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Post by vicki on Aug 15, 2005 5:46:42 GMT -5
Hi
I've been reading all your posts for a while now and have finally plucked up the courage to post myself so please bear with me - this might be a long message as I don't really know where to start!
Here goes... I'm 26 and have been going to the dentist (on and off!) since I was 3.
When I was about 2 years old I had surgery (nothing to do with teeth) which meant I needed stitches. A couple of the stitches were too painful to remove so I was taken back to hospital a couple of weeks later to have them removed under general anaesthetic. To cut a long story short, when they clamped that awful mask on my face I was absolutely terrified and tried to escape but they held me down, all I remember is crying my eyes out and pleading with them to stop but they wouldn't and it ended up with me getting a few hard slaps and eventually passing out (probably because of the shock).
Anyway, time went by and when I was 3 I got taken for my first visit to the dentist and as soon as I sat in the chair, again I felt completely freaked out but due to a combination of my mum standing guard and making sure I didn't 'misbehave' and also the fight/flight/freeze response (my body always chooses freeze and tremble!), I was completely paralysed apart from shaking like a leaf - I couldn't speak. Fortunately I've got (or did have) near perfect teeth so I never needed anything doing and each visit lasted 1 minute max so I was just about able to cope but still filled with terror at the thought. It carried on like this until I got to about 16 and was told I might need a filling at the next visit. The thought of that struck such terror through me that I didn't go back for nearly seven years.
Then about 5 years ago I went on holiday and ended up with salmonella food poisoning which made me ill for weeks and has left me with bad ongoing acid reflux which I am told is probably here to stay. It started eroding my teeth (mainly lower) and my teeth became so sensitive that I didn't know whether I was more terrified of what was happening to my teeth or going back to the dreaded dentist (same practice, different dentist - the previous one (ironically) retired due to panic attacks!)). I tried to make an appointment which I ended up cancelling many times - I could write a book on excuses to cancel appointments.
When I did eventually go back (about 3 years ago), I had 2 weeks of panic attacks and sleepless nights, so I took Beta Blockers (my GP prescribes them for existing panic attacks which I've had since 13) and a friend came with me to make sure I didn't chicken out - all went well, the new guy obviously realised I was terrified and was really nice but the fear is still as bad as when I was 3 and is getting worse. During this time the worst thing I've had done is a filling (I had one of the worst panic attacks ever and made a complete moron of myself). Dentist no. 2 retired last year due to stress - so now I'm onto no. 3 - who I met for the third time a couple of weeks ago (and who, I am convinced, thinks I'm completely nuts but I can't bring myself to confess to being terrified).
Things didn't go so well - I didn't make quite such a moron of myself as when I had the filling but I came pretty close.
The problem I've got now, is that my next check up is in 5 months (because I admitted my teeth were sore - which is obvious because I've got no enamel left on the biting surfaces and holes the size of craters in every one - but didn't actually tell the truth which is that they hurt like hell when I eat and a couple are cracked - I'm too scared of the consequences).
In the past (for the panic attacks) I've tried counselling, beta blockers, hypnotherapy and numerous self help books on psychology. I have been taught self hypnosis and as I found out - it's fantastic when I'm safe at home on my bed but there's more chance of me winning the lottery than being able to concentrate enough to use it during appointments! I suspect my fear is something to do with being laid flat and being out of control due to past events (which also include being mugged, beaten up and left on the floor for my mobile phone when I was 22). I don't think it's got anything to do with treatment as such because I have a couple of medical conditions which mean I've had some pretty horrible things done in hospital and that doesn't really freak me out - apart from things like MRI scans where I'm trapped.
I'm now at the point where I am so scared, I haven't a clue what to do next. My teeth are so sore - I only eat soft food where possible.
Thanks for having the patience to read this. Sorry for going on a bit! Any ideas?
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Post by letsconnect on Aug 15, 2005 8:11:41 GMT -5
Hi Vicki , thanks posting here ! I've got lots of ideas, whether they're any use is a different matter altogether, lol ... in a bit of a rush right now, but I'll get back later! Many thanks for joining!
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Post by letsconnect on Aug 15, 2005 15:42:04 GMT -5
OK, here are my thoughts (this may turn out rather long, lol): First of all, congratulations on being able to verbalize your fears so clearly - for many people, one of the big problems is that they can't pin down exactly what they're afraid of. Also, you've already taken a lot of steps (counselling, self-help books, hypnotherapy etc.) which might come in handy, even if at present they haven't had much of an effect on your dental phobia. I feel that maybe you've been focusing on internal factors - things you might be able to change about yourself in order to cope with the situation. But oftentimes, it's the situation that needs to change, rather than you as a person. You mentioned two main issues, firstly, the feeling of being trapped, and secondly, making a moron of yourself. (1) It is perfectly understandable that you would feel trapped, considering the traumatic experience you had when you were very little. Many people with a dental phobia report that feeling trapped, pinned down, and out of control are a major feature of their phobia. The solution is that you need to know that you can "escape" anytime and that you are in control at all times. You mentioned being frozen with fear/paralysed as a three-year old, and this probably hasn't changed. It takes a lot of trust in the operator (i. e. dentist) to know they will stop anytime you need a break. Some of this trust is based on instinct - we may trust some people almost instantly, because they send out the right "vibes". So I would suggest trying to find a dentist who "feels" right for you. You need to know that if you feel like getting up and walking out, you could do so. For most people, it is sufficient to know that their dentist will stop when they give a pre-arranged stop signal (e. g. raising a hand, lifting a leg, or raising both arms). But if you're prone to freezing, you may need to practice the stop signal with your dentist first, so that should you actually need a break, you'll be able to actually give the signal. Dentists will have different ways of dealing with this; for example, some will let you give the stop signal a couple of times while doing something pretty innocuous, while others might know of some more elaborate routines (such as telling their patient to count to 10 internally, then stop on some agreed signal, then count to 20 and so on). I feel it would be great if you could find a dentist who actually tells you that you're in charge, without you having to ask for it. This idea of patients being partners in their care is becoming more widespread. But dentists usually only offer this spontaneously if they know their patient is terrified of being out of control. Dentist no. 2 retired last year due to stress - so now I'm onto no. 3 - who I met for the third time a couple of weeks ago (and who, I am convinced, thinks I'm completely nuts but I can't bring myself to confess to being terrified). Sorry for being blunt - but you'll have to. Maybe not with this dentist, though... (see below): all went well, the new guy obviously realised I was terrified and was really nice but the fear is still as bad as when I was 3 and is getting worse. I take it from what you said about dentist 3 that he's not as good with nervous patients as dentist 2. Also, you're mentioning the fear getting worse since changing dentists (which would lead me to believe that the two events are connected? Correct me if I'm wrong . If your main problem is actually lying down, then it may be possible to find a dentist who will treat you sitting up. I usually don't like advocating this, because it makes things more difficult for the operator (contrary to popular opinion, I'm not actually a dentist-hater, lol )... but this could well be a good option in your case. Another factor that might be worth looking at is the environment, which can send out powerful clues. For example, is there a happy atmosphere in the surgery? To give an example (highly dependent on the layout and oftentimes not possible), some dental practices have a policy of leaving the doors to the treatment rooms open and having chairs face the general direction of the door, which is a very powerful environmental clue that escape is always possible (therefore, it tends to have a calming effect on people who are prone to feeling trapped). Little things like that which are barely noticeable can have a profound effect on how we interpret a situation. Another example includes "white-coat syndrome": some people will freak when they see a dentist in a white coat, but feel a lot calmer when the dentist is wearing scrubs or everyday clothes. Other factors which might be worth considering are - would you feel more comfortable with a female dentist? Would distraction help (if our attention is turned towards something distracting in the environment, this makes it more difficult to focus on internal states)? There was something that struck me in your account. With your history, one would imagine that you would have been frightened of doctors as well as dentists (many people with a history such as yours would report having a doctor phobia as well). Maybe you're an exception to the rule, but if not, did something happen somewhere along the line which made you less scared of doctors? If so, how did this change come about? Were there any specific instances (or a-ha moments) which made a difference? It can be useful to look at similar situations and analyse what triggered a "turn-around". (2) On to point 2, "making a moron out of yourself". I got the impression that you're not that worried about the panic attacks per se, but rather a dentist's reaction to it - that they will think you're weird, nuts, a moron. I don't know how to properly explain this, but there are some people who have special gift, or a special personality, which allows us to let our guard down without worrying about the consequences. Part of the problem might be that you didn't get that feeling with dentists in the past. Human beings have a perceptional bias which leads us to believe that a person's behaviour in one situation is indicative of their behaviour in other situations as well (also known as the "fundamental attribution error"). Of course, the fact of the matter is that we all behave differently in different situations, and that context matters more than inherent personality traits. Dentists are as prone to making the fundamental attribution error as the next person - it's a universal characteristic (at least in the Western world). However, many dentists nowadays realize that past bad experiences cause you to act the way you're acting, and will not assume that you act the same way once you're out of the door. In fact, quite a few of them will admire you for the courage you're showing by coming in DESPITE being terrified. It can also help to bring this out into the open and actually tell your dentist what's on your mind - "You must think I'm a complete moron for acting like this - but whenever I go and see a dentist, I get a panic attack because I had a bad experience in the past". Often works wonders... unless you're dealing with someone whose emotional IQ is in the double figures - in which case they're unsuitable for a nervous patient, anyway. Your reaction is nothing unusual, anyone with your experiences would react the same way. It's nothing to be ashamed about, and accepting yourself as you are, panic attacks and all, goes a long way. YOU know that you don't behave this way in all situations, it's an isolated context and you are ENTITLED to your panic attack. I'd better stop waffling now... I have no doubt that you will be able to figure out something, though, with your level of commitment ! Regarding the acid reflux, has anything been recommended to protect the enamel?
