In the book “Fear and Trembling in Las Vegas”, the author takes his readers through their experience in the chase of the American Dream. He is under the pseudonym of one Raoul Duke who travels with his attorney who is called Dr. Gonzo, from Samoa. Together they arrive in the “Great Red Shark” as this place was always referred to as a gigantic pimped Chevrolet convertible vehicle, and initially land in Las Vegas as a journalist and his attorney in pursuit of a story about a motor race.
They soon abandon their course and go in pursuit of the elusive American Dream in what Thompson referred to as Gonzo Journalism. With time, however, they get frustrated and gets into a stupor because they start using different sorts of intoxicating substances including alcohol, cocaine and even cannabis.
The two gentlemen arrived in Las Vegas with the trunk of their car so full of different drugs and intoxicating concoctions that one would be reminded of an anti-narcotics forensic laboratory. It had two bags, seventy-five mescaline pellets and five sheets of blotter acid. There was a salt-shake which was actually half full of cocaine powder instead of salt. They also had tequila, rum, Budweiser, raw ether and even amyls.
This dangerous living was actually a distraction from the punishing life in Las Vegas and America in general. Their dream of making it big, aptly put by Duke as “gross physical salute to the fantastic possibilities of life in this country”, this is description statement is able to show that they are terribly shattered when they find out that things are not actually the way they expected.
It is a depiction of the generational restlessness and frustration when things don’t seem to work at all. They also resort to violence with the aim of destroying everything that reminds them of the American capitalism and extravagance. As A puts it (up there), “no one is safe from their comic terror”. They unleashed threats and harassments to chambermaids, tourists and everybody else. They destroyed hotel rooms and stoned vehicles on the streets and even indulged in petty theft.
They escaped the law because they were in Las Vegas at a time when lawlessness was reigning supreme, but the comedy is in the fact that they were robbing and molesting even the poorest and most powerless of all people. In what he called his “chemotherapy chair” or the place he sat regularly when intoxicating himself with drugs, he could reminisce over the situation in Las Vegas – the chaos, lawlessness and poverty and what they portend for the American Dream. This is what made him fearful and loathsome.
Another hilarious part of the book is where the locals were wondering why he was driving around in a Cadillac, to which he responded “you don’t go around chasing the American Dream in a Volkswagen a white Cadillac Convertible and nothing less” a statement exclaimed.
In a nutshell, “fear and loathing in Las Vegas” is a vivid narration and hilarious narration of an adventure induced by consumption of all sorts of drugs. They refer to it as chasing the American Dream, though done in a complete stupor and recklessness. It is also perceived as a separation of reality from fallacy, which is funny because the perceived reality is actually through the eyes of a person in a trance courtesy of the massive intake of different intoxicants.
Thompson argues that if they work the issue in the right way, then they would make it right. This was a statement made as Raoul Duke, agues in favor of the drugs. His argument is to the effect that they can only achieve the American Dream if their search is guided by and conducted under the influence of mescaline tabs, jimson weed, ether and all the other substances they had at their disposal.
Together with his attorney, they invade all the nice hotels in Las Vegas and accumulate huge bills which they actually abandon. They walk out on the pretext of going to cover the Mint 400 and the Conference on Narcotics and Dangerous Drugs. Actually a keen observer will notice they are under influence of the same drugs whose conference they are about to attend. The drugs had certain effect on them and their pretence could be easily be detected with no doubt.
Again in their adventures, Thompson shoots away in the desert with a .357 Magnum gun and has an intimate encounter with Lucy whose teeth remind him of a baseball and eyes look like jellied fire. They also witness an overweight policeman and his similarly obese wife, or so they assume, in a public show of sexual activity. The most interesting thing about this scene is that their huge audience includes about 1000 policemen and women. This was a very big number of personalities and was very ironical.
They are engrossed, or so they pretend, in a movie about the dangers of consuming marijuana. This situation is targeted to depict the lawless nature of Las Vegas where anything goes and the public is actually thrilled rather than dismayed or embarrassed. This scene, according to Thompson, can only be tolerable if one is under the influence of some strong substance that will create an illusion in the mind of the user.
Another comic scene is where they ask a waitress whether she can give them directions where to find the American Dream, i.e., if she knows where it is. A lengthy conversation ensues involving the waiter, a short order man and the two guests. The question appears confusing and they begin to ponder whether it is the name of a place, a former discotheque which went by the name “Psychiatrist’s Club”. Its location is on Paradise Avenue in the outskirts of Las Vegas.
There are varied thoughts about the American Dream and whether the duo found it or not. For instance, Christopher Lehmann-Haupt argued that they never did because they actually knew it does not exist right from the word go. On the other hand, it is argued that their run amok lifestyle in Las Vegas was actually the American Dream in their context and they actually lived it.
Reading the book gives one a feeling of an adventurous spirit and attention to amazements. The illusions of the American Dream are also very hilariously presented, in particular, given that the chase is done under influence of intoxicating drugs.
At the same time, the illusions of the American Dream are expressed in a hilarious way by the author considering the information relayed in the reflection idea presented.
Robert Frost had it tough growing up and during his adulthood it did not get any easier. Frost wrote poetry relating to his rather challenging life experiences because he used it as a coping mechanism. Fear and anxiety were common images in his writing which is why his poetry explicitly depicts his true inner self.
He vented out his anger through writing and this made his works appeal passionately to his readers. This influenced his writing and was a means of escape. He was not mentally ill as some people argue. Frost “knew himself”, that is why he was able to control his fears and balance the tension between the inner and outer self-forces.
The “knowing” and not “knowing himself” are statements of disagreement with the world. In Sheehy’s article, Lawrence Thompson notes that the ultimate problem of Frost biographer is to see if the biographer can be enough of a psychologist to get far enough back into the formative years of Robert Frost and to try to realize and clarify what forces were functioning, back there, to produce the curious forms of fixation which Robert Frost had to fight with of all through his life (Sheehy 393).
This challenge of having to delve into Frost’s background from a psychological perspective to explain whether or not he “knew himself” works to justify the view that he was not mentally ill.
Lisa Hinrichsen agreed with Thompson in accepting the idea of frost neurotic behavior. She includes a psychological analysis of Sigmund Freud in her article (Hinrichsen 42). Based on Freud’s psychoanalytic approach to fear and anxiety, the latter is used in Frost’s poetry in conjunction with conditions created in his poetry that reflect anxiety irrespective of any objective, while fear is fundamentally focused toward an object.
The Freudian theory helps us understand Frost more from a psychological standpoint. Hinrichsen develops her argument referring to Freud who gives anxiety to be associated with a “disruptive, uncontrollable character” and explains that it generates a feeling of “uncomfortable helplessness.” (Hinrichsen 48).
Hinrichsen claims that the anxiety of Frost’s poetry could be formed with the presence of conscious and unconscious fears. “Many of Frost’s poems are clearly self-consciously controlled spaced filled with boundaries, walls, doors, and frames that define spatial confines and carefully scaled scenes” (Hinrichsen 48). That Frost was more focused on expressing himself in relation to his experiences rather than making a blunt reference to remote life issues is clearly depicted in his works, as illustrated by Hinriechsen.
Frost constantly sets restrictions for himself in his poetry. Mental illness, which ran so commonly in this poet’s family, may become a serious reason for these fears. Enduring so much loss and suffering for years, Frost could be afraid to become mad himself and sets boundaries for his own emotions and imagination; though, this attempt to guard his inners self could be quite an insensible effort.
