As people with a history like mine often do, i’ve had severe dental phobia most of my life. To have to hang my mouth open and have someone poking around in there, sometimes causing me pain, can be a brutal trigger. As a child, my mother stopped caring about my dental health around the time she was committed; i was in grade one. The only time she’d bring me in was for an emergency, which happened occasionally. I wasn’t much for brushing, which resulted in a few abscesses and a couple of pulled teeth.
Once on my own i just dodged the dentist. I finally paid attention when i found an excellent family physician during my pregnancy with my second child. She urged me to attend to my teeth, which were becoming problematic.
I required many appointments to get my teeth cleaned and a number of fillings followed. Neither the hygienist nor the dentist seemed to realise or care about my severe anxiety, and i was shamed and lectured every visit, guaranteeing more avoidant behaviour. It wasn’t until i was well into therapy with my current counsellor that i finally dealt with my fear head-on.
I found a nice lady dentist who’d been doing it for decades, and i went to talk to her. No cleaning, just x-rays, and a chat about what i was looking at to get my teeth shipshape. I told her of my phobia. (No, really? Like my huge, watering eyes and clenched fists didn’t already announce it.) I indicated as delicately as i could that it was trauma-based. She was immediately receptive, kind and gentle in her response, and assured me that i wasn’t her only patient with these issues. She said she’d work with me, to help me overcome my anxiety as much as possible (at my pace), and to attain and maintain healthy teeth and gums.
I know a fair number of people who use sedation dentistry to handle this issue, but i wanted to at least try to do it without drugs of any kind. I prepared as best i could; going over what was going to happen in my head, looking at pictures i’d taken of the dentist’s office, and the chair that i’d be sitting in, the ceiling that i’d be looking at (they have tellies up there – how smart is that?), i thought of how i feel in a dentist’s chair, and went over the different methods i could use to cope:
– focused breathing,
– body mindfulness,
– reminding myself that the intensity of the feelings are a response to trauma that’s no longer happening,
– stopping the hygienist and asking for a break,
– stopping the hygienist and talking briefly about the feelings,
– stopping the hygienist and rescheduling,
– using an anti-anxiety med beforehand,
– sedation dentistry,
– maintain dental health as best i can on my own, do more therapy around the issue, and try again at a later date.
I was stiff as a board the first time i sat for a cleaning; eyes as big as saucers, hands and feet clenched hard enough to cramp. The hygienist had a soft, soothing voice, and she calmed my jangled nerves with banter about her children, a recent move, a holiday. Her demeanor was quiet and kind, and i knew she wasn’t going to hurt me. Cleaning my teeth properly would take a few visits, they’d already told me, but i never sensed any disapproval from her, and there was never the slightest hint of a tsk or a tut-tut in her voice.
Then it’s time for my dentist to do some fillings, some caps, and even a root canal, to preserve my teeth for as long as possible. Her voice is also soft (i think dentists may cultivate this voice – also smart) but her vibe is jovial, even goofy. Her assistant is sarcastic, with a deadpan delivery, and between the 2 of them, they provide a great service and a show besides, which distracted and delighted me so much that i came to look forward to seeing them. Not even kidding.
I settled in to regular maintenance, and then the recession hit. We had to let go of our dental insurance, and i didn’t want to stress our already squeaky budget, when i knew my teeth were in good shape, and i was now diligent and conscientious with care. We still had a son at home who required extensive orthodontic work, and so i stopped going for a couple of years. When our financial situation improved, i went back, thinking there’d be no problem.
Oh, but there was.
I missed a number of appointments, for which i provided lame excuses, and i’d call after and reschedule with a self-deprecating chuckle. Six months later i did the same thing, i missed my first appointment and called, saying it had totally slipped my mind and i’d be there for sure next time. The receptionist fixed another time with me, but i noted something in her voice before we hung up – a hesitancy. I felt uneasy.
She called me mid-morning the next day.
