Wednesday, December 02, 2009


Rachel and I are talking a lot these days about the power of suggestion, the power of good suggestion, the helping power that can move a person out of a rut into the space where certain impossible things now seem possibly possible. This is a fun and natural conversation for us, since we often use hopeful language to make suggestions in our counselling. For example, in a counselling session with someone battling the despairing influence of depression we might say “you’ll find it easier to get up in the morning when your depression lifts,” or “You may not be feeling confident yet, but you’ll feel better about looking for a job when your confidence increases.” We’d say these things casually, tucking them unobtrusively in the middle of conversations about other things. These are simple, hope-focussed suggestions, hints about a future we can imagine. Making suggestions is, for the most part a rewarding activity. We see enough responses, enough shifting of posture, enough snapping to attention to know that a well placed suggestion can do a lot. Hypnotists have known this for thousands of years.
Because the subject of suggestion is on our minds, we are also reading these days about the power of suggestion, which is how I came to notice a very brief passage about the use of suggestion to increase the rate of flossing—yes, you read it right—flossing your teeth with those annoying waxy strings that hook into the crevices and make your gums bleed if they’re already a little infected. As you might infer from the tone of this writing, I am sensitive on the subject of flossing. .
Sore gums and crowded teeth aside, it may be that I am sensitive because the idea of flossing exposes a part of my character that I would rather not expose—the obstinate part, the stubborn part, the rebellious part, the ignore-all-the-evidence-and-do-what-I-have-always-done part. Now I am sure that my parents would support me in saying that I tend to be an obedient sort, a rule follower, a do-gooder, not much teen-age rebellion in my history. My experience with smoking was limited to—maybe—20 cigarettes, none of them purchased with my own money. I am one of those who managed to get through life without experimenting with mind-altering drugs. For the most part I eat a balanced diet, cross only at designated crosswalks, sit quietly in church and cooperate with efforts to keep the peace. All this history seems incongruously incompatible with my long-established approach to flossing.
Flossing is one of those ugly monsters that haunt my life. Because it is a monster, I try to avoid it—a behavior that disturbs dental hygienists and makes them want to scare me into flossing. The dread of flossing has power over me, much more power than the fear of tooth decay, more power than the dental hygienists.
“There seems to be quite a bit of plaque on these lower front teeth,” says Christie the dental hygienist. Christie and I are basically strangers, having met approximately two minutes earlier. She may think she is the first in her profession to describe plaque on my teeth But her pronouncement can hardly be taken as news. Others in her place have been reporting the same to me once or twice annually for forty years. Usually the news is followed by a bit of a lecture on flossing which I would document here, except that I try not to hear any of it. If I could respond to the lecture, which I usually can’t because my mouth is otherwise engaged, I would say, “Yes, I know there’s plaque, and I hear you say that flossing will remove it. But I hate flossing. As an alternative I have decided to make a commitment to visiting a hygienist twice a year to have the plaque removed. I came to you even though I knew you would lecture me. That’s how committed I am to the twice-a-year cleaning! I hate lectures.”
Whenever I know a familiar lecture is about to begin, I prepare to close my ears. My ears are closing now. Nothing Christie is about to say will sway me. I have been playing this game far too long.
But Christie, it seems, is not playing by the rules. Things are not going quite as I had planned. There is no lecture. Even my closed ears can hear that the lecture has not begun. So my ears open up and a warm sense of relief spreads over me like a soothing blanket. My jaws relax.
“I wonder,” she muses later in a gentle unconcerned voice, perhaps the voice of idle curiosity, “I wonder just how often you are flossing.”
