Episode #229: Dr. Ben Bernstein – Helping Dentists Perform At Their Best

Dr. Eric Block: Welcome to the Stress-Free Dentist Podcast. I’m your host, Dr. Eric Block. As always, I want to inspire, entertain, and educate you on the best tools and technologies out there. My goal is to help make your practice and career more profitable, efficient, and most importantly, more enjoyable.

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Hey everyone, welcome back to another episode. And today I am joined by Dr. Ben Bernstein, who is a PhD in psychology. Uh, Ben, thanks so much for joining us.

Dr. Ben Bernstein: I am so delighted to be here. I’ve been listening to your podcast, and I am all for the stress-free dentist, so thank you for having me.

Dr. Eric Block: Yeah, it’s great to meet you. And, um, you know, you call yourself a performance psychologist. Can you tell me exactly what that means and how you differ from a traditional psychologist?

Dr. Ben Bernstein: Yeah, so I’m happy to. Um, so my, uh, focus for the last 45 years has been on human performance. Uh, what are the conditions that people—particularly people in high-stress, high-performance endeavors, occupations—uh, what do they need to really perform at their best under pressure? So, thriving under pressure, how to perform. So that’s my focus.

I work with, um, Olympic athletes. I work with, uh, surgeons. I work with lawyers and, um, parents, and, uh, a lot of test takers of all ages, you know, who crumble when they go to take a test. So, um, I have focused on that. I was trained as a traditional therapist, but I found that psychotherapy, um, though it gave me a lot of insights and a lot of skills, it wasn’t my preferred mode of working. I’m a very active guy.

I like to really get in there and, uh, and, you know, just work with people to see what they need to perform at their best. So I developed a model—a performance model. That’s the subject of my three books, and that’s what I train people in, whoever I’m working with. Same model, but different circumstances.

So, uh, yeah, it’s all about human performance. I just want people to perform at their best. And, um, it also comes outta my own learning, you know, in terms of my own background and, uh, different high-stress, pressure performance situations that I’ve been in, that I had to learn how to handle all of that.

So that’s the difference. And I don’t know other people who call themselves a performance psychologist. I gave myself that because, um, say "psychologist" and people usually think two things. One is you’re diagnosing them as they’re speaking, which I’m not. And then the other is that you’re a therapist. So I’m not diagnosing, and I’m not doing therapy. I just want people to perform at their best.

Dr. Eric Block: That’s great. And, um, you know, dentistry is definitely a high, a high-stress, um, high-pressure job. How did you end up working with dentists?

Dr. Ben Bernstein: Well, it dates back to when I was in graduate school, which feels like 200 years ago. Um, I was at the University of Toronto, and I, um—I’m American—but I was doing my graduate work up in Canada. And, um, I needed some real dental work, and I didn’t have much money. And somebody said, "Hey, go to the dental school," you know, ’cause you could go.

So I went, and, um, I just realized that I had had a bunch of dental work in my mouth. My oral hygiene as a kid was not good, you know, did a lot of sweets, all of that business. And, um, but this was the first time I was in an environment where people were being trained to be dentists. And it was so stressful, it was so high-pressure.

And I’m now a graduate student of psychology, and I’m looking at these people, I’m thinking, "Whoa, this is really hard." You know? And I came to find out later that dental schools depend upon the students—third- and fourth-year students—to bring in income for the dental school. So there’s a lot of pressure, and it’s, um, it’s just really difficult. It’s such a difficult field. So that’s when I started to clue into it. You know, I mean, dentistry, general dentistry—four years—it should probably be six, you know, just because of the specificity of the training.

Dr. Ben Bernstein: Fast forward—I have a phenomenal amount of dental work in my own mouth. So I probably have 20 crowns. I don’t know how many root canals, three implants. I once had five teeth knocked out. I mean, I just, um, I’ve spent a lot of time in three different dental schools and four different countries, and I’ve just had a lot of experience in the dental chair, you know, as a patient and then observing what goes on.

And I just kept thinking, man, all these people—not just the dentists, the assistants, the hygienists, the front office people, the back office people— all need help. It’s a very high-stress occupation, as you well know.

Dr. Eric Block: What do you think makes dentistry, uh, one of the most stressful professions out there? And then just a, uh, a tag on that question. Did you notice any differences from the different, uh, when you’re in different countries getting treatment? Or was it a lot of similarities?

Dr. Ben Bernstein: Um, that’s, that’s a really good question. I have to think about that a little bit more. Um, for the most part, it’s quite similar. I mean, culturally, of course, there are differences about how people are talked to and treated and things like that. But, um, the first part of your question about what is it that makes dentistry so particularly stressful—so in the healthcare professions, um, of which, you know, you are and I am, um, the focus is on the interaction with the patient.

