International Handbook of Clinical Hypnosis - E-Lib FK UWKS

HYPNOSIS IN DENTISTRY 287
and practicing self-hypnosis is an incredibly rewarding personal growth tool.
Beyond that, associating with practitioners from other medical disciplines can be
extremely educational and enlightening. In our community, the component section
of the American Society of Clinical Hypnosis meets bimonthly to discuss advances
in and case studies of clinical hypnosis. Besides the formal meetings, this author
meets with three other colleagues a general surgeon, an oral surgeon and a
psychiatrist) on a monthly basis to conduct small group practice of hypnotic
techniques. We take turns at being the `operator' and `subject', videotape the
session and review our individual experience. This group has been conducting these
sessions since 1993 and the fact that we still meet regularly is testimony to the
value of exploring via hypnosis. The second level is achieved by creating a
hypnotically calm dental environment in which direct and indirect, verbal and nonverbal,
messages are presented to enhance patient comfort and cooperation. At this
level audio and videotapes produced by outside sources and/or the doctor can be
offered to the patient. The ambiance of the of®ce, from the background music to
the aromas in the air, to staff friendliness and genuine interest in the patient, will
affect the dental experience. Nitrous oxide/oxygen with an adequate dose of
positive hypnotic suggestions is effective at this level. The dentist with advanced
training in clinical hypnosis can offer the third level of hypnotic intervention. At
this level overt hypnotic interactions are utilized. The patient is interviewed, the
term hypnosis is actually used, a history is taken, consent forms are signed, the
session is recorded on videotape, the Hypnotic Induction Pro®le is administered,
and if appropriate, the patient is asked if they would like to be taught how hypnosis
can be useful. While dentists feel much more comfortable in molding patients'
teeth rather than behavior, and opt to make appropriate referrals to mental health
professionals, there are situations in which brief hypnotic intervention by the
dentist is appropriate. At some level, every dental practice that has frightened
patients and a dentist who wants to offer suggestions for relief should bene®t from
the contents of this chapter.
COVERT HYPNOTIC INTERACTION
The ®rst doctor±patient, eyeball-to-eyeball interaction is the most crucial. Commonly,
the patient is at some level of the ®ght-¯ight-bite response and the dentist
has the opportunity to manipulate this hypnotic state to enhance patient comfort in
the dental situation. The hypnotic interaction has begun before the ®rst word is
uttered. There is no overt effort to enter into a verbal or written contract that
hypnosis is part of the interaction, and the patient enters into a spontaneous trance
state. The ®rst step for the dentist is to raise the patient's chair to eye level with that
of the doctor's. The doctor also rolls back the dentist's stool about 5±6 feet from
the patient in order to communicate to the patient a sense of equality in controlling
the situation and a sense that personal space is not being violated. As the medical-