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American Journal of Clinical Hypnosis Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/ujhy20
Subjective Apperception and Use of Color during Dental Procedures under Hypnosis: Report of a Case Louis L. Dubin D.D.S.
a
a
Thomas Jefferson University Hospital Temple University School of Dentistry , Philadelphia, Pennsylvania, USA Published online: 20 Sep 2011.
To cite this article: Louis L. Dubin D.D.S. (1976) Subjective Apperception and Use of Color during Dental Procedures under Hypnosis: Report of a Case, American Journal of Clinical Hypnosis, 18:4, 282-284, DOI: 10.1080/00029157.1976.10403812 To link to this article: http://dx.doi.org/10.1080/00029157.1976.10403812
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden.
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THE AMERICAN JOURNAL OF CLINICAL HYPNOSIS
Volume 18, Number 4, April 1976 Printed in U.S.A.
BRIEF CLINICAL REPORT
Downloaded by [UZH Hauptbibliothek / Zentralbibliothek Zürich] at 23:12 07 May 2015
Subjective Apperception and Use of Color during Dental Procedures -under Hypnosis: Report of a Case LOUIS L. DUBIN, D.D.S. Thomas Jefferson University Hospital Temple University School of Dentistry Philadelphia. Pennsylvania
The patient with whom we are concerned in this report was first seen by the author in February, 1974. A 46-year-old, white female, she had been referred to the office for an extraction utilizing the modality of hypnosis. She reported a lifelong history of dental problems now complicated by allergy to all local anesthetics. She had recently been refused outpatient extraction by several dental surgeons despite the fact that she was able to take nitrous oxide and, in fact, had had other teeth extracted in this manner. 1 After a thorough psychological profile and initial evaluation, a successful trance was induced and the tooth uneventfully removed on her second visit. The success of this modality led the patient to request additional restorative treatment, which had previously been postponed, due to the severity of her allergies at that time and the extensive nature of the treatment needed. Her spontaneous, subconscious use of color proved a unique and vital component of her total experience with hypnosis. She
spontaneously reported the presence of the color during the many subsequent conversations with the author. On detailed questioning, she reported a life-long history of dreaming in color, sometimes in a single color and at others, in a full color panorama. A recurrent dream, following a traumatic prepubertal event, which persisted from age 11 to age 20, was always recalled in a vivid green, not unlike that produced by the filters used in early moving picture serials prior to the advent of technicolor. She first described the color as "horror-film" green. For her, the color had become associated with the traumatic event and probably accounted for her dislike of that particular shade of green. The green, together with what she described as an "ugly purple", became the coloration of her hypnotic analgesia. Unable to achieve the transfer of glove anesthesia, the patient was able, under hypnosis, to achieve an anesthetic block which she described as an "interruption of the neural pathways" to the tooth or teeth which were to be worked upon. She used the color as an indication of the depth she 1 The reason for refusal to administer nitrous oxide required for the prevention or relief of pain. to this patient is being pursued, but is complicated by After achieving success in self-hypnosis, ethical considerations. the patient later successfully completed en2 A complete history of this patient's work with dodontic treatment with a clinician in that hypnosis during dental procedures is now in preparaspecialty." tion for publication. 282
BRIEF CLINICAL REPORT
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THE PATIENT'S REPORT
I didn't become aware of the presence or significance of the green and purple until my second or third trance. I think they had probably been there during my first trance and during the extraction, but then I attached no importance to them and do not remember them. I do remember that in the first trance there was some fluffy white substance that has always since appeared very early in each trance, prior to the appearance of the other colors. It always takes a sort of elongated, tubular shape, very much like a eat's tail, or even a moustache. (The author wears a full white moustache, which the patient concedes may have given her the image). It is sometimes hazy in appearance and other times shiny and sharply defined. But it always precedes the state I am in when I experience analgesia. After it has been present for a short time, it seems to spread out, becoming even lighter, and is followed by a sort of ugly purple and a shade of green that I associate with horror films seen in my childhood. I don't see these colors when I am using a trance just to relax, but they occur invariably when I am attempting to reach a state of analgesia or anesthesia. In later trances, I'm not sure just when, I became aware that the intensity of the colors was directly related to the degree of analgesia. And as I became more skilled, I was able to produce additional' color on demand. That is, I could think, 'well, I