Chapter 1: Understanding Dental Fear

The thought of visiting the dentist can evoke feelings of dread for many people. It's not necessarily the dentists themselves—who can be quite friendly—but rather the experience of dental treatment that triggers anxiety. Nowadays, dental procedures are usually painless, and while lying with an open mouth for a while can be uncomfortable, the actual fear often lingers from childhood experiences.

Reflecting on my own fears, I realize that the term "dentist" still makes me want to cringe and escape. Growing up in the Soviet era, the dentist was often portrayed as a figure of terror. Many children shared terrifying tales about dentists, comparing them to horror stories filled with dark imagery. The idea of a trip to the dentist was so dreadful that kids would do anything to avoid it, often hiding their toothaches in fear of a visit.

Back then, while anesthesia was generally effective for surgeries, dental treatments often occurred with minimal or no pain relief, and the equipment was far from reassuring. The memories of those times can evoke anxiety even in those who never experienced it firsthand.

More troubling than the equipment, however, was the approach towards children. Dental visits were daunting, and children were not permitted to have their parents present, which only heightened their fear. The environment could be intimidating, with nurses and doctors using stern words to manage unruly patients, which often made the experience more traumatic than necessary.

Chapter 2: Mikhail’s Journey

Mikhail (name changed with permission) has a story that resonates with this experience. Decades after his childhood dental visits, he still feels apprehensive about appointments. Despite his efforts to cope, he endures tachycardia during procedures, especially when they extend over two hours, which puts immense strain on his body.

To help Mikhail, we incorporated elements of Gestalt therapy along with the SIBAM technique. The first step was to identify specific memories that triggered his fear. Mikhail recalled numerous incidents, but one memory stood out vividly: a moment when he was a six-year-old boy restrained in a dental chair, his mouth held open.

This memory was laden with fear, paralysis, and vulnerability. Such emotions often hinder action. The trauma manifests physically, halting the body's natural responses.

The second task was to uncover those suppressed actions. I encouraged Mikhail to delve back into that memory, and he noted a rise in his heart rate.

• "What do you wish you could do in that moment? Tune into your body. Are your muscles tense?"

Mikhail instinctively moved his hand outward, signaling a desire to distance himself from the dentist.

• "I need space from the doctor," he expressed, gesturing to create distance.

As he repeated this movement, Mikhail's actions grew more deliberate. He began to feel more at ease while revisiting his memories; his heartbeat steadied, and his anxiety diminished.

In exploring further, Mikhail identified another instinctive desire—to turn away from the situation. He practiced this movement multiple times, extending his arms and turning his body, which further enhanced his sense of calm and safety.

Mikhail wasn't expressing aggression or resentment; instead, he was processing his trauma. This indicated that there were still unresolved actions to address.

During our continued sessions, I suggested Mikhail consider what he most wished he could do as a child—escape. I instructed him to get up quickly.

Mikhail executed the three movements sequentially: arms out to the side, a turn away, and then a stand-up.

At that moment, he sprang up, and with that, his anxiety dissipated entirely.

Chapter 3: Techniques for Managing Dental Anxiety

In this section, we will explore various techniques to help manage dental anxiety, ensuring that visits to the dentist become less daunting and more manageable.