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Post by vicki on Aug 16, 2005 4:04:18 GMT -5
Thankyou so much for the advice - where to begin?(!) The hypnotherapist I've seen in the past used the analogy of my anxiety/panic attacks (in general - not consulted her yet regarding the dental phobia) being like a huge knot in a piece of string and that it was just a question of gradually unpicking the knot bit by bit when it became tangled - I can kind of relate to this but in relation to the dental phobia, the piece of string is more like a snake with massive fangs which is too big to unpick, keeps moving around and trying to bite me if that makes any sense!?!
You raised some interesting questions for me, some of which I think I may have the answers to, I don't know but here goes anyway...
(1) About changing the situation rather than changing myself - although I realise that what happened when I was little and since is not really my fault, somehow I've been led to believe that my anxiety/panic attacks are, so everything I've tried in the past focussed on me changing - for example, I read somewhere (probably on this site - can't remember!) that nobody is born terrified of dentists and that it is a learned response. If this is the case then I figured that I needed to 'unlearn' it - but it hasn't happened for some reason I still haven't figured out... This is part of the reason I chose to take Beta Blockers for my panic attacks rather than the Antidepressants/Tranquillisers that my GP suggested because I thought it would be like covering it up with a plaster rather than trying to sort it out. The Beta Blockers are a way of reducing some of the physical symptoms without affecting thought processes - so I guess in a way, yes I am really deathly ashamed and probably spend as much energy trying to cover it up to stop anyone finding out as I do trying to sort it out.
(2) Regarding the need to escape and whether or not I trust my current dentist - although I've been 3 times, I'm kind of in a weird sort of trance-like terror so I find it very difficult to communicate (which is completely my fault, I know) and the appointments have only been 10 minutes (NHS pressures and all that!!) so I've managed to get them over and done with quickly so the answer to the question about trust is that I don't know - not really given him a chance (which is unfair on my part!) - but I do know what you mean about feeling at ease with people etc.
(3) About the layout of the place - from what you've said about position of door/chair etc - it couldn't be more perfect - the door is straight ahead and about 2 steps away (can't be left open because I'd have everyone in the waiting room peering in!) - this in some ways makes it worse because the door might as well be locked for duration of the appointment (because I can't move apart from trembling so I lay on my hands) even though I know that I chose to go in there and therefore must be able to choose when to come back out.
(4) Lying down vs. sitting up? Not sure - I think you probably hit the nail on the head when you said it could be to do with trust - I don't really trust that many people anyway and tend to jump (and look like a demented star fish, lol!) if anyone moves suddenly. Also, when in a state of panic, perceptions/all five senses seem to become really exaggerated so for example, the ticking clock sounds like someone's trying to smash the wall down, the radio which is playing (quietly I'm sure!) in the background sounds like a loud music concert and when the dentist speaks it sounds like he's shouting even though he's fairly quietly spoken!!! In a nutshell - it's like I'm trapped inside my own body.
(5) Absence of doctor/hospital phobia - because of the nature of the other medical conditions up until the age of about 12 I was in hospital nearly every weekend either attached to a drip, having more tests than you can shake a stick at or having some sort of surgery. I didn't have a choice but I never really liked it (who would?! lol). Mostly I trusted the doctors because I knew them very well - although some things really really freaked me out such as the endoscopy I had the other year - I got sedated with midazolam but because I was so terrified I produced so much adrenalin that it had no effect and I had a mega panic attack and they couldn't get the endoscope down my throat far enough. Later, when it was over, I collapsed in my mum's office (she works as a manager at the hospital and is a nurse by background - she ought to be more understanding about my anxieties but is exactly the opposite - can you believe she actually enjoys dental treatment!!!!).
Lastly, as for the acid reflux - dentist no. 2 said it needed to settle down before they could repair anything (all my teeth are sensitive to some degree but the ones that are really affected are the lower ones at either side). At the first appointment (when I went back after 6/7 years) he told me to use Duraphat toothpaste and fluoride mouthrinse to try and re-mineralise the teeth (the enamel is completely gone on the biting surfaces down to the dentine which is full of holes and looks like it's been eroded by acid funnily enough - pretty much like when people drink far too many fizzy drinks except I don't!). Also suggested I use Sensodyne toothpaste and mouthrinse as well to try and reduce the sensitivity. When I asked what the outlook was, I was told that the 6 or so teeth badly affected would need crowns once the erosion settled down but in the meantime at every appointment I've had stronger Duraphat put on the teeth. I asked my current dentist what the outlook was (to see if the answer was any different as different people have different ways of dealing with things) and the answer was that he'd not seen anything like it before... not very helpful to me but then again he only has about 4 years experience and is about the same age as me.
Sorry for the long message - being a copywriter/designer I should be able to write shorter messages shouldn't I?!
