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DENTAL ANXIETY DISORDERS 305 dynamic factors. Instead, hypnosis is utilized to facilitate the patient's understanding of his special mode of mental functioning. The state of hypnosis can provide the context in which to conduct an accelerated programme of imaginal desensitization Frankel, 1976) or it may be used to produce an analogous symptom in the surgery, that closely resembles the psychopathologic abnormalities most troublesome to the individual. If one can produce the symptom and guide the patient to a degree of familiarity with and mastery over this experimentally induced situation he begins to learn something about the shift in functioning that is involved in causing and in controlling his own psychopathological manifestation. Furthermore, the careful integration of self-hypnosis into the strategy reinforces the patient's conviction that they can exert effective control. This method also articulates well with the procedures involved in counterconditioning implosion and shaping behavior. The speci®c implication relative to the dental situation also involves the genesis and management of dental phobic illness. The role of hypnotizability as a facilitator in the acquisition of dental phobias should be recognized. The recognition and management of spontaneous trance states, particularly in children, deserves special attention. Children have been considered as being particularly hypnotizable London & Cooper, 1969) and the association of trance states with actual or perceived dental trauma warrants careful consideration. Studies of hypnotizability, particularly in phobic children, may add further evidence as to the involvement of hypnotic responsivity in the development of dental phobias. The results and foregoing discussion would suggest that hypnosis would be eminently suitable in the management of dental phobias. The literature is replete with accounts of techniques and a multitude of applications of hypnotic techniques to dentistry. In more recent times, the attempts to relate hypnotic responsivity to the production of dental analgesia have ranged from the excellent work and, more or less expected, ®ndings of Gottfredson 1973) who found a moderate relationship between hypnotizability and pain reduction and the remarkable claims of Barber 1977) who found that hypnosis was effective in pain reduction in virtually all cases and was not related to hypnotizability. Further dental research should be aimed at relating dental phobic disorders to DSM-IV classi®cation, age of acquisition of dental phobic disorders and hypnotizability of phobic children, biological aspects and twin studies. Forgione 1988) has emphasized that direct and indirect hypnotic suggestions have been shown to distort perception, induce sensory changes and modify expectancies in both phobic and normal populations. Implicit in these ®ndings is a caution for dentists that even if they are untrained or unwilling to practise hypnosis or hypnotic-like techniques, they should be aware that a signi®cant portion of the population is highly responsive to suggestion. Attention should therefore be given not to deliver suggestions to patients that may be counter-productive to treatment.
306 INTERNATIONAL HANDBOOK OF CLINICAL HYPNOSIS Otherwise treatment dif®culties and enduring problems may be created inadvertently. Suggestions given formally or informally, explicit or implicit, dramatic or subtle, may impact on behavior and psychopathology. REFERENCES APA 1994). Diagnostic and Statistical Manual of Mental Disorders 4th edn). Washington, DC: American Psychiatric Association. Barber J. 1977). Rapid induction analgesia: Aclinical report. Am. J. Clin. Hypn., 19, 138±147. Borland, L. R. 1963). OdontophobiaÐinordinate fear of dental treatment. Dent. Clin. N. Am., 1, 683±690. Coman, G, 1992). Hypnosis in the treatment of BulimiaÐAreview of the literature. Aust. J. Clin. Exp. Hypn., 20, 89±104. Crawford, H. 1997). Lecture, 14th International Congress of Hypnosis, San Diego, USA. Crawford, H. J. & Barbasz, A. F. 1993). Phobias and intense fears: Facilitating their treatment with hypnosis. In J. W. Rhue, S. J. Lynn & I. Kirsch Eds), Handbook of Clinical Hypnosis. Washington, DC: American Psychological Association. Foenander, G., Burrows, G. D., Gerschman, J. A. & Horne, D. J. 1980). Phobic behavior and hypnotic susceptibility. Aust. J. Clin. Exp. Hypn., 8, 41±48. Forgione, A. 1988). Hypnosis in the treatment of dental fear and phobia. Dent. Clin. N. Am., 32, 745±761. Frankel, F. M. 1974). Trance capacity and the genesis of phobic behavior. Arch. Gen. Psychiat., 31, 261±263. Frankel, F. M. 1976). Hypnosis: Trance as a Coping Mechanism. New York: Plenum Press. Frankel. F. M. 1979). Hypnotic responsivenessÐClinically a mixed blessing. Aust. J. Clin. Exp. Hypn., 7, 117±123. Frankel, F. H. & Orne, M. T. 1976). Hypnotizability and