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What is hypnosis?
Hard to say... but it could be described as the quieting of the conscious mind. Hypnotists can help you achieve a state where
you can more readily access your subconscious mind, and then give suggestions to help you visualize what it is you want to
accomplish. Hypnosis is characterized by a trance state. "Trance" is a state of mind in which our normal awareness
of the outside world is reduced, and our attention is focused on some activity, physical stimulus, image, fantasy, thought
or feeling. People enter this state spontaneously everyday, for example being lost in thought or day dreaming, absorption
in sports, reading, listening to music, surfing the web or driving "on autopilot". Hypnosis formalises this process
of "entrancement" and intensifies it. The person being hypnotised is given a series of instructions which are intended
to assist them in achieving a trance state. Hypnosis is not a form of treatment or therapy in its own right, but is used as
an adjunct to other therapeutic approaches.
Hypnosis is NOT magic, you don't "loose control" any more than you would in the everyday examples above, and
as long as it's used by a responsible professional there should be no concerns regarding safety (more about this below). It
is impossible to hypnotize someone against their will - even if some stage hypnotism routines (such as making people eat whole
lemons and the like) seem to suggest otherwise, these people actually have the wish to cooperate with the instructions! For
example, they may wish to please the hypnotist, and enjoy performing for the crowd and being the centre of attention.
Another salient feature of hypnosis is RAPPORT - a "meeting of the minds", an emotional affinity or feeling
of mutual trust. Did you ever find yourself "mesmerized" by someone who exudes confidence and happiness AND appears
be interested in you as a person, AND has complete faith in you? That's a potent mix - it's very easy to follow suggestions
given by such a person. Being "entranced" in such a way is an example of "informal" hypnosis, that is,
hypnosis without a set of formal instructions.
Hypnosis in its broadest sense can be many things, let's look at some examples below.
Self-Hypnosis and Relaxation
Usually, the purpose of self-hypnosis is to achieve a state of relaxation. It can also be used to give yourself a set of instructions,
or positive feelings (for example, by repeating to yourself a positive statement about yourself). Or you can let someone else
do the hard work for you, and splash out on a hypnosis tape/CD! These come in many flavours, such as boost your self-esteem,
relax, go to sleep, etc. Check out our freebie - a 5-minute relaxation MP3:
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Free "Stressbuster" hynosis download (for use with stereo headphones)!
Click here to listen!
Click here to download Stressbuster!
The "Stressbuster" mp3 download is brought to you by Adam Sargant, who originally created this rapid relaxation
session because it annoys him that smokers can go and get a five minute chill out break when things get stressy, so he wrote
an exactly 5 minutes long relaxation session. While not suitable for treatment of a true phobia response, relaxation as a
technique can be a powerful tool for dealing with more general forms of anxiety. So if there are "no smoking" signs
in the waiting room, this will help pass the time until you can sneak out for a ciggie ;)... Recorded onto an mp3 player,
or onto CD, it can be played discretely on most portable audio players in the waiting room or on public transport.
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Dental Fear Central has received some negative feedback about the dental phobia download from www.hypnosisdownloads.com, so
you might want to save your money on that one. Apparently, it's very generalized and does nothing to deal with your specific
fears. One hypnosis CD series which has been highly recommended is by Dr. Rick Collingwood, e. g. "Happiness and Self-Esteem".
Search for Rick Collingwood on amazon.com, and it'll come up. He's Australian, so if you don't like Ozzie accents, you may
be out of luck. If you've tried any other hypnosis CDs you'd like to recommend (or warn people about), e-mail connect@dentalfearcentral.com!
Here's what a psychologist and fellow dental (ex-)phobic, John Harvey, has to say on the topic: "I find that deep-breathing
exercises and "self-hypnosis" types of relaxation exercises can and do work. The trouble with them is that they
usually work only if you practice them pretty much daily. Add to this the possibility of hyperventilating if the breathing
exercises are done incorrectly and the practicality of this approach seems limited. I won't say don't try meditating in the
examining room, but it may not be the best place to start practising. The exception to this would be a course of relaxation
training that was actually undertaken in a dental suite under the direction of a behaviour therapist probably when no examination,
cleaning or intervention was scheduled. That said, systematic desensitization with "imagined" stimuli (memories
of trips to the dentist) never really helped me. It has been informative, kind and competent dentists who have helped me re-learn
(literally) how to be a dental patient - through repeated exposure to good, collaborative care." (Journal of the Canadian
Dental Association, January 2005)
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DIY Relaxation Tips
The 7/11 Technique:
Go to the nearest 7/11 store, buy a big tub of ice-cream, and plonk yourself in front of the telly - instant relaxation! No,
wait - that's not it...