Timing is everything. She is friendly. She is curiously unconcerned. But she is curious, and I am relaxed, just relaxed enough, just free enough from her probings into my mouth that I can take a breath and answer the question, just comfortable enough to blurt out the truth.
“I’m just wondering how often you floss,” she says.
And I say, “Never!”
Never? Now why did I say such a thing? It makes me look bad, and it is not entirely true, since I have been known to floss once or twice after a visit to the dentist, and occasionally I floss in desperation when I can still taste garlic the morning after a meal at a pasta restaurant. But somehow “Never!” sounds really true, truer than it would sound if I had told her that I floss sometimes, or “not as often as I should.”
She laughs. This does not appear to be the answer she was expecting. No wonder I am thrown further off guard. Hygienists rarely laugh while talking about flossing, and I’ve always been a sucker for laughter.
Christie returns her attention to my mouth. You have time to think when somebody is working in your mouth. Who knows where your mind might wander before the next opportunity to speak. Somehow the cleaning seems just a little bit incomplete without the accompanying lecture.
As if daring her to fall into the expected pattern, I use the next opening to explain my reasons for not flossing. My gums hurt and the floss sticks and unravels between my teeth.
Now I wait for her to refute my logic, the closest thing to a lecture I can reasonably expect. But she won’t bite. In stead of trying to convince me to floss, she asks me to remind her to give me a little brush that looks like a Christmas tree. This little brush, she assures me without a hint of doubt regarding my commitment to that brush, this little brush will help clean the spaces between my front teeth.
Now we are definitely in unfamiliar territory and I am a little lost. She has me in the palm of her hand. Never before has anyone suggested there was an alternative to flossing. She’s back in my mouth. My mind is wandering again. It wanders to the research about suggestions and flossing. Soon enough I hear myself mentioning the research to her. Maureen A. Kelly, D.D.S., Harlo R. McKinty, and Richard Carr from Lincoln, Nebraska reported that 8 months following suggestions to improve flossing, 67% of patients, as compared with 15% of a control group, were found to have healthier gums.
“Hmmm,” she says a little later, “I get quite a bit of time to talk while I’m doing this work. I could use that time to make suggestions.”
“Yes you do get time to talk,” I agree when I am permitted. She does not ask what suggestions she ought to make.
We sink into companionable silence. It is comfortable here, she intent on her cleaning, I lying back, drifting. But Christie is not prepared to settle for mere agreement. She is wondering about other things. Reaching a conclusion she declares, “I don’t think the suggestions would work unless a person really believed that flossing would help.”
Now I snap to attention. A professional response is required here. “You are correct,” I say. “Suggestion only works when a person is willing to believe you.”
“Yes,” she says, as if that explains everything, which, of course, it doesn’t. The burden of explanation rests with me.
I give it a try. “To tell you the truth,” I say with an air of conspiracy, “I actually do believe that flossing helps.” Now that my professional side has been activated, I don’t want her to think I haven’t been aware of the research linking flossing with dental health.
The problem with passionate declarations is that you tend to hear them yourself. You hear them as truths, even when your ears are closed. The next time your mind wanders, you find yourself remembering what you heard yourself saying, reliving the passion you felt. So now I have created a problem, have made myself uncomfortable with the disconnect between my beliefs, my knowledge and my actions.
Back at the office, pushing bits of carrot and apple around with the tip of my tongue, I drift into the last half of my lunch hour, taking a moment to reread the little research piece on suggestion and flossing. This research supports the power of suggestion to change action. Unfortunately some of the suggestions appear in language a mere psychologist cannot easily interpret. The researchers report that the groups were given the following types of suggestions.

