How Fear Impairs Learning

Build your relationships first….then your dentistry. ~ Bob Barkley

Month: July 2017

How Fear Impairs Learning

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Emotions directly influence how we see the world, because they influence how we interpret the actions of others and the events which occur around us.

When we are fearful, we commonly do not seek to challenge WHY we are feeling this way, rather we seek to confirm it.

We do this on a subconscious level by referencing what is happening against what we are feeling. The feeling drives the interpretation, which in turn drives a rationalization – all of which can be completely inaccurate and unhelpful.

We see this with some new patients whose fear of being hurt completely impairs their health care choice-making, which then impairs their health, which causes them to hurt themselves even more.

So when our patients are gripped by fear they tend to discount or ignore new information. Psychologist Paul Ekman calls this being in a “refractory state”, “during which time our thinking cannot incorporate information that does not fit, maintain or justify the emotion we are feeling.”

So the same mechanism which guides and focuses attention at critical moments can distort and block the capacity to process new and helpful information.

This is why attempting to teach a patient at a fearful moment (such as at an initial emergency visit) is so unproductive. We must at least temporarily resolve their immediate issue, allow a helping relationship to be established, (which catalyzes a feeling of safety to emerge), AND THEN attempt to facilitate learning – most ideally at another time and in another environmental space.

Bob Barkley said, ” …dentists who, for the most part, avoid explanations in favor of helping patients to think clearly are more likely to influence their behavior.”

And he was right.

Paul A Henny DDS

Dental Insurance – An Intentional Deception

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Dentists who are contractually involved with insurance today are fully aware of the shift toward PPO style plans, which restrict patient access to dentists of choice, as well as restrict dentists under contract from referring to specialists of choice.

In and of themselves, these restrictions would be manageable if it were not for the substantial reductions in fee code compensation, where in some cases, that compensation drops from payments in the range of 82% of “reasonable and customary” rates down to 58%.

One does not need an MBA or a degree in accounting to see that a broadly experienced additional compensation drop of 24% devastates profitability, which then forces upon the practice changes in business structure and climate to survive.

This external force – the shift from indemnity plans to PPO plans- is affecting the dental profession more than any other trend, as it demands a ramped-up economy-of-scale approach to dental practice. In other words, it is forcing the dental profession to become industrialized, where patients become “units” and workers become day laborers.

With all of the focus on maximizing productivity and reducing costs, while maximizing profitability, the discussion of health is easily lost, and the dentist and teams are reduced to being repair workers laboring under a remedial philosophy, and with patients who are often dissatisfied with both the outcome and their experience.

This trend line was noticed early by Bob Barkley in 1972 when he said, “Dental service corporations play a very critical role nationwide since they can stymie progress in prevention…Somehow service corporations acquire a marked distrust for the honesty of dentists and use this as a reason for holding back on their preventive teaching programs. One prominent dentist-executive of a large corporation declared that to pay for such teaching would be an open invitation to fraud.”

So there we have it- the core of the problem, the fact that dental insurance has everything to do with money and is only peripherally associated with health. And that the contractual relationship between the dentist and service corporation is founded on distrust. Consequently, a more dysfunctional relationship could not be designed or advanced.

Paul A Henny, DDS

Thought Experiments LLC, ©2017

Read more at www.codiscovery.com

Reality Check

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The concept of reality represents one of life’s great  paradoxes, because we tend to think of our reality as being universal, while at the same time experiencing it in a our own unique way. Additionally, we cannot fully understand our experience by ourself; we cannot experience our experience fully by ourselves because reality must be grounded in perspective, and perspective is impossible without experiencing life with -and around-others.

That is why we can not learn how to optimally live life from a book, class, video, or even through others telling us how. We have to live it WITH others. We have to experience the struggles, joys, victories and defeats, and by so doing – experience meaning – and through meaning, perspective.

It is my belief that reality must also be reflected back to us by its source, its Creator, and only through His love reflected back to us that we can experience true reality. Consequently, we cannot know the truth about the world until we know that God loves us.

And that I believe, is why WORSHIP is in the Cross of Life that Dr. Pankey shared with us, because reality requires worship – worship not of what we have created individually or collectively, but of Him.

Paul A Henny, DDS

Thought Experiments LLC, ©2017

Read more at www.codiscovery.com

Long -term Behavior Changes are Rooted in Changes in Self-perception

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We all struggle to create new and better habits. This is largely due to the seemingly automatic way that our brain functions.

The key to getting around this neuro-biologic roadblock is to focus on creating a new self-concept, as our current behaviors are simply a reflection of our current self-identity.

In other words, what we do now is a mirror image of the type of person we believe we are – consciously or subconsciously.

So, to change our behavior, we need to start believing new things about ourselves. Each action that we perform is essentially driven by the fundamental belief that what we are doing is possible – or not.

So, if we change our self-concept, then our behavior changes to support that new belief.*

The same holds true with our patients. If a patient believes they have “soft teeth”, or that “everyone in my family has bad teeth”, or “bite splints don’t work for me”, then they will synthesize behaviors which support those beliefs UNTIL the belief is disproven BY THEMSELVES.