And dentists have a very limited interaction with the patient because you’re working on their mouth—hard to communicate. Um, that’s one thing. The other thing is, and in my experience—and now my experience is limited to the dental schools that I’ve worked in, and I have worked in two different ones, so I can’t make this as a categorical statement and I won’t—but in my experience, the students aren’t really trained to deal, really trained to deal with the more human aspect of dentistry.

Dr. Ben Bernstein: The interactive aspect, let me put it that way. So what makes dentistry particularly stressful is that a dentist will come in and, you know, Mr. Jones will be sitting in the chair, grabbing onto the arms, and the dentist will say, "Oh, Mr. Jones, how are you doing?" And he’ll say, "I’m good, I’m good."

But what’s really happening, that I discovered, is that the dentist often—not always, but often—has a front of "How are you, Mr. Jones?" but inside the dentist is actually feeling what Mr. Jones is feeling. Okay? So there’s a psychological term—I think I may have coined it—called the "induced reaction," which is that sensitive healthcare people actually get induced into the state of the patient.

Which diagnostically can be very helpful to realize Mr. Jones is freaked out and he doesn’t want to be here, and all of those things. But you don’t want to pick that up and hold that, because what happens for a dentist—and I’ve heard this innumerable times in workshops that I give all over America—there’s a split between "Hi, Mr. Jones," and what’s going on inside.

And that split is very, very hard to manage. I mean, that split itself is quite stressful—that you’re doing two things at once. So I would say that’s the more personal part of dental practice.

Dr. Ben Bernstein: You have to run a business. You have to manage a staff. These are not skills—they may be touched on, and most dental schools will do some kind of work on that—but running a business and managing a staff are very different kinds of skills than, you know, than basically microsurgery that you’re doing in a person’s mouth.

And so, I’m sure you know as well as any dentist that office dynamics and, um, what people come into work with—not only yourself, but your hygienists, your assistants, your office people—it’s a lot of work. And then the overhead is so high, and insurance, and we can just keep adding it on and on and on.

Plus, often when people get out of dental school, they’re starting a business. They may even be building a building. They may be starting a family, and it just, you know, one thing leads to the next. So the pressures really do build up.

When I used to travel around the country for the ADA as a speaker, I would look out on the audience and I would just see so many people who looked tired, you know, and who looked really kind of worn down—and some, a fair degree of unhealthy-looking people. And, you know, in a healthcare profession, you want to be healthy. I mean, you want your practitioners to be healthy, right?

So, yeah. All of those reasons—it makes it, it’s a very, it’s a unique profession in that way. And I don’t think people realize the complications and intricacies of running a practice, of being a dentist. And I’m talking about general dentists. When you get into the specialists, you know, it’s about other aspects of that as well.

Dr. Eric Block: Yeah. You know, in school, we talk, um, not almost to the patient, but over the patient—commonly to our professors. You know, "Hey, uh, professor, you know, the patient’s, you know, she’s not biting correctly. She’s not biting down the right way." We’re talking about them and not to them. Um, uh, so there’s, you know, so many things that we didn’t quite learn with patient or staff management.

And, um, you know, it definitely came with experience for me. Um, I do wish that I had taken more classes on leadership and public speaking and, yeah, and behavior management and how to work with staff. And, um, but you know, when you’re in school, you just want to just—you want to just graduate and, you know, pass your clinical…

Dr. Ben Bernstein: Of course you do. Of course you do. That’s, that’s part—that’s a fault—of the whole, our whole education system, which is all geared to getting out, right? It’s not really geared to being in. You know, you have two young kids, I’m sure you know what I mean. It’s like—we’re always into, what’s the next thing?

I’ll give you a really good example of this. At one dental school, I was asked to co-teach a class for third years in chairside ergonomics, because dentists develop, as you well know, a lot of different chronic pain. And so, the dentist faculty member said he was going to take pictures of people in odd, weird positions and talk about that. And then I was going to give students the pointers about how to not take on all that physical stress and duress on their body.

It was a great lecture—very animated. I was really involved. Well, wouldn’t you know, one student came up to me at the end of the class and said, "How much of this is going to be on the final?"

Dr. Ben Bernstein: And I was like, oh, goodness. My heart just went out to her. It was like—the rest of your life, this is like… you know? But this speaks to your point. We just, we want to move on. We want to get out of here.

But I’m sure—I know—there are a lot of good things going on in good dental schools all over the place, for sure. However, you’ve got to complete your requirements and all that.

I want to say one other thing to you—or tell you one other thing, if you don’t mind. This business about "over the patient"—I stood by a chair when a student had finished one procedure and had to call the faculty over. I don’t think people understand how people get trained in dentistry, but every procedure has to be checked, right? On a list.