(1) ”Suggestions involving oral health which explained the need for routine dental flossing to prevent periodontal disease and interproximal caries; (2) suggestions involving personal appearance which cited healthy looking gums, clean teeth, and the benefit of avoiding interproximal decay; and (3) suggestions dealing with social desirability which mentioned better smelling breath and a cleaner, more well-kept appearance.”

Not quite getting it, I reread the three kinds of suggestions. What, I wonder, is interproximal caries? No time for this stuff. I have other work to do. But suggestion is a powerful thing. I spend my breaks attending to images of Christie standing over me, making suggestions, though I cannot quite focus on the exact words she is saying. What would she be saying? Surely she would not be getting my attention with dental talk about the prevention of periodontal disease and interproximal caries. Nor would she be getting my attention by trying to frighten me with threats of future dental problems. In order to change my actions by making hopeful suggestions she’d have to be speaking to me in my language.
Hers is the language of dental knowledge, the causes and effects of certain conditions. With the help of a dictionary I gain a little better understanding of some terms. It seems that caries are cavities caused by decay on the surface of the teeth. Interproximal caries occur on the surfaces between the teeth. Plaque is the film that sticks to the teeth after the bacteria have done some work on the leftover food .
Mine is the language of hope, of symbols that invite me to move forward, with a recognition of the things I am moving away from. Hope language is the language of a shared journey, of not being all alone. Hope language is the language of I can, and if I cannot believe that I can, I want to hear you say that you believe I can.
When I wonder what Christie would say if she knew more about making hopeful suggestions, the process of making a script using the things I know about hopeful suggestions and the things I understand about this research turns out to be more possible than it seemed in the beginning.

“And now I am going to clean your teeth,” says my imaginary Christie warmly, leading me to believe that there is nothing I have to do except relax. “And now I am going to clean your teeth while you relax in the chair, and I will make it as comfortable as I can and you can let your mind wander, while I clean your teeth, taking away the food and debris that has filled in the spaces and settled on your gums, just as you would take it away with the floss, taking it away with the floss so your teeth will be clear and shining, taking away the remains of yesterday’s dinner or today’s breakfast, leaving the surface of the teeth clear and shiny. I am working here towards clean and healthy, clear of bacteria, taking away the sugar and starch and the bacteria that would harm the clean surface, taking away all the bits of food that would make your gums sore. And now I am taking away the food and the film that has formed on the surfaces between . your teeth, the bacteria that make your breath smell, taking it away to leave the surface shiny and free from bacteria that will work with the food to decay the enamel, work to decay the enamel if it should remain there for a day, or a week, or even a month despite your brushing. And as I work here, watching your teeth grow more and more clean, seeing that I can make those teeth clean simply and without too much bother, I feel good about the possibility that those teeth and gums can be healthier with flossing. I can picture you flossing as you would in the morning, or maybe at night, or even after each meal, just as people with healthy teeth and gums tend to floss, maybe even smiling right after you floss, even though you never thought you could smile after you floss, because you are taking away the bacteria and the sugars that have settled on your gums and found a place to make an infection. And I can imagine your tongue going round and round in the way that tongues go round and round, finding bits of food and reminding you that these bits of apple or carrot or candy could start an infection in your gum if they were to stay there for a day or a week or even longer than that. And I can imagine how that touch of the food on the tip of your tongue could be the little prompt to remind you that you could floss away that food in only a moment. And I can imagine how good your mouth would feel and how good you would feel knowing that the food has been taken away before it starts to infect your teeth and inflame your gums, knowing that your flossing has made it possible for you to have a mouth that is clean and breath that is fresh with shining healthy white teeth. And I wonder how you would feel knowing that you have clean healthy teeth that will last ten years, maybe twenty years, maybe thirty years longer because they were healthy and cared for and flossed in the mornings or maybe the evenings to take away the food that would work with bacteria to wear them away, but can’t wear them away or make them sore because of what you did to protect them.”

And here, I see, is the proof that the time Rachel and I have spent considering the power of suggestion has not been spent in vain. Suggestion is a powerful thing. For even though I have written this script, it has fooled me. I notice that I am feeling proud to have protected my gums, a pleasant but curious pride, given that protecting them is a thing I have not yet done. So I get out the floss and start taking away those bits of apple and carrot. And then at supper I work on removing the bits of salmon and salad. And even though a piece of floss gets stuck between two back teeth and has to be removed with the tweezers, the memory of that moment seems to dull during sleep. I pause before leaving the house to dislodge the remainder of the toast I ate for breakfast.
That totals three flossings after a visit to the hygienist. I do believe this is a record number. Could it be that Christie and I have unwittingly tampered with a monster?

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