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American Journal of Clinical

Hypnosis
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Dental Surgery in a Psychiatric

Patient
a
Irving I. Secter D.D.S., M.A., F.I.C.D.
a
Clinical Dentistry , University of Illinois, College of
Dentistry , 808 S. Wood Street, Chicago, 60612, USA
Published online: 20 Sep 2011.

To cite this article: Irving I. Secter D.D.S., M.A., F.I.C.D. (1964) Dental Surgery in
a Psychiatric Patient, American Journal of Clinical Hypnosis, 6:4, 363-364, DOI:
10.1080/00029157.1964.10402377

To link to this article: http://dx.doi.org/10.1080/00029157.1964.10402377

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 THBAXERICAN
JOURNAL OF CLINICAL
HY~NO~IE
Volume VI, Number 4, A p d 1964
Printed in U.S.A.
BRIEF CLINICAL REPORTS
DENTAL SURGERY IN A PSYCHIATRIC PATIENT
Irving I . Secter, D.D.S., M.A., F.I.C.D.l
This report is of a 50 year old female,
who has been my patient for more than
25 years. She came to the office by appoint-
ment, anticipating the need for the removal
of two mandibular premolars.
At this time, she was receiving psychiat-
ric treatment for a conditon labelled
“delusional paranoia.” Her particular de-
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lusional system was built around the concep-
tion that certain members of her family
were conspiring to put her to death by
poisoning her food and in other ways. I n
matters, not touching upon her delusion,
she was quite rational. Her psychiatric
treatment had included shock treatment
and “injections.”2
She had been over the years an ideal
dental patient. Local anesthesia, and many
varieties of dental and surgical procedures
were accepted with equanimity and confi-
dence.
On this occasion the patient was very
nervous and apprehensive. She stated that
she was undergoing medical treatment and
that she was receiving many injections as
part of her treatment. These injections were
very upsetting and she dreaded the thought
of more injections. She had heard that I
used hypnosis for dentistry and asked if
something could be done to avoid injections.
That she was under a psychiatrist’s care
a t this time was known to me. My decision
was to defer the use of hypnosis until after
consultation with her psychiatrist and
my reply to her request for hypnosis was
Asst. Prof. Clinical Dentistry, University of
Illinois, College of Dentistry, 808 S. Wood Street, tion procedures are superfluous. Contrib-
Chicago 60612.
’Identity of medication not known to author. were the factors of motivation and con-
363
the general statement of, “Everything is
possible.”
She was seated in the operatory and an
examination was made of her dental needs.
The examination was made slowly and de-
liberately in order to give me time to formu-
late the manner in which her request could
be postponed until a consultation could be
held with the psychiatrist. At this time, her
eyes seemed to glaze and her whole body to
relax. It appeared that she was in a self-
induced trance. With the assurance that,
“Everything is O.K.,” I reached for the
appropriate forceps and removed the two
teeth. They did not come out readily. About
two minutes were required for the extrac-
tions. Suggestions of “You’re doing fine,”
were made repetitiously. During this time,
she sat immobile without manifesting any
signs of awareness or of pain. A few mo-
ments after the removal of the second tooth,
she opened her eyes and asked, “Is it over?”
After several years, she still recalls this
experience with pleasure. She is very proud
of having been a good hypnotic subject.
DISCUSSION
This case tends to support a hypothesis
that no one hypnotizes anyone else. As a
corollary, only those things take place, in
the production of hypnosis or in iB utiliza-
tion, that the patient makes happen or al-
lows to happen. The clues for successful
treatment are frequently provided by the
patient. An experienced therapist or re-
search worker may frequently recognize
those situations in which ritualistic induc-
uting to the patient’s success, no doubt,
 364 BRIEF CLINICAL REPORTS

fidence. Additional points upon which this
report perhaps has pertinency, are (1) the
alarmist views so often expressed regarding
the possible dangers of hypnosis in psychi-
atric patients, and (2) the opinion fre-
quently stated that psychiatric patients
may be hypnotized only with extreme diffi-
culty.
I n this case, in spite of a current history
of psychiatric disturbance, the patient pro-
ceeded to achieve her legitimate goals with
nothing but benefit to herself.

HYPNOSIS AS A RELAXANT FOR THE

CEREBRAL PALSIED PATIENT

Irving I . Secter, D.D.S., M.A.l, and Moses B. Gelberd, D.D.K2

The junior author has been for several various types of restraints and sedation
years regularly engaged (on a part-time are used, according to the individual need.
basis) in the dental treatment of cerebral The junior author was aware of the im-
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palsied children. One or more of the fol-
lowing conditions, in varying degrees of
involvement was present in each of these
patients : spasticity, athetosis, rigidity,
ataxia, tremor.
As dental patients the cerebral palsied
may exhibit some or all of the following:
1. Inability to sit quietly in the dental
chair.
2. Inability to control movements of the
extremities.
3. Inability to control tongue, lip or head
movements.
4. Inability to control movements or
closure of the jaw.
5. Inability to swallow properly or con-
trol salivation.
6. Inability to maintain proper oral hy-
giene.
As the above list indicates, dental care of-
ten becomes a diEcult problem for the den-
tist and the cerebral palsied patient. Treat-
ment is frequently accomplished as a hos-
pital procedure with general anesthesia ad-
ministered by an anesthesiologist. Under
these conditions extensive dental treatment
is performed a t each session. At other times
Asst. Prof., Clinical Dentistry, University of Dental School of the Hebrew University a t
Illinois College of Dentistry, 808 S. Wood Street, Jerusalem, Israel.
Chicago, 60612.
a Formerly dental consultant, Illinois Children’s
Hospital School.
portance of relaxation in the treatment of
the cerebral palsied patient. He hypothe-
sized that if hypnosis could be employed in
these cases, the spontaneous relaxation
which generally accompanies hypnosis
would facilitate dental treatment and per-
haps be valuable in other respects. Arrange-
ments were made with the senior author
to test the hypnotizability and responsive-
ness of a group of children in the Shady
Oaks Camp for Cerebral Palsied Children
a t Lockport, Illinois.
At that camp, in August 1957 two morn-
ing sessions, each of two hours duration,
were spent with a total of twelve children.
They ranged in age from eight to sixteen.
Four were spastic patients. The remainder
were athetoid patients. Physical involve-
ment ranged from mild to extensive. The
camp psychologist indicated that the in-
telligence, as measured by I.&. tests, ranged
from sub-normal to normal. A number of
these children were non-verbal and com-
municated with the operator by means of
a word board or gestures. Present as ob-
servers were the authors, the camp director
(a trained physical therapist) , other in-
terested camp personnel and the dean of the
The matter of playing the “sleep game”
was discussed with the children. All but