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Post by letsconnect on Aug 16, 2005 14:01:49 GMT -5
Thanks for elaborating ! So trust is a major issue. One practical, straightforward problem jumps out at me: it appears that your current dentist lacks the knowledge to deal with your case (purely in dentistry terms - he's never encountered anything like this before). This must be very disconcerting. How can you trust someone who has no experience with your problem For the relationship between a patient and a health care provider to be trusting, it must be a caring relationship. If your current dentist doesn't know how to take care of your dental needs (never mind the psychological ones), what are the chances that you can learn to trust him? Close to zero, I would imagine. The reason why I said to focus more on outside things (the "environment" in its broadest sense, which includes the dentist) in my last post: it seemed to me that up until now, you've been focusing almost exclusively on what you can change inside yourself. Which of course is great, but has lead you to a dead end - because this won't change the external circumstances. You cannot learn to trust someone else by going deep inside yourself and breathing slowly, for example - the only way trust can come about is if you interact with the other person and find out what they're like, and if you can indeed trust them (one problem is time - more about that below). Otherwise, your trust would be misplaced. Some people find it helpful to explore how they know they trust someone. Everyone is slightly different in this respect - some people rely solely on instinct, others need verbal reassurance from the person in question, others need a sense of control, or a combination of these or other things. In the past, some people have found that writing down all the things they'd need to know from their dentist in order to trust them, and then presenting that list to their dentist and going through it together, has helped them. Trust is a very personal thing and not everyone learns to trust another person in the same way. So it's difficult to make any hard-and-fast recommendations on that score. As you said, time is a huge factor. You've learnt to trust other health providers because you got to know them well. When you have dental treatment under the NHS, time is a, shall we say, very limited resource. I don't know if it would be financially viable for you to go private? In order to be able to help you, even a "phobic-friendly" dentist would need to know that you experience panic attacks in the dental setting. They need to know that you "freeze" and feel unable to do anything in that situation. Only then can they offer suggestions as to how they might be able to help you. So the one thing you need to change about yourself (rather than about the "environment") is to lose the urge to "cover up". Things like panic attacks are very common, and do not carry a huge amount of stigma in today's society. While people may feel forced to cover them up in their job (because of potential negative consequences), the same isn't true when you're dealing with a health care provider. Dentistry, in the UK at least, is officially defined as a "caring profession", and dentists have to take into account other co-existing health conditions (both physical and psychological) all the time. Granted, some of them are much better at the latter than others. I couldn't help noticing some similarities in your account of how you experience your dental visits to experiences typically reported by people who have experienced some sort of abuse (you mentioned a mugging, which must have been pretty traumatic). You've probably come across the following page already, but just in case you haven't: www.dentalfearcentral.com/abuse_survivors.htmlSome of the tips on that page might also work for your situation. It's quite clear from your posts that you are motivated to co-operate and willing to work with a dentist, it's just that the circumstances so far have never been quite right. Oh, and no need to apologize for the long posts, I'm worse !
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Post by vicki on Aug 17, 2005 6:54:56 GMT -5
Deep down somewhere inside I know that by letting someone know (or see) what I feel and/or why, will help me on the trust issue but I think something else may be preventing me from doing this...
You know the saying about lightening never striking twice in the same place? Well it does, and in my case it has. (Time to wrestle another skeleton out of the wardrobe - not quite sure how or why I feel able to say what I have said so far as nobody on earth has ever known anything about any of this - strange then, that I'm 'revealing all' on a message board that anyone in the world can read!).
The experience I had in hospital when I was 2 was not a 'one-off'. It happened again when I was about 6 or 7 but this time it was even worse. Different hospital, different type of surgery (nothing serious but it required a GA) and different doctors/nurses. Usually patients (more particularly kids) are offered a pre-med to calm nerves before operations but I refused on this occasion because I figured (even though I was only 6 ish) that I wouldn't be able to run away/escape if I was doped should my previous experience be repeated.
Consequently I was as nervous as hell (normal reaction in these circumstances anyway), getting wound up into such a paralysed panic that my veins shut down - this only served to wind up the anaesthetist, his mate and the nurse who told me I was going to be knocked out using gas - you can imagine the flashbacks that started. I decided it was time to get out of there so I leapt off the trolley and tried to do a runner but couldn't get out the room because the door handles were too high up! As soon as they touched me, I froze. Once again I got pinned down and shouted at (they might as well have been speaking a foreign language because I couldn't figure out much of what they were saying apart from I'd been bad and should do as I was told and that if I didn't I would never wake up). I do remember them turning me face down and hitting me a couple of times but I can't remember much after that so I don't know whether I fainted or what happened. When I woke up back on the ward, my mum was there and I wondered if it had all been some sort of hallucination - but deep down I knew it wasn't because my back was sore. Later on, I went to the toilet and looked in the mirror - my back was covered in bruises - some in the shape of handprints/fingers. I never told anyone because nobody would have believed it - doctor's/nurses don't do that kind of thing do they? No, of course not. You can imagine the lies I had to tell to my parents as to why I was wearing winter clothes in the middle of summer for a few weeks(until the bruises went) so that nobody ever found out.
Therefore, in certain situations (dental appointments being an excellent example!) I can't 'interact' as much as I probably need to for fear of the consequences. And I know I need to. Ever seen South Park? Maybe I should start talking in the third person and using a puppet like Mr Garrison the teacher! Voicing my concerns and showing any trace of panic/fear = (I don't even know how I would describe it!). If I do interact there is probably a 95% chance I'll panic (to what degree I don't know). It's a vicious circle.
I'd already read the page suggested before my first post and yes it did strike quite a few chords with me - although I might as well add that fortunately I have no history of any other sort of abuse.
Yes I am sort of motivated in a completely terrifed sort of way - I know that if I don't get my teeth sorted out they'll just get worse and it'll be worse for me in the long run. Despite my joke attempt at the last appointment of "Can't I have all my teeth out so I can have dentures so I don't have to come here anymore?" (They thought I was being serious!) I am very attached (obviously!!) to my teeth.
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Post by letsconnect on Aug 17, 2005 11:04:48 GMT -5
You know the saying about lightening never striking twice in the same place? Well it does, and in my case it has. ... I never told anyone because nobody would have believed it - doctor's/nurses don't do that kind of thing do they? No, of course not. You can imagine the lies I had to tell to my parents as to why I was wearing winter clothes in the middle of summer for a few weeks(until the bruises went) so that nobody ever found out. I can see how those horrible incidents when you were little would make having a panic attack seem like a "bad omen" ("if I panic, something terrible will happen"). As you realize on a conscious level, what happened back then would obviously not happen again, because you'd be liable to report any dentist who took advantage of your panic attacks for assault. So realistically speaking, the past can't repeat itself in the same way. But if lightning strikes twice in the same place, we take this to mean that it's likely to strike there again. We all predict events based on past events - if the same thing happens twice in a row, under similar circumstances, this suggests a cause-and-effect relationship. It's a simple survival mechanism - we learn to predict the consequences of our actions, so that we can avoid behaviours which can hurt us in the future. The problem is that sometimes, an apparent "connection" between two events is pure coincidence, and a cause-and-effect relationship does not actually exist. It's almost like "magical thinking", which of course doesn't make it any less real - when faced with a "threatening" situation, it's normal to let your instincts take over and act on them. For the simple reason that all animals (including humans) use their instincts (rather than logical thought) during a fight-or-flight situation. In evolutionary terms, there simply isn't enough time to think things through and ponder the pros and cons of various courses of action when faced with something which could badly hurt you. It's interesting that you tried to cover up and hide what happened when you were about 6 from the people around you (interesting because I would have behaved in the same way, whereas one would think that most kids would run straight to their parents and complain). The ultimate irony is that it's the abused (and I would classify the hospital staff's behaviour as abuse) who feels the shame and guilt, while really, it should be the abuser who should feel ashamed and guilty. For some reason, people who are abused in some way tend to blame themselves, rather than the perpetrator - and come up with all sorts of reasons (no matter how far- fetched) that they somehow caused the abuser's behaviour. Not too sure why this happens (there are probably lots of theories out there), but it's a pretty universal phenomenon. Maybe it would have been too painful to admit that the people who are supposed to take care of you (in this instance, hospital staff) might have instead taken pleasure in assaulting you. Because by implication, that would mean that the authority figures who are supposed to take care of you cannot be trusted, which would make the world a very frightening place indeed. Easier on one's world-view to blame oneself... "if I hadn't panicked, they might have been nice to me"... The reality, of course, is their behaviour was abominable, and that you would reasonably expect adults to calm down a frightened child, rather than beat them into "obedience". What I'm saying is, maybe there was more going on than just fearing that nobody would believe you. Maybe not, I don't know. All this is mere speculation. It might also help to talk about what happened in the hospitals with a close friend in real life (I found that helped somewhat in putting things into perspective for me). Ever seen South Park? Maybe I should start talking in the third person and using a puppet like Mr Garrison the teacher! Great analogy! I suppose that when people put things in writing to their dentist, they essentially use a piece of paper as "the puppet". Or consciously "acting out" a panic attack could be described as a "puppet" as well. In both examples, something acts as a "go-between". I'm sure there are other ways of achieving the same effect. One thing I would maybe suggest is when you do eventually communicate your feelings to a dentist, is to see if this can be done in a "neutral" environment. I'd imagine that the incidents in the hospital both happened while you were in the equivalent of the treatment room, so if there's any any other room available where you can sit down together, it might make things easier.