phobic behavior. Arch. Gen. Psychiat., 31, 261. Frischolz, E. J. 1997). Lecture, 14th International Congress of Hypnosis, San Diego, USA. Frischolz, E. J., Spiegel, D., Spiegel, H., Balma, D. L. & Markell, C. J. 1982). Differential hypnotic responsivity to smokers, phobics and chronic pain control patients. Afailure to replicate. J. Abn. Psychol., 91, 269±272. Gerschman, J. A. 1983). An investigation of chronic orofacial pain and dental phobic illness. PhD Thesis, Melbourne University, Melbourne, Australia. Gerschman, J. A. 1988). Dental fears and phobias. Aust. Fam. Phys., 174), 261±266. Gerschman, J. A. & Burrows, G. D. 1989). Dental phobic disorders and hypnotizability. J. Dent. Res., 68, 4), Abst. S13, 553. Gerschman, J. A. & Burrows, G. D. 1995). Hypnotizability and dental phobic disorders. In G. D. Burrows & R. O. Stanley Eds), Contemporary International Hypnosis pp. 309±379). Chichester: Wiley. Gerschman, J. A. & Burrows, G. D. 1997). Dental anxiety disorders and hypnotizability. In M. Mehrstadt & P. O. Wikstrom Eds), Hypnosis in Dentistry pp. 25±31). Hypnosis International Monographs. Gerschman, J. A., Burrows, G. D. & Reade, P. C. 1980). Hypnosis in dentistry. In G. D. Burrows & L. Dennerstein Eds), Handbook of Hypnosis and Psychosomatic Medicine pp. 443±479). Amsterdam: Elsevier/North Holland, Biomedical Press. Gerschman, J. A., Burrows, G. D. & Reade, P. C. 1987). Hypnotizability and dental phobic disorders. Int. J. Psychosom., 33, 42.
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International Handbook of Clinical
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Copyright # 2001by John Wiley & Son
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vi CONTENTS PART IV SPECIFIC DISORD
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Contributors Peter B. Bloom,MD Depa
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Preface The editors of this volume,
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1 International Handbook of Clinica
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INTRODUCTION 5 1988) have all but i
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INTRODUCTION 7 of chemical anesthes
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INTRODUCTION 9 two relevant memory
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INTRODUCTION 11 problem. The author
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INTRODUCTION 15 illnesses such as c
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PATIENT SELECTION 37 render a clien
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PATIENT SELECTION 39 der Kolk, 1987
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PATIENT SELECTION 41 somatically an
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HYPNOSIS AND DEPRESSION 131 THE DEF
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HYPNOSIS AND DEPRESSION 135 tions a
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HYPNOSIS AND DEPRESSION 137 depress
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HYPNOSIS AND DEPRESSION 139 has any
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HYPNOSIS AND DEPRESSION 141 Beckham
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10 International Handbook of Clinic
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HYPNOSIS, DISSOCIATION AND TRAUMA 1
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11 Conversion Disorders C. A. L. HO
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CONVERSION DISORDERS 161 van der Ko
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CONVERSION DISORDERS 163 imitates t
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CONVERSION DISORDERS 165 On examina
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CONVERSION DISORDERS 167 plained de
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CONVERSION DISORDERS 169 and physio
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PERSONALITY AND PSYCHOTIC DISORDERS
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DISSOCIATIVE DISORDERS 189 1994; Sp
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DISSOCIATIVE DISORDERS 195 identity
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DISSOCIATIVE DISORDERS 197 Table 13
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DISSOCIATIVE DISORDERS 199 hypnotic
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DISSOCIATIVE DISORDERS 201 Alpert,
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DISSOCIATIVE DISORDERS 203 Kluft, R
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EATING DISORDERS 207 1. `I sometime
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EATING DISORDERS 213 apartment, enj
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EATING DISORDERS 215 EGO STATE THER
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Page 302 and 303: DENTAL ANXIETY DISORDERS 301 nosis
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