Frost’s plan was to put fear in his mind. His inner and outer forces are used here in the sense of “Tree at my Window.” In this poem, Frost illustrates two distinctive forms of self, which influence his being. He employs the imagery of the tree as the outer, and the speaker the inner.
While Hinrichsen and Eben Bass share the same ideas on inner and outer forces, Hinrichsen argues that the fear Frost has comes from anxiety within the poet. She expounds that the voice of fretfulness talks as a form of motion or flight in his poems. Bass focuses on fear, which comes from an outside object, just like the main image in Frost’s poems.
He explains nature’s risk and how it creates fear in the poems’ speakers. Both nature and feeling are associated with what Eben Bass refers to as the “outer,” which can be a physical thing, for example the desert in “Desert Places”, birches in “Birches” and window in the “Tree at My Window” which are normally used as physical or figurative obstacles between outer and inner; between fear and safety.
The “outer” is attributed to vulnerability, nature and improbability as opposed to the “inner” which is characterized by tranquility and peace. He claims that Frost’s poesy is characterized by competition stuck between the inner and the outer, but Frost was able to control this tension and cope with the stress creating a balance between his inner and outer forces.
Bass did not mention in his argument about Frost being neurotic. To Bass, Frost “knew himself” to a point that made him able to control his fear and create a balance between his inner and outer forces. This self- knowledge by Frost attests to the sincerity of his fears and anxiety and to the reality of similar feelings to the average reader whose poetry appeals to, teaches and admonishes.
Some fears are normal and positive to each other and everyone has some fears sometimes, stated Mary Reufle in her article “On Fear.” She describes the fear as normal and positive thing to each one, especially the poet. Reufle sees fear as an advantage to the poet.
According to Eben (34), if one bends over their page and does not suddenly tremble with fear and throw away their pen, then their writing would have little value. In a sense, you have to have some level of fear and tension in order to engage the reader.
In Sheehy’s article, she quotes Lawrence Thompson who talks about the same idea that Bass talks about in the balance between inner and outer self that Frost has.
Thompson says, “I do not see any reason for even bothering to use the word neurotic. “The boundary line between the healthy individual and the neurotic individual is too constantly fluctuating” said Thompson, “we all cross that line into the neurotic realms, quite often. The only question is whether we are able to get back and recognize where we’ve been” (Sheehy 394). Frost was able to control his fear and use it as a strength through expression.
Thompson thus dispels the claim that Frost was of ill mental health, and in so doing, justifies the consciousness with which Frost expressed his inner state of being, which appeals equally to his readers inner beings as a requirement for the accurate interpretation, and subsequently, the success of his poetry. Thompson’s assertion that being healthy and being neurotic could be a state of health of all humans further nullifies the neurotic claim against Frost.
Does Frost “know himself”? Is it still a big question? Horney says, “It is a question of knowing ourselves well enough to recognize as aberration as such.” Horney in her introduction had emphasized the significance of self-knowledge in the process of outgrowing a childhood obsession with self and moving toward a healthy self-realization.
Thompson, at this point, is still uncertain about how well Frost “knew himself,” whether his deceptions were truly self-deceptive to the extent that Frost could not recognize the actual from the idealized. Even as his conviction about Frost’s neurosis grew and his will to diagnose strengthened, however, Thompson remained reluctant to adopt the term “neurotic. Robert Frost “knew this is how he needed to write in order to cope.
Even if Frost was neurotic or not, anxious or not, he still “knew himself”. Frost was not weak or lost which gives us the idea that there is a connection between his inner and outer self; Frost was not only able to leave this connection between the two forces, but also he kept the tension neutral between the two forces.
Frost knew that false control strengthens the wall of separation so he tried hard to eliminate this wall by contacting deeper and vaster faculties to activate him even while the wall was still present. Beside that, Frost was not able to let his inner control his outer, but he was able to keep the balance between the two forces.
Socrates once said, “May I have beauty in my inward soul, and may the outer and the inner be as one.” Frost was not able to make his outer and inner as one, but he was clever enough to use his ability of controlling his fear and balancing the tension between the inner and outer forces to benefit the reader and himself.
Works Cited
Bass, Eben. “Frost’s Poetry of Fear.” American Literature 43.4 (1972): 603. Academic Search Complete. Web.
Freud, Sigmund. A General Introduction to Psychoanalysis; Trans. by G. Stanley Hall. New York: Boni and Liveright, 1920; Bartleby.com, 2010.
Hinrichsen, Lisa. “A Defensive Eye: Anxiety, Fear and Form In The Poetry Of Robert Frost.” Journal of Modern Literature 31.3 (2008): 44-57. Academic Search Complete. Web.
Poe’s short fiction offers a broader range of themes and greater psychological complexity. The uniqueness of his style is that Poe puts readers into the world of fantasy and strong emotions and feelings. Many of his works mixed with murder and suspense depicting the worlds full of cruelty and violence. One of the most unnerving qualities in Poe’s fiction is the construction of tales that feature human mind. His works center upon interior crises where the human mind is under assault. Thesis Fear of premature burial dominates in many Poe’s stories as a reflection of troubles and hardship he experienced all his life.
Edgar Poe was born on January 19, 1809, in Boston. When he was only two years old, Edgar lost both his parents, traveling actors. Frances and John Allan were to bring Edgar into their home, although that Frances had to convince her husband to assume guardianship over. The main personal problem of Edgar was that he was never legally adopted by John Allan (Silverman, p. 2). Allan treated his foster child kindly, although real affection came from Allan’s wife. Frances was apparently devoted to Poe during his childhood (Carlson, p. 5). During Poe’s adolescence, John Allan became increasingly impatient and demanding. In England, he attended Manor School at Stoke Newington. Then, the family moved back to Virginia. Poe attended the University of Virginia only one year and was expelled for his gambling. He started his career as a poet and writer in Baltimore in 1930s. From 1831 to 1835 Poe lived in poverty in Baltimore. He tried unsuccessfully to find work as a schoolteacher, an editorial assistant, and for a spell may have even rejoined the army. During these years, he struggled to make a living, occasionally writing poems but never making enough money to secure a decent diet or purchase sufficiently warm clothing (Silverman, pp. 15-17).
The theme of fear of premature burial dominates in most of his stories and can be explained as a result of desperation and emotional distress. The Gold Bug, “The Tell-Tale Heart” and The Murders in the Rue Morgue etc. depict fear of death and scenes of murder (Silverman, p. 212). In Poe’s stories of revenge, the fear of death helps to undercut the protagonist’s criminal plan. Most of these tales reveal a desire to be caught or at least a need for self-punishment that is as strong or stronger than the urge toward violent crime and the attendant anarchy of its brief personal freedom (Jacobs, p. 43). For instance, in The Tell-Tale Heart and The Black Cat the police arrive and stimulate a desire on the part of the narrator to confess his crime and undergo punishment from the state. In The Masque of the Red Death and The Tell-Tale Heart, clock imagery is associated with the destruction of criminals (Bloom, p. 122). Poe’s characters commit their crimes and almost instantaneously activate some principle of judgment. These tales of homicide often conclude with the understanding that the destruction of another human being (Bloom, p. 56). Bloom underlines:
in his 1844 tour de force, “The Premature Burial,” Poe wrote, “the boundaries which divide Life from Death, are at best shadowy and vague.” Describing one of those “cessations… of vitality” known to result in accidental burial, he mused, “where, meantime, was the soul?” The question of the soul’s whereabouts during sleep and after death has a long tradition in Western philosophy, stretching back to Plato and Aristotle” (Bloom, p. 127).