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Post by vicki on Aug 18, 2005 11:29:55 GMT -5
Thanks so much for your advice so far - from a 'mental/emotional' perspective, I've progressed quite a bit this week since posting on this site. What you say does ring true for me (although I really really wish it didn't :-( ). I just hope that one day, I'll be one of the lucky ones who post a success story on here, although it does feel like a long long way off at the moment.
I've been researching alternatives on the internet today (during work hours - so I keep closing the windows because I don't want anyone finding out what I'm up to!) and it would seem that the area I live in is a bit of a black hole as far as sympathetic/phobic friendly dentists are concerned (I came across a couple who offer sedation but little else in the way of constructive help. For obvious reasons mentioned in earlier posts, there's no way I could cope with sedation. In fact to quote someone I once heard on an American chat show "I'd rather sandpaper an alligator's ass in a phone booth!" or jump from a plane at 30,000ft without a parachute). It's almost like I'm surrounded by a very small bubble which I want to break out of but can't. The trouble is that if someone touches the bubble it's terrifying - hence the problem trusting people, particularly those who need to come close (I know it sounds strange).
I have posted a request on askyourneighbour.co.uk - but under a different name incase anyone who knows me finds out (stupid I know but I can't 'come out of the closet' yet). At least by posting on this site, I'm not 100% in denial anymore (probably about 85% now which isn't much progress but it's a start). Still not sure what to do about the fact I lied about how sore my teeth were at the last appointment (i.e. I played it down rather than telling the truth and saying it hurts like hell) - do I a) pick up the phone and make an appointment before the next checkup (and somehow confess to the way I feel), b) give up on the idea and search for a new dentist (which I know will stress me out even more - change is unsettling in certain situations and it's probably no coincidence that the fear got worse when my dentist changed - better the devil you know etc) or c) ignore the pain, develop a painkiller addiction and wait for the next appointment - it's like playing russian roulette, except that instead of the gun only having one bullet, it only has one empty chamber instead!
You mentioned in your first post that I was able to verbalise my fears clearly (meant to put this in the last post but forgot!) - about 6 years ago when I was at college, one of the counsellors (I saw her about the panic attacks) recommended a book which we worked through at each appointment - and of which I now have my own copy that I now work through. It's called 'Mind Over Mood' by Christine Padesky & Dennis Greenberger. Although it's 50% about depression and 50% about anxiety, it shows how to examine emotions, feelings and situations and identify triggers, 'hot thoughts' and past events. Really useful book which I would recommend to anyone who has trouble identifying triggers for panic attacks and also identifying thought processes.
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Post by letsconnect on Aug 18, 2005 14:26:02 GMT -5
I've been researching alternatives on the internet today (during work hours - so I keep closing the windows because I don't want anyone finding out what I'm up to!) and it would seem that the area I live in is a bit of a black hole as far as sympathetic/phobic friendly dentists are concerned (I came across a couple who offer sedation but little else in the way of constructive help. It's really hard to know with the sedation ones - some offer it as an adjunct for those with a "procedure" phobia who desire sedation, whereas others seem to be one-trick ponies. A lot of people would interpret "dental phobia" to mean a fear of dental procedures per se, so when asking around, it might be a good idea to know what you're looking for in a dentist. I have posted a request on askyourneighbour.co.uk - but under a different name incase anyone who knows me finds out (stupid I know but I can't 'come out of the closet' yet). Not stupid at all - very sensible (if it's any consolation, only one of my cyberfriends knows my full identity). Still not sure what to do about the fact I lied about how sore my teeth were at the last appointment (i.e. I played it down rather than telling the truth and saying it hurts like hell) - do I a) pick up the phone and make an appointment before the next checkup (and somehow confess to the way I feel), b) give up on the idea and search for a new dentist (which I know will stress me out even more - change is unsettling in certain situations and it's probably no coincidence that the fear got worse when my dentist changed - better the devil you know etc) or c) ignore the pain, develop a painkiller addiction and wait for the next appointment - it's like playing russian roulette, except that instead of the gun only having one bullet, it only has one empty chamber instead! Actually, this is a tough one... Your second dentist gave you some really good advice, the GERD really should be brought under control before attempting anything permanent. But you were saying that the doctors have been unable to figure out the cause so far? Are you on any medications to help with the problem? The problem really is that apart from palliative care (Duraphat being a prime example), not all that much can be done until the medical problem has been tackled (as far as I'm aware - I'll have to read up on the topic, it's quite a common one). Which of course is as frustrating for dentists as for their patients . Did you have Duraphat applied during your last visit, and what measures are you taking at the moment to help with reducing sensitivity or avoiding pain? Also, do you have any problems with grinding or clenching your teeth? I'm going to pick Gordon's brains later, lol ;D It's called 'Mind Over Mood' by Christine Padesky & Dennis Greenberger. Although it's 50% about depression and 50% about anxiety, it shows how to examine emotions, feelings and situations and identify triggers, 'hot thoughts' and past events. Really useful book which I would recommend to anyone who has trouble identifying triggers for panic attacks and also identifying thought processes. Thanks for the recommendation - I'll add it to the website, if you don't mind?
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Post by letsconnect on Aug 18, 2005 19:16:58 GMT -5
OK, back from the brain-picking session... might not be such a big problem after all. Usually you're looking at replacing the lost enamel with either composite or bonded porcelain (veneers or crowns - but bonded rather than cemented) (got a few of those bondings myself, they do work, but you need someone who's fairly skilled to make them properly). The NHS bit would be the big problem though, most of the best treatment wouldn't be readily available on the NHS... (I had been looking more at "big cases" - those cosmetic dentistry full mouth restoration ones - hence my skewed views on this one) (if you want a free second opinion via e-mail, anonymously, that can be arranged ). Still, it would be good to tackle the actual medical problem first, so that the restorations will last for as long as possible. You can also try the following: * regular fluoride rinses * rinsing out with baking soda immediately after an acid attack (obviously, doesn't work if you have acid reflux during sleep, but during the day...) * rubbing sensodyne toothpaste directly onto the sensitive areas (to reduce the pain factor) * avoiding acidic foods/drinks (esp. soft drinks) * sucking on xylitol-containing, sugar-free sweets oduring the day (non-chew stuff), to balance pH level in saliva and reduce risk of decay * eating bits of cheese immediately after after acid attacks (to balance pH level and remineralize affected areas) * don't brush your teeth for at least half an hour after an attack (instead, nibble on a piece of cheese) If anyone else has experienced acid reflux problems, please feel free to chip in !