Very simply, you begin by breathing in through the nose to the slow count of 7 so that you inflate your stomach, chest and
as though you couldn't inhale any further. Then slowly, very slowly release the air by opening your mouth and breathing out
very slowly to the count of 11.
The in-breath influences the sympathetic nervous system which revitalises the person however, the outward breath influences
the parasympathetic nervous system which induces an unconcious relaxation response. It is recommended that you repeat this
procedure at least 10 times, usually with your eyes closed to allow you to keep your concentration. Apparently, this one also
works very well on reducing the intensity of the gagging reflex.
Some tips I find useful:
I like to close my eyes during any treatment - instant removal of noxious visual stimuli! If you'd still like to know what's
going on, have your dentist demonstrate what they're going to use first, and let them explain to you what they're doing while
you're not looking. This doesn't work for everyone (some people want to see what's going on at all times), but for me, it's
the single most effective flashback prevention measure. Very easy, too! Obviously, it all depends on the nature of flashbacks
and what events triggered them in the first place, so for some people this may actually be a bad option. Some people don't
want to know anything at all, in which case sedation may be the way to go! Again, go with what feels right for you!
A lot of people will hold their breath when they anticipate pain, experience some discomfort, or are otherwise anxious.
Make an active effort to remind yourself to breathe normally.
Fold your hands on top of your tummy, unless you prefer someone to hold your hand (don't hold on to the side of the chair!),
and make an active effort to relax your hands as well as the parts of your body which tend to get tense, e. g . your back.
Concentrate on finding areas of tension and relaxing them. This actually requires quite a bit of concentration. If you feel
up to it, you can visualize a relaxing scene, such as lying on a - rather buzzy ;) - beach, on top of that (which exceeds
the powers of my concentration... but a lot of people find visualization quite easy to do :-)).
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Hypnosis
Some dentists are also trained in hypnosis. Mike Gow for example, who's put together a whole site with frequently asked questions,
so there's no point in repeating it all here - simply go to his site:
Hypnosis and Dental Hypnosis
First of all, let's distinguish between "informal hypnosis" (much of what was described earlier on this page, such
as rapport, would fall into that category) and "formal" hypnosis. What follows is in relation to formal hypnosis.
Some applications of hypnosis in dentistry include controlling a strong gag reflex, treating chronic facial pain, modification
of unwanted habits such as teeth grinding, and much more. Interestingly, it is not used that frequently for treating the actual
phobia. This is because hypnosis works extremely well with some people, but isn't for everyone. For example, Mike uses hypnosis
"formally" with only about 15% of his phobic patients. But for those 15%, it works really well! It is also common
to integrate hypnosis with sedation. Hypnotic techniques can be used to enhance the effect of sedation (IV and perhaps more
so inhalation) - not necessarily in the context of "formal" hypnosis however.
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The Big Debate - Can Hypnosis Be Harmful? How to Find a Safe Hypnotherapist
It has been suggested that hypnosis is a bad idea if someone has experienced certain types of trauma. Are there any circumstances
under which hypnosis could prove harmful?
