance stuff.

 

[brit]

Re: NLP or CBT

Perhaps we need to stop talking about the notion of "friends" and instead replace this with the idea of the dentist and patient being "equals": deep down there is an undisputable truth that the dentist-patient relationship is not equal but both parties can go some way to disregarding this in order to create a safe environment where the patient feels equal to, and not intimated by, the dentist.

Just thinking I feel, as if I am a social equal of doctors and dentists by virtue of being university educated but I suppose the professional distance thing is even greater and more intimidating for those who do not feel this and it is then even more important for those people that the dentist should seek to reduce any perceived social/professional (real or otherwise) distance.

From the DFC Home page:
'We view people as partners and active participants in their care'. For me being partners, implies friendliness, working together and some considerable degree of equality.

 

[letsconnect]

Re: NLP or CBT

Maybe what Daniel is saying is that he feels dentists needs to put their patients' needs before their own, and this is why the relationship is unequal? (which would be sort of the opposite view - that the dentist is actually in a subordinate position and has to yield to their patients' needs, more like a servant than a friend in some ways )

I'm really enjoying reading everyone's comments (so much more eloquent than my own ) - stop editing them, lol! (oh and thanks for the politeness theory link - I hadn't come across that one before - very interesting!!)

 

[brit]

Re: NLP or CBT

Maybe what Daniel is saying is that he feels dentists needs to put their patients' needs before their own, and this is why the relationship is unequal? (which would be sort of the opposite view - that the dentist is actually in a subordinate position and has to yield to their patients' needs, more like a servant than a friend in some ways )

Maybe, but the trouble is the reality is that a lot of dentists would definitely not see themselves as the 'patient's servant' and see themselves as the authority figure in the unequal relationship of dental knowledge - where they have the power of (unnecessary) diagnosis over the vulnerable patient.

It is much easier to teach dental students to be 'friendly' and therefore build good working (note I said working not professional) relationships more easily, than it is to get them to see themselves as the 'patient's servant'...not going to happen...NHS dentists are most definitely not the patient's servant i.m.h.o..given the limited time available and the limited treatments covered.

 

[brit]

Re: NLP or CBT

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.

This is all well and good in the case of an ethical dentist who would only ever recommend what they would consider appropriate for their own teeth in the first instance but it is not the real world to think that all dentists behave ethically and are never financially motivated, so a dentist's friendliness and ability to put the patient at ease and how much what they recommend seems to make sense to the less dentally-informed patient (anxious or not) - will be one of the ways the patient judges whether they feel they are in 'good safe' hands and whether to go ahead with treatment.
Someone obviously standing on professional distance would not find me taking my 'ongoing elective dentistry' needs along to them because I want to view a dental appt as being on a par with a trip to the hairdresser i.e. no big deal.
Patient's can only go on someone's reputation, hearsay and how the dentist personally makes them feel, in choosing who provides their care long-term, so I think the more the dentist reduces the professional distance which is undoubtedly there, the better for building up their practice.

 

[Dr. Daniel]

Re: NLP or CBT

Hey everyone.

I would like to elaborate a bit about the whole "friend" issue that I raised.
What is the differance between a conversation between friends and a conversation between patient and a psychologist? It is not the diploma's, it is not the money element, it is not the special location of the clinic (a clinic or a coffee place). There is only one fundamental differance and this is that when friends meet together, the focus of the interest can shift from one friend to the other. However, in therapy the focus of the hall meeting is on the patient. The same principal is applied to any kind of treatment, including at the dental clinic: the focus is the paitnet's needs.
This is indeed an ethical concept, and in the real world things work differntly. There are many dentists who unfotunetly (ab)use their authoroty and the paitnet feels helpless in this situation.
That is why I find it important to raise this concept in this thread. I was trying to incourage thedental phobic readers to do two things:
1) Tell the dentist what are their needs. For example: "I need to know what is happening during the treatment", or "I do want to feel any pain", or "I suffer during the dental treatment because of my fear".
2) Make sure that the dentist aknowledge and actualy does something about it, shows a commitment to attend this need. If the dentist does not do so, I think this dentist is not suitable to treat phobic patients.

I do agree that when the communication between the dentist and the patient is open, transperate, and onest, most likely this concept is apllied.
However, there are dentists who are friendly and charming bu tthey actaully do what they want to do. As an example, there is the film "10", when Dudley Moore goes to such a dentist.

