International Handbook of Clinical Hypnosis - E-Lib FK UWKS

296 INTERNATIONAL HANDBOOK OF CLINICAL HYPNOSIS
breathing, the oral cavity must be entirely unobstructed. Since dental instruments
obstruct the cavity, a sense of suffocation overcomes the patient, and a gag re¯ex
manifests itself. Secondly, situational factors inducing previous gagging may lead
the patient to believe that s/he is `prone to gagging.' Finally, clinicians who label
the patient as a `chronic gagger' reinforce the patient's self-image as a gagger.
There are several effective approaches used for the patient with the hyperactive
gag response. First show the patient that it is possible to breathe through the mouth
while the mouth is open. Ask the patient to close the mouth and gently and calmly
inhale and exhale through the nose. After a few moments of nasal breathing, ask
the patient to continue to breathe through the nose, and open the mouth. Finally,
ask for permission to demonstrate nose breathing with an open and full mouth, and
once granted, gently spray water into the mouth with the air/water syringe. Let the
patient experience their ability to comfortably breathe through the nose as the water
pools in the mouth.
An elegant approach to help the patient who has a hyperactive gag re¯ex which
prevents them from wearing a dental prosthesis, having intraoral radiographs taken
or having an impression made, is based on Dr Harold Golan's classic script Golan,
1990a). The script has been modi®ed here, and a similar one may be pre-recorded
by the practitioner. The patient may listen to the tape in the of®ce or clinic or be
offered a copy to listen to at home.
The body is the person's most prized possession ... and deserves the respect of good
health. With the new teeth dentures) the face looks well. See how people respond
warmly to the new smile. The new teeth make it possible to eat well, to be able to
swallow naturally, to aid in digestion. Remember that properly chewed and digested
food is necessary for life itself.
Notice how good it feels right now, how the breathing rate has slowed. Every
muscle from the tip of the toes to the top of the head is relaxing, comfortably and
easily. [Name the muscle systems.] It's pleasant and reassuring to practice calm
breathing at least six times a day until it becomes second nature ... Do this after a
while with eyes closed or open, because it's necessary to eat with eyes open.
Carry out this magni®cent skill ...whenever the need arises. It's pleasing to be in
control of the body. Smile, realizing an immense feeling of con®dence and
pride ...Smile at the tissues of the mouth and throat, using this new control ... This
relaxation is the most complete a body can experience. Now make a tight ®st. Make
the arm rigid, strong, tight. Stronger, tighter. Feel the tension. Now relax [relaxes the
arm and hand.] This is what happens during gagging ... tightening of the throat
muscles and forgetting to relax the muscles. Now tighten and then relax the other ®st,
the other arm. Knowing how to tense and relax is a wonderful skill. Every portion of
the mouth and throat can be tightened and relaxed. Let the mouth relax. Relax the
palate, throat, ¯oor of the mouth, the cheeks. Continue to sense the relaxation, let the
eyes open, let the mouth open and with a clean ®nger touch the various parts of the
mouth and become aware of the comfort. Experience a sense of great con®dence to be
able to touch any area of the mouth.
Now, feeling rested and refreshed, as though waking up from a very pleasant nap,
let the eyes open in a few moments ...Let that inner smile grow...