Firstly, a Quick Summary of trauma types:
Type I and Type II Trauma are terms developed by Lenore Terr to describe different types of trauma. A single traumatic
event such as a fire or single rape episode is considered to be Type I Trauma. Repeated, prolonged trauma, such as extensive
child abuse, is considered to be Type II Trauma. According to Terr's formulation of this concept, these two types of trauma
result in different coping styles. Individuals with Type I Trauma receive support from family and friends and usually remember
the trauma event. This can often be the type of trauma experienced by individuals who have had a bad previous experience at
the dentist's. Individuals with Type II Trauma are more likely to have severe PTSD symptoms, such as psychic numbing, and
dissociation. Type II Trauma is often kept a secret and support from family and friends may be absent. Solomon and Heide build
on the work of psychiatrist Lenore Terr, by proposing a third category, Type III trauma. Type III trauma occurs when an individual
experiences multiple, pervasive, violent events beginning at an early age and continuing over a long period of time. Diagnostic
criteria include alterations in memory and consciousness, frequently including dissociation; emotional numbing; major developmental
deficits; poorly developed, often fragmented, sense of self; a core belief that he or she is fatally flawed and has no right
to be alive; a sense of hopelessness and shame; trust issues that interfere with normal relationships; and no concept of a
future. Treatment of individuals who have sustained Type III trauma is more complex and demanding relative to survivors of
Types I or II trauma.
There are two circumstances under which hypnosis could prove harmful in the context of dental phobia:
(1) A patient may be attending a 'hypnotherapist' for the phobia and a dentist for the dental treatment. Now, the dentist
may possibly repeat a bad experience, and therefore contradict 'promises' made by the hypnotherapist. The danger would be
if hypnosis is used to promise that everything will be ok, and then something unexpected happens - as this will obviously
worsen the phobia by re-traumatising the patient. Usually it is possible to avoid this problem by NOT promising anything when
possible, but instead to state what is 'likely to happen' while highlighting that 'in the unlikely event of x, y or z, you
will be pleasantly surprised by how little it bothers you and how in control you feel'. Patients also should always be able
to stop the procedure if things are getting to a point whereby they are feeling traumatised again.
(2) There may be another related or unrelated type II trauma on top of the type I trauma of the bad dental experience.
It is important that anyone using hypnosis is able to recognise if there are other psychological issues (e. g. in this case
the possibility of type II trauma) and, if these issues are outside their field of expertise, to refer to an appropriate individual.
Obviously as a dentist I would not be using hypnosis outside my field and would therefore not be treating people suffering
from other type II trauma anyway. If such a trauma is suspected or identified, an appropriate referral for that problem is
made should the patient wish.
Should hypnosis be avoided completely in the case of a type II trauma?
I don't see why a professional who deals with type II or even type III trauma anyway should not use hypnosis in a controlled
and responsible manner with such a patient in beginning to come to terms with whatever the problem is. I would just say something
like "It is essential that that your hypnotherapist is fully trained in treating your problem" (even if they did
not use hypnosis). Hypnosis is an adjunct to therapy, and it can only be as effective as the underlying therapy permits.
How can people ensure that a hypnotherapist won't "mess with their heads" and inadvertently harm them?
I would recommend that hypnosis should be used as an adjunct to therapy by an appropriately trained professional who is a
member of a recognised society. There are many 'lay' hypnotherapists and the public find it very difficult to differentiate
between people who are plumbers and did a weekend course and now (quite legally) advertise in the yellow pages, and folk who
have an associated profession in which hypnosis is used as an adjunct, and have undertaken extensive courses. Even with detailed
explanation of qualifications it is difficult to know what's what. There has been some controversy recently as a 'lay' organisation
hired a room at a London Hospital, and certificates were issued to people with no medical/dental/psychology background stating
that they trained in hypnosis at the Hospital! How misleading is that to the public! Definitely a mine field, and my advice
would be stick to a professional who is a member of one of the recognised hypnosis societies. Lay hypnotherapists ARE NOT
qualified in any way, and often have undertaken a hypnosis course despite their lack of related qualifications. They then
promote themselves as qualified hypnotherapists. Qualified hypnotherapists are very much in a minority. As there is no real
stipulation for additional qualifications in hypnosis, any dentist (or medical professional) can 'dabble' in hypnosis with
only a very basic understanding of it. It is my opinion that anyone going to a UK hypnotherapist should use someone who is
registered with one of the major hypnosis societies in the UK, i.e. BSECH, BSMDH, BSMDH (Scotland), BSMDH Mets & South,
or RSM Section of Hypnosis & Psychosomatic Medicine. Anyone who is a member of these societies has at the very least undergone
training (probably of 4 to 8 full days) related to their profession. This would undoubtedly be the safest way of determining
that you are going to someone who is qualified in treating you. UK and Worldwide reputable hypnosis societies can be located
by contacting the International Society of Hypnosis. Societies can be found by searching their website:
International Society of Hypnosis Website
The information above was provided by Mike Gow, BDS (one of only five dentists in the UK with a M.Sc. in Hypnosis applied
to Dentistry!). Many thanks to him for taking the time to answer these common questions. If you're in the US, you can check
for membership in the American Society of Clinical Hypnosis or the Society for Clinical and Experimental Hypnosis (these are
the only two nationally recognized organizations for health care professionals using hypnosis). You can contact a state or
local component section of the American Society of Clinical Hypnosis to find out if a person is a reputable member.
