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Self-image ...

June 1, 2011
Every human being develops a mental image of him- or herself over time that is the result of interactions with many people ...

How patients perceive you

by Dianne Glasscoe Watterson, RDH, BS, MBA

Every human being develops a mental image of him- or herself over time that is the result of interactions with many people, including parents, siblings, teachers, and peers. Self-image has been described by educators with the famed Cleveland Clinic as "an internal dictionary that describes the characteristics of the self, including intelligent, beautiful, ugly, talented, selfish, and kind. These characteristics form a collective representation of our assets and liabilities as we see them." How you feel about yourself can and will affect the quality of relationships you form with patients, coworkers, family, and friends.

What is self-image?

Self-image is our self-portrait. It is not necessarily what we see in the mirror, as that image may be real or distorted. The people with whom we shared close relationships while growing up sent us messages that were either positive or negative. If the messages were generally good, we are more likely to see ourselves as being worthwhile. However, if there was a history of regular negative feedback, such as being oft criticized, teased, or berated by others, we are more likely to struggle with poor self-esteem issues. From the Mayo Clinic: "When you have healthy self-esteem, you feel good about yourself and see yourself as deserving others' respect. When you have low self-esteem, on the other hand, you put little value on your opinions and ideas, and you constantly worry that you aren't good enough."

Our culture is intensely preoccupied with body image. Unfortunately, many people develop poor self-images because they are not able to achieve what they consider to be the "perfect" body. Some live lives of extreme rigor and discipline to maintain what they consider to be a superior body image. Mental illnesses, such as anorexia nervosa, cause an individual to see a distorted image when viewing his or her own body in the mirror.

In addition to the physical self-image, every person has an emotional self-image. When a person is unhappy with his or her body image, there is continual emotional discontent. Some have learned to be accepting of their physical appearance and tune out the negative cultural vibes. The outward body is the shell, but who we are resides on the inside. Choices we make have an impact on how we feel about ourselves. We can choose to be honest, moral, and caring, or we can choose to be dishonest, immoral, and uncaring. Those choices affect our emotional self-image.

The pitfalls of an overly high or poor self-image

While it is best to be balanced, some people develop a self-image that is overly high. Such people have an inflated sense of self-worth and often feel superior to others. These feelings can lead to arrogance or self-indulgence and make the individual believe that he or she deserves special privileges. Dental professionals with an overly high self-image tend to evoke feelings of resentment and turn people off when attempting to engage in personal interaction.

A dental professional with an inflated self-image may unknowingly cause those with whom they interact to feel inferior. They may carry on conversations that include over-the-top self-promotion, braggadocio, or even back-handed compliments. For example, a dentist once commented on the company where a patient in his chair was employed by saying, "I see you work at XXX. I'm surprised a smart lady like you would work at a place like that." Needless to say, the patient was offended by this dentist's derogatory comment. (The patient was my mother.) It is typical for prideful people to disconnect from those whom they feel do not measure up to their level of superiority; i.e., the little people.

At the other end of the spectrum are those with a poor self-image. When a person has a poor self-image, he or she sometimes develops a "poor me" complex. Such individuals often focus on their perceived weaknesses and give little credit to their own skills and assets. They feel they can never quite measure up. A dental professional with a poor self-image may have feelings of inadequacy and/or inferiority. These feelings, if pervasive enough, can be translated by others to be aloofness or an uncaring attitude. Interestingly, a poor self-image can also elicit feelings of impatience, sharpness, defensiveness, unhappiness, even hostility. People with a poor self-image do not "like" themselves, and deep down they cannot conceive why anyone else would like them either. It is not unusual for people with a poor self-image to lash out at others.

Self-image and patient communication

A healthy self-image is found somewhere between the two extremes. A person with a healthy self-image recognizes his or her good characteristics as well as the flaws. When one understands his or her own worth, it becomes easy to respect others.

A dental professional's self-image can affect his or her ability to communicate effectively with patients and coworkers. A healthy self-image projects confidence, mental stability, assertiveness, and resilience. Dental professionals with a positive self-image are generally happy. Patients perceive when their caregivers are happy and well-adjusted, and respond positively to those who focus on their needs.