In the short stories, Poe tells readers about his true feelings and emotions, fears and distress. It is possible to say that inner feelings and fears are more real for his protagonists than elements found in reality (Bloom 23). Poe’s first-person narrators force the reader to enter a world of fear. Following It is a world of gross distortion, unreal construction, and irrational propensities toward violent behavior. For instance, the protagonists in The Tell-Tale Heart, The Imp of the Perverse, The Black Cat, The Cask of Amontillado, and The Masque of the Red Dead all emerge from similar conditions (Jacobs, p. 38). They spend too much time alone, divorced from meaningful social community, family, and friends. Fear of premature burial is expressed through obsessive behavior and delusions. As this occurs, thoughts of murder and the pursuit of selfish pleasures are inevitable consequences (Bloom, p. 115).
The Cask of Amontillado is one of the best exampled of fears and doubts experiment by Poe. Montressor meets Fortunato on an Italian street and entices him home to his wine cellar. Fortunato has no awareness that he has insulted Montressor. Montressor sealed him between two stone layers by building a wall in front of Fortunato. Poe writes: not only punish, but punish with impunity” (Poe, p. 76). Foe portrays ability to assess and judge situations accurately. Poe’s narratives of murders and murdering pivot around acts of violence and the criminality; the darkness of these stories is not lightened by any degree of love or affection (Bloom, p. 145).
The Masque of the Red Death is an example of Poe’s fear of death and premature burial. This story suggests an imaginative nature of the plot. Overwhelmed by images of costumes, bejeweled masks adding to the allure and mystery of beautiful and privileged people, and a decadent environment of rich colors and sounds, Poe portrays sudden death and premature burial: “black chamber the effect of the fire-light that streamed upon the dark hangings through the blood-tinted panes,.. there were few of the company bold enough to set foot within its precincts at all” (Poe 45). In the Tell Tale Heart, Poe creates the world of fantasy using unique symbols and settings (Jacobs, p. 32). The narrator claims to be totally sane, he admits that there never existed a real motive for murder; it was just that the old man’s eye vexed him: As the narrator spends a week preparing himself to commit the crime, he forms a bond with the old man, acknowledging that the victim’s terror of death is likewise shared by the man who will bring death into the bedchamber: “Many a night, just a midnight, when all the world slept, [terror] has welled up from my own bosom, deepening, with its dreadful echo, the terrors that distracted me. I say I knew it well. I knew what the old man felt, and pitied him” (Poe, p. 65). These fears and terrors can be found in many stories of homicide and revenge. Following Joseph Patrick Roppolo: “a parable of the inevitability and universality of death.” Death cannot be barred from the palace, he argues, because it is in the blood, part and parcel of our humanity, not an external invader. Hence, according to Roppolo, the spectral figure is not a representation of mortality (which is already present) but a figment of the imagination: man’s “self-aroused and self-developed fear of his own mistaken concept of death” (Bloom, p. 120).
Using the themes of death and fear of premature burial, Poe puts readers into the world of monsters and murders. Critics (Bloom, p. 34) admit that alcoholism was the main caused of emotional distress and fear of death.
Many of Poe’s protagonists have much in common with Poe himself. “Poe witnessed in losing his mother and wife to tuberculosis, and both at the age of twenty-four, took on an obsessive quality for Poe the writer, since the two most important women in his life essentially “bookended” his artistic career with their strikingly similar deaths” (Davidson, p. 54), These fears and terrors were mirrored in many stories including “The Black Cat”. For instance, after disposing of wife and cat, the narrator of The Black Cat says, “My happiness was supreme! The guilt of my dark deed disturbed me but little…. I soundly and tranquilly slept; aye, slept even with the burden of murder upon my soul” (Poe, p. 76). “The burden of murder,” proves too heavy for these men to bear (Bloom 145). They descend into self-punishment that is narrated from within the lonely silence of the tomb, the jail, or the lunatic asylum. The black cats in this tale possess certain supernal qualities that certainly confound the narrator. The wife of protagonist in The Black Cat: “made frequent allusion to the ancient popular notion, which regarded all black cats as witches in disguise” (Poe, p. 51). It is a story that confronts the issue of alcoholism and the destructive effects that it produces upon marriage. When the narrator confesses that “my disease grew upon me—for what disease is like Alcohol” (Poe 54), he reflects a thought that Poe himself understood. Alcohol produced violence and aggressive behavior (Bloom, p. 140).
Poe’s alcoholism not only cost him friendships and important connections because of he quarreled violently with others, he also spent time in jail for public drunkenness. In creating the narrator in The Black Cat, Poe invested him with many of his own character flaws while drunk; the narrator is not meant to be Poe himself, but Poe used many of the particulars of his own experience in rendering the narrator’s personality. Similar to this story, in The Masque of the Red Death Poe reminds readers that the devastating and incurable effects of the Red Death, with its horrible “bleeding at the pores,” isolates the victim “from the aid and from the sympathy of his fellow-men” (Poe, p. 57). In the end, it is Prospero himself who is “shut out from the aid and sympathy” not only in his selfish pursuit of pleasure and arrogant exclusion, but in the very manner in which he dies: alone in the black room, face-to-face with Death. Critics (Davidson 61) admit that death of his young wide Virginia had a great impact on his physiological well-being and addiction. Poe lived another two years after the death of Virginia, and they were perhaps the most miserable of his life (Bloom, p. 116).
Poe died on October 7, 1849 in Baltimore. Similar to many of his tragic characters, he faced the same tragic death. Following Silverman, alcoholic ‘was hurrying him to the grave’. Similar to the writer, Poe’s protagonists feel elation; they awarded themselves psychologically at the same time that they have eliminated the oppression and fears of death. It is possible to say that fear of premature burial and death is caused by life troubles (death of his relatives) and intoxication state which led him to distress and anxiety.
Works Cited
Bloom, H. The Tales of Poe. Chelsea House Publishers, 1987.
Carlson, Th. C. “Biographical Warfare: Silent Film and the Public Image of Poe”. The Mississippi Quarterly 52 (1998): 5.
Davidson, Edward H. Poe: A Critical Study. Harvard University Press, 1957.
Jacobs, R.D. Poe, Journalist & Critic. Louisiana State University Press, 1969.
Poe, E. The Complete Stories. New York: Everyman’s Library/Alfred A. Knopf, 1992.
Silverman, K. Edgar A. Poe: Mournful and Never-ending Remembrance. Harper Perennial, New York, NY. 1991.
This reflection will look at the theme of community policing which is among the most critical issues in criminal justice. The article developed by Roh Sunghoon and Oliver Willard entitled “Effects of Community Policing upon Fear of Crime” will be used to provide a reflective summary. This will mainly capture the stated hypotheses and research questions, variables examined, research methods, limitations of the methods used including a brief analysis of the findings.
Main Analysis
The purpose of the article aimed at identifying the intervening factors in relation to how people perceive community policing and decrease of criminal threat and anxieties among citizens; therefore, the two researchers aimed to address the way a better comprehension would be achieved on the causal relationship between the two variables.
It is arguably so that a reflection on community policing is a major issue today and it needs serious consideration. In the article examined it was noted that vulnerability to crime as a result of socio-demographic factors leads to a greater threat. In other words, it is stated that people who experience more fear of crime depend on their perception as being more vulnerable to it. Actually, the article explains a number of models in relation to fear of crime.
