RA Survivors and Dentistry

I have a miserable time at the dentist. It’s not that I’m a chicken; it’s because I was tortured as a child by a dentist or somebody pretending to be a dentist. Over the years I have learned ways to make it a little less unbearable.

First, I tell all new dentists, in general terms, what my background is. I learned this the hard way twenty years ago when I had an emergency and my regular dentist wasn’t available and so sent me to the person who was covering for him. I figured, “I’m only going to see this guy once, so I won’t bother telling him.” I was so anxious that he tried everything he could think of to make me relax. Finally he said, “Just think of me as a witch doctor who make everything all right by magic.” I shot right up in the chair and said, “Don’t talk to me like that! I was abused by a dentist in a Satanic cult.” Shall we say he was startled?

We both calmed down enough to get the procedure done, but my regular dentist said that he was so shaken up that he had to send him a nice bottle of wine to persuade him to continue being on call.

Second, I kept changing dentists until I found a gentle soul. He’s a total gem. He practices dentistry half time, is an MFT and sees clients half time, and is writing a book on treating phobic patients. (Anybody who needs a dentist in San Francisco, just let me know. And you bet I will review his book when it comes out!)

Third, I have figured out some methods to keep myself in the present and out of flashbacks. I have no compunctions about asking for what I need because my dentist and his assistants dislike flashbacks almost as much as I do. Here’s what I’ve learned to do:

I ask them to keep talking about anything at all during the procedure. Hiking, dental school stories, their grandmothers, baseball, whatever. I just need their voices to hang on to and keep me in the present.

I tell them to let me know ahead of time what they are going to do, how much noise it will make, how long it will take. Surprises are not a good idea.

I ask for a lead apron because the weight is reassuring and goggles because they make me feel like my eyes are protected. Apparently I am not a freak; others find the apron and goggles comforting.

Last time, I was asked if I wanted nitrous oxide. I thought I could get through it without it. But why make life harder for myself, if I didn’t have to? I gratefully accepted it.

Nitrous disinhibits and I got relaxed enough to give him some feedback I had kept to myself until that point. (Again, I had made life harder for myself by not speaking up sooner. I think this pattern needs looking at!)

All dentists seem to minimize the amount of pain involved. They must teach them in dental school that the word “pain” frightens patients and it is better to use a euphemism. Well, it’s not. At best it’s annoying, at worst it destroys trust in the dentist. It’s not a “little tinge” or a “pinch” or “you may feel some pressure.” Be honest and call it what it is. “This will hurt moderately for about one minute. Raise your hand if you need me to stop.” I may be dental phobic, but I am still an intelligent adult and I don’t like being lied to.

The other thing I figured out under nitrous is that the torture I had experienced as a child had magnified the nerves’ response to pain.  Repeated stimulation of the nerve-to-brain pain pathway had set me up to be overly sensitive to dental pain for the rest of my life. I checked this out and was told that I was right.  Perhaps some people really do experience a novocaine shot as “a little pinch.” Apparently there are lucky folk who are even able to fall asleep while being given novocaine!!!

So it’s not our fault. We aren’t being sissies. It’s completely sensible to take care of ourselves and soothe ourselves the best we can. We can’t lessen the pain or eliminate the fear; we are stuck with it for life. But we can handle pain and fear in a way that gives us some measure of control, which we never had as children. That in itself is assertive and empowering, well worth doing.

Book Review: Perpetration-Induced Traumatic Stress

Perpetration-Induced Traumatic Stress: The Psychological Consequences of Killing by Rachel M. MacNair (2002) Praeger, Westport, CT. (Preview in Google Books.) This review was first published in Survivorship Journal 14(3).

Here is a book review I wrote for Survivorship back in 2007. When I looked it over, I found I remembered the book vividly. Since the topic has not been written about much, even in survivor circles, I thought it was worth sharing here.

This is the first work I read on PTSD in perpetrators, and it confirmed many of my hunches.  The book draws material from history, literature, sociology, research studies, and biology, as well as psychology. It was difficult to read emotionally, and I was grateful for the slightly dry tone, for it distanced me a little from my feelings. It also validated that my reactions of distancing are normal, given the circumstances.

There are chapters on combat veterans, executioners, the Nazis, law enforcement, murderers, and abortion practitioners – all adults who have killed as adults (if you consider abortion as killing). Although there is no material on children who have killed or on cults, where I harmed people, I could relate to almost every point.

It appears that PTSD symptoms, especially intrusive images, intrusive thoughts, and hyper-vigilance, are more intense among people who have killed than among people who have been victimized. The less socially sanctioned the act (e.g. atrocities against civilians in war versus killing in battle), the more severe the symptoms. PTSD is a common reaction even to situations when the victim is not seen, as in bombing.

A section on German officers’ reaction to guards shooting Jews standing before mass graves in the concentration camps has stayed vividly in my mind’s eye. Adolf Eichmann said, “Many . . . unable to endure wading through blood any longer, had committed suicide. Some had even gone mad.” After observing the shootings, Himmler was so badly shaken that he ordered the construction of gas chambers to place some distance between the soldiers and the murders.

