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Feature: Facing Our Fears Kathy Beard, RDH, BSDH

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We are all aware of the common adage that experience is the best teacher. I would qualify this motto by adding… if we use that experience for good.

Communication is one of the most powerful instruments we utilize within our armamentarium. Words and their inflection, as well as actions can encompass both positive and negative consequences. We must ask ourselves, how are we being received? The answer to this question is somewhat contingent on whom might be the recipient of our dealings. What cannot be contested is that everyone needs care and understanding.

We all lead complicated lives and it is wise to remember this consideration while communicating with fellow staff members, other professionals and our patients. These principles have been profoundly illustrated to me during my personal struggle with obsessive compulsive disorder (OCD), and by the examples set by those caregivers who have encouraged me to face both my professional and personal fears. If it were not for the joint efforts of my physician, psychiatrist and clinical psychologist, I would not be where I am today. Everyone should have such personal care! I am also grateful for the skill and teamwork which I encountered at the Anxiety & Stress Reduction Center of Seattle (ASRC).¹

My primary objective in sharing this struggle is to provide hope for those who are openly or silently suffering with OCD, an anxiety disorder affecting 2.2 million Americans of both genders at the same rate.² OCD frequently becomes apparent during the teen and young adult years, and typically progresses slowly.³ In retrospect, I can see where this was true in my life as well, but it was not until 2006, that I began noticing my life spinning out of control after an emotional encounter. I was placed on Zoloft by my physician, but found it did not agree with me. I began seeing a social worker/counselor from May 2006 to October 2007. By May 2008, I realized that I could not continue in clinical hygiene. I was experiencing severe obsessions and compulsions which became very apparent to my employer as well as my fellow employees. I was the first person in the office in the morning, and the last one to leave at night, often returning home after 10 p.m. or so. I was fearful I would make a mistake and inadvertently hurt a patient somehow. I would continually question whether the operatory was clean enough, and wonder if I cleaned the tray of instruments properly. Were my chart notes understandable? Did they clearly represent the treatment I had rendered? When I would return home, I would shower for one to two hours, often using a full bar of soap each shower session.

These worries spilled over into my personal, everyday activities as well. I could no longer cook meals, and it became extremely difficult to touch our dirty laundry.

These illustrations introduce examples of the most frequent varieties of OCD. The debilitating trepidation that someone might be harmed by carelessness combined with the "rituals" performed trying to ease those fears for one, and "checking" items over and over again being another. The obsessive portion of OCD fears the worst, while the compulsive measures temporarily relieve those fears.4

As I saw my clinical future slipping, I tried to find other avenues to stay in the career I loved. I became founder/president of Premiere Hygiene Study Club from 2008- 2009. I also earned my Bachelor of Science degree in Dental Hygiene from Eastern Washington University's Dental Hygiene Degree Completion Program at Pierce College in 2009. Thankfully, there was no clinical component to this schooling.

In May 2010, I began the process of healing. I was referred to a psychiatrist who placed me on Prozac. I was referred to a clinical psychologist from the Anxiety & Stress Reduction Center of Seattle (ASRC). I was impressed by their confidence in evidence-based treatment:

"Both evidence-based medicine (EBM) and evidence-based practice (EBP) assert that making clinical decisions based on best evidence, either from the research literature or clinical expertise, improves quality of care and quality of life. EBP is unique because it includes the preferences and values of the client and family in the process."5

My psychologist employed a method known as cognitive behavioral therapy (CBT), which assists individuals in recognizing actions which need to be modified.6 An example of this method used in my case is known as exposure and response prevention.³ "The following statements illustrate this principle…
  1. You cannot always control your thoughts.
  2. You cannot always control your feelings.
  3. But you can always control your behavior.
  4. As you change your behavior, your thoughts and feelings will also change."4
Also, two books were recommended to me and gave me comfort as I went through the "recovery" process. They were Getting Control: Overcoming Your Obsessions and Compulsions by L. Baer4 and Stop Obsessing! How to Overcome Your Obsessions and Compulsions by E.B. Foa.7 In less than three months, and in approximately 13 sessions, I was done with treatment. I will always have to contend with OCD, and take medication, but it will never take over my life again!

I have learned many lessons which I will bring back with me to the dental setting, such as the benefits of taking time to understand the individual in my chair. What works for one personality, might not work for another. Some might not know why they react in a certain way – I did not understand where my fears came from! They just might need to know that someone genuinely cares.

Providentially, experiences of these past few weeks have added to this journey. As I contemplate these events, I realize they will be extremely helpful in caring for future patients. A family member recently had surgery which went awry. There was much confusion and miscommunication between all of the different entities. It left me wondering, are we sending our patients home understanding services rendered? Are they confused about what treatment they are scheduled for, or how to care for a surgical site? Are we attentive, loving and kind? Do they feel cared for? There is much to ponder as we try and use our experiences for good.

References
  1. Anxiety & stress reduction center of Seattle (ASRC). (2010). Retrieved December 10, 2010, from EBTCS Web site: http://asrcseattle.com/
  2. Facts & statistics: Anxiety disorders association of America, ADAA. (2010). Retrieved January 31, 2011, from Anxiety Disorders Association of America Web site: http://www.adaa.org/about-adaa/press-room/facts-statistics
  3. Obsessive compulsive disorder. (2010). ASRC of Seattle: Obsessive compulsive disorder. Retrieved December 10, 2010, from EBTCS Web site: http://asrcseattle.com/ ocdisorder.html
  4. Baer, L., Ph.D. (1992). Getting control: Overcoming your obsessions and compulsions. New York, NY: Plume.
  5. What is evidence based treatment? (2011). ASRC of Seattle – Evidence-based treatment. Retrieved January 27, 2011, from EBTCS Web site: http://www.asrcseattle.com/ebt.html
  6. What is cognitive behavioral therapy (CBT)? (2010). ASRC of Seattle: Cognitive behavioral therapy. Retrieved December 10, 2010, from EBTCS Web site: http://asrcseattle. com/cbt.html
  7. Foa, E. B., Ph.D., & Wilson, R., Ph.D. (2001). Stop obsessing!: How to overcome your obsessions and compulsions (Rev. ed.). New York, NY: Bantam Books.
Author’s Bio
Kathy Beard, RDH, BSDH, has enjoyed the dynamics of a dental hygiene career for more than 25 years. Her duties as past president of Premiere Hygiene Study Club, as well as her responsibilities in implementing a safety program, have enriched her understanding of the importance of continued communication. She resides in Washington State with her husband, and has one daughter.
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