This will not be captured in this current analysis though. Just to reiterate, community policing is a fundamental prerequisite to the reduction of crime and its implementation creates more confidence in the police force. In other words, the satisfaction the public exhibits with the police service eliminates the fear of crime.
In terms of methodology, the article used research information from a study conducted in 1998. Therefore, the approach focused on personal data that incorporated respondents’ demographic aspects; the study sought information on personal crime including victimization experiences, how the respondents’ perceived neighborhood crime and lastly their experience or level of satisfaction with the local police (Oliver & Roh 673).
The main dependent variable was fear of crime which was estimated through the responses given on the way in which threatened people are towards crime in the immediate community. The responses were categorized through an ordinal scale.
The independent variable referred to ‘perception of community policing”. The aim was to understand the way people regarded community policing within their immediate environment. It was noted that the way people perceived community policing also marked the level of their fear of crime.
In the analysis of findings, the researchers applied t-test to establish whether there was a major difference in relation to the level of crime fear among people who experienced community policing in their environment. The results obtained supported the hypotheses of the study. For instance, it demonstrated a major correlation between “fear of crime and perceived approach to community policing and covariates’ (Oliver & Roh 675).
In regard to negative correlation towards the perception of community policing as well as fear of crime it was demonstrated that the more majorities of people perceive community policing the less they will feel threatened by crime. However, the study did not establish any connection between age and level of fear of crime.
Conclusion
The researchers did not discuss the main weaknesses in the methods used. However, there were some and this can be traced in the very nature of the research approach. As such quantitative process is the best because it provides empirical analysis and verification in testing the hypothesis and study variables. However, that does not guarantee validity of the findings.
It is not possible to quantify fear and even one cannot establish it in the subject itself. Thus, such a study may be developed in future by use of triangulation or mixed methods approach. That way the qualitative analysis will help the researcher capture the feelings of the respondents in a deeper manner.
Works Cited
Roh, Sunghoon & Oliver, Willard. “Effects of Community Policing upon Fear of Crime: Understanding the Causal Linkage.” An International Journal of Police Strategies & Management Vol. 28 Iss: 4 (2005): 670 – 683. Print.
Despite the decrease in the global crime rate, the fear of crime has grown significantly over the last decades. There are several implications that are needed to be kept in mind while examining the causes of the fear’s increased popularity. Curiel and Bishop (2017) report that the rate of victimization, meaning the rate of actual crime taking place, is opposite to the rate of fear of crime. For example, the areas that are most secured with the lowest number of crimes tend to be more fearful than people from the areas where the crime rate is high.
One explanation for the heightened feeling of fear among individuals is that the rate of violent crime is still high, even though the general crime rate has decreased. Bureau of Justice Statistics reports that “17 out of every 1,000 residents age 12 or older and living in an urban area were victimized by violent crime in 2009” (as cited in Greene and Heilbrun, 2018, 9. 46). Moreover, Curiel and Bishop (2017) suggest that the instances of victimization are distributed unevenly across the areas, which distorts the image of crime for some individuals. In other words, people may not realize that the crime rate is decreasing when they think about the areas with a high concentration of crime.
Furthermore, technological advancement made it possible to report and document more instances of crime. With the development of the Internet, the public is more exposed to current criminal activity. Police identify more criminals, which creates a solid, vivid face of crime, regularly appearing on TV and Internet news. Therefore, people right now are more informed about their threats to their safety than during the times, where instant access to the information was not possible, which may be the factor for the increased level of fear of crime.
Does Franklin Delano Roosevelt have any legacy? It is evident that that the weak nature of the presidential office in America has never changed after several decades.
It may be justified to argue that the state of welfare is not admirable at all because it is largely in a state of chaos. Criticism has been leveled against the Sacrosanct Social Security plan that was once admirable in the face of the American public and the world at large.
Although the above questions may be mind boggling, the “Freedom From Fear” book by David M. Kennedy offers the best opportunity to reflect such terse questions.
The book is indeed an eye opener since significant historical events have been neatly engrossed in a narrative form with special focus on political administration of justice (Kennedy 2003, 86-88).
The author has offered a detailed account of the Roosevelt era in the book. Individuals who have deep passion for political history of the United States may simply describe the entire book as an old-fashioned history that is good enough for highlighting our weak political systems.
There are a number of major military, economic and political queries that Kennedy keenly pursues in the book. The author also inquires some of the major decisions and the architects behind the landmark decisions that have dearly affected the wellbeing of Americans.
From the outset of the book, there is predomination of dead white males. This does not imply that the author is attempting to sideline the interests of vulnerable groups such as minorities, children and women.
The era of the anti-lynching law debates could not have allowed the author to dissect certain segments of the population. It is also interesting to mention that the Japanese internment was a grueling issue during the depression years.
Nonetheless, it may be unfortunate that the author clearly ignored the American pop culture when compiling the key tenets of the book.
Whereas the latter omission may be judged bitterly by critiques of this book, it is interesting to note that the era of the Great Depression has been dramatically discussed by the author to the best satisfaction of the reader. In any case, what could be the purpose of filling the pages of the book with the American pop culture?
What could have been the historical significances of Citizen Kane, Louis Armstrong, Mickey Mouse or Jack Benny in the economic and political wellbeing of Americans?
After the end of the First World War, the American public was mainly interested in forging austerity measures that would positively transform political and economic growth. The author has indeed tackled some of the most intriguing issues of the Great Depression era.
For instance, the emergence of totalitarianism and the New Deal have been critically examined in the book (Kennedy 2003, 107).
The author has also aroused and retained the attention of his readers by documenting a historical account through a number of surprises. For example, Herbert Hoover receives a very kind treatment from the author. It is not common for presidents to be lauded by most elites in society.
The author observes that Herbert was a scholarly and reflective person. He equates him to an astute political philosopher. Kennedy also posits that the former president was a real source of help and inspiration during the First World War.
Nonetheless, the author has negatively described the character traits of Herbert Hoover to the extent that the audience may begin to feel sorry for the former president. At some point in his description of the politically-correct individuals, the author remains too rigid.
Some of the historical weaknesses of political leaders during the Great Depression era are quite callous. He asserts that Roosevelt and the whole of his administration never knew the strategies to adopt during the Great Depression era.
By 1938, the New Deal was concluded. It followed the enactment of the Fair Labor Standards (Kennedy 2003, 201). The author does not merely give an account of the piece of legislation that ended the New Deal. He pauses in the middle portion of the book to appraise the effectiveness of the Act.
This approach assists the reader to cultivate deeper thoughts and insights before proceeding with the subsequent chapters. The author critiques the much-taunted objectives of the New Deal by arguing that it never managed to redistribute income or end the Great Depression.
According to Kennedy, the deal merely offered job security to Americans. Needless to say, the author is quite elusive when examining aspects such as market security, financial security and life-cycle security in relation to the New Deal.
The Second World War has also been given an expansive view by the author. War and foreign affairs are tackled in the second part while the first section mainly dwells on domestic affairs. The astounding productive capacity was the main reason behind the success of the United States.
The author repeatedly revolves around this theme. Perhaps, it was not necessary for Kennedy to overemphasize the economic strength of the United States against other global players bearing in mind that the country was already an economic powerhouse even before the advent of the First World War.
By the end of the first part of the book, there is no doubt that Kennedy has managed to persuade his allies and friend in the same measure.
The author has skillfully articulated and tossed his arguments on both sides of the debate. He has highlighted the leadership pros and cons of both Herbert Hoover and Franklin Delano Roosevelt.
Reference List
Kennedy, David. 2003. Freedom from Fear: The American People in Depression and War, 1929-1945. New York: Oxford University Press.
