I finally dragged myself to see a dentist today, and to my surprise, I discovered that my gag reflex (that can usually deal with non-trivial throat pounding) was strongly activated by a small device that I was instructed to bite onto to get x-rays. “What the hell is going on here?” I contemplated, searching my neuroscience memory banks. I realized: It’s all about context.
Plenty of research around pain shows that the same stimulus can be perceived differently under different contexts. Our brain’s top-down predictions play a huge role in creating our reality. Fear and loss of agency are large components increasing our perception of pain. One notable VR company is using these ideas to transform how kids react to getting shots.
Despite the dentist being friendly, I felt afraid and anxious, which caused my negative response. Part of the problem was my previous experience at dentists. Another part of the problem was the way Western medicine tends to carve up our body into sub units treated by specialists without looking at the bigger context of our body. The dentist was focused on being efficient and trying to give my teeth the best care, the rest of my body was of no interest. If my dentist were a dominatrix, she would have found playful seductive ways to get me to hand over my agency to her, to be fully consenting and even excited to be poked and prodded.
Compersion (the ability to feel another person’s joy) is a magic capability of our brain. We feel this often while having sex. Physical sensations that might be challenging or painful are experienced as joyful giving, connecting to the other person’s pleasure. This ability is likely based on our mirror system and on how flexible our sense of self actually is. All the best body workers and sex workers I know have learned to tap into this compersion mechanism creating feedback loops with their clients that are based on them staying connected to their own joy. Somatic therapist focus on similar mechanisms, helping their clients repattern trauma responses by tapping into their own ability to self regulate.
To try to distract me and prevent me from gagging, my dentist suggested I pick up one leg. It might have helped a little but I can’t help but wonder if we lived in a more embodied, sex-positive and consent-based society what would dental and other medical treatment look like? Dentist tapping into their sadistic side so patients can feel compersion might seem far fetched, but could we be using less external chemical interventions and tap into playful, fun and consentful feedback loops with medical care givers that see us as full human bodies when we are under their care?
That wasn’t the only reason I wished my dentist was a dominatrix. Dominatrices are highly trained in consent communication, using signals like green (keep going), yellow (I’m ok but nothing more intense), red (stop now).
Feeling dissociated while my jaw was throbbing and I was almost choking on my own saliva, I finally managed to reconnect to my body and realized I can at least try to communicate my discomfort. I made some hand waving gestures to get the dentist’s attention, and managed to catch a breather. I’ve heard some dentists do have clear communication guidelines where you can lift your hand or gesture to communicate levels of discomfort. I think this type of communication is key in helping maintain agency and prevent harmful dissociation and trauma.
The medical community can learn a lot from what dominatrices and sex positive culture already know, which is that a big part of any experience is our brain-body connection.