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Post by vicki on Aug 19, 2005 3:47:06 GMT -5
Thanks for the reply...
The main problem that I have with the reflux is that it is predicted to be an ongoing thing. Before the food poisoning, I had never even had any acid reflux/heartburn (got a real shock one night when it suddenly came out of nowhere - the pain was so intense it was unbelievable!). After the initial attack, more followed that were a few weeks apart (this was just over 3 years ago) and then they increased in frequency until it was constant and my oesophagus became so sore that I tried every 'over the counter' drug available, slept sitting up and drank several pints of milk a day. It wouldn't stop so I went to see my GP who I have to say was as much use as a chocolate frying pan and said they couldn't do anything else apart from trying H2-receptor antagonist drugs such as ranitidine and cimetidine etc. Tried the drugs, they didn't work so the GP lost interest (they usually do because I have a couple of pre-existing medical conditions that they don't really understand - not related to the reflux) and just said drink milk and gaviscon and that was that!
I noticed my teeth were being damaged (at this point I hadn't been to the dentist for 6/7 years) and became so terrified at the thought of both losing my teeth and having to visit the dentist again. I'd actually been struck of the practice list because I hadn't been for so long and kept ignoring the letters they sent - my mum believed my 'cover story' about 'forgetting' to go and managed to sweet talk them into letting me re-register (she knew the dentist who ran the practice - told him I'd been at university and therefore living away from home - partly true - I had been at college for 5 years but I still lived at home!)
Fortunately, as mentioned previously, my mum works at the local hospital and arranged for me to see one of the consultant gastroenterologists who organised just about every test going (including an endoscopy and colonoscopy - not a pleasant experience I can assure you!) - the conclusion/diagnosis was that as a result of the salmonella 2 years before, the whole digestive system had been damaged/irritated - apparently infections such as salmonella can effect permanent changes to the intestines etc. My drugs were changed from H2-receptor antagonists to a proton pump inhibitor called Esomeprazole (Nexium) which after a few weeks started to take effect and the pain was reduced. These drugs aren't really meant to be taken forever (probably for around 6 months) because they're usually used to treat stomach ulcers and prolonged attacks of reflux but there is no evidence at the moment to suggest that they are harmful if they're taken permanently so the guy I saw told me to use them as needed (they don't work instantly - more a cumulative effect), a few months on, a few months off as needed which is what I do (as well as drinking loads of milk and gaviscon when it's bad). So I'm left to my own devices as far as managing the reflux goes.
I was also told that there is surgery available to try and cure the reflux which involves wrapping the top part of the stomach around the oesophagus to reduce the flow of acid but apparently it doesn't always work and more to the point, due to the other pre-existing conditions, it would be very risky in my case and they wouldn't recommend it anyway! Newer procedures are being developed but these are apparently still a long way off.
I do rinse regularly with fluoride mouthrinse after brushing with the duraphat. During the day I also rub sensodyne onto the teeth (and use mouth rinse if the acid is bad). I am back on the Nexium at the moment but if it is bad I also drink loads of milk (neutralises acid - like cheese apparently). At the last dentist appointment I was told to chew gum when it was bad - I actually hate chewing gum (urghh!) but am trying it anyway - it hurts like hell sometimes because when I chew, the saliva it produces gets trapped between the chewing gum and the biting surfaces of the affected teeth - argghhh! I can't win. So I like your suggestion of sugar free sweets!!! The rest of my teeth seem to be OK (and are complete with enamel and no holes!)apart from being very sensitive to hot and cold (something which I've not confessed to). Strangely enough - the teeth that are affected are not so sensitive to hot and cold but they are when chewing things.
During the last appointment I did have Duraphat applied - it hurts like hell having things poked in the holes (sounds disgusting doesn't it?!) and I could have cried but obviously didn't - was motionless, terrified and panicking as usual! Also had two x-rays taken - not an experience I wish to repeat - tensing my muscles enough to stop them trembling even for a couple of seconds is so hard sometimes.
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Post by vicki on Aug 19, 2005 6:05:41 GMT -5
Forgot to mention in last post... You asked about whether I have problems clenching or grinding my teeth - I don't grind but I sometimes clench my teeth when I'm wound up/stressed - someone told me that if you put the tip of your tongue behind your teeth at the top, it stops you clenching - I also use a combination of self hypnosis and EFT to try and stop it (it has reduced it). The only other time I clench my teeth is when in extreme panic/terrified - due to the trembling, my teeth 'chatter' which is soooooo embarrassing because people can hear it - also another reason why I take Beta Blockers especially before dental appointments.
Feel free to recommend the book I mentioned on the website (I'm sure the authors would be grateful for the publicity!). As you can probably imagine, I've worked my way systematically along the self-help and psychology shelves in most bookshops searching for 'the answer' to both my panic attacks and dental fear (terror would be a better word ) and not had much luck apart from with this book.
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Post by letsconnect on Aug 19, 2005 13:43:11 GMT -5
It sounds like you're doing everything within your power to manage the reflux . At the last dentist appointment I was told to chew gum when it was bad - I actually hate chewing gum (urghh!) but am trying it anyway - it hurts like hell sometimes because when I chew, the saliva it produces gets trapped between the chewing gum and the biting surfaces of the affected teeth - argghhh! I can't win. So I like your suggestion of sugar free sweets!!! That's why I didn't mention chewing gum ;D - I would think the less stress you put on those teeth, the better (not only because it's painful, but also because you'll prevent further damage). Eating soft foods is probably a good idea right now, because the areas with the holes are not very resistent to wear and tear. The rest of my teeth seem to be OK (and are complete with enamel and no holes!)apart from being very sensitive to hot and cold (something which I've not confessed to). Sensitivity is very common and usually results when some dentin is exposed where the tooth meets the gum (don't ask me how I know, lol ). For example, it might be due to brushing too hard, or in some people, it can be due to genetics. Again, applying things like duraphat and rubbing on Sensodyne can help. There's a webpage on the problem here: www.dentalgentlecare.com/sensitivity.htmGordon was saying it would be a good idea to put some glass ionomer into the big holes on the biting surface, as well as something like an NTI splint for the clenching (if it's still a problem), to prevent further damage. Though it's pretty much impossible to tell over the internet (without actual photos/x-rays - maybe crowns are a better solution). Apart from that, it sounds like you're doing all the right things . If you don't mind me asking - what is the worst thing that could happen if you were to confess that you're terrified to a dentist? (P.S.: cheers for the go-ahead re. the book you mentioned, I've added it to the page on common fears!)
