Could placing attachment over authenticity be the reason behind dental burn-out?

Dr Huthaifa Abdul Qader

Tue. 27. June 2023

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Human beings have a need to emotionally bond with others and to be their authentic selves. In psychology, these are considered basic survival needs. Infants’ attachment to their mothers improves children’s chances of survival, and gut feeling informs adults about danger. Attachment means connection, belonging, loving and being loved. Authenticity is the capacity to be in touch with ourselves and to be able to express and manifest who we are in our relationships and social interactions.

As the pioneering endocrinologist János Hugo Bruno Selye said, “The biggest stresses in human beings are emotional ones. The biggest stressor of all is trying to be who you’re not.” There is always an inherent fear in moving towards our authenticity. Ever since our childhood, we have been through various traumatic experiences which caused us to subconsciously be afraid to express and manifest our authentic selves. Our mind unconsciously pulls us towards a safe zone by compromising our own needs in return for social validation. Without recognising, confronting, understanding and accepting this fear, our need for attachment will always be chosen over our need for authenticity, and later there will be an inevitable price to pay.

Only when compassion is present will people allow themselves to see the truth

The above quote, by renowned author A.H. Almaas, reminds us that we must also show compassion for ourselves. In situations when we keep suppressing our emotions for the sake of attachment, we may ask: “Why am I still acting that way?” This is not an actual question; rather, it is a statement that implies a feeling of unworthiness. It is a statement because we subconsciously know of our self-doubt. It is a self-accusation of lack of unconditional self-worth. Another way to ask the same question is: “Why am I really pretending to be that way?” By doing so, we shift our awareness towards compassionate curiosity. In situations that pressure us to repress our authentic selves, we need to compassionately question our attitudes by detaching ourselves from our behaviours. Only then will the answer come to us.

Suppressing ourselves in the presence of certain people is a habit picked up in childhood. We unconsciously think: “If I am authentic, nobody will like me”. These habit energies are automatic behaviour patterns that dictate many of our daily interactions and life decisions, despite our desire to think rationally. Unless we train ourselves to confront and change these behaviour patterns, the same habits will remain.

According to renowned addiction expert Dr Gabor Maté, addiction is not a choice that we make, nor is it a disease that we inherit; it is an attempt to solve a problem. Dr Maté has said: “Pleasure is necessary for life, however we often lack pleasure in our lives unless we turn to means that make us temporarily forget about our problems.” Similarly, tendencies to numb pain, discomfort and the fear of alienation signal the existence within us of issues which we try our best to keep at arm’s length. In order to understand and resolve why we crave pleasure, why we lack comfort and why we are in pain, we have to look deeper within ourselves and that can only happen by slowing our life tempo down. These factors almost always have their roots in childhood experiences that resulted in compensation through addiction to substances or through personality patterns, such as seeking validation, approval and praise from others.

We stress ourselves in the clinical environment to the extent that we actually make ourselves sick

In psychology, burn-out is defined as a state of physical and emotional exhaustion. It can occur when we experience long-term stress in our job or when we work in a physically or emotionally draining role. The Slow Dentistry Global Network teaches that, by treating an appropriate number of patients per day while implementing its four cornerstones, all dental practices can achieve a stress-free experience and a painless treatment and all dental practitioners can protect themselves from physical burn-out. However, this does not necessarily prevent emotional exhaustion. The daily exposure to a high volume of emotional stressors will eventually result in dental professionals becoming unconsciously overwhelmed, anxious or depressed. The constant exposure to the pain and suffering of patients eventually leads to compassion fatigue, which is a combination of emotional exhaustion, depersonalisation and reduced personal accomplishment.

The three main components of stress are:

• the stressor, which is the external event;
• the processing apparatus, which is our unconscious interpretation of the external event; and
• the physiological response, which is the internal reaction to the external event.

The components that play the most significant role in weathering stress in dental practices are our own subconscious beliefs and interpretations. Dental stress is interpreted subconsciously to the extent that we keep unconsciously suppressing ourselves in taking on the emotional burdens of our patients and for the sake of attachment, desiring to be accepted, loved and respected; and by doing so, we stay disconnected from our true selves. We stress ourselves in the clinical environment to the extent that we actually make ourselves sick. In that way, ultimately, burn-out can teach us a lesson.

Self-awareness requires vulnerability; however, as individuals, we conceal our vulnerability through compensatory mechanisms that keep our hearts closed. (Image: Broggi Production/Shutterstock)

The whole point of this article is for readers to become conscious of the root cause of burn-out. Burn-out is not inevitable. However, if you do suffer from emotional exhaustion, rather than seeing it as a calamity to battle against, see it as an opportunity to learn. What we have been learning, over and over again, is that we have never been ourselves. Burn-out indicates the need to come back to our authentic selves. Unless we as healthcare providers begin to set healthy boundaries and prioritise self-care, this condition will continue to persist and affect our job satisfaction and commitment.

Patient selection is an aspect of ethical dental care that is misunderstood and misapplied. By refusing to treat patients who do not align with the set of values and codes of conduct of their dental practice, dental professionals can avoid many of the factors that contribute to emotional burn-out. The Slow Dentistry Global Network introduces the concept of personal congruence as a tool to navigate through almost all challenges and difficulties that dental professionals may face throughout their careers. Personal congruence is developed over time, and the less it is practised, the more confusion and dissonance creep into our relationships with our team members and patients. It exposes areas of misalignment between our values and our behaviours, thus serving as a compass for maintaining our well-being. By coming to know ourselves, we are able to be ourselves—that is why heightened self-awareness is one of the most important personal skills that every dental professional is advised to nurture.

Self-awareness requires vulnerability, and for most of us, being vulnerable is challenging and uncomfortable. So why is it difficult to be vulnerable? The Latin word “vulnerare” means “to wound”. Because our wounds are too raw to confront, we cover up our vulnerability by using compensatory mechanisms that keep our hearts closed. This emotional unavailability prevents us from learning how to practise self-love. Our childhood traumas have caused many wounds which have forced us to put on personality layers in order to protect us from further wounds. These traumas are not events; they are the wounds that we sustain inside of us which cause us to suppress our true emotions. The good news is that our authentic selves are never lost; we can recover our authentic selves in the same way that people recover after being sick. To recover means to find something, and when something is found, it means that it was never lost in the first place.

Our recovery must come first so that everything we love in life does not have to come last

Human functioning is shaped by formative experiences, and we have trouble understanding those whose formative experiences are different to our own. All of us live on the same spectrum of human emotions; some may feel down for a period and snap out of it afterwards; others may fall into deep depression and see the world through different lenses. Those who have never experienced depression may never be able to relate to those who have, and they may become judgemental of them. Nobody should be a passive recipient of everybody else’s care. We need to regain our sense of agency, to actually look at our behaviours, our patterns and our dynamics and be courageous, open and curious enough to detach ourselves from them in order to start our own journey of healing. Let us start by asking ourselves: “Why am I still numbing myself? Do I really need to tolerate that patient’s attitude? Am I really still that infant, a young child who needs to choose attachment over authenticity?” Only then will the answers come to us.

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