In one scene of the film Django Unchained, the audience is introduced to a violent, although disorganized and tumultuous, group who weak white bags over their heads. Acknowledging the movie’s historical basis, one can understand that this mob is a fictional portrayal of the Ku Klux Klan’s predecessors. The Klan (known as the KKK) is a hate group that appeared during the Civil War in the 1860s (Belew). The KKK was a violent response to the conflict’s aim of eliminating slavery of black people.
However, the history of the Klan did not end when black people received their right to become American citizens. The Klan’s existence could be divided into three periods, each of which was initiated by a change in civil rights that challenged the “white power” narrative.
The first Klan’s goal was simple – to retain their ownership of black slaves and maintain the status quo of white superiority. The group did not have a central power, but its fear of newly freed African Americans led to the creation of many small organizations in Southern states. White people were scared that their lives would never be the same, and their fear turned to extreme violence against black people. The tone of the violent acts that the KKK members performed was vigilant – supporters of white supremacy believed that they were punishing black people for crimes, whether the latter were real or not (Sullivan 36). As a result, while the movement was not systemic, its aggressive approach led to many victims.
Then, the movement appeared again after being suppressed for decades. The second KKK wave started in the 1920s, and its business-resembling system transformed the group of small chaotic mobs into an expansive network with mysteriously protected memberships (Gordon 40).
At this time, the hate group was not as focused on black people living in America as on groups that were seen as threats to the American culture and tradition. Fear of black people was followed by hatred towards Jewish people, Catholic Christians, and immigrants whom the KKK portrayed as un-American in contrast to white, Protestant, American-born men and women (Percy). As a result, the second wave was not as focused on violent practices and race hierarchy, but the ideological purity of the American nation.
Finally, one may see that the ideas of the KKK, namely white supremacy, persist in the modern world. The third KKK became active during another time when the make-up of the country was changing – the Civil Rights era. In the 1950s and 1960s, white supremacy organized its forces once again, responding to civil rights activists’ calls for desegregation and equality (Owens et al. 572). Again, the groups calling themselves the Klan were disorganized and violent, returning to lynching, protesting, and marching as ways of intimidation.
This wave of the KKK’s activity continues to the present day, with the groups responding to the rising Black Lives Matter movement for black people’s call to end police brutality (Belew). One can see that the connections between white people’s fear of losing political, economic, and cultural power and white supremacy are apparent.
The fluctuation of the KKK’s activity corresponds with the times when the United States’ politics moved towards racial and ethnic equality. The current Klan-based-organizations continue spreading their rhetoric under the guise of nationalism, although their ideas exclude American-born Jewish and black people, imagining a future for white, Christian society instead. All three waves of the KKK could be defined by their members’ fear of losing the full authority over economic and political processes.
The depiction of the future KKK members in Django Unchained, while comical, should not be dismissed as a simple joke – the level of organizing did not prevent the hate group from killing and torturing numerous people. The KKK’s resurgence is both a sign that the times are changing and equality is still mistaken for a threat to white people.
Gordon, Linda. The Second Coming of the KKK: The Ku Klux Klan of the 1920s and the American Political Tradition. Liveright Publishing, 2017.
Owens, Peter B., et al. “Threat, Competition, and Mobilizing Structures: Motivational and Organizational Contingencies of the Civil Rights-Era Ku Klux Klan.” Social Problems, vol. 62, no. 4, 2015, pp. 572-604.
The most distinctive features of Modernism could be enumerated as Universality, development of Political thought, advent of technology and science, different inventions, approach towards Arts, literature, Specified Cultures, distinctive warfare and industry. There are several social and economic factors that make the Modern society different from the Pre Modern Society. Modernism a complex and intricate civilization but the Pre Modern society lacked all these elements and the major aspect of the society and religion was mostly superstition. The aspects of superstition, juxtaposed with entail of religion, was instrumental in every walks of life and this was an alter existence against clear thought process and science. (Knott, 188-9) This was the time in early American history when the fearsome cases of witch-hunt took place and one of the most terrifying incidents was the Salem Witch Trials.
Salem Witch Trials
In 1692 in the counties of the English ruled Massachusetts there were conducted a series of trials which meant to prosecute persons accused of practicing witchcraft in these areas. The outbreak began with the sudden and rather unusual illness of the daughter (Betty) and niece (Abigail) of the local Reverend Samuel Parris. Betty, aged 9 was the first to be affected and displayed what we would today call ‘hysterical’ behavior, often screaming and convulsing with pain, throwing things about and crawling around her room. She has also famously been quoted to have felt “pinched and pricked with pins”. To relive her of her strange affliction reverend Parris soon summoned the local doctor, (supposedly) William Griggs who sowed the first seed of trouble by suggesting that her illness was less physiological and more ‘supernatural’. (Kumar, 334)
Abigail Williams, 11, Parris’ orphaned niece complained of similar symptoms soon after Betty and promptly a handful of other girls all over the village displayed the same antics as Betty and Abigail. The people of the village of Salem were famous for their strict Puritanism. The neighboring revolutionary war (to which the Salem residents apparently contributed and war refugees from which probably took shelter in Salem) had left them even more attached to their faith. Death, war and a frantic return to religion provided a fertile ground for the re-emergence of some time tested superstitions. The timely intervention of the young girl’s ailment was exactly the sort of thing that would set a quiet village like Salem on fire.
Given their interest in the subject village girls often coupled together to ‘tell’ fortunes and practice divinations just to keep themselves busy during long idle evenings. Tituba, a young slave girl Parris had acquired from Barbados proved popular at such congregations due to her stock of mystical stories. Occasionally, she was also reported to have ‘told’ fortunes. Following Griggs’ ‘diagnosis’ the village quickly decided that Betty, Abigail and the other girl’s suffering was surely a result of witchcraft being practiced in the village. Residents quickly justified this allegation by referring to the recent loss of cattle and other such similar misfortunes and before long almost all the villagers were sure about witches inhabiting the same space as them.
Tituba was, predictably enough, the first person to be accused of practicing witchcraft. It could be stated that her sex, social status, proximity to the ‘victims’ and most importantly her ethnicity, though unfortunate, left her particularly vulnerable to the allegations. After her two other women Sarah Good and Sarah Osborne, both social outcasts and unpopular were similarly accused of being witches. Ironically, while the two Sarah’s never accepted the allegations as true, Tituba soon confessed to being a witch. Sarah Osbourne later died in prison, the other two were later hanged to death. (Tyerman, 233-37)
Claim
Human Beings are naturally expressionistic. Thus, if repressed they consciously or subconsciously search for methods of self-expression. In an atmosphere as that of Salem in 1692 women were allowed little or no room to articulate their personal desires, as a result they remained eager to find means to attract attention and establish their existence. The unexplained affliction of the women in Salem has occupied much academic space. In the absence of any real medical evidence for this sort of collective suffering, most academicians and medical practitioners have time and again suggested that the symptoms exhibited by the girls were, in all probability an ‘act’, which the girls used to attract attention.