need more pain relief than I have,' and I would concentrate on bringing in more color and it would come. The colors did not always stay throughout the procedure, but would come and go as I needed them. As the trance lightened, or if you said you were finishing up, they would leave slowly and be replaced by the fluffy white color with which the trance had begun. On at least two occasions, the colors assumed definite geometric shapes, sort of like chemical crystals, with pedestals on one or both ends. But later they returned to the more amorphous shapes that they began with. As I have become more adept at summoning them, they have had a tendency to_swirl and sometimes to mesh, though they have retained their individual coloration. I have never seen one color without the other - both are always present. But I think the most interesting thing about them is that as I use the trance more, I find the colors have either changed in hue or become more beautiful. In fact, when I first mentioned them, you asked me if they were my favorite colors. They were, at that time, my least favorite - in fact I hated them. I don't know if it is a measure of my own greater serenity, but I am beginning to like purple, and I have hated it all my life. I guess it's because to me, now, purple means 'no pain.' You asked me about other colors, too. The only
283
other distinct color I have seen didn't initially occur in the trance, though now it does. It occurred the first time after you had finished some work and said you were done. I lightened the trance and removed the block from that tooth. Then, without telling me, you went back and polished that tooth. Though that tooth had not hurt before, while the block was on, the polishing suddenly became agonizing and all I could see was jagged, blood red, which I now associate with pain, though before it had been a favorite color. The only other color I see is flesh color. As I told you, I almost always see some faces, usually early in the trance, sometimes between the white and the green and purple, and, rarely, late in the trance. The faces are almost always in normal flesh tones, though sometimes they seem a ghostly white. In any case, they don't seem related to the analgesia and I haven't made any conscious connection between them and any particular stage of the trance. COMMENT
Up to now in hypnosis, we have been dealing with objective clinical observation by the hypnotist and subjective expressions by the patient. What this patient's experience suggested to us, among other things, was that there is a definite, though subjective, point of arrival at which, within her own frame of reference, the patient is aware of her readiness for an indicated procedure. In this case, the readiness was correlated with the intensity, discreteness, and configuration of color - the color had become her "biofeedback" without calibrated instrumentation. Intrigued by this possibility, we have now collected a small sample (100 patients) using hypnosis for a variety of purposes in the practice of dentistry and its subspecialties. In each instance, we made a point of asking the patient if he or she usually dreamed in color or if he or she was aware of the presence of any color, or black and white, during the hypnotic trance. We found a surprising number of patients who did, though many of them commented that they would not have been apt to mention it spontaneously. We' also attempted to find out what, if any, relationship the phenomenon of color had to depth of trance and the degree of analgesia or anesthesia. In those
Downloaded by [UZH Hauptbibliothek / Zentralbibliothek Zürich] at 23:12 07 May 2015
284
BRIEF CLINICAL REPORT
who responded positively to questions 3. About 50% of the patients queried by about the presence or use of color, we us reported dreaming in color. Of those found a high degree of relationship and a who did not, there was a color trance atnumber of other interesting facts: tachment - usually to non-favorite colors. 1. The color varies with each patient and In these patients, the configuration of the appears to have some meaning to the pa- color assumed dominance and remained tient, that is, he or she chooses it (either constant in subsequent trances. subconsciously or consciously) for the ef4. Also, as did the patient in this report, fect it has on him or her. it appeared that some of these patients 2. As did the patient in this report, some could recognize at what stage they were others reported seeing geometric configura- ready for the procedure to be initiated, and tions in the colors, which also varied with at times were able to bypass certain steps of the individual. Variations of these were hypnotic induction by concentrating on also observed by the patients at different color. This again suggests the possibility of stages of trance and from one trance to the a non-instrumental "biofeedback" technext. We noted no particular pattern of nique. color variation or of gradations in the same Obviously, this small sample does not color, but we did find that, as patients be- permit any specific conclusions to be came more at ease with hypnosis, they did drawn. It does, however, suggest a worthnot require the same depth of color for while line of investigation, and further studies are now underway. analgesia as they had in early trances.