At first it seemed odd to me that so very little had been written on the subject. But as I read the book, it became clearer. Society colludes to keep the subject cloaked in silence. Individuals do not talk of their reactions out of guilt and for fear of appearing crazy. Society objects to discussion; mention of PTSD in solders who have killed has been attacked for being anti-war propaganda, thus stigmatizing as unpatriotic those who would shed light on the issue.

The reason I found this book so powerful is that ritual abuse, by its vary nature, includes forced perpetration. It is a lot easier for most of us to accept that we were victims and that we wished we could have been saviors, helping other children, than to admit that we were also perpetrators, albeit unwilling perpetrators for the most part. And yet, unless we stop pushing that side of our experience out of consciousness, it is apt to erupt in one form or another and to shadow our present life with self-hatred and guilt.

I hoped that the publication of Perpetration-Induced Traumatic Stress would signal the start of sustained research and attention to the issues involved. When I searched in Google Books, I found precious little. Rachel McNair has written several books on related subjects, all of which look good. I did find On Killing: The Psychological Cost of Learning to Kill in War and Society by Lt. Col. Dave Grossman (2014)  First published in 1995 Little, Brown and Co, NY, NY. (Preview in Google Books.) Grossman also has a website; http://www.killology.com/ which contains information about other n=books, articles, audio visual material,and workshops.

However, I found nothing else, and I am afraid that the subject has faded back into the woodwork.

Mike Skinner, Activist Musician

Mike splits his time between his music, teaching about abuse and mental health stigma,  “Surviving Spirit” (a non-profit and also a newsletter), his family, many friends, and fun things, like hiking and camping. As you might guess, he has a lot of energy.

He had an awful childhood that included physical, sexual and emotional abuse from his parents and their friends. What saved him was reading about people who survived against all odds and the Beatles, who opened up another world to him. He became a drummer and joined local bands, eventually touring England for two years with the hard rock band “American Train.” He then spent fifteen years running a small record company and managing an agency that booked 20-30 groups.

At that point, Mike had a flood of memories and came into the mental health system. Here is an excerpt from his blog at http://www.mskinnermusic.com/home/walk-mental-health-awareness-month/

“I came to dread those words (‘mental illness’ or ‘mentally ill’) back in the early to mid nineties, when the horrors of my childhood abuse came back to ‘visit’ me in 1993. I became grief-stricken and overwhelmed by the terror associated with my early life. I was numb with shock and pain and deeply depressed because I was finally dealing with the unresolved sadness, hurt and losses associated with my childhood years. The flashbacks associated with that time frame seemed to roll on in an endless loop – having to ‘watch’ and revisit all of the sexual abuse memories I had worked so hard to suppress was overwhelming and it brought great suffering. Labels were placed upon the experiences I was having now, Post Traumatic Stress Disorder [PTSD] and Major Depression…and yes, within those descriptions came the many treatment providers letting me know that I was “mentally ill”, and life as I knew it was over. My life, as they were prescribing, would be one of over-medication and the belief that I would never be able to work again. Hmm…a person becomes sad, frightened and overwhelmed because of these horrible life experiences and that means you are destined to a life of nothingness? Wow! How sad and oh-so wrong to believe that. Please know, there were some wonderful mental health treatment providers who did not espouse these hurtful views to me, but sadly, many of them were part of a “mental health” system that did believe in these warped thoughts.”
Well, Mike  proved them wrong, in spades, and built a whole new career based on helping others.

Because of how he was treated when he was in the first stages of coming to terms with his past, he puts  “Please know, I AM NOT A DIAGNOSIS” and “A diagnosis is not a destiny!” all over his websites and newsletters.

Mike writes and performs in two areas, abuse education and fighting mental health stigma, and everything else. Everything else includes his own songs about life, love, loss and hope and cover songs from the Beatles, The Eagles, Cat Stevens and classic rock. He performs  in settings ranging from intimate coffee shops to concert halls with audiences of several thousand.

His music of advocacy and education is performed just about any place people want him. Some of the big names that did want him are Oprah Winfrey, the United Nations, and the State Department.  He’s on the Board of Directors of dozens of non-profits working to end child abuse and human trafficking and has spoken on Webinars, TV and the radio.

Plus he puts out a monthly newsletter describing about 20 artists and activists involved in healing projects; “Surviving Spirit: Healing the Heart Through the Creative Arts.” It has several thousand subscribers internationally.  He’s also active in the non-profit of the same name. You would think he worked thirty-hour days, without sleep.

Now if you are a musician, a writer, a dancer, an artist working in paint, ink, sculpture, fabric (or just about anything else) or a public speaker on child abuse or the stigma of “mental illness,” please remember that Mike is extraordinary in many ways. Try not to compare yourself with him! Each of us is different, each has a different talent and approach. And we need every single person to stand together and give strength to all of us for this long, hard, but intensely rewarding fight.

Use Mike as inspiration to help you start and get through the day. Please write him, let him know what you are doing and ask to be included in the newsletter, so that you, too, will inspire others. You will join his circle of friends and learn of many people doing fascinating work.

You can listen to tracks from his three CD’s, “Train of Tears,” “Waitin’ for a Train,” and “Pirates.” Go to http://www.mskinnermusic.com/home/ and pull down the “Music” tab.

Check out the back issues of “The Surviving Spirit” at http://newsletters.survivingspirit.com/index.php
Ask to subscribe at http://www.survivingspirit.com/contact-us.html