I have become extremely conscious of the relationship between a patient’s emotional state and ultimate practice success. To some, that may seem like a bit of a reach. Have you ever spent time thinking about your dental patients and what the role of the amygdala plays in case acceptance? The amygdala hijack is powerful and shouldn’t be disregarded.
The amygdala is part of the brain located near its base. It is the source of strong emotions: fear and pleasure, for example. The term “fight-or-flight” originates from early humans, who were potentially exposed to the threat of death or injury much more often than we are in the modern day. When a person feels threatened, the amygdala is what is in charge of this response. In modern times, the amygdala can be triggered by anxiety, fear, or similar emotions. It will signal the release of hormones that evoke the fight-or-flight reaction.
Sometimes, people can control or even override this reaction by using other parts of the brain, specifically the cerebral cortex. This is the part of the brain that is used to make more thoughtful and rational decisions.
Psychologist Daniel Goleman coined the term “amygdala hijack” to refer to a time when the cerebral cortex is simply unable to override the amygdala. Imagine you are taking a nice hike through the woods. It’s a beautiful day. You are noticing flowers, the birds, the clear sky, and the lake off in the distance. Suddenly, you turn the corner and in front of you is a big rattlesnake. (Or maybe a bear depending on where you live.) Your amygdala will immediately assume control of the situation. You will forget about the surroundings. Your blood pressure will rise and blood will be sent immediately to your legs and other major muscles in case you need to run or fight.
The organs that are not essential will slow or even stop. Your airway will open as much as possible to take in more oxygen. Your pupils will dilate to allow more light and improve your vision. You are now ready to fight or flight.
While there may not be a rattlesnake or bear in your dental office, many patients are in a state of controlled or partial amygdala hijack when they’re sitting in your operatory. The courage required just to walk in your office door was huge. Of course, their cerebral cortex is forcing them to control or suppress their emotions. They breathe in what seems like an odd way in an attempt to control the situation. What they really want to do is fight or flight. (If they choose one, let’s hope it’s flight.)
During a patient’s treatment, we can use calming techniques like relaxed words, headphones, nitrous oxide, medications, etc. That said, in non-treatment moments, like a recall exam or limited exam, if that person’s amygdala is overriding the cerebral cortex, he or she is literally unable to devote as much brain power to understanding our consultations. This is why I strongly recommend that if you are fortunate enough to have a consultation room in your office, it be used to discuss treatment.
All treatment, no matter how small. Of course, the consult room is still in the dental office, but it is not in the middle of drill and suction sounds, scary looking instruments, etc. We should also ask patients if they’d like to see close up pictures of scary things before we put an intra-oral photo on the monitor or TV.
I am thoroughly convinced that case acceptance is much higher when a patient is in the correct moment to hear and understand treatment. If the amygdala is controlling the moment, the patient will usually say something like “I’ve got to think about it” just so he or she can get out of there…. flight.
A huge part of this is improving treatment plan consultations and therefore case acceptance. If you are ready to take your consultations, and therefore your production, to the next level, call us. We are here for you.