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Post by vicki on Aug 21, 2005 5:28:32 GMT -5
I don't really know what the worst thing that could happen would be. The strange thing about the human mind (particularly mine!) is that it tends to fill in the gaps with whatever terrifies it the most. But what I do know is that in the past most people (in general) haven't responded very well if they've either found out about the panic attacks (which thankfully don't happen as frequently as they used to) or are unfortunate enough to witness me having one. People who've known me for years are quite often pretty horrified if they find out because it's the last thing they expected - apparently I 'put on a very good act' to cover it up (I'm also, ironically, the person people seem to turn to in a crisis although god knows why - they don't realise I'm just as worried/scared as them!). If people react negatively to another person's panic, it usually adds fuel to the fire (I know from my own experiences and also other people I've come across who have panic attacks). So over the years I've become more aware of what 'gives the game away' and have managed to some extent to cover up the signs accordingly (including chemical assistance in the form of beta blockers). It's like trying to hold a door shut against a force 9 gale - it actually takes a lot of energy (probably more than the actual panic itself). In relation to the dental phobia in my case, I'm running out of energy and the door is falling off it's hinges! The dental fear seems to work on two levels; I know I have a problem with trust and others' perceptions of my fear and I think it must be the underlying cause of it, but on top of that I also fear the environment and everthing in it as well. I don't really know why the environment freaks me out, the only thing I can think of is that it's somehow related to the underlying cause(s)? For example, I know that needle/injection phobia is pretty common in dental fear but I don't have a needle phobia (had too many stuck into me! ), but yet when I needed a filling, on sighting 'the needle' (which looked as large as a knitting needle), I went from silent terror to outright panic within a few seconds (and was told I looked like the figure in the Edvard Munch painting 'The Scream' ). Someone I went to college with (who also had panic attacks) compared living with panic attacks to living life on a snakes and ladders board - an analogy which I can relate to. I suppose if I confess my fears and the fact that I'm terrified to a dentist, I'll end up on a snake (probably that long one too! ) - people who are fearful or who panic can be perceived to be more hassle or more difficult to deal with and more often than not this makes it twice as hard for the person who panics because they usually do want to do (or have in the case of dental treatment) whatever it is but are so scared. I wish so much that I had a more straight forward fear such as gagging - perhaps I would have been able to sort it out by now. You deserve a medal Let's for having the patience to read my insane ramblings!
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Post by letsconnect on Aug 21, 2005 10:10:47 GMT -5
But what I do know is that in the past most people (in general) haven't responded very well if they've either found out about the panic attacks (which thankfully don't happen as frequently as they used to) or are unfortunate enough to witness me having one. If people react negatively to another person's panic, it usually adds fuel to the fire I'm sorry you've had such bad experiences with people's reactions in the past . It's understandable that you would now expect everyone else to react the same way. Have you ever had a sympathetic response though? I suppose the reason I'm asking is that I've had my share of panic attacks, and no particularly negative reactions (apart from the odd person who'd feel a bit uncomfortable with it). I don't really know why the environment freaks me out, the only thing I can think of is that it's somehow related to the underlying cause(s)? Perhaps, never having felt at ease in that environment, it acts as a trigger (simple association learning)? For example, I know that needle/injection phobia is pretty common in dental fear but I don't have a needle phobia (had too many stuck into me! ), but yet when I needed a filling, on sighting 'the needle' (which looked as large as a knitting needle), I went from silent terror to outright panic within a few seconds (and was told I looked like the figure in the Edvard Munch painting 'The Scream' ). Uhm, that's why a lot of dentists try and keep the needle out of sight and inject at an angle where you can't really see it (personally, I need to close my eyes for any injections, dental or otherwise)... Who said you looked like the figure in 'The Scream'?? Was it meant to calm you down (as a way of injecting humor into the situation - no pun intended ), or was this said quite seriously? Either way, it sounds as if all this comment really did was to embarrass you further. I suppose if I confess my fears and the fact that I'm terrified to a dentist, I'll end up on a snake (probably that long one too! ) - people who are fearful or who panic can be perceived to be more hassle or more difficult to deal with and more often than not this makes it twice as hard for the person who panics because they usually do want to do (or have in the case of dental treatment) whatever it is but are so scared. It's true that some people (including dentists) perceive people who are fearful or who panic as "difficult" - no doubt about it. But it's also true that other people have no or little problem dealing with someone who's panicking, and they're pretty laid-back about it - it's simply not a big issue. For others again (and they tend to be highly empathetic types), it's not a big issue, but they're so caught up in trying to make everything just right for their patient that they start panicking themselves - which in turn can make their patient MORE rather than less nervous ;D. Add to that the fact that you're bound to project your own feelings onto them ("I feel embarrassed, therefore, they must think I'm a total idiot"), and you end up in a heap of emotional confusion and turmoil. So what I'm trying to say is, not everyone will regard it as a problem, especially if they know that you're terrified because of past experiences. I get the impression that those dentists who are most likely to perceive "nervous" (<-- euphemism ) patients as particularly difficult are either the anal types (of whom dentistry appears to attract its fair share ), or people who simply do not believe that people may have had bad experiences in the past (and as a result, attribute fear to stable personality characteristics, rather than the situation - again, we're back to the fundamental attribution error).
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Post by vicki on Aug 22, 2005 3:49:34 GMT -5
Panic is a strange thing - it seems to be perceived by most as perfectly normal in some situations but not in others. For example most people would freak out if they were stuck in a car on a level crossing and a train was coming - but if the same person was lost in the middle of a massive shopping centre or foreign city, panic could be regarded as an over-reaction because the fight or flight response is triggered yet there is no danger, therefore other people don't understand why they're panicking. It can come as a complete surprise to them, 'out of the blue', because it challenges their preconceptions of the person they thought they knew - suddenly that person changes into a terrified, sometimes hysterical (unfortunately not in the funny sense though!) and 'different' person - one who they've never met and are unsure of... could this person be nuts? Sometimes people decide that you're no longer the person they thought they knew - the one who is perfectly normal and who laughs and jokes and all the rest of it.
The examples of the shopping centre and foreign city are real from my past. Both times I was with a friend whom I'd known for many years. Both friends knew I sometimes get a little 'nervous' and were seemingly OK with that. The one who was with me on holiday was freaked out, thought I was nuts and left me panicking in the middle of a place I'd never been before. The other friend (during the shopping centre 'incident') had completely the opposite reaction and has stuck with me through thick and thin (the only person in the world who knows about the dental phobia but not in quite as much depth as I've gone into on here). As I've found out, it can be an excellent way to sort out who your real friends are.
But as usual, I'm wandering off the point... (!). During the dreaded filling appointment, I saw everything from the syringe being prepared to it being injected into my mouth - it was right in front of me. I suppose I thought (even though I was already terrified) that if I watched, it wouldn't be as bad (this theory works for me in other pain inflicting situations). I couldn't have been more wrong. When the dentist made the comment about me looking like the person in The Scream - he wasn't laughing or smiling - it was an observation (which obviously I wish he'd kept to himself!) - it just highlighted to me how bad I must look.
At the moment I'm sat at work typing this with tears dripping on my work - not sure whether they're from the emotions caused from typing this or because some of the milk I've just drunk has soaked through the holes down into my teeth (I get this weird popping sensation as it soaks through the holes - then it hurts like ****!) and has caused a really sharp stabbing pain which is taking ages to settle.
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Post by letsconnect on Aug 22, 2005 14:12:36 GMT -5
- I'm sorry to hear you're in such pain. Hope you're feeling a bit better now . The examples of the shopping centre and foreign city are real from my past. Both times I was with a friend whom I'd known for many years. Both friends knew I sometimes get a little 'nervous' and were seemingly OK with that. The one who was with me on holiday was freaked out, thought I was nuts and left me panicking in the middle of a place I'd never been before. The other friend (during the shopping centre 'incident') had completely the opposite reaction and has stuck with me through thick and thin (the only person in the world who knows about the dental phobia but not in quite as much depth as I've gone into on here). As I've found out, it can be an excellent way to sort out who your real friends are. But as usual, I'm wandering off the point... (!). No, that was the point exactly ! Not everyone is going to have a problem with someone who panics. If you knew that the dentist would not react badly to you having a panic attack, would that change things? Really, it's a bit of a "so what" issue. You're the type of person others like to hang around with. You're the type of person that others turn to in a crisis. But in certain situations that act as triggers, you may panic. So what?? Nobody's perfect!!! Of course, it's distressing to you, but realistically speaking, it's simply not a huge issue in the broader scheme of things. What actually happens when you have a panic attack (as in, what would an outside observer perceive), and how long do they last for? (there's a reason why I'm asking, it's not just idle curiosity) During the dreaded filling appointment, I saw everything from the syringe being prepared to it being injected into my mouth - it was right in front of me. If it's any consolation, I'd say an awful lot of people (perhaps the majority?) would have reacted the same way. When the dentist made the comment about me looking like the person in The Scream - he wasn't laughing or smiling - it was an observation (which obviously I wish he'd kept to himself!) - it just highlighted to me how bad I must look. It highlights to me that this was not a very professional comment to make . Really, I wouldn't read too much into that one incident - many people would have reacted exactly the same . I'm quite a big fan of tell-show-do techniques, but you've gotta be selective in what you show the patient... some things look more worrying than others.
