- Nov 11, 2008
WOW- I feel so lucky to have found a fellow geek!!! I am also interested in linguistics, but my real baby is literary theory. I really think that "control" is an illusion in a dental situation, both due to the inherent nature of the exam, equipment and my own bad experiences. I cannot help but think about it terms of Foucauldian concepts of power and control.
Geeks Anonymous! We should have our own sub-forum. Three members and counting!
There is a famous linguistic theory on “politeness” by Brown and Levinson which calculates variables such as perceived social distance and power to examine what they refer to as Face Threatening Acts in both positive and negative ways or what we usually think of as being “polite” or “impolite”. For my hons dissertation I shadowed retail assistants in a few different department stores (with the stores’ permission!) to apply the theory and create an understanding of what we would class as good or bad customer service. Typically the problems arose when there was a conflict of power and distance with both assistant and customer believe they had the upper hand on each other. I think a similar study in dental offices would be fascinating, to show how the choice of language used by dentists can convey a heightened sense of power over the patient and add to the fear and could lead to a better understanding of how to communicate with different groups of people. In addition to this, I have long felt that a study on the harsh sounds which naturally occur in many fear inducing words in long overdue. Certain phonemes create a lot of noise and/or are plosives meaning that they can be “spat out” which a lot of people do (IMO) when talking about things they find distasteful or want to convey a sense of foreboding. Like the way in which many people will say “well, I’m off to…. The DENtist…” in that tone of voice which tells us exactly how they feel about the appointment – whether due to a genuine anxiety, for humour or because it’s just what you do/how people say it… I would love to hook a variety of people up to a spectrograph to measure the sound energy when saying words such as dentist, injection, jab etc and perhaps measure them against words which are more obviously threatening with similar sound patterns like, well danger for example. You could do this with people who report no fear, those who identify as dentally phobic and also dentists themselves to see the differences and then also use the spectrograph to try different tone of voice and see how that affects the bursts of energy which could lead to conscious modification of voice to create a more soothing experience for the patient.
But then I am a geek. And a geek that missed my chance to do this and to old to go back.
Shamrockerin, there were a few thoughts that came to mind when reading your post so I wanted to respond.
Hence, why I do not feel "in control" as a dental patient:
1. I am outnumbered from the moment I walk into the office. The dental assistant is there to assist the dentist; she's on his 'team' and I have no one on mine while I am back there. There's nothing like being outnumbered to make you feel defenseless.
This comes back to the issue discussed elsewhere about dental assistants. I am lucky that the practice I attend has a culture of letting patients get to know the assistants and I do feel that they are on my side – or at the very least, neutral in proceedings and I could easily talk to any one of them about particular fears on any given day. I actually feel like they are a kind of advocate for me. If things don’t work that way in your practice – and I have had exactly the opposite in previous experiences myself, could you have your husband or trusted friend/relative with you? I know I couldn’t allow anyone I know “in real life” to see me at the dentist so in a way have learned to take comfort in being out there on my own – I feel more in control having made that decision not to allow another team member.
2. The way the dental chair reclines so that i am lying flat on my back. i understand that this is the way modern dental chairs work and that it is more comfortable for the dentist, but lying flat on one's back certainly does not reflect a feeling of being in control.
I can only sympathise here. This is an issue with which I still struggle. Again though, the panic and loss of control does subside for me when the dentist/hygienist/assistant starts talking me through the appointment.
3. The old adage about having the "upper hand"? Well, since the dental team hovers above me, they actually DO have the upper hand! It's very easy to assert physical and mental control over someone when you are above them.
Again, this is true and I can only say that familiarity and a comforting environment where the dentist makes a point of telling me that this is my appointment and I am in control has helped me overcome this.
There are also, of course, situations where lying flat out and/or having someone standing over you can be a good and relaxing thing. I’m thinking about massages and other beauty treatments but I am sure there must be more but one you start thinking that being in this position needn’t always be a negative thing, you can make the leap to it not always being negative in every specific situation either.
4.The dentist says "Raise your hand if you feel anything". Well, this sounds great in theory, but raising hands is something that schoolchildren do. It is an action taught to them by authority figures (teachers) and subverts their agency. I can raise my hand all I want, but ultimately, the dentist has the decision to "call on me" or acknowledge my signal. Also, this illusion of control shatters incredibly easily. . .say, when a dentist tells you to raise your hand if you "feel anything" and then ignores your signal.
Perhaps this is something to discuss with your dentist. Due to some bad experiences in my past, I do not feel comfortable using a stop signal despite having utmost trust in my current dentist and my issues with this have similar roots to what you mention. Instead I have a system where I ask my dentist to stop at regular intervals, before the treatment has begun so the onus is not on me to have to raise my hand or worry about the signal being ignored or upsetting the dentist. Yes, it still puts the authority on him but in asking it to be done this way at an early stage and seeing my wishes respected, I still feel in control and it is a system with which I am much more comfortable.
5. Dentists have titles: I always call my dentist Dr. S----- out of respect and politeness, and I can only imagine the amount of work and sacrifice it takes to achieve that title. However, the fact that dentists have titles while their patients (like me) do not, highlights the nature of the power relationship and implies Marxist assumptions relating to education and intelligence.
I have been discussing this recently with not a dentist but a medical doctor. Both this doctor and my dentist go by first names and it took me a while to get used to that but it does certainly level the playing field to some extent. Of course other people do not like this and take comfort in titles, feeling that this emphasises the clinician’s professionalism or perhaps they don’t want to “humanise” the clinician, preferring what happens in that office to be a separate world from real life where people have names. You could, however, insist on being called by your own title (Mrs/Ms/Miss/etc) just to put in some additional power/distance if you would feel more comfortable.
On a personal note, I’m only 33 but hate it when people just call me by my first name without asking first. It makes me actually tell them, “it’s Mrs… if you please”. I’m such a fuddy duddy but no matter if I am in a bank, shop, sports centre, doctor’s office… I like to be asked if it is okay to use my first name before just jumping in there.