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Stress reduction = risk reduction

in Your Health

Stress reduction = risk reduction

The use of hypnosis to counteract stress in dentistry

Stress means pressure - a test of your coping resources.

Stressors occur all the time, but if they are well within the range of our coping resources, then we don't experience them as distress but take them in our stride, or even find them enjoyable, so that we take on challenges deliberately to test our mettle, as in many sports and other voluntary stressors.

Can you cope?

What most of us mean by stress is actually distress, resulting from the realisation that we cannot cope with the pressures on us, and/or the pressures we can see building up ahead. The balance of stressors and coping resources varies between people and at different times in a career. For instance, what was challenging and interesting at the outset may become limiting and frustrating after ten years, or twenty.


The risks of distress are exhaustion and distraction. If you are anxious, then part of your attention will be absorbed by this emotion, and it is therefore difficult to concentrate on the delicate skills required in dentistry. There are a variety of strategies to deal with this and one of the more obvious is to remove the stressor. Indeed stress is a significant contributory factor to early retirement among dentists (1).
Stress can contribute to poor posture, particularly in the neck and shoulders.

Another very common strategy is to self-medicate; alcohol and other substances alter the neurochemistry by which the distressing messages are transmitted through the central nervous system (CNS).
Some studies indicate that dentists are no more at risk of substance abuse than other sections of the population (2), but others indicate a higher risk for dentists (3, 4). In any event, the consequences for dentists are more serious for any level of substance use, due to the fine clinical discrimination and manipulative control required for safe practice.

Better solutions

Quitting dentistry and resorting to alcohol and other substances are very high-cost and high-risk strategies, respectively. A better way to counteract the stress of work is a good work-recreation balance and a supportive social network. However, in the face of financial pressure, career pressures, patient demands and/or personal problems, these ideal resources may not be available, or at least not in sufficient quantity to reduce stress on their own.

Where does stress reside?

Stress occurs in the central nervous system, which is doing 'its job' of keeping us alive by warning us of dangers threatening us and arousing our emotional reactions to these. Distress arises because our sophisticated and complex lives do not allow us to enact the simple, straightforward responses which would relieve our emotional impulses.
You cannot flee when you are not looking forward to seeing a patient, or a colleague, or going into the practice on a Monday morning, or getting through a pile of paperwork. Nor can you deal with your problems by physically fighting with them – it takes patience, control, logic and other mental skills. So, how can you manage your emotions, which are causing you this stress?


It is tempting to use the faculties of logic and control to attempt to manage the imagination, however in the case of strong emotions, this strategy is often only partly successful at best, and can even cause stress in itself by generating inner conflict. It is more effective to use the imagination itself, the direct connection with the emotional source from which the problems are emerging. The imaginative and emotional faculties are often called the subconscious mind, as a 'shorthand' term, because for most people they tend to act semi-autonomously.


Hypnotherapy acts directly upon the imaginative faculty of the CNS, which in turn connects directly to the emotions. When we are distressed, it is generally because our imagination is operating us, rather than the other way round. We have the remarkable faculty of being able to cause ourselves trouble not just in the present but also in relation to the past and the future at the same time. Even if the present moment has no particular stressor, we can imaginatively recall and brood over past stressors, and we can also anticipate future stressors and rehearse them in our imaginations, with accompanying emotions that in turn create stress.


Hypnotherapy is the art of gaining direct access to your imagination and inducing its cooperation to produce desirable emotional states, such as serenity, focus, energy, motivation and relaxation. If you want to demonstrate to yourself that this is entirely possible, then close your eyes and vividly imagine putting a slice of lemon in your mouth and see what happens. Once the taste is vivid and real enough to you, the result is inevitable. Whereas everyone has an imagination, and most people have some access to it, practice is generally needed to develop skills to a useful level. It also helps to have someone to guide you through the process until you get the hang of it.


Hypnosis is most frequently used to induce a relaxed state known as a trance, which in turn makes the imagination more receptive to positive suggestions generating relaxing, encouraging and motivating ideas – these are modified for individual goals and preferences.
Suggestions can be used to enhance coping skills and to improve performance in a wide range of activities. This open state of mind is useful for bringing into clear focus and resolving inner conflicts and selfdoubts exacerbating the effects of external stressors. Rapid refresher techniques using hypnosis can enhance any break or rest periods, once the skills are established.

John ButlerDr. John Butler is a clinical hypnotherapist and trainer with over 25 years' experience. He teaches hypnosis to dental professionals for patient care and managing personal stress

1_ Burke FJ, Main JR, Freeman R 1995 'The practice of dentistry: an assessment of reasons for premature retirement' British Dental Journal 182,7: 250-254
2_ Rockville MD, Substance abuse and mental health services administration, 2009 'Results from the 2008 National Survey on Drug Use and Health: National Findings' Office of Applied Studies, NSDUH Series H-36, HHS Publication No. SMA 09- 4434;2009
3_ Kenna GA, Wood MD 2005 'The prevalence of alcohol, cigarettes and illicit drug use and problems among dentists' J Am Dent Assoc 136,7: 1023-1032
4_ Curtis, EK 2010 'When Dentists Do Drugs' AGD Impact, March 2010


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