Dental Anxiety - What You Can Do For Yourself...

The following are strategies survivors of childhood sexual abuse have found helpful in reducing dental anxiety:

Anything that increases your sense of control:

Talk to your dentist or hygienist about your concerns.

Ask your dentist to explain all procedures.

Ask your dentist to forewarn you of pain.

Develop an agreed-upon signal indicating you want to stop.

Tell your dentist when you are afraid.

Mental techniques that you can practice ahead and while at the dentist:

Slow, deep breathing Imagining a safe place

Self talk: I can get through this. It will be over shortly. I am safe

now. I am taking care of my health.

Other things to do:

Bring a friend.

Bring a soothing audiotape; i.e., music or relaxation.

Bring a comforting stuffed animal.

For women, wear pants instead of a skirt.

Talk with your health care specialist about the possibility of medication.

Give a copy of this information to your dentist.

What Your Dentist Can Do To Help...

Your dentist and hygienist might consider some of the following to help ease your anxieties:

Offer an initial appointment just to talk

Place the dental chair in an upright position

Keep the door open

Have the dental assistant present

Not touch the patient's body

Offer audio tapes of relaxing music

Check in frequently with you so you can feel more in control of what the dentist is doing

Offer a body covering (i.e. an x-ray cover)

Explain procedures throughout the office visit

1. Tell yourself you are having a flashback and that this is okay and very normal in people who were traumatised as children (or as adults.)

2. Remind yourself that the worst is over - it happened in the past, but is not happening now. The "child" inside you who was abused is giving you these memories to use in your healing and, however terrible you feel, you survived the awfulness then, which means you can survive and get through what you are remembering now.

3. Call on the "adult" part of yourself to tell your "child" that she is not alone, not in any danger now, and that you will help her get through this. Let your child self know it's okay to remember and to feel what she feels and that this will help her in healing from what had happened to her. However hard it is for you, she is communicating in the only way she can.

4. Try some of these ways of "grounding" yourself and becoming more aware of the present: - stamp your feet, grind them around on the floor to remind yourself where you are now. - look around the room, noticing the colours, the people, the shapes of things. - listen to the sounds around you: the traffic, voices, the washing machine etc. - feel your body, the boundary of your skin, your clothes, the chair or floor supporting you. - have an elastic band to hand (or on your wrist) - you can "ping" it against your wrist and feel it on your skin - that feeling is in the now, the things you are re-experiencing were in the past.

5. Take care of your breathing: breathe deeply down to your diaphragm; put your hand there (just above your navel) and breathe so that your hand gets pushed up and down. You can also count - to 5 - as you breathe out and in. When we get scared we breathe too quickly and shallowly and our body begins to panic because we're not getting enough oxygen. This causes dizziness, shakiness and more panic. Breathing slowly and deeply will stop the panic.

6. If you have lost a sense of where you end and the rest of the world begins, rub your body so you can feel its edges, the boundary of you. Wrap yourself in a blanket, feel it around you.

7. Get support if you would like it. Let people close to you know about flashbacks so they can help you if you want them to. That might mean holding you, talking to you, helping you to reconnect with the present, to remember you are safe and cared for now.

8. Flashbacks are powerful experiences which drain your energy. Take time to look after yourself when you have had a flashback. You could have a warm, relaxing bath or a sleep, a warm drink, play some soothing music, or just take some quiet time for yourself. Your "child" and you deserve being taken care of, given all you went through in the past.

9. When you feel ready, write down all you can remember about the flashback and how you got through it. This will help you to remember information for your healing and to remind you that you did get through it (and can again).

10. Remember you are not crazy - flashbacks are normal and you are healing.

Ten Commandments to Remember During a Panic Attack Adapted from Fensterheim, H. and Doer, J. "Stop Running Scared!"

1. It does not matter if you feel frightened, bewildered, unreal, unsteady. These feelings are nothing more than an exaggeration of the normal bodily reactions to stress.

2. Just because you have these sensations doesn't mean you are very sick. These feelings are just unpleasant and frightening, not dangerous. Nothing worse will happen to you.

3. Let your feelings come. They've been in charge of you. You've been pumping them up and making them more acute. Stop pumping. Don't run away from panic. When you feel the panic mount, take a deep breath and, as you breathe out, let go. Keep trying. Stay there almost as if you were floating in space. Don't fight the feeling of panic. Accept it. You can do it.

4. Try to make yourself as comfortable as possible without escaping. If you're on a street, lean against a post or stone wall. If you're at the cosmetics department of the department store, find a quieter counter or corner. If you're in a boutique, tell the salesperson you don't feel well and want to sit for a while. Do not jump into a cab and go home in fear.

5. Stop adding to your panic with frightening thoughts about what is happening and where it might lead. Don't indulge in self-pity and think, "Why can't I be like all the other normal people? Why do I have to go through all this?" Just accept what is happening to you. If you do this, what you fear most will not happen.

6. Think about what is really happening to your body at this moment. Do not think, "Something terrible is going to happen. I must get out." Repeat to yourself, "I will not fall, faint, die, or lose control."

7. Now wait and give the fear time to pass. Do not run away. Others have found the strength. You will too. Notice that as you stop adding the frightening thoughts to your panic, the fear starts to fade away by itself.

8. This is your opportunity to practice. Think of it that way. Even if you feel isolated in space, one of these days you will not feel that way. Sometime soon you will be able to go through the panic and say, "I did it." Once you say this, you will have gone a long way toward conquering fear. Think about the progress you have already made. You are in the situation.

9. Try to distract yourself from what is going on inside you. Look at your surroundings. See the other people on the street, on the bus. They are with you, not against you.

10. When the panic subsides, let your body go loose, take a deep breath, and go on with your day. Remember, each time you cope with a panic, you reduce your fear.