 

[gettingthere]

Re: NLP or CBT

I think this is a really interesting and important debate – although perhaps no longer particularly relevant to the original topic. For my part, I’m a bit concerned that, having voiced my worries about the original statement being potentially damaging to phobics, I have gone on to further perpetuate this through my own claim that the relationship is not equal. Having thought about this for most of the night, I was actually planning to qualify this with an alternative view but see that Letsconnect has beaten me to it with the same thoughts – lol. Maybe what Daniel is saying is that he feels dentists needs to put their patients' needs before their own, and this is why the relationship is unequal? (which would be sort of the opposite view - that the dentist is actually in a subordinate position and has to yield to their patients' needs, more like a servant than a friend in some ways) I was originally thinking that the dentist had the slight upper hand by simple virtue of the fact that the patient pays him to provide a service but yes, there is a converse way of looking at this, which gives the patient as the paying customer, more “power” in the relationship, which is a useful way for anxious patients to reframe the situation to allow for more comfort and confidence in the dental office but yes, Brit is correct in saying that asking trainee dentists to think this way is likely to increase resentment of the patient rather than help build constructive relationships, which is why it is easier to think in terms of “friendship”. Perhaps this is all just a semantic issue and it is the notion of “friend” that is the sticking point rather than how a dentist, or indeed a patient, should behave in the clinical setting? If, for example, I was asked to write out a list of my “friends”, I would no doubt centre this around people I see socially, enjoy spending time with (at least some of the time, lol) and with whom I have a “real-life” connection – some more distant than others. This satisfies definition 1 in LC’s post and often also 3 & 6. I wouldn’t think to consider my dentist as part of this list. If, however, I was writing a list of people whom I trust, who have shown me mutual and equal respect and who have supported me in difficult times, my dentist would be pretty damn near top of the list along with a core group, but not all, of the first list (and others including my current doctor). In this case, going by definition 3 in particular, I could still term this group to be my “friends”. Brit,Quote:Originally Posted by gettingthere
At the end of the day, I would not want my best friend practicing dentistry on me, even if she were hugely skilled in the field -Well we are all different and I for one would; and if I had any relative including a parent skilled in the field who I trusted, I would want them to work on me as well. You would at least know from the 'get go' that they would have your best interests at heart...which is certainly not a given otherwise.

I have a few medical doctors amongst my personal friends and they are all people who I would judge as being extremely kind and friendly with their patients, I highly doubt anyone is scared of seeing them. This may be because I only make friends with nice people. Their patients are not their friends (well some are actually) but the key to the success of the professional relationship is their medical knowledge coupled with good friendly communication skills. One is in small village and he is known for 'hanging out over a cuppa to hear the gossip' on home calls and he is essentially a 'friend of the family' for many long-term patients. He would socialise with anyone with shared interests if he gelled with them, whether they were a patient or not. Life's too short and in some cases too remote for all this professional distance stuff. I have also been thinking a lot about this issue, which I raised, and can only say that it comes down to personal experience and you have been very lucky (perhaps this is the norm and I am the unlucky one?) in your dealings with both medical professionals and people you have met in everyday social life. Yes, had I had the same experiences, I would probably feel exactly the same way but the fact remains than in my life I have had the misfortune to meet 5 unfriendly dentists and 1 great one. The ratio of unfriendly doctors almost the same. Added to this, I know two medical professionals in my social life. One is the wife of my husband’s friend and it is clear to me – and to her – that she would be much better off in a research position as everytime I meet her she is complaining about the patients with whom she comes into contact as she finds them needy, whiny and should be grateful that she is there to make them better rather than getting upset when treatments are unpleasant. I have also heard her say that she seeks to deliberately hurt particularly annoying patients and she and colleagues often have contest to see who can be the first to “make a grown man cry” when giving injections. Funnily enough, this hasn’t helped my negative feelings about health providers or needle phobia. The other is a GP friend of a friend, who turns up at weddings, christenings and other occasions connected to our mutual friend. Unfortunately and coincidentally, I went to school with this woman where she bullied and made my life misery. Yes, people can change but again knowing that she has gone into this profession re-enforces my negative stereotypes of GPs. One thing that I try to remember, however harsh this sounds, is that neither of these women are my “friends” through choice. I find it difficult to look at my “real friends” and imagine whether I would let them practice on me if we were in this situation simply because I find the idea of being friends with a doctor too strange for my liking. Conversely and perhaps contradictorily however, I do have such a good relationship with my current dentist and doctor that if this were to spill into “real-life”, I think both would slot right in amongst my social circle because they are nice people and easy to talk to – the type of people to whom I can imagine being – and would be proud to be – friends! This is mainly because if both of their respective clinics, I am not really aware of any “professional distance” – I am treated as an equal, even if that is not really the case, and because of this way of treating people I couldn’t care less what the “real” situation is. All that really matters is this feeling of equality and mutual respect. Just thinking I feel, as if I am a social equal of doctors and dentists by virtue of being university educated but I suppose the professional distance thing is even greater and more intimidating for those who do not feel this and it is then even more important for those people that the dentist should seek to reduce any perceived social/professional (real or otherwise) distance. I think a good practitioner will treat all patients as equal to himself and also to each other regardless of how many qualifications or similar once might possess. Concentrating on education as a measure of equality can also have an opposite effect – when I was in hospital for extractions under GA, the anaesthetist was chatting and questioning me about myself to distract from the situation which was really starting to freak me out. When I mentioned university she laughed and said that as an educated person, I should know better than to have “silly” phobias and that I was the first intelligent person she had come across to have this kind of reaction. This made me feel worse and really affected my self esteem for a while. In terms of power/distance I felt more unequal to doctors/dentists than ever before by virtue of the fact that I should be “like them”. When all is said and done, conversation is a two way thing and within the dental clinic this needs to be upheld whether discussing the patient’s teeth (allowing the patient to have an equal say in potential treatment options rather than the dentist dominating the conversation by being dictatorial and authoritarian) or simply chatting about hobbies and interests – either as a way of putting new patients at ease or continuing a natural exchange with long-term patients with whom a solid relationship has developed. A dentist who chats in a friendly manner about outside topics and then proceeds to dictate dental treatments is as unhelpful as one whose sole purpose is to talk about teeth, even with the full participation of the patient, but show no interest in that patient as a person. This is symbolic of friendship and should allow both parties to benefit from the dr-patient relationship – which is my understanding of Dr Daniel’s post.