And that takes time.

And it I takes trust.

And it takes self-discovery, because a logical explanation on our part will not over-ride a deeply held, emotionally-stimulative belief on their part.

And that’s a fact.

The reason it is so hard for us to get our patients to change -and stick to new habits- is that we focus too much on performance, without allowing time for the patient to change their self-concept relative to dental health.

This realization was at the very core of Bob Barkley’s work. When Bob discovered that patient motivation to change could evolve out of facilitating a change in their belief about themselves, dentistry changed forever.

Has this truth changed YOUR beliefs about patient behavior?

Paul A Henny DDS

*Maxwell Maltz, MD wrote a fascinating book on this topic called Psycho-cybernetics.

Thought Experiments LLC, ©2018

Behavioral Change Starts with a Change in Self-perception

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We all struggle to create new and better habits. This is largely due to the seemingly automatic way that our brain functions.

The key to getting around this neuro-biologic roadblock is to focus on creating a new self-concept, as our current behaviors are simply a reflection of our current self-identity.

In other words, what we do now is a mirror image of the type of person we believe we are – consciously or subconsciously.

So, to change our behavior, we need to start believing new things about ourselves. Each action that we perform is essentially driven by the fundamental belief that what we are doing is possible – or not.

So, if we change our self-concept, then our behavior changes to support that new belief.*

The same holds true with our patients. If a patient believes they have “soft teeth”, or that “everyone in my family has bad teeth”, or “bite splints don’t work for me”, then they will synthesize behaviors which support those beliefs UNTIL the belief is disproven BY THEMSELVES.

And that takes time.

And it I takes trust.

And it takes self-discovery, because a logical explanation on our part will not over-ride a deeply held, emotionally-stimulative belief on their part.

And that’s a fact.

The reason it is so hard for us to get our patients to change -and stick to new habits- is that we focus too much on performance, without allowing time for the patient to change their self-concept relative to dental health.

This realization was at the very core of Bob Barkley’s work. When Bob discovered that patient motivation to change could evolve out of facilitating a change in their belief about themselves, dentistry changed forever.

Has this truth changed YOUR beliefs about patient behavior?

Paul A Henny DDS

*Maxwell Maltz, MD wrote a fascinating book on this topic called Psycho-cybernetics.

  • Thought Experiments LLC, ©2017

Continue reading “Behavioral Change Starts with a Change in Self-perception”

The Personal Growth Paradox

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Jerry Seinfeld was discussing what it initially felt like to get married, which he described as a feeling of nervousness and helplessness, “like being strapped into a rollercoaster, headed to the top of the hill, where the marriage awaits!”

“It’s like any growth,” Seinfeld said, “you can’t really be ready for it. It’s new….you’re going to have a new life as a result…You’re going to be a new person.”

Jerry Seinfeld is right on this, we are never fully ready for growth in our personal and professional lives. We are never fully ready to start a practice, to hire a new team member, let another one go, start a marketing program, incorporate a new technique, or to experiment with better ways to facilitate learning with our patients.

Personal growth represents one of life’s many paradoxes; we are not ready to grow precisely because we need to grow, so we must start before we feel we are fully prepared for it.

Almost by definition, growth must be something which makes us feel unprepared and uncertain, because if the growth process was comfortable and easy, it wouldn’t be growth, it would be familiar and therefore a repeat of something we already know.

And it would be boring…

Nor would it move the needle.

There will never be a perfect time to do something which challenges and stretches us. And this will always be the case, so we need to get used to it feeling that way.

Starting a marriage? …A new and unknown level of interpersonal commitment.

Having your first child? …Lots of learning on-the-fly.

Choosing a new and more consciously purposeful direction for our practice? …Lots of unknowns on the front end.

This is not to say that growth should be a reckless process, particularly with regard to running a business and managing relationships. We must first explore our desires, intentions, and motivations. We need to think things through…but at some point we must embrace uncertainty because it is the only path forward.

We can never be ready for true growth, and that’s why it’s called “growth”. All we can do is step into it with everything we’ve got, and move forward toward the next uncertainty.

Paul A. Henny, DDS

Thought Experiments LLC, ©2017

“Loss Aversion” Often Drives Your Patient’s Decisions

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Psychologists tell us that ‘loss aversion” represents our psychological tendency to strongly avoid losses over gains.

For instance, research has shown that if someone gives you $10, you will experience a small boost in satisfaction. On the other hand, if you lose $10 you will experience a dramatically higher loss in satisfaction.

Yes, the responses are opposite, but the magnitude of response slants negatively toward loss aversion.

This tendency toward a scarcity mindset is subconscious, and can cause us to make bad long-term decisions in favor of protecting that which we already possess. And this tendency is also amplified when a person perceives themselves to be under economic threat or is in distress.

All of this has direct application to patient behavior relative to dental care treatment cost and the physical threat that the treatment process may represent in their mind.

