DBT For Coping With Fear at the Dentist



Fear is an interesting thing. We have the ability to experience fear as a protective instinct, but for many of us who are emotionally sensitive, a part of our brain that senses and responds to danger (the amygdala) can go into overdrive, sending Emergency Broadcast System style warnings to us that something is dreadfully wrong, when in fact we are safe.

If you've ever experienced an anxiety or panic attack, you know this all too well.  I was talking with a friend the other day about how I used to call 9-1-1 a few times a year, terrified that something was dreadfully wrong or that I was in a life threatening situation, only to end up embarrassed as it was explained to me,  after a fire battalion and ambulance crew made their way into my apartment, that I'd "simply" had an anxiety attack.

I know better now and am able to use various techniques, such as self-talk, diaphragmatic breathing, and guided imagery to calm down and relax my nervous system, but back then  I wasn't aware of these tools.  Even when I did become aware, I wasn't always willing to use them.  I was too afraid and didn't believe I would be safe unless I got assurance from a medical professional.

Fear shows up in other ways, too. Up until a couple of weeks ago, it had been about five years since I'd seen a dentist. Why? I was afraid. Afraid of the sterile looking environment with all of those dental tools. Afraid of the white coats. The needles. Not being in control. The pain. The sound of the drill. The list goes on.

Somehow, I decided it was okay to let my dental hygiene go by the wayside, and I am still amazed at how long I went and the pain I've tolerated because of the fears that held me back from getting the proper dental treatment that I have needed.

While my teeth are not ghastly by any means, it's not always what's visible that matters the most.  When a severe TMJ (Temporomandibular disorder) episode (which I am told I suffer due to PTSD), recently caused the pain in three teeth became unbearable, I realized I could no longer put off going to the dentist. 

I had recently set an appointment to see a new dentist, but she's not taking clients until September. When I emailed the other day saying that I was concerned and having pain, I was referred to a specialist who works with her office. He saw me the same day, took x-rays, and confirmed that I need a root canal and one tooth and, if the sensitivity continued in the other teeth, I would need treatment on those as well.  Additionally, it was highly recommended that I get fitted for a guard to help with the TMJ.

Without a willingness to use DBT (Dialectical Behavior Therapy) skills, I wouldn't have made it to the specialist. Let me explain.


I used DBT skills in this initial appointment to be effective for this process:
  • Opposite to Emotion Action:  I was AFRAID. The usual action that goes with fear is to avoid.  I practiced Opposite Action by facing my fears and showing up to this appointment.
  • Wise Mind: I asked lots of questions of the dentist, and rather than make assumptions about what a root canal is (I really wasn't sure) and run with my fears and stories about what the experience would be like, I got the facts.  Having this information made me feel less frightened.
  • Reduce Emotional Vulnerability (Emotion Regulation): One of the skills in this set is treating physical illness, which I am doing by taking care of this tooth infection.
  • Radical Acceptance: I radically accepted that in order to restore health in my mouth, I needed to have the necessary dental work completed.

DBT Skills I used in the week between my initial assessment and the actual root canal appointment:

  • Wise Mind: I found medical videos on YouTube about the procedure, which helped me feel informed.  Gone were the stories I made up in my mind about what happens during a root canal. I now had facts and felt more at ease. I'm not going to say that having this procedure looks like a cakewalk, but I am much less fearful having watched this video.
  • Coping Ahead: I used this skill in a few of different ways. The first is that I left the appointment card out in plain site so that I would see it often.  This was to desensitize myself to the fact that I have the appointment.  Secondly, I have been talking (and emailing) about my upcoming appointment with loved ones. Thirdly, I have been using visualization to imagine myself successfully getting through the procedure, as I did in the past when I had severe anxiety over an upcoming pap smear.  I talk about that in this post.
 
Here are the skills I used on the actual day of the first root canal: 

I essentially revisited the skills that got me to the initial appointment...

  • Opposite to Emotion Action:  I faced the fear and made a commitment that no matter how scared I felt on the morning of the appointment, I would show up. And, I did. I was terrified, but I made it there.
  • Wise Mind: I reminded myself that this would be a short procedure, that I was safe, and that I could make it through. I was also advised by the dentist to take an Ativan (anti-anxiety medication) 60-minutes prior to the appointment, so I did, and I reminded myself that this would help with some of the panic symptoms.
  • Reduce Emotional Vulnerability (Emotion Regulation): I reminded myself that I would feel so much relief mentally knowing that I had taken care of this tooth infection rather than letting it get worse.
  • Radical Acceptance: I once again radically accepted that in order to restore health in my mouth, I needed to have the necessary dental work completed.
  • Self-Soothing:  I tweeted and Facebooked this image from the lobby of the dentist's office. I had taken several copies of Cat Fancy magazine with me to self-soothe as I waited for my turn. It helped. :)
Image from my copy of Cat Fancy Magazine



I got the root canal taken care of.  Most of my fears were unfounded, and it was a quick, almost entirely painless procedure.  The only pain I felt was the needle used to numb the area and some tenderness for a few days after.  In a strange turn of events, I am looking forward to having more work done in a couple of weeks.

It's amazing what happens when we skillfully stare fear in the face: we end up taking care of ourselves and feel good about doing so.


What personal care situations are you avoiding due to fear?  How might you use DBT skills to help you overcome this issue?


Thanks for reading.
More soon.


Watch the documentary "Border _" , a compassionate film on Borderline Personality Disorder right now by clicking here.


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