Are you apprehensive and constantly stressed? Helena Alder, dentist and Integral Master Coach explains what you can do to break the worry cycle

Do you often find yourself worrying about the outcome of a treatment plan or the expectations of your orthodontic patients? How do you currently go about dealing with that worry? Worrying seems to be an innate part of dentistry, especially in orthodontic dentistry where patients show up at your door to improve their smiles and subsequently their appearance and well-being. Often only the perfect smile is good enough.

A British Orthodontic Society survey (2016) shows that an increasing number of the adult population in the UK are seeking out orthodontic treatment in order to improve on their appearance, and with increasing numbers of adult patients with aesthetic demands come increasing pressures on you as an orthodontist. And this brings me back to my original question – how do you currently go about dealing with that increased pressure and potential worry?

Perhaps you are one of those orthodontists who thrive on pressure or you simply accept worrying as part of the job. If this is working well for you, I’ll say – great! However, if you are anything like me, a disconcerting situation with a patient can easily turn into a knot in the stomach. Before applying mindfulness to these situations I would carry this knot around for days at a time, but since regularly applying the principles in this article all I can say is that I worry much less. Try and see for yourself.

What is worry?

First of all, what is worry? In my definition worry is simply a chronic anxiety of the unknown. It is usually created or intensified by a trigger. So, if you take the example of an orthodontic case that turned out less than favourable and the patient is unhappy, their complaint can be the initial trigger. What happens next is what is interesting though. It is perfectly natural to be concerned and worried in this situation as something very important is at stake. However, we normally have a habitual way of dealing with worry and most of us would simply carry the worry around until the situation is resolved.

But what I discovered when I applied mindfulness to triggering situations like this was that approaching my worry mindfully actually helped me calm down, view what was happening with more perspective, and it helped me take action with a clearer head. Ironically it also allowed for more acceptance of the situation as I came to acknowledge ‘this is happening anyway’. Acceptance does not mean I sit back and not take action, but I realised that if I fight what is happening in addition to dealing with the situation itself, I am just adding unnecessary stress to the situation.

The worry cycle

What I call the worry cycle gets activated by a trigger, for instance the situation above, and what happens is that certain thoughts, emotions and also sensations in the body will accompany the trigger. This usually happens below the surface of our conscious mind, and our experience of the thoughts, feelings and sensations taken together will be a sense of ‘I am worrying about this situation’. This general sense of ‘worrying’ is where most of us act from when we try to deal with the situation in the best way we know how to.

However, as we slow down and take a look underneath the surface of the worrying, we get to see that the thoughts, emotions and sensations actually feed in to each other, and one tends to magnify the other. So the thought ‘this is not going to end well’ can trigger a feeling of anxiety which triggers a knot in my stomach (sensations) which again magnifies the thought that ‘this is really not going to end well’…and on it goes. As you can see you get caught in the worry cycle and you don’t even know it.

So, how do I apply mindfulness to the situation? It might look like this:
1. I recognise a situation has triggered me to start worrying.
2. Recognising this, I choose to slow down and get curious;
• What is the situation?
• What are the thoughts swirling around my head regarding the situation?
• What am I feeling?
• What sensations in my body are accompanying my thoughts and feelings?
3. In other words, I am applying mindful awareness to what was initially unseen to me, and instead of accepting that ‘worrying is simply a part of orthodontic dentistry’, I can instead choose to break it down and mindfully take charge of my inner experience of ‘worry’.
4. Having mindfully gathered the information above, I ask myself; what necessary actions do I now need to take? Are the thoughts and feelings even realistic? What might be some more constructive things I could be telling myself than, ‘This will not end well?’ Could it be, ‘I am unsure about the outcome with this patient, but whatever it is I am more than capable of dealing with it?’
5. This means that I can take action from a place of clear understanding of the situation rather than react from my sense of worrying.

Using the breath

You might be thinking; now how do I slow down enough to become more mindful? This is where using your breath can help. Using the breath to slow down and come in to the present moment is a tool that has been used for millennia. You can only breathe in the here and now in the present moment, and it also helps you take a step back from the worry. So when you recognise you are triggered by a situation, it’s as simple as taking a pause and choosing to pay attention to your breath instead of your worry – as you inhale and as you exhale.

An easy place to start is to focus your mind at the tip of your nose as you notice the stream of air…coming in, going out. Stay with your breath for a few minutes until you notice yourself feeling calmer, and then return your attention to the situation as described in the box below, getting curious about what you can discover.

The bigger picture

Mindfulness distinguishes between formal and informal practice, and what I have described above fall in the category of informal practice. This means you are practicing it ‘on the go’ which is very valuable. However, I would also like to take this opportunity to warmly encourage you to find some time each day for a formal mindfulness practice as well.
This means setting aside some time each day to practice watching your breath on a regular basis, and this in my experience makes it much easier over time to deal with the challenges and triggers of daily stressors. If you would like some help with this, please do not hesitate to contact me at