Young girls such as Abigail and Betty, who remain confined to their home doing little besides household chores such as sewing, cooking etc. crave the merriment of youth and the spotlight attached to it. Puritans however maintain that kids ‘should be seen and not heard’, and hence their values are often completely contradictory to what children usually want. Given the constant lack of attention received children often resort to tactics to attract the sort of attention they want. This tactics may be the sort that we are used to such as tantrums, crying, throwing things, holding their breath etc. or under certain circumstances it may also be what we otherwise call ‘pretension’ or ‘play acting’. (Prawer, 227-229)
Explanation
The young girls in Salem were engaged, in all probability in such a mass play acting practice. It possibly began as an accident with Betty, but once she and those around her discovered the potential of being afflicted they too jumped into the bandwagon one by one. Each emulated the other and while in public eye used their sudden position of power to cause harm to and accuse everyone and anyone they despised or disliked in the most juvenile manner. It was a power play of the most childish kind, only it ended with about 19 innocent people being killed unnecessarily. (Powell, 49)
The witch hunt in Salem enflamed further with a sudden outbreak of a small pox epidemic, which many believed was the witches doing. As a result of these minor events the accusations flew till even the most unlikely of people came to be accused of being a witch. And then suddenly in 1693 the witch hunt died down much in the same way as it had begun, without a band but with a whimper. All those accused of practicing witchcraft were pronounced innocent (although this proclamation continued till early 20th century, until when the descendants of the accused fought to clear their ancestors’ name). Many of them were even accepted back within the folds of everyday life in Salem. Many others left forever and never returned to the place which maligned their reputation forever. (Manning, 115)
Conclusion
Not much is known of the Parris household except that they moved and that Abigail Williams never recovered from her affliction and died soon after. It can also be stated that the fact that Parris’ young son too died young and of insanity perhaps indicated a seed of lunacy which remained sown in the family. Academicians, psychologists and descendants of the accused and the victims have never quite figured out what happened during that rather eventful year in 1692 in the somnolent village of Salem. Even today it continues to intrigue people from all over the world like an unsolved mystery in the pages of time. (Powell, 53-55)
Works Cited
Knott, Paul. Development of Science: 15th C-17th C. Dakha: Dasgupta & Chatterjee, 1979.
Kumar, Hiranarayan. Power of Opportunity: Win Some, Lose None. Sydney: HBT & Brooks Ltd, 1988.
Manning, Charles. Principals and Practices: Human History. Wellington: National Book Trust, 1989.
Powell, Mark. Anatomy of Witch Hunts. Dunedin: ABP Ltd, 1991.
Dental anxiety is the type of anxiety experienced by the patients who are soon to visit a dentist for an appointment or treatment (Bracha, Vega & Vega 2006; Saatchi et al. 2015). Oral health procedures are perceived as frightening (Appukuttan et al. 2013; Saatchi et al. 2015). Due to the negative expectations, the patients with high levels of dental anxiety may behave in an aggravated manner and disrupt the professional’s work (Frydendal Hoem & Marlén Elde 2012). That way, dental anxiety is a significant issue for both the dentists and their patients. The prevalence of dental anxiety was evaluated in many studies conducted throughout the world. This review presents the definition, risk factors of dental anxiety, its epidemiology, four groups of patients, impact, techniques of addressing dental anxiety, its effects, and assessment methods.
Definition
To provide an appropriate definition of dental anxiety, it is important to define fear at first. Fear is characterized as an individual’s reaction to a dangerous event or a threatening environment (Naudi 2009). In this regard, dental anxiety can be described as an individual’s perception of versatile dental procedures and visits to the dentist overall as threatening and dangerous (Naudi 2009). Settineri et al. (2013) argued that dental anxiety should be classified as a part of the family of mood disorders instead of that of anxiety disorders. That way, studying the facts that contribute to the prevalence of anxiety in dental patients, the researchers should study the psychopathological profiles of anxious individuals (Settineri et al. 2013).
This conclusion implies the need for cross-disciplinary links between dentistry and psychiatry. In fact, from the psychological perspective, dental phobia, as a term, maybe a misnomer; Bracha, Vega, and Vega (2006) propose a new name for it – Posttraumatic Dental Care Anxiety- a term that reflects the nature and the most common cause of the phenomenon. According to this study, the prevalence of dental anxiety is likely to be 14 times higher in the patients who had experienced painful dental treatments who also become 16 times less compliant with dental care and just as unwilling to return to the dentist’s office for another procedure.
Due to the feeling of anxiety and fear, the patients may demonstrate inadequate behaviors during their dental treatments (Madfa et al. 2015). Also, many patients tend to avoid visiting a dentist for their regular checkups and dental procedures when they experience dental health problems (Gaffar, Alagl & Al-Ansari 2014).
Epidemiology
Dental anxiety is a phenomenon that was registered all around the world. Many studies have been done to evaluate the prevalence of dental anxiety. Fear of dentists is one of the most common phobias registered by the psychologists (Yip 2012). Moreover, the overall prevalence of dental anxiety may vary from one group of patients to another and also is diverse in different countries. (Naudi 2009). Depending on the types of subjects and their characteristics, the researcher all around the globe reported rates of dental anxiety that hesitate from very low to very high (Naudi 2009). In other words, it is possible to conclude that geography is an insignificant factor when it comes to the prevalence of dental anxiety (Naudi 2009).
For instance, Frydendal Hoem and Marlén Elde (2012) reported that prevalence of dental phobia and anxiety among adult patients is usually estimated somewhere between 4 and 20%, in rare cases, it is found to be even higher – 40%. Besides, the authors reported that about 16% of the phobic patients develop their fears in adult life being between 18 and 26 years old. Busuttil Naudi (2009) reported that the prevalence of dental anxiety in Scotland is slightly higher than 7%; that in the United States of America is varied between 6 and 10%. Overall, the researcher in Scotland mentions that dental anxiety prevalence is very different throughout the globe and the variations usually fit into the wide range of 3 to 43%.
Attaullah (2011) assessed a sample of 385 university students in Islamabad to identify the levels of dental anxiety; the findings showed that 21% of the sample had it and just as many had dental fear. The author evaluated this prevalence as high and recommended that another study is done assessing the stimuli that contribute to the occurrence of dental fear and anxiety for a purpose to understand the phenomena and possibly, begin addressing them to alleviate the patients as well as the dentists.
In Romania, Rãducanu et al. (2009) investigated the prevalence of dental anxiety among children and adolescents and pointed out that 21.6% of the sample were recognized as anxious. The children who had the highest levels of anxiety and anxious behaviors were usually younger than 6 years; also, female children were more likely to be anxious than male children. Hamissi et al. (2012) assessed a sample of 780 randomly selected teenagers studying in high schools of Iran and found that the prevalence of anxiety in the group was about 30%, of which 29% had high levels of it and 21% also had levels of fear. Another Iranian study evaluated a sample of 473 participants and showed the prevalence of dental anxiety of about 59%; out of this sample the members with higher levels of anxiety were women; also, the individuals without previous traumatic and painful oral treatment experiences were less likely to experience anxiety (Saatchi et al. 2015).
Hawamdeh and Awad (2013) estimated the prevalence of dental anxiety in a sample of 413 university students and found it to be 36% (mid-level of severity); the researchers’ goal was to find the correlations of anxiety with demographics of the sample. The authors found that dental anxiety was not in correlation with the gender of the respondents and the frequency of their visits to a dentist; the following predictors of dental anxiety were identified: the anticipation of painful sensations and the lack of control over the situation (Hawamdeh & Awad 2013; Viswanath, Kumar & Prabhu 2015). Yip (2012) reported the dental anxiety prevalence rates to be as high as 8 to 12% in the adult population of the United States. Also, the author stated that many female patients suffering from dental anxiety avoided pregnancy for a purpose to stay away from visits to a dentist’s office.