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Post by vicki on Aug 23, 2005 4:23:05 GMT -5
If I went to a dental appointment and I knew that the dentist (or anyone else in there) would not react badly to me panicking, it would probably make things easier although I'd still be terrified. So what happens during panic attacks? Years of reading books, talking to others and surfing the internet have enabled me to identify (in my case) two types of panic attack. The first type are those which I worry myself into (worry/stress in response to a known event/situation in the future) where the panic happens before and during whatever 'it' is. The feelings/symptoms with this type tend to appear gradually and increase in intensity until the panic is in full swing. The second type are those which happen without any warning - sometimes when I least expect it. These also happen in response to something and appear like someone has flicked a switch - everything starts more or less at once. I have managed to get some sort of control over the first type (although there are exceptions for some reason - appointments at the dentist being the main one), but not the second type. If I have an appointment at the dentist (which apart from being held at gunpoint etc, is the most terrifying situation I could be in), then the vicious cycle of thought processes starts e.g. "what if....", or "if x happens, what will I do then". Using the book mentioned earlier, I can usually come up with some sort of plan to deal with "x" in most situations, so that if it does happen, yes it's still scary but at least I can make an attempt at dealing with it. Visits to the dentist seem to be an exception to this - the sleepless nights start over a week before and it generally goes downhill from there! Once at the actual appointment, I'm already in the advanced stages of the first type of panic attack - then sometimes the first type changes into the second type - and it's like some huge monster which I've no hope of escaping from and if other people are present it's like I'm trapped like a goldfish in a bowl (I obviously do escape the monster otherwise I wouldn't be alive to tell the tale!). I know there is a difference between how people witness my panic and how I do, probably because I change some of my behaviour to try and disguise it. Trembling - I usually sit or lay on my hands which helps to control it sometimes, but quite often my whole body shakes so this probably makes it look even more strange - I also drop things a lot! Breathing - can be anything from irregular to full on hyperventilation which obviously can't be hidden and is probably the most alarming aspect for other people (I know it won't kill me and I always have a paper bag with me wherever I go - but if I use a paper bag it sometimes attracts even more attention so I try and overcome it with will power by holding my breath for a while instead). Heart rate/pins and needles - nobody can see this but I can feel it - the beta blockers can go some way to preventing this. Dizziness - I try not to move unnecessarily - otherwise I have a tendency to look a bit drunk if I walk! I have seen some people at the dentists pacing round the waiting room like a caged tiger - If I did this, I'd look like a drunk tiger who would probably end up on the floor! Freezing/being unable to move - not a lot I can do about this, so for instance if I am asked to open my mouth, I don't always do it straight away and get asked twice so I probably appear like I'm being difficult?! I jump easily - as mentioned before, everything seems magnified sounds, sights, the lot - I tend to jump or flinch - all I can do is pray that nobody notices. I tend to jump easily anyway and in a bizarre kind of way people learn to adapt to you being like that - for example our boss at work is a very 'touchy feely' sort of person (not in a horrible way) and has a habit of putting his arm round people when he talks to them (male or female) but because I jump like a cat on hot bricks he has learnt not to with me which is fine because it means I don't look so daft. I don't mind people touching me - I appreciate a hug as much as anyone else - it just makes me jump sometimes! Large pupils - people may notice this but fortunately my eyes are very dark brown. Skin colour - I either go deathly pale or red and white blotchy - so I tend to wear clothes that show as little of me as possible as my skin changes are very obvious to others (I know because several people have pointed it out). Speech - 99% of the time I talk completely normally but when "nervous" I suddenly find myself stammering and forgetting what I'm saying so I try not to talk too much - that's if I can talk. All in all, to outside observer my behaviour must look strange , but maybe strange behaviour that nobody says anything about is better than risking people seeing I'm panicking and their reaction to that, so in a way I suppose I've dug myself into a hole . How long do the panic attacks last for? I don't honestly know - it differs. If it's in response to a situation then once I've left that situation it tends to calm down but if I'm on my own sometimes it can go on for ages.
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Post by letsconnect on Aug 23, 2005 7:46:15 GMT -5
I'm in a bit of a rush right now but will reply later... just wanted to say, have you come across this site yet: www.doyoupanic.co.uk/home.htmlI was just offered a link exchange (which I'll gladly accept, for a change, lol), and having had a first glance, it looks very promising (it's sort of a first-hand account of panic disorder).
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Post by letsconnect on Aug 23, 2005 9:39:27 GMT -5
A couple of quick thoughts: If I have an appointment at the dentist (which apart from being held at gunpoint etc, is the most terrifying situation I could be in), then the vicious cycle of thought processes starts e.g. "what if....", or "if x happens, what will I do then". Have you ever allowed your mind to go 'blank' in that situation and let the panic 'wash over you', so to speak? Personally, it appears to me as if the 'what if' thought processes might be the culprit... maybe you could replace the 'what if's with 'so what's'. Another tip which was posted on the dentistry questions board: " I was taught in therapy to look upwards when experiencing a panick attack. I do know the feeling when you just want to run because you cannot even say a word or even concentrate on anything else but to GET THE HELL OUT OF THERE, and I know things get closed in like being in a bad dream. That is why they suggest looking up and never looking down." I would think that looking up might also help because usually, when we are caught up in "what if" thought processes, we tend to look down and to the side, and looking up may interfere with being able to concentrate on our internal state, thus disrupting the vicious circle. Back to Mr. Garrison and his puppet: if your friend from the shopping center incident lives near you, she might be able to act as the "puppet" and explain things to the dentist beforehand. That way, they've been 'warned' , lol, and know what to expect, which may be one worry off your shoulders. Alternatively, you can use written communication as the puppet. More later!
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Post by vicki on Aug 24, 2005 3:55:24 GMT -5
I've visited the website suggested - and yes I can relate to some of it. Fortunately I don't panic 100% of the time - although I do worry a lot (in case it isn't obvious in my posts! ) but I know that it's not really that unusual. You may be right about the thoughts being the culprit - which is why I either try to ignore them or deal with them by coming up with a plan. So by the time I get to an appointment - all the 'thinking' has been done (or successfully ignored) so I don't actually have any 'what if' thoughts that I'm aware of - at this point my mind is full of fear/panic and the physical side of things is starting to show. I have tried letting my mind go blank so to speak but the fear is still there like a big ugly monster. The last time I tried at the dentists was when I had the filling (about 2.5 years ago - the worst I've had done since is have Duraphat applied at every appointment - which is bad enough). Up until the point where I was told a filling was needed, I was purely concentrating (as usual) on trying to hide my fear and all the things that give the game away. At the point he told me I needed a filling, it was like someone had thrown a bucket of cold water over me - I was that shocked - the very thing that I feared the worst - ie, an appointment of longer than I thought I could deal with and a drilling and filling session (the threat of any sort of treatment being what prevented me from going for 6 or 7 years previously) that all thoughts did leave my mind, it did go blank. I was at the point where my worst fears were about to be realised - I had to accept the inevitable. Suddenly I was on a calm beach (metaphorically speaking) for a couple of seconds - then there was a huge wave crashing towards me that I couldn't run from - the only thing I could do was stand there and be hit by it. What followed has to be in my personal top 10 of humiliating panic attacks - so I guess you could say I'm afraid of letting things go blank too much - unless I knew it would be totally safe and there was no way a panic attack could be triggered or that there wouldn't be any negative consequences if I did have one. I was also taught (by my hypnotherapist) to look up. From a self hypnosis perspective, there are certain things that can help the mind to go into the alpha or trance state - looking up and laying flat being two examples. The sight and sound of sharp pointy instruments and everything else in there proves one distraction too far! Any ideas anyone? My friend actually lives a couple of hundred miles away - but I really need to somehow do this myself otherwise I don't think it will ever get any better (though god knows how - not exactly the kind of thing that's easy to put into words, verbal or written is it?!). Really sorry I don't have a more simple problem; but at least if I manage to come out of the other side so to speak, I'll have a decent success story to post on here!