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NLP (Neuro-Linguistic Programming)
While much of neuro-linguistic programming, or NLP for short, consists of Dale Carnegie-style stating-the-obvious with some
New Age elements mixed in, some of its principles are sound. Basically, it's about changing the way you interpret and think about
things. The two most common NLP techniques used for phobias are termed "anchoring" and "submodality modification" - here's the lowdown:
Anchoring
Basically, anchoring is sort of a formalized learning by association. To recap the meaning of "learnt association":
e. g. fear of the "drill" (sorry, handpiece ;)) is a learnt association between a particular stimulus (what you
see, hear, smell or touch) and a particular feeling (most commonly, that would be fear if you weren't properly numbed). Obviously,
you can also learn to associate stimuli with positive feelings. For example, many people find that the smell of freshly baked
bread and coffee evokes a pleasant feeling.
Associative learning most commonly occurs spontaneously and automatically, but you can make a conscious effort to associate
a stimulus (e. g. dentist) with a response (e. g. total and utter bliss ;) - you may find this a hard one to pull off *grin*,
don't worry - you don't have to go that far...). The link between the stimulus and the feeling is instant, automatic and repeatable.
Proper anchoring NLP style, however, usually requires the help of a practitioner, who will help you create a so-called
"resource" anchor. Basically, that's a physical signal you give yourself (such as curling your toes) which then
triggers a happy feeling (such as self-confidence, or a sense of control). I had a link to detailed instructions here, but
it's disappeared already, which sort of confirms my suspicion that NLP is a fly-by-night activity... oh well! If you're REALLY
into it, you can always find an NLP practitioner (they often attach "Masters" degrees to their name, but please
note that these are not proper university degrees).
Submodality Modification
Most people remember events in the form of pictures. These pictures can be represented in lots of different ways. For example,
you may be looking at the picture as you saw it or you may be picturing yourself during the event. The picture may be close
to you and large, or small and further away. It may be bright and colourful or dim and in black-and-white. The characters
may be moving and you may "hear" sounds accompanying the event. Or they may be still and silent. All these features
are examples of the "submodalities" of the memory and you will tend to be more emotionally involved with the memory
if the picture is brighter, closer, more colourful and if you are able to associate sounds or even smells with it.
To use the technique of "submodality modification", you change the submodalities of the memory so that you are
able to feel better about it. For pleasant experiences that you want to enhance, you brighten, colour and animate the picture
and bring it close to you. For bad experiences you dim it, dull it and move it further away. Try the following example:
Recall an event that was unpleasant for you. Most (but not all) people find they're either in the picture or the picture
will be close to them and the figures large in it. It will probably have colour and be quite bright and you may be able to
hear and smells things.
Now pretend you've got a TV-type remote control, which you can use to change the picture quality and much more.
Using the remote control, put a frame around the picture so that you are no longer in it but watching yourself. Then,
use the "zoom out" function to move the picture away so that it gets smaller and smaller. Turn the brightness and
colour down. You might want to turn the volume down and stop the action. Now pick up this tiny dark picture, put it in a box,
close the lid and walk away.
Many people find that this exercise diminishes their negative feelings about the unpleasant event. And apparently it becomes
easier with practice.
A word of warning: this exercise is not recommended for major traumatic events, as it could provoke uncontrollable flashbacks.
So - don't try this at home unless you're sure you're comfortable with it.
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