Also, assessing the prevalence of dental anxiety and pain among the children of five years of age Moura-Leite et al. (2008) found that 25% of the sample demonstrated anxious reactions to the visits to a dentist according to the reports of the parents. Dental pain was found to be tightly connected to anxiety. Alaki et al. (2011) researched Jeddah assessing the prevalence of dental anxiety in adolescents and teenagers studying in schools and found that of 518 children, 34% showed high levels of dental anxiety. Moreover, the researchers observed that dental anxiety in the children was in a positive correlation with that of their caregivers.
Shim et al. (2015) offer a systematic review to assess the prevalence of dental anxiety in adolescents and children; the percentage of anxious patients, according to the findings, is 10%. The literature included in the review covered 142 years. The authors report that prevalence tended to become less significant depending on the age of the children (the older the children – the less anxiety); also, they found that girls were more anxious than boys, and the dental pain was a serious contributing factor to the level of anxiety or its presence. Nakai et al. (2006) concluded that anxiety levels were in correlation with the children’s gender (girls were more likely to experience it) and some of the aspects of dental treatments such as invasive procedures, injections, and meeting strangers. Also, the researchers noticed that the dental fear that first appears in childhood tends to become less evident as the people age (Hmud & Walsh 2009).
Alvares Duarte Bonini Campos et al. (2013) assessed a sample of 592 participants and reported that the percentage of individuals suffering from dental anxiety was 15%. The same study also mentioned that the British researchers detected 11% prevalence of dental anxiety in their research, and the Canadian study showed the prevalence of this phenomenon as high as 31% (Alvares Duarte Bonini Campos et al. 2013). Some other studies conducted in Brazil reported the dental anxiety prevalence equal to 17, 18, and 32.5% (Alvares Duarte Bonini Campos et al. 2013). Also, the anxiety prevalence was higher in female samples than in male ones, which allows one to conclude that females are more likely to be affected by this phenomenon (Al-Afaleg 2011; Al-Khalifa 2015).
Also, some researchers pointed out that rural dwellers tend to experience a higher level of dental fear and anxiety than the residents of the urban centers (Malvania & Ajithkrishnan 2011).
Risk Factors
Along with the epidemiology of dental anxiety, many researchers focused on the major risk factors contributing to its development and severity. In particular, the scholars identify a multitude of different impacts, however, many of them tend to repeat from one patient to another (Appukuttan et al. 2013; Bhola & Malhotra 2014). To be more precise, one of the most commonly found risk factors is the frequency of visits to the dentist; the individuals who attend a dental professional more often tend to have a lower prevalence of dental anxiety (Gaffar, Alagl & Al-Ansari 2014).
Moreover, another risk factor is the presence of a chronic dental condition and the need for multiple and frequent treatments during which the patients feel pain and discomfort (Gaffar, Alagl & Al-Ansari 2014). Also, one more significant driver of dental anxiety is the quality of an individual’s dental hygiene – this risk factor includes such behaviors as replacing toothbrushes, visiting the dentist for checkups, using mouthwash, brushing the teeth every day (Bhola & Malhotra 2014). Practically, the researchers found that individuals whose dental hygiene is poor tend to have a higher level of dental anxiety (Bhola & Malhotra 2014).
Moreover, Tellez et al. (2014) found a strong correlation between the painful experience during the last visit to the dentist and the following dental anxiety when facing the need to have another dental appointment. Swarthout-Roan and Singhvi (2013) and the University of Adelaide (2016) connected the prevalence of dental anxiety in female patients with the traumatic experiences of the past such as rape and molestation. Practically, the invasive oral procedures carried out by the dentists and the patients’ lack of control over the situation were named as the primary sources of distress and fear.
The prevalence of dental anxiety in children was explored in Brazil by Oliveira and Colares (2009) who connected it to the dental pain that occurs due to caries; they also related it to such causes as dental fear of the parents and previous painful experiences of visiting a dentist; another factor driving dental anxiety was the age of a child that was related to the fear of meeting strangers. Moreover, Kanegane et al. (2006) attempted to relate dental anxiety to the education and income level of their sample and found connections; however, they concluded that about 50% of their sample carried the fears as the results of previous dental treatments. Akeel and Abduljabbar (2006) named the level of education as a risk factor for dental anxiety. Serra-Negra et al. (2011) found that having experienced a dental treatment recently or expecting it shortly increases the levels of anxiety.
In Australia, the researchers found that about one out of six adult dental patients is affected by various levels of fear and anxiety related to the dental treatment; the prevalence of the same phenomena is lower in children – one in ten child-patients experience them (The University of Adelaide 2016). About 5% of Australian patients suffer from high and severe levels of dental anxiety. These are the levels that are capable of producing adverse effects on the patients’ quality of life. Moreover, just like American researchers, scholars from Australia found connections between dental anxiety in women and the traumatic experiences from the past related to sexual abuse (The University of Adelaide 2016).
Finally, another risk factor is knowledge of dental procedures. In particular, the students studying to become dentists tend to have a lower prevalence of dental anxiety than the people whose knowledge of dental treatments is more superficial (Sghaireen et al. 2013).
Vulnerable Groups
Frydendal Hoem and Marlén Elde (2012) described the Seattle System that distinguishes between four groups of dental patients based on the causes of their dental anxiety. The first group is ‘Anxiety of Specific Stimuli’, it involves the patients whose fear is triggered by the specific visual or audial factors such as needles, the sound of the drill, the idea of having a tooth removed, and sitting in the dental chair, to name a few (Appukuttan et al. 2013). The second category is ‘Distrust of Dental Personnel’, it includes the patients who are anxious due to the need to interact with an unknown individual (the dentist) and have no control over the situation (Frydendal Hoem & Marlén Elde 2012).
In particular, such patients are anxious about their dentists being rough while providing treatment or concerning only about their money but not about the needs and comfort of the patients (Frydendal Hoem & Marlén Elde 2012). The third group is ‘Generalized Anxiety’, it concerns the patients who have anxiety in general; they are likely to be highly unsettled by a visit to the dentist (Frydendal Hoem & Marlén Elde 2012). Finally, the fourth group is ‘Anxiety of Catastrophe’, it involves the patients who tend to feel paranoid about the potential adverse outcomes of the dental procedures such as numbness not going away after the treatment is over, or an unexpected allergy to a certain medication used on them (Frydendal Hoem & Marlén Elde 2012).
Impact on Patients Direct & Indirect
First of all, due to the avoidance of dental treatments and regular checkups, anxious individuals are likely to develop dental issues and have deteriorating dental health (Gaffar, Alagl & Al-Ansari 2014). Consequently, it is possible to assume that the poor dental health would affect the quality of life of the individuals adding stress from dental pain, communication issues due to halitosis, employment issues, and unsatisfying personal image (if one’s teeth are visibly affected by a condition) (Frydendal Hoem & Marlén Elde 2012). Also, The Swedish authors Wide Bouman et al. (2013) pointed out that dental anxiety is a rather serious problem for the patients and it may produce and very significant adverse impact on the life of an affected individual. The Swedish researchers stated that this issue is in strong connection with the other types of anxiety and mentioned that it can lead to the reduction of a person’s quality of life and cause social isolation (Wide Bouman et al. 2013).
Effects on the Dental Professional
From the perspective of a dentist, anxious patients are very difficult to work with because they tend to disrupt the work of a dental professional or even prevent them from performing their duties well (Madfa et al. 2015). Also, a patient who is unsettled and restless tends to endanger themselves due to startling, moving, and using their hands to interfere with the dentist’s work (Madfa et al. 2015). Moreover, as pointed out in the research conducted by Madfa et al. (2015) in Yemen, dental anxiety experienced by the patients can cause the deterioration of the relationship between the client and his or her dentist and even result in misdiagnosing due to the patient’s unsettled behavior during the dental examination or treatment procedures.