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Post by letsconnect on Aug 24, 2005 6:14:37 GMT -5
I guess you could say I'm afraid of letting things go blank too much - unless I knew it would be totally safe and there was no way a panic attack could be triggered or that there wouldn't be any negative consequences if I did have one. What do you imagine the 'negative consequences' to be? What would a dentist need to do / how would they need to react in order for you to feel comfortable with having a panic attack in front of them? From a self hypnosis perspective, there are certain things that can help the mind to go into the alpha or trance state - looking up and laying flat being two examples. The sight and sound of sharp pointy instruments and everything else in there proves one distraction too far! Any ideas anyone? I think it would be best to leave any instruments until after the panic attack is over and you're reasonably comfortable... and if you can't take the sight, to close your eyes. Some people like to listen to music, but others find that a distraction too far. I don't know, but some people find that a blanket helps them (for that cocoon effect). My friend actually lives a couple of hundred miles away - but I really need to somehow do this myself otherwise I don't think it will ever get any better (though god knows how - not exactly the kind of thing that's easy to put into words, verbal or written is it?!). Hey, you're the copywriter around here !!
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Post by vicki on Aug 25, 2005 3:16:10 GMT -5
The negative consequences could be anything from being laughed or shouted at to being beaten up because someone is irritated/angry. Logic says that it's unlikely that I would come to any physical harm as other people in the building would hear it but it still somehow exists as a possibility, which leaves being shouted at or humiliated - haven't a clue on this score. I can't predict people's reactions, perhaps if I could I would be a lot calmer ! I've never felt comfortable having a panic attack in front of someone else - not even friends or family as I know it's not 'normal'. I think I was about 12 when I had my first panic attack and for the past 14 years or so, I've been conditioned to believe (by various people) that it's not normal and that I should get a grip etc. Obviously since I've got older and read more, talked to more people and surfed the net, I realised it was a lot more common than most people think. If I were to have a panic attack at the next appointment (rather than silent terror which probably looks equally as strange - I have no control over whether it's silent terror or panic attack) then it may help if the reaction wasn't , or as it has been in the past when I am and feel like
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Post by letsconnect on Aug 25, 2005 9:40:41 GMT -5
The negative consequences could be anything from being laughed or shouted at to being beaten up because someone is irritated/angry. Logic says that it's unlikely that I would come to any physical harm as other people in the building would hear it but it still somehow exists as a possibility, which leaves being shouted at or humiliated - haven't a clue on this score. I can't predict people's reactions, perhaps if I could I would be a lot calmer ! Do you think it would be possible for you to let a dentist know that you fear they might laugh at you or shout at you? And, have you tried (in the past) to sit down with a dentist just for a chat? I know this can sometimes be difficult depending on the layout of the space, but quite often, something can be arranged. You mentioned trust being a major issue, and it's a lot harder to build up trust if you're in the chair (I find, anyway). One of the things which helped me was feeling on an equal level with my dentist, if that makes any sense. Maybe if you can build up some trust first, the relationship between yourself and your dentist would feel more like a partnership (working in concert), rather than what you've been describing so far (being in a vulnerable position with little or no control over what's happening). I've never felt comfortable having a panic attack in front of someone else - not even friends or family as I know it's not 'normal'. "Comfortable" was probably a bad way of describing it, lol - "bearable" might be a more apt description . If I were to have a panic attack at the next appointment (rather than silent terror which probably looks equally as strange - I have no control over whether it's silent terror or panic attack) then it may help if the reaction wasn't , or as it has been in the past when I am and feel like If you could "warn" them beforehand about what to expect, would that make it less likely for them to react with , , or ? The negative consequences could be anything from being laughed or shouted at to being beaten up because someone is irritated/angry. Logic says that it's unlikely that I would come to any physical harm as other people in the building would hear it but it still somehow exists as a possibility, which leaves being shouted at or humiliated - haven't a clue on this score. I can't predict people's reactions, perhaps if I could I would be a lot calmer ! Do you think it would be possible for you to let a dentist know that you fear they might laugh at you or shout at you? And, have you tried (in the past) to sit down with a dentist just for a chat? I know this can sometimes be difficult depending on the layout of the space, but quite often, something can be arranged. You mentioned trust being a major issue, and it's a lot harder to build up trust if you're in the chair (I find, anyway). One of the things which helped me was feeling on an equal level with my dentist, if that makes any sense. Maybe if you can build up some trust first, the relationship between yourself and your dentist would feel more like a partnership (working in concert), rather than what you've been describing so far (being in a vulnerable position with little or no control over what's happening). I've never felt comfortable having a panic attack in front of someone else - not even friends or family as I know it's not 'normal'. "Comfortable" was probably a bad way of describing it, lol - "bearable" might be a more apt description . If I were to have a panic attack at the next appointment (rather than silent terror which probably looks equally as strange - I have no control over whether it's silent terror or panic attack) then it may help if the reaction wasn't , or as it has been in the past when I am and feel like If you could "warn" them beforehand about what to expect, would that make it less likely for them to react with , , or ?
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Post by vicki on Aug 26, 2005 7:43:18 GMT -5
Anything is supposed to be possible - but trying to do something and actually being able to do it are two very different things. I know I'm going to have to do something though because the time when appointments are more frequent and longer than 10 minutes is getting nearer the more damaged and painful my teeth get. Somehow I have to get through them without making a complete idiot of myself and being terrified to the point of paralysis . Besides, on the wall behind me at work is a huge sign with the quote "if you always do what you've always done, you'll always get what you've always got" - it's supposed to be the company ethos (and what we tell clients when they don't agree with what we're saying ). I guess I'm scared of being labelled nuts or whatever other euphemism people care to use - by letting a dentist know that I fear they may shout/laugh at me if I'm 'nervous' or panic would reflect badly on me and perhaps make me appear like a nervous wreck who can't cope (probably a pretty accurate description, lol!). I've never tried having just a chat - it feels like the more minutes I spend in there, the more opportunities there are for me to panic. I don't think I'm averse to talking as such (quite capable of talking the hind leg off a donkey as the saying goes!) but taking the risk scares me to death. The aim of each appointment in the past has been to get it over and done with and out the door in as little time as possible, with as much time as possible before the next appointment. This is why at the first appointment with the current dentist, I took the opportunity of persuading him I needed appointments every 6 months instead of every 3 months (I didn't say why - he was obviously puzzled but thankfully didn't say anything). I know it wasn't a good idea as there was probably a good reason why I had to go more often. I asked the previous dentist for 6 month appointments but he smelt a rat (so to speak) and said no. I've only ever 'warned' someone that I may panic once in the past - they didn't really take me seriously, probably thought I was worrying too much and said everything would be OK. But it wasn't.... they were surprised when 'it' happened. When I was they were
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