 

[brit]

Re: NLP or CBT

Gettingthere
Thanks for pondering further...I hope I can withdraw from this thread now...I despair at how you run into so many 'cruel medics' - the comment about intelligence from the anaethetist would be inappropriate/rude in any social situation never mind one in which she is supposed to be emotionally supporting you through 'going under GA'.
Our experience with medics is happily chalk and cheese.
I believe my experience to be more the norm for the UK because if yours were more typical, 'doctor phobia' as opposed to 'dentist phobia' would be much more widespread.

Your 'nurse friend' is simply in the wrong profession and will no doubt come unstuck one day when someone complains.

On DrDaniel's thing about the charming dentist being a risk too (as per Dudley Moore film which I haven't seen)...I'll take my chances...i.m.e. coldness is a good indicator of 'it's time to run'...been there, done that.
Friendly, caring (painless) and competent are my criteria. Like you, Gettingthere, my current dentist would be high up there on list of people I trust, not because I have asked him to do anything special for me...he seems to treat all his patients in the same manner...he treats me the way I want to be treated without me having to say anything...this is bordering on perfection for me...a manner which is very unlikely to ever produce a phobic patient. He has had treatment himself which probably explains why he puts the patient's comfort first so much (or it could just be for financial reasons, to make you come back and refer friends but I doubt it).

When Drdaniel mentions knowing dentists who are phobic themselves of treatment, I have to wonder how painless their dentistry is, no wonder they are afraid if they do bad uncaring dentistry themselves.

 

[Dr. Daniel]

Re: NLP or CBT

On DrDaniel's thing about the charming dentist being a risk too (as per Dudley Moore film which I haven't seen)...I'll take my chances...i.m.e. .....
...When Drdaniel mentions knowing dentists who are phobic themselves of treatment.

First of all, I did not say that being charming dentist is a risk, not at all. I appriciate people who are friendly with me and I try my best to be friendly to others. What I tried to do is to distinguish between the style of communication (being charming) and the actual direction of the treatment (the well-being of the patient).
Regarding the dental phobic dentists, without mentioning names, I know two specialists for treating children (pedodontologists) who are afraid of the dentist, specially because of fear of pain. I speculate that this is why they chose to specialise with children, because of their own story.

 

[gettingthere]

Re: NLP or CBT

Gettingthere
Thanks for pondering further...I hope I can withdraw from this thread now...I despair at how you run into so many 'cruel medics' - the comment about intelligence from the anaethetist would be inappropriate/rude in any social situation never mind one in which she is supposed to be emotionally supporting you through 'going under GA'.
Our experience with medics is happily chalk and cheese.
I believe my experience to be more the norm for the UK because if yours were more typical, 'doctor phobia' as opposed to 'dentist phobia' would be much more widespread.

Okay, but remember that, as I have detailed elsewhere, I was conditioned as a child to believe that doctors (and dentists) were bad people whose mission was to hurt and humiliate. The notion of medics as helpers and healers is actually pretty new to me and one that I have tried hard, and am still trying, to adopt as my default response in recent years. Yet sometimes I lapse back into negative thinking and I will concede that although I have had the misfortune to meet a few very unhelpful people (this anaesthetist and a few specific others), it is possible that, especially in my early years, some of the doctors whom I recall as being unfriendly or even frightening, may not have been so but my own expectations and interpretation of appointments may have clouded my judgement or I subconsciously rejected these events as they did not fit my internal negative model of what a doctor is. In fact, if I am being honest with myself, my statement in the last post was an example of a negative knee-jerk reaction the concept of doctors and in thinking about it further, I can come up with a good number of doctors (and nurses – including those I came across during my GA experience, who couldn’t have been nicer and which illustrates this point as I had disregarded this in favour of focussing on the bad element of the day) who have shown me kindness and respect – one that at least equals the truly bad experiences and I have edited my original post accordingly in light of this.