This is also the exact way the insurance industry can manipulate policy holders into doing what they want, instead of doing what is in a patient’s best interest.

You see, if the insurance company can slow down a decision and divert a patient’s attention toward cost instead of health, loss aversion can naturally kick in. And when loss aversion kicks in, the patient elects LESS treatment. And when the patient elects for less treatment, the insurance company takes it to the bank…the CEO gets the bonus and eventually, the multimillion dollar mansion on the hill.

The patient has been psychologically gamed, and has made a bad decision that benefited the insurance company. We see this happen all the time through the policy vehicle called “pre-authorization.”

The insurance company knows that if they can instill doubt as well as perceived financial loss into the mind of the patient, they can do the victory dance in the end zone over and over.

So, how do you avoid the ‘loss aversion” heuristic from being methodically installed into your patient’s brains?

Co-discovery, that’s how.

Only through deeper understanding and a stronger motivation to resolve a progressive loss of health ( another strong loss aversion heuristic ), can you trump the insurance company’s psychological strategy.*

And better yet, stop doing pre-authorizations, as they only allow someone who knows nothing about your patient, and who has never examined them, to weigh in with an ill-informed opinion which may trigger a loss aversion response.

And if they do, chances are that they win and you and your patient will lose.

It’s your game, so why do you allow this to happen over and over again?

Einstein called such behavior “insanity”.

Paul A Henny, DDS

* Almost all large corporations today employ psychologists to measure, map, predict -and if possible- alter human behavior.

Thought Experiments LLC, @2017

Read more at www.codiscovery.com

Leverage Your Right Brain to Better Use your Left Brain

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Bob Dylan became the first musician to win the Nobel Prize for Literature, but he never set it as a goal, and he has no idea how it ever happened. In truth, Bob was just following his heart, his intuition, and his creative sense.

Bob’s work was the result of an inductive method, and consequently, he violated every rule regarding song structure and lyrics. He followed his vision before he had a full understanding of what he was creating, and consequently he let his incredibly high right brain skills guide him while leveraging his left brain musical knowledge.

And that made his work both unique AND resonate with the public like no other singer-songwriter had ever done before.

Relationship-based / health-centered dentistry requires this same approach. It requires a deep foundational understanding of dentistry on a technical level, but it also requires us to let go of the confines of our knowledge, and allow our creative minds to sense, intuit, and synthesize something new – inductively.

Recently, I had the privilege of meeting two prospective new clients who were seeking my assistance. And they had no idea what kind of help they needed – all they knew was that it was significant.

In the past, I would have jumped in quickly and built an elaborate solution for these individuals by examining them and staging a “case presentation” to demonstrate my exceptional problem solving skills and expert status.

And all of this would have been achieved through a deductive process based on my training, experience, and the scientific method, with little consideration for how they felt or even what they perceived as being important.

Today however, I rarely do that. Instead, I try to use induction to understand them…hear their pain and frustration, as well as try to facilitate in them a vision for a better future, one which makes sense to them and causes them to feel better about them-self.

And that requires me to get off my high horse and try to see dentistry as they view it…a confusing mess of things and choices that they have no capacity to place appropriate value upon.

That is why they called, not because they thought they had a titanium deficiency, or because they wanted to look like the cover model of Glamor Magazine.

They called because of their feelings, and likewise it was Bob Dylan’s understanding of feelings which catapulted him to the top.

And the same is possible for you.

Paul A Henny, DDS

Thought Experiments LLC, ©2017

On Philosophy

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There is an important distinction between “having” a philosophy and “living” a philosophy.

“Having” a philosophy implies that one has a vision of a better way of life, but it doesn’t necessarily mean that the thoughts are being acted upon…that progress is being made in the direction of that vision. “Having” a philosophy therefore can often represent little more than a dream.

“Living” a philosophy, or living with a clear sense of purpose, is about engaging life based on our values, on an accurate understanding of ourself, on a realistic view of the world around us, on a clear understanding of what we are trying to accomplish, focused on principle-centered goals, and by acting daily with integrity to support all of the above.

Drs. Pankey and Barkley talked extensively about the need to clarify our practice philosophy and to apply it daily. But most of us rarely think of ourselves as philosophers – particularly through our daily practice – so we struggle seeing the true value in deeply engaging ourselves in this type of internal work.

Their point was that living a life with greater purpose is often an opportunity which lies right in front of us. And consequently, the opportunity for a life full of emotional, spiritual, and financial reward lies there as well.

Approaching life from a “givers” perspective yields more back in return. It is a perspective of abundance – that loving and caring for others is a reciprocal experience and therefore inherently Win-Win.

Our daily decisions are what drive us toward our future. And it is what we believe about ourself and the world around us -our philosophy- which influences our direction toward a greater or lesser purpose.

Now is good time for you to examine or re-examine your personal philosophy, and subsequent practice and life purpose.

Take the challenge, because here on earth, you only live once.

Paul A. Henny, DDS

Thought Experiments LLC, ©2016

Read more at www.CoDiscovery.com

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