American Journal of Clinical Hypnosis Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/ujhy20
Subjective Apperception and Use of Color during Dental Procedures under Hypnosis: Report of a Case Louis L. Dubin D.D.S.
a
a
Thomas Jefferson University Hospital Temple University School of Dentistry , Philadelphia, Pennsylvania, USA Published online: 20 Sep 2011.
To cite this article: Louis L. Dubin D.D.S. (1976) Subjective Apperception and Use of Color during Dental Procedures under Hypnosis: Report of a Case, American Journal of Clinical Hypnosis, 18:4, 282-284, DOI: 10.1080/00029157.1976.10403812 To link to this article: http://dx.doi.org/10.1080/00029157.1976.10403812
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden.
Downloaded by [UZH Hauptbibliothek / Zentralbibliothek Zürich] at 23:12 07 May 2015
Terms & Conditions of access and use can be found at http://www.tandfonline.com/ page/terms-and-conditions
THE AMERICAN JOURNAL OF CLINICAL HYPNOSIS
Volume 18, Number 4, April 1976 Printed in U.S.A.
BRIEF CLINICAL REPORT
Downloaded by [UZH Hauptbibliothek / Zentralbibliothek Zürich] at 23:12 07 May 2015
Subjective Apperception and Use of Color during Dental Procedures -under Hypnosis: Report of a Case LOUIS L. DUBIN, D.D.S. Thomas Jefferson University Hospital Temple University School of Dentistry Philadelphia. Pennsylvania
The patient with whom we are concerned in this report was first seen by the author in February, 1974. A 46-year-old, white female, she had been referred to the office for an extraction utilizing the modality of hypnosis. She reported a lifelong history of dental problems now complicated by allergy to all local anesthetics. She had recently been refused outpatient extraction by several dental surgeons despite the fact that she was able to take nitrous oxide and, in fact, had had other teeth extracted in this manner. 1 After a thorough psychological profile and initial evaluation, a successful trance was induced and the tooth uneventfully removed on her second visit. The success of this modality led the patient to request additional restorative treatment, which had previously been postponed, due to the severity of her allergies at that time and the extensive nature of the treatment needed. Her spontaneous, subconscious use of color proved a unique and vital component of her total experience with hypnosis. She
spontaneously reported the presence of the color during the many subsequent conversations with the author. On detailed questioning, she reported a life-long history of dreaming in color, sometimes in a single color and at others, in a full color panorama. A recurrent dream, following a traumatic prepubertal event, which persisted from age 11 to age 20, was always recalled in a vivid green, not unlike that produced by the filters used in early moving picture serials prior to the advent of technicolor. She first described the color as "horror-film" green. For her, the color had become associated with the traumatic event and probably accounted for her dislike of that particular shade of green. The green, together with what she described as an "ugly purple", became the coloration of her hypnotic analgesia. Unable to achieve the transfer of glove anesthesia, the patient was able, under hypnosis, to achieve an anesthetic block which she described as an "interruption of the neural pathways" to the tooth or teeth which were to be worked upon. She used the color as an indication of the depth she 1 The reason for refusal to administer nitrous oxide required for the prevention or relief of pain. to this patient is being pursued, but is complicated by After achieving success in self-hypnosis, ethical considerations. the patient later successfully completed en2 A complete history of this patient's work with dodontic treatment with a clinician in that hypnosis during dental procedures is now in preparaspecialty." tion for publication. 282
BRIEF CLINICAL REPORT
Downloaded by [UZH Hauptbibliothek / Zentralbibliothek Zürich] at 23:12 07 May 2015
THE PATIENT'S REPORT
I didn't become aware of the presence or significance of the green and purple until my second or third trance. I think they had probably been there during my first trance and during the extraction, but then I attached no importance to them and do not remember them. I do remember that in the first trance there was some fluffy white substance that has always since appeared very early in each trance, prior to the appearance of the other colors. It always takes a sort of elongated, tubular shape, very much like a eat's tail, or even a moustache. (The author wears a full white moustache, which the patient concedes may have given her the image). It is sometimes hazy in appearance and other times shiny and sharply defined. But it always precedes the state I am in when I experience analgesia. After it has been present for a short time, it seems to spread out, becoming even lighter, and is followed by a sort of ugly purple and a shade of green that I associate with horror films seen in my childhood. I don't see these colors when I am using a trance just to relax, but they occur invariably when I am attempting to reach a state of analgesia or anesthesia. In later trances, I'm not sure just when, I became aware that the intensity of the colors was directly related to the degree of analgesia. And as I became more skilled, I was able to produce