How your patients perceive you

It is reasonable to assume that patients develop a perception of you based on many factors, including your physical appearance, disposition, level of friendliness, caring attitude, appearance of your operatory, and delivery of care. Is one factor more important than the others? Several patient interviews based on the following questions revealed some interesting perceptions:

  1. When you think of your dental hygienist, what first comes to mind?
  2. How would you describe her appearance?
  3. Is her appearance important?
  4. How does she make you feel when you go in for preventive care?
  5. Do you dread going to see your dental hygienist?
  6. How would you characterize your most recent visit?
  7. Anything else you'd like to add about your dental hygienist? Would you/do you recommend her to others?

Five points of view

Jillian (young professional) – "My hygienist is professional, not too stuffy, and she makes me feel relaxed and welcome. My dental hygienist always asks me if I'm flossing. I feel like I'm always being grilled about my home care. I guess that's part of her job. I had bad dental experiences growing up and very bad teeth. So I have lots of anxiety about going to the dentist. I like the water tools she uses, and her chit-chat relaxes me. I drive 45 minutes to this office, and I have referred lots of friends and family. One of the things that impressed me most was that they sent a beautiful packet with information about the practice. Nobody made me feel ashamed of my ugly teeth. In fact, I feel OK about spending large sums of money to get good teeth. I plan to never leave this practice."

Sarah (hotel concierge) – "My dental hygienist is the 'motherly' type in a good way. She's a suburban mom, very professional, and well-kept. I think she has to look good because she's a professional. Sometimes I feel guilty when she says, 'Wow, your gums look great – I can see you've been flossing,' when in fact I have not been flossing. I like her a lot."

Jenny (registered nurse) – "When I think of my dental hygienist, the first words that come to mind are capable, clean, and professional. Her clean appearance is important to me in particular since she will be working in my mouth. I never dread going to see her, as I know I'm doing a good thing for my own health. My visits are not rushed or prolonged but just right. I have recommended her to others. But one thing that makes me feel very uncomfortable is when she complains of not feeling well. If she's not well, she should not be working at all!"

Kay (CPA) – "When I think of my dental hygienist, my first thought is 'Oh, no, not that time already!' Her appearance is very clean and professional. That's important to me, because if she had metal all over her, I would be out of there! She makes me feel welcome and she is friendly, except for one time when she insinuated that I hadn't kept my teeth brushed. The girl before her told me how nice I kept my teeth. I do dread going to see my hygienist because I have to have my teeth scraped and poked. I want my visits to be quick because I miss work. The office used to open at 7:00, which was more convenient. I don't want chatty, and I don't mind quiet. I don't recommend her to others, because I don't even know her name – isn't that a pity?"

Steve (businessman) – "My dental hygienist is generally pleasant. Her appearance is important to me, because if she doesn't look together, what about her office and dental equipment? She makes me feel welcome and seems glad to take time with me. I never dread going to see her, and I have recommended her to others. My former hygienist was fired for always complaining."

In conclusion

The way in which patients perceive their dental hygienist can affect the quality of communication and interaction. From the patient interviews, two factors stood out:

  • The appearance of the dental hygienist is important.
  • What patients remember most is how their hygienist makes them feel. The way a dental professional feels about him or herself affects how patients feel about their provider.

Self-image is not static; it changes over time as a person matures and develops according to situations in life. Everyone goes through times when they feel insecure about their appearance, abilities, or accomplishments. It's when the negative feelings become long-standing that self-esteem suffers. A person's own thoughts have the most impact on self-esteem. Fortunately, one's thought process is one aspect of self-image that can be controlled. People can learn to reframe negative thinking that tends to focus on weaknesses and flaws.

Dianne Glasscoe Watterson, RDH, BS, MBA, is a professional speaker, writer, and consultant to dental practices across the United States. She is CEO of Professional Dental Management, based in Frederick, Md. To contact Glasscoe Watterson for speaking or consulting, call (301) 874-5240 or email [email protected]. Visit her Web site at


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