And in this, we seem to have come right back round to CBT!!!

 

[brit]

Re: NLP or CBT

First of all, I did not say that being charming dentist is a risk, not at all. I appriciate people who are friendly with me and I try my best to be friendly to others. What I tried to do is to distinguish between the style of communication (being charming) and the actual direction of the treatment (the well-being of the patient).
Regarding the dental phobic dentists, without mentioning names, I know two specialists for treating children (pedodontologists) who are afraid of the dentist, specially because of fear of pain. I speculate that this is why they chose to specialise with children, because of their own story.

Well I hope they are providing pain-free care for those kids...and if they are, surely they can bring themselves to believe the same is available to them even if they have to travel a bit, should they seek it out.

Drat I came back into this thread!

 

[gettingthere]

Re: NLP or CBT

Well I hope they are providing pain-free care for those kids...and if they are, surely they can bring themselves to believe the same is available to them even if they have to travel a bit, should they seek it out.

Drat I came back into this thread!

Or, perhaps it comes down to what I said about myself on another thread in that I am still afraid of "the" dentist, i.e. knowing that an unfamiliar dentist may cause me pain but am not at all fearful of my dentist and his methods.

"Dentally fussy", remember

 

[vicki]

Re: NLP or CBT

Wow, this has certainly taken a different direction from the original question !

I wonder if the distinction needs to be made between being 'a friend' and 'being friendly' ? For example, as a hypnotherapist, people come to see me with all sorts of problems and issues. They come because they are experiencing some sort of difficulty in their lives and they want help to sort it out and ultimately feel better about the situation. If they had the experience and/or knowledge to work with their problem/issue themselves, they wouldn't be coming to see me, so in that sense, the client-therapist relationship is unequal because I have the training and experience etc, whereas they do not.

However, the client-therapist relationship is equal because they are coming to see me, for which they pay me a fee and in return I use my knowledge and skills to help them with their problem or issue (pretty much the same as a patient goes to see a dentist). So in simple terms, it's an equal exchange - one thing in return for another. If it was unequal, where one person either had more importance or was perceived to have more importance, then this would lead to several issues including the client maybe feeling as though they are being judged and therefore not able to fully express their feelings (this is just one example).

In the course of therapy, in order to help the client feel at ease and able to talk freely about whatever is troubling them, I need to be 'friendly' and talk to them in their language, in a way that we both understand and in a way that makes them feel comfortable. This may involve mentioning aspects of my personal life if it's relevant to helping the client, as it's part of building rapport (although I don't ever tell people with dental phobia that it affects me too...!! ). However, the focus is always on helping the client as part of the client-therapist relationship which is based on mutual trust and respect. So in other words, I am 'friendly' but I am not their 'friend'.

If the relationship were to cross the line from being 'friendly' to being 'a friend', the therapist-client relationship would take on a completely different dynamic altogether and probably wouldn't work - I suspect the same is true for other types of relationship e.g. dentist-patient, doctor-patient etc.

 

[letsconnect]

Re: NLP or CBT

I don't think we fundamentally disagree on the issues raised here - a lot of it seems to be down to semantics. The sentence "The dentist is not supposed to be your friend" could be easily (mis)interpreted to mean "The dentist is an enemy and is not on your side" (as per definition 3 of the word friend).

When I originally read that statement, it reminded me of an article which Keith Hayes for this website back in 2004 where he referred to his patients as his friends - and I must admit, it brought a smile to my face at the time . I don't particularly like the word "patient" (mainly because of its latin origins - the original meaning being "undergo, suffer, bear"), but haven't come across a good replacement as of yet (both client and customer seem to emphasise an monetary transaction rather than the care dimension).

What is the differance between a conversation between friends and a conversation between patient and a psychologist? It is not the diploma's, it is not the money element, it is not the special location of the clinic (a clinic or a coffee place). There is only one fundamental differance and this is that when friends meet together, the focus of the interest can shift from one friend to the other. However, in therapy the focus of the hall meeting is on the patient.

Yes and no... I would think that most psychologists learn a great deal from their clients/patients, so the relationship especially for a novice psychologist would often be quite reciprocal. I remember reading Dave Carbonell's book on panic attacks and he described how he developed an interest in this topic when he met a patient (whom he was supposed to assess I think) and felt totally out of his depth, so he asked this person to explain to him and teach him about panic attacks. And although on the surface, the focus of the interest is still on the patient and their issues, the knowledge gained in this example actually benefited the psychologist much more than the patient (of course, future clients/patients may have also benefited!).