"The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet and in the cause and prevention of disease." - Thomas A. Edison

Peter Varley BDSc, FDSRCS, DFHom(Dent.) and Geoff Graham BDS.(profile)

Hypnosis is an altered state of consciousness in which the imagination is greatly enhanced and the power to criticise is greatly reduced. Suggestions are therefore accepted more readily and acted upon more easily.

Deep, Medium and Light Trance

In a hypnotic trance the level attained can vary between people. Deep trance subjects are the only ones who really appreciate that they are being hypnotised.

Some people can go into a very deep trance, about 20% of the public, but others may only be able to experience some of the hypnotic phenomena and could be classed as medium trance subjects. These amount to about 50% of the public. Others may only achieve a light state of hypnosis and experience very few of the hypnotic phenomena. These will amount to about 30% of the public. Deep trance subjects can be treated and helped more easily, but medium and light trance subjects need more sophisticated techniques to help them. It is very difficult to change someone from a light trance subject into a deep trance subject.

• 20% Deep Trance
• 50% Medium Trance
• 30% Light Trance

Assessing Hypnotic Capacity

There are a number of ways of assessing what sort of hypnotic capacity a person will have. Before using formal hypnosis it is necessary to find out what sort of capacity the person is capable of. Spiegel’s Capacity Test is simple and quick to do and accurate for about 70% of the population.

Patients with a poor trance capacity will probably respond better to Neuro-Linguistic Programming (NLP) or some informal technique. Anyone who chooses, can be helped with hypnosis to make significant changes to the way they live. The main proviso is that the person really wants help to change the way they feel or what they do.

The Mechanics of Hypnosis

With all hypnosis, both formal and NLP, it is the patient who eventually makes the changes possible. Hypnosis is a quick and generally easy way of teaching the patient to make the changes in their behaviour that allow their life to be more comfortable and enjoyable. Hypnosis will achieve nothing if the person cannot use the techniques taught.

Having briefly explained above what hypnosis is and equally important, what it is not, we will explain how we use the state of hypnosis to bring about changes in our patients.

Rapport

One of the most important conditions we fulfill when communicating with anyone is to build rapport with that person. The quickest and easiest way to do that is to use the hypnotic procedure of pacing the patient. If we pace a person then we rapidly build rapport and at the same time the patient goes into a spontaneous light informal hypnotic state.

Leading

Leading means giving the person a way out of their difficulty and it is very effective after you have paced the person on more than one level. They will just follow your lead.

Verbal Pattern

When a person leans towards a particular verbal pattern it is necessary to respond in the same pattern

Pacing

To pace someone we have to get into the rhythm and flow of how that person thinks and processes their thoughts. ‘You are just like me and I can trust you’. They then do not realise that we are pacing them.

Emotional Pacing

The first level of pacing is to meet the person on the same emotional level that they present with. If the patient comes into your consulting rooms obviously nervous and frightened, it is no use trying to make them feel better by being jolly and happy to see them.

You may say, ‘I guess it is quite frightening in here’. Their unconscious mind then thinks, ‘You really understand me, I can trust you.’

Agreement Pacing

The next level of pacing is agreement pacing. It is no good disagreeing with your patient at the first meeting otherwise they will not trust you at all.

Posture Pacing

This is done by you adopting a posture similar to your patient. If they sit down you sit down. If they cross their arms or legs you cross yours but do it as if in a mirror image and try to not exactly copy your patient but do something similar

Tone and Tempo Pacing

This means that you talk with your patient using the same tone and tempo. You also breathe at the same rate as your patient, breathing in when your patient breathes in and out when they breathe out. This is very important and very powerful as a level of pacing.

Language Pacing

This entails talking on the same level as the patient and particularly using the same sense of language.

Visual Language
If the patient is using visual language then you must use visual pacing. For instance if the patient says, ‘The sky is a beautiful blue today’, it is no good saying, ‘And isn’t it lovely and warm?’ Blue is a colour and visual, warm is a feeling.

Auditory Language
Similarly if the patient may be using auditory language, you must reply in auditory language.

Values and Beliefs Pacing

You should always remember that values and beliefs are ‘The Truth’ to the patient who holds these values and beliefs. If you violate their values and beliefs at the first interaction with your patient you will be very lucky if they ever trust or believe you again. Find out what the values and beliefs of the person you want to work with are, before you enter into any sort of pacing communication.

Content Pacing

The last level of pacing is content pacing. Many people do not listen and come out with something that has nothing to do with what has been going on. Have the courtesy to listen and reply to their topic if you can.

Behaviour Therapy in Dentistry

Behaviour therapy is most effective when there is a deep trance patient or at least a good medium trance patient. First of all it is necessary to establish rapport with the patient by the methods explained above. Then using the patient’s imagination you use direct suggestion to relax them and make them more at ease. Following this it is easy to suggest a removal of their fear. You must remember that four letter words like fear, pain and hurt are forbidden, because to fully understand what these words mean, the person being hypnotised must access their meaning by which time it is too late.

