Somewhat complicated reasoning going on here, should be over this, am not.

[happywithoutyou]

I'm not sure really if this is too crazy/complicated for this forum but I need to vent somewhere and it kind of seems like this is the most appropriate place. There isn't really a forum like this for more general medical phobia and the next thing I have to address is dental stuff, so I hope this is ok.

I used to(?) have a fairly complicated needle phobia which was basically with me my entire life but expanded into something resembling OCD where I was kind of forcing myself to think about needles constantly and consequently permanently triggering myself. I went through almost a year of combined cognitive analytic and exposure therapy and considered myself recovered until something happened a few months ago which I think might have messed things up.

My issue is that I cannot stand to be restrained, or feel restrained, cannot get my head around the idea of allowing someone to hurt me on purpose, but also could never ever force myself to tell someone to stop if they *were* hurting me. I need to feel in control but found it very hard to exert that control, ever. Part of my therapy was learning how to say stop, and then working on not needing to say stop! I was doing so much better until I had an endoscopy a few months ago, was sedated, and was refused when I told the doctor to stop the procedure. I feel like I partly remember it, may be imagining it, but have been told by my partner who was standing outside that I did indeed tell them to stop and they did persist, though he said no more than that and I didn't ask. Anyway since then all the old feelings have come back.

*I started seeing a dentist alongside my therapist last year but have been having issues with my wisdom teeth and gums for about three months and can no longer bring myself to do anything about it (I tried, and it seemed that when my therapist wasn't around, the same dentist was not-so-nice).

I also have a fear of vomiting which was never addressed in therapy (probably not helped by the whole endoscopy scenario), and am now unable to tolerate x-ray plates (when I did go back to the dentist she simply gave up). This is also linked in complicated situational ways to everything else.

I'm not quite sure what the best next step is. I definitely need a deep cleaning and the possibility of my wisdom teeth being impacted was mentioned. I do not want to undergo IV sedation again because I would be out of control. Part of me feels like I need to flood myself with phobia stimuli but I cannot do that unless I'm with a cooperative dentist who will work on my terms and stop me from trying to take myself out if things go too far too quickly. And I don't know that I could force myself to do it completely cold turkey without some kind of chemical assistance. Am I damned if I do, damned if I don't?

 

[tabatha7]

Re: Somewhat complicated reasoning going on here, should be over this, am not.

What about general anethsia? You would be completely out that way. Is this an option?

 

[happywithoutyou]

Re: Somewhat complicated reasoning going on here, should be over this, am not.

That feels like even more of a loss of control. I need to be at least partly present, if that makes sense

 

[letsconnect]

Re: Somewhat complicated reasoning going on here, should be over this, am not.

Hiya ,

you are on the right forum! It's really quite common for medical phobias and dental phobias to co-occur, because the underlying concerns are usually very similar.

It sounds to me as if you already know what to do: find a dentist who is prepared to take things at your pace, and someone you can really connect with. It must have been quite horrible to realise that the dentist you've been seeing was "putting on an act" while your therapist was with you. You didn't really say what the dentist did differently, but I take it that the whole thing kind of fell apart once you didn't have your therapist as an advocate with you.

You're ahead of the game in that you've got quite clear ideas about what you fear and how you would like to be treated, e.g. setting the pace and being in control. And you probably already have quite concrete ideas about how you would achieve these things, if you had a co-operative dentist.

I'm making the assumption (knowing how difficult it can be to find sympathetic dentists) that the problem now is finding a co-operative dentist, who is not too intimidating, because that wouldn't allow you to voice all the things you already know and steer them in the right direction so to speak. Someone who's a bit more humble and open to listening to you and taking new ideas on board?

Maybe it would also help to have an advocate with you - not standing outside, but actually in the room with you - someone with clear instructions as to when to intervene.

I also think that your therapist should know (if she doesn't already) that the dentist in question doesn't behave the same way when your therapist isn't around. This might make her look for someone else to work with and prevent other people experiencing a similar let-down.

I don't know what your relationship with your therapist is like now, but I'd think that tackling the emetophobia issue with her (or somebody else) might be a good idea. You've come such a long way!! Yes you were extremely unlucky with the endoscopy experience, and that was assault IMHO (maybe reporting them might ease some of the hurt and help others from experiencing similar treatment? - but like you said, it's actually quite difficult to piece together what really happened and the evidence probably wouldn't be strong enough), but you are able to say "no" now. And that's more than most people are capable of. You only need to look at the Milgram experiments to see how few people are capable of saying "no" to perceived authority figures.

Anyway, as far as I can make out, you're very well equipped to do this and avail of the treatment you want. You've got the self-insight, you've got the ideas, and you've got the ability to say "no". All you need now is someone who is happy to work with you .

 

[brit]

Re: Somewhat complicated reasoning going on here, should be over this, am not.


Finding the right dentist for you is the answer...someone you trust to work at your pace and not make you feel out of control. You clearly haven't found that person yet and it may well not be a lady dentist.
It's up to you how far down the sedation scale you go to find the right balance between control and being able to cope with the situation.

Once you find the right person..it is about liking them and trusting them...so long as that person also has painfree techniques...you should then ultimately be able to cope with just local anaesthetic..since there will be no pain during treatment.
These dentists are slightly rare but do exist. If you are in the States, a 'fee for service' dentist rather than an HMO type would have the ability to devote the extra time you may well need until you feel more confident. You need to pay for time and TLC from an ethical dentist and that way you will get over it.
It's definitely easier to be assertive re your comfort and stop procedures if you just use local anaesthetic but there may be a less drastic happy medium than going cold turkey like that.
It sounds like you were undersedated at your medical treatment and that has traumatised you...done by someone else it could have been a different story. I suppose they continued because you weren't screaming the place down...that's the danger with sedation and it's great that your boyfriend was right there so he could have intervened if necessary.
Best wishes - keep searching for a dentist who enjoys helping anxious/nervous patients without always just resorting to sedation for fastest results.