Management of Anxious people
To be able to deliver high-quality and safe dental care, a dental practitioner is to know how to manage anxious patients. There exist methods that could help a dental practitioner achieve a calm and harmonious environment while delivering dental care (Frydendal Hoem & Marlén Elde 2012). Adult patients are easier to manage than children (Frydendal Hoem & Marlén Elde 2012). Adults can be reasoned with and are more perceptive of motivation and soothing communication (Frydendal Hoem & Marlén Elde 2012; Gao et al. 2013).
Management of dental anxiety is critical because it produces important benefits for both the patient and the dentist; due to the elimination or minimization of dental anxiety and its effects, the patients can receive a safer treatment of higher quality, and the dental professionals can work faster and more successfully; besides, both parties find themselves in a calmer and stress-free environment (Madfa et al. 2015). DeNitto (2009) identified that the invasive dental procedures such as root canal procedures and dental surgeries are usually surrounded by fears and anxiety of the highest levels due to the patients’ negative perception of these types of treatments. The researcher connected them with the invasive nature of the procedures that is related to fearful expectations of pain and proposed audiovisual distractions as reconditioning factors to reduce anxiety.
Techniques for Helping People with Dental Anxiety
The Nigerian researchers Koleoso, Osinowo, and Akhigbe (2013) argue that the pharmaceutical treatment of dental anxiety may have dangerous consequences and offer relaxation therapy and cranial electrotherapy stimulation as ways to address the problem. The researchers state that dental anxiety is a serious factor that usually contributes to the deterioration of dental health (Woodmansey 2010). One of the major techniques for work with anxious individuals is the one known as iatrosedative (Frydendal Hoem & Marlén Elde 2012).
This technique is based on the calming and confident conduct of the dental practitioner that ensures a patient’s trust and calms him or her down (Frydendal Hoem & Marlén Elde 2012). Some other techniques include rehearsal, where the dentist demonstrates their actions to the patient before carrying them out, and behavioral control, where the dentist and the patient work out a system of signals that would provide the latter with more control of the situation (Frydendal Hoem & Marlén Elde 2012). Also, for the patients who experience distrust of the dental professional, there are two helpful techniques – informational control (the patient learns about the treatment and develops a better idea of what would be happening during it) and building a trustful relationship with the dentist – this approach may take some time and work after several visits (Frydendal Hoem & Marlén Elde 2012).
Moreover, for the patients whose dental anxiety is caused by their general anxiety, the techniques for the latter are the most helpful; they include distraction, relaxation, cognitive restructuring, guided imagery, and thought to stop. (Frydendal Hoem & Marlén Elde 2012). Finally, for the patients suffering from what is known as the anxiety of catastrophe, the approaches, and helpful techniques are based on the establishment of a trusting relationship with the dentist and developing the feelings of calmness and confidence that can be achieved with the help of the iatrosedative technique (Frydendal Hoem & Marlén Elde 2012).
Assessing Dental Anxiety
The patients’ levels of dental anxiety and fear can be assessed by dental professionals and researchers for different purposes. There is a variety of scales and questionnaires helping to carry out a survey that would allow the evaluation of the severity of dental anxiety experienced by the patients. For instance, some of the most commonly applied questionnaires are titled the Dental Anxiety Scale (DAS) and the Modified Dental Anxiety Scale (DAS) (Madfa et al. 2015; Minja, Jovin & Mandari 2016). One more assessment is known as the Dental Fear Survey (DFS); finally, another well-known assessment tool is the Dental Belief Survey (DBS) (Frydendal Hoem & Marlén Elde 2012). Due to the variety of tools, each practitioner may choose the ones that are particularly suitable for the objectives of their assessment in particular. Al-Namankany, de Souza, and Ashley (2012) concluded that none of the existing scales is suitable as a golden standard for measuring anxiety in all types of child-patients.
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Medical science has already revealed methods to make the treatment process as much comfortable for the patient as possible. Indeed, these days even a visit to the dentist is quite a tolerable procedure, as there are psychological and physiological approaches to the matter, which allow patients to feel safe during the process. The treatment is usually divided into stages that include verification of the psychological problem and further proceedings with the patient in order to make him or her comfortable. This paper will review some of them and provide an example of a conversation between a patient and doctor.
Managing Dental Fear / Anxiety
In order to find out the most effective ways to cope with the patient’s dental fear, one might consider those methods which will be applicable in accordance with the state of a client. First of all, it is critical to outline the fundamental importance of procedures and interventions that are related to this sphere. The appearance of various complications if some condition is left untreated might contribute to the emergence of the need for more complex or painful procedures. For this reason, it is critical to address the dentist in time and eliminate fear.
Another approach is the provision of patients with an opportunity to select among specialists. Availability of multiple options will have a positive impact on clients’ states as they will be able to cooperate with health workers they consider reliable or attractive to them. This approach shows a high level of effectiveness in various settings. Furthermore, many patients might have fear because of the loss of control. To mitigate this very feeling, there should be an opportunity to make pauses during any stage of treatment and availability of tools to inform about the deterioration of individuals’ state. It will help also help to provide patients with the guarantee of their safety and avoid anxiety or feelings of claustrophobia or similar undesired conditions.
Finally, many patients state that they might feel embarrassed when dentists look in their oral cavity and investigate it. This fear can be mitigated by making a comparison between this and other clinical interventions that are offered with the primary aim to improve the quality of life. In such a way, using these measures, dental fears can be reduced, and patients will be able to enjoy a positive environment.
Managing Dental Gagging
Another undesirable effect of dental treatment is gagging, which might affect the result of doctor’s work. In order to restrict its negative influence, the doctor, as well as the patient, might follow the below-given pieces of advice.
The doctor may apply an isolating interlayer called cofferdam to reduce the negative impact of instruments on the oral mucosa.
The patient is recommended to take herbs and pills with a sedative effect.
It is advised to breathe through a nose to prevent the irritation of the nasopharynx.
The patient also needs to have a meal an hour before the procedure in order to avoid excessive salivation.
Dialogue Sample
Good afternoon!
Good afternoon!
How do you feel? Are there any particular concerns?
I feel fine, thanks for asking. The only thing that concerns me is my last visit to the dentist. I had quite an unpleasant experience and felt threatened by even thinking about the next visit ever since.
I see. Let me help you overcome your fear. What are you afraid of the most?
Well, I am not sure, but I feel really terrified by pain and any unexpected actions during the process.
How do you think, what scares you exactly? Is it somehow connected with the car accident?
Well… It is hard to say. However, I admit that after the accident, I started worrying about anything that I cannot forecast.
Then I guess the problem is connected with the shock you have experienced. After the tragedy, you are threatened with the idea of something sudden, unexpected appearing.
You are probably right, and I need to work on this.
Certainly, and I can assure you that there is nothing to be afraid of, as every step of the treatment procedure will be preannounced. Firstly, I will make an anesthetic injection in order to prevent any unpleasant feelings. After several minutes I will start the procedure by making notifications about the beginning or end of each step. Besides, we might even find a special sign to stop the process if you suddenly feel bad. You will also be provided with a collection of TV shows to distract you during the procedure. Does the strategy describe seem appropriate?
Yes, it does. Thank you for the clarification.
You are welcome. Let’s start the procedure then, shall we?