Case History

The following is a report from a dental phobic patient. It is in his own words and will show you why hypnosis should be used in dentistry. His name has been deliberately omitted.

I have never consulted a doctor since infancy and one brief, early trip to a dentist (under the motivation of enormous pain) left me with my prejudices reinforced. Although I wished to be ‘normal’, years turned into decades with every birthday a reminder of my inaction.

There are several practising dentists in every High Street but for me they may as well have been on planet Mars. Going for treatment was like asking myself to walk blindfolded through a door with sudden unknown terrors on the other side. How could I expose my condition to a professional, used to ordinary requirements, without severe embarrassment?

My glimmer of hope was having chanced upon a book which appeared to have amazing relevance to my case. The really decisive moment was when I took the plunge into seeking a no-commitment, informal meeting with a hypnotherapy dentist. I trusted that the counselling skills would take precedence over the dental skills initially. This indeed was the case and from our very first session I realised that everything would be done to give me reassurance, that my case was not unique and that my ‘door’ would be opened very carefully to let me pass through safely.

The therapy sessions were different from any other experience but were very pleasant. I feel that in an incredible short number of weeks, if not days, I was able to make a smooth transition from pure therapy to handing over control to complete the treatment stage. By then I had changed my incorrect, deep-seated perceptions. The physical treatment was of course expertly done, bore no relationship to my preconceived horrors and resulted very quickly in my having a longed-for good dental appearance. I cannot put into words the sheer pleasure and satisfaction of simply being able to smile, to talk face to face and not least, to enjoy foods which had been impossible for decades. I also went on to take full advantage of my career opportunity.

This has happened recently and I still marvel that it happened at all. The process has also bolstered my self esteem generally in all manner of other areas of my life. I am so grateful for the avenue which this approach gave me. I can only say that I could not have followed a ‘conventional’ route and do not know what would have happened with further passage of time. In simple layman’s terms the vicious circle of decay = avoidance = decay = etc, was broken. In condensing a lifetime of experience into these few words I have necessarily skipped a vast amount of detail but I do have a final sentiment:

If anyone feels that they have a problem they do not wish to expose to the normal system, please remember that you are not. A little searching will find an alternative method to take you from hopelessness to happiness by breaking your own vicious circle.’

Hypno-Healing

We all possess a natural healing process in our body and mind that can be stimulated and accelerated by hypnotic suggestion. Our defence mechanisms can work with our regenerating systems and aid natural healing. However, occasionally this natural process works against itself and delays healing. In the latter case this can normally be changed by hypnotic suggestion.

A common time to observe this negative phenomenon is in the tissue reaction to burns and surgery. It is the oedema that occurs following surgery that often does more harm than the surgery itself. This oedematous swelling and subsequent tissue reaction can often be controlled by hypnotic suggestion provided the suggestions are made before the swelling or tissue reaction occurs. This will then allow the healing process to be greatly accelerated.

It is possible to influence the autonomic nervous system to produce a stimulation of the sympathetic and parasympathetic systems. Hypno-healing is largely achieved through stimulation of the parasympathetic system to promote healing. Both systems work through the Hypothalamus which can be influenced by hypnotic suggestion.

Sometimes healing is influenced by positive psychological processes in the mind, in this case accelerating healing or the reverse effect is also noticed when the mental processes are negative.

Uses of Hypnosis in Dentistry

• Stress Management for the patient and for the dentist.
• Treatment of dental anxiety and phobias.
• Hypnotic treatment of Pain.
• Hypnotic control of bleeding, saliva production and gagging.
• Help with tolerance of appliances, e.g. dentures, orthodontic appliances.
• Hypnotic treatment of bad habits, e.g.thumb sucking, tongue thrusting, smoking.
• Help with the treatment of mouth ulcers and gum disease by mind-body healing.
• Helping to promote healthy healing and reduction of post-operative swelling or pain.

Conclusion

I hope we have managed to show what hypnosis is, most importantly what it is not and why more dentists should consider using hypnosis. Hypnosis will help build your practices and for you to be in a position to help patients who otherwise would not be able to face dental treatment. Hypnosis should help a dentist to have a more relaxed and happy life and be more able to communicate with his patients, staff, spouse or children.

Geoff Graham BDS.

Geoff is a Founder Fellow (1969), Past President (1992-95) and Council Member (1969-present) of the British Society for Medical and Dental Hypnosis (BSMDH).

Geoff is a member of The International Society of Hypnosis and has lectured and conducted workshops throughout the world. He has written four books on hypnosis - two on Formal Hypnosis and two on NLP. They have been published internationally and will be part of the Russian teaching programme in Psychotherapy.

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