She told me that they wanted very much to continue providing me with dental care, but in order for that to happen they were going to require the cost of the appointment up front. She explained that my dentist couldn’t continue losing money when i didn’t show up, that it wasn’t fair for her or anyone.
I bristled. Feelings flooded my body, and i reacted with offense.
“This feels like i’m being punished for being mentally ill,” i said.
“I’m going to have to discuss this with my husband and i’ll get back to you,” i said.
To my credit, before the end of the phone call, i knew she had me dead to rights. But shame is a massive trigger, and i was dissociated and edgy for the rest of the day. It took me a while to bring it up with my husband, but not too long, and he understood right away. I called the receptionist back within a day or 2, and told her i knew they had to do what they were doing. And then i paid them.
I was anxious about the cleaning. I thought about why. It wasn’t just being embarrassed – it was a few things. There’d been a break in my association with them, one where i wasn’t in therapy, and i hadn’t had to deal with some of the triggers that dentistry touches on. I was now back in therapy, and learning to stay in my body during times when i feel emotions and/or physical sensations that i don’t want to feel. I understood why i was dodging. I knew i was setting myself up to miss my dates with my dentist.
I was trying to avoid all the feelings.
I showed up on time, and prepared. I knew i was going to feel awkward and embarrassed, which was normal and appropriate to feel, because i’d done them wrong. I hadn’t meant to, and i knew that. I knew they would all be gracious and kind, as they had always been, and they were. When the cleaning was done, my dentist was there at reception, and she gently asked me, “Do you understand that we had to do what we did?”
I told her that i did, and i told them all that i was sorry. I told them that it hadn’t occurred to me that i was costing her money, or inconveniencing anyone – but it should have, and i was ashamed about it.
She said, “You know, we just wouldn’t have had you back if we didn’t like you so much, eh?” And i could see that that was true.
I could also see that, while i’d fucked up, i’d also done some things right.
I’d been honest about my mental illness and my fears and anxieties from the jump.
I’d carefully built relationship with them, so much so that when i started behaving poorly, they tolerated that behaviour for as long as they could – perhaps longer than they should have done, and only for my benefit.
And when they finally called me out, i accepted responsibility for my actions.
Yes, for the briefest of moments -the space of a phone call- i reacted badly, but i knew almost immediately that i was in the wrong, and why, and that i could and would put it right and it was going to be okay.
I got caught doing something shitty, and i reacted by trying to avoid taking the blame. To assuage my chagrin by haughtily providing an excuse.
I’m not bad – i’m sick!
While that is true in a way, it’s neither appropriate nor is it helpful to apply that in this instance. After i hung up the phone i felt it right away – i was convicted in my heart by a jury of me. I’ve identified myself to these people as someone who lives with serious, multiple diagnosis mental illness. I’ve done so first for my benefit, but also for others like me. I want to bring awareness and exposure to those around us, in service to us and apart from that, who have little or no experience with us (or knowledge that they’re having such – because they certainly are, am i right?), and by so doing, help pave a way for fellow neuroatypicals and those living with mental illness to do the same. To see that it can be done, and perhaps they might do it, too.
I feel the weight of that responsibility. It’s a good weight, one i’ve willingly and purposefully shouldered, and it’s a right thing and a steadying force in my life. It gives meaning and provides balance and even serendipity. I would not so inadequately, so boorishly represent a community that has my love so easily, and needs help and understanding so desperately.
The love and life that i’ve found there made my path clear, and set my shoulders squarely towards it.
Yes, part of the reason why i behaved the way i did was the way i was raised and the way my brain responded to try and save me, to help me cope and to perhaps spare me some of the worst of it, that i might survive. And survive i did – and in these last years, even more and better.
Yes, there are reasons -childhood causations- for my behaviour, but in the end, today, right now, at this moment, i am as free and autonomous and aware as i can possibly be, and i am happy and grateful and relieved indeed, to be solely responsible for my choices and actions.
And sometimes i’m just wrong. And i was.
I accepted the consequences, which were fair, and no one abused me and i didn’t die.
I can hardly wait to screw up again.