additional' color on demand. That is, I could think, 'well, I need more pain relief than I have,' and I would concentrate on bringing in more color and it would come. The colors did not always stay throughout the procedure, but would come and go as I needed them. As the trance lightened, or if you said you were finishing up, they would leave slowly and be replaced by the fluffy white color with which the trance had begun. On at least two occasions, the colors assumed definite geometric shapes, sort of like chemical crystals, with pedestals on one or both ends. But later they returned to the more amorphous shapes that they began with. As I have become more adept at summoning them, they have had a tendency to_swirl and sometimes to mesh, though they have retained their individual coloration. I have never seen one color without the other - both are always present. But I think the most interesting thing about them is that as I use the trance more, I find the colors have either changed in hue or become more beautiful. In fact, when I first mentioned them, you asked me if they were my favorite colors. They were, at that time, my least favorite - in fact I hated them. I don't know if it is a measure of my own greater serenity, but I am beginning to like purple, and I have hated it all my life. I guess it's because to me, now, purple means 'no pain.' You asked me about other colors, too. The only
283
other distinct color I have seen didn't initially occur in the trance, though now it does. It occurred the first time after you had finished some work and said you were done. I lightened the trance and removed the block from that tooth. Then, without telling me, you went back and polished that tooth. Though that tooth had not hurt before, while the block was on, the polishing suddenly became agonizing and all I could see was jagged, blood red, which I now associate with pain, though before it had been a favorite color. The only other color I see is flesh color. As I told you, I almost always see some faces, usually early in the trance, sometimes between the white and the green and purple, and, rarely, late in the trance. The faces are almost always in normal flesh tones, though sometimes they seem a ghostly white. In any case, they don't seem related to the analgesia and I haven't made any conscious connection between them and any particular stage of the trance. COMMENT
Up to now in hypnosis, we have been dealing with objective clinical observation by the hypnotist and subjective expressions by the patient. What this patient's experience suggested to us, among other things, was that there is a definite, though subjective, point of arrival at which, within her own frame of reference, the patient is aware of her readiness for an indicated procedure. In this case, the readiness was correlated with the intensity, discreteness, and configuration of color - the color had become her "biofeedback" without calibrated instrumentation. Intrigued by this possibility, we have now collected a small sample (100 patients) using hypnosis for a variety of purposes in the practice of dentistry and its subspecialties. In each instance, we made a point of asking the patient if he or she usually dreamed in color or if he or she was aware of the presence of any color, or black and white, during the hypnotic trance. We found a surprising number of patients who did, though many of them commented that they would not have been apt to mention it spontaneously. We' also attempted to find out what, if any, relationship the phenomenon of color had to depth of trance and the degree of analgesia or anesthesia. In those
Downloaded by [UZH Hauptbibliothek / Zentralbibliothek Zürich] at 23:12 07 May 2015
284
BRIEF CLINICAL REPORT
who responded positively to questions 3. About 50% of the patients queried by about the presence or use of color, we us reported dreaming in color. Of those found a high degree of relationship and a who did not, there was a color trance atnumber of other interesting facts: tachment - usually to non-favorite colors. 1. The color varies with each patient and In these patients, the configuration of the appears to have some meaning to the pa- color assumed dominance and remained tient, that is, he or she chooses it (either constant in subsequent trances. subconsciously or consciously) for the ef4. Also, as did the patient in this report, fect it has on him or her. it appeared that some of these patients 2. As did the patient in this report, some could recognize at what stage they were others reported seeing geometric configura- ready for the procedure to be initiated, and tions in the colors, which also varied with at times were able to bypass certain steps of the individual. Variations of these were hypnotic induction by concentrating on also observed by the patients at different color. This again suggests the possibility of stages of trance and from one trance to the a non-instrumental "biofeedback" technext. We noted no particular pattern of nique. color variation or of gradations in the same Obviously, this small sample does not color, but we did find that, as patients be- permit any specific conclusions to be came more at ease with hypnosis, they did drawn. It does, however, suggest a worthnot require the same depth of color for while line of investigation, and further studies are now underway. analgesia as they had in early trances.