And the faculty dentist came over, looked in the patient’s mouth just like this, and said, "Oh my God." And the poor patient was lying there with her mouth wide open, and the student looked like she was just gonna lose it. Of course. You know? So it’s, um, yeah, it’s complicated. It is. It’s a complicated profession.

Dr. Eric Block: I think from now on, whenever my wife asks me a question, I’m going to ask right back, "Is this going to be on the final exam?"

I love that statement. It’s just so true. But, what would you say are some red flags that a dentist just isn’t handling the stress in a healthy way?

Dr. Ben Bernstein: Yeah, well, some of the standard ones—and obvious ones, but they need to be said—are exhaustion and irritability. Okay? If you’re getting too tired, your fuse gets shorter. There’s no question about it. This is true in any field. I mean, I work with professional athletes and, you know, one of the things we have to make sure is that they’re getting proper rest, and that they’re really recouping.

Irritability, short temper, or difficulty focusing—any of these are signs that the stress is building. There’s a scientific relationship between stress and performance that my work is based on. You’ve probably heard of this—the Yerkes-Dodson curve. It’s a bell curve: too little stress, performance goes down; too much stress, performance goes down. But just the right amount of stress is where we perform at our best.

Dr. Ben Bernstein: When you start to go over the top into too much stress, what’s going to show up is problems in teamwork, decision-making, being able to carry out complex tasks over a period of time—and dentistry is just filled with complex tasks over a period of time. So, those are the symptomatic things.

For a while, I was working with the California Dental Wellness Committee. So these are dentists who would have lost their license had they not been caught with alcoholism or drug addiction, or some other addiction. And there they were, given the opportunity to work on themselves in various ways. This goes on in different states—to work on themselves—and one of those ways is to come to a therapist or a psychologist. And I was chosen to be one of those people.

Dr. Ben Bernstein: What I became aware of in that process was that what happens often is that the dentist I was talking to would get used to increasing amounts of stress, so that zone kept moving. That’s not productive, okay? And it goes on incrementally—it makes sense. There’s nothing bad or wrong about the person, but as time goes on, you get older, the bills get higher, and that stress threshold keeps moving—and it wears you down.

So, having a drink, going online, looking at pornography—I mean, there are many different things people do to relieve that. I don’t call them bad habits. I don’t like to categorize people that way. They’re unproductive. They don’t lead you to where you want to go. They’re not healthy in the sense of your being available to your patients, to your staff, and then to your family.

Another sign is that there are family problems—issues that go beyond the usual ones of having a spouse, kids, a house, and whatever the challenges are these days—and there are many these days. You want to look for the unproductive behaviors that can keep going if they’re not really checked.

Dr. Eric Block: What are, what are actually some good ways, um, for a dentist to reduce stress?

Dr. Ben Bernstein: I’ll tell you two that come to my mind immediately. One of the most successful dentists I ever met and worked with had a wonderful practice—practice in his practice. In other words, he had a daily practice. And what he did on a daily basis—and I would encourage anybody listening to this to do this in their own way; you don’t have to follow this exact way—but the practice was great, which was to show appreciation for every member of his staff every day.

Now, to some people, that may sound a little extreme—and it might be—but appreciation is such a stress-reducing tool. I don’t think people realize how much it really helps. I mean, my wife and I have been married for 33 years, and in our early years, we had a lot of conflict, and we had to go to a therapist. We have two very different cultures. And what the therapist taught us was how to appreciate each other.

Appreciation means perceiving value and expressing gratitude. So, you say to your assistant, “That was so helpful when you anticipated my, you know, what I would need,” right? “And I’m so grateful to you.” So you’re perceiving value, and you’re expressing gratitude. This is a great stress reducer—for the person giving the appreciation and the person receiving it—because you want to spread this throughout the office.

Dr. Ben Bernstein: Now, on a personal level, one of the things I have found dentists find so helpful is the following. Well, just to back up a little bit—one of the things I noticed when I started working chairside and watching dentists is that patients would be holding their breath. And what I noticed is that the doctor was holding her breath—or his breath. That’s another induced reaction, right?

Patient is there, doctor is there—holding your breath. Your brain thinks you’re dying. So your stress is going up, not down. Okay? So, I’ve had dentists come to me in workshop breaks and say, “I don’t have time to breathe.” Okay? So, you know, it’s funny—it’s not funny. It’s both. You’re breathing all the time!

So here’s what I recommend. And I know what they mean—they’re going from operatory to operatory, the schedule is as tight as can be. I totally get it. Here’s what I recommend to everybody:

When you move from one patient to another—even just around a wall—stop midway. This takes five seconds.

Close your eyes.

Exhale through your whole body, down to your feet, into the floor.

Inhale all the way up.

Open your eyes.

That’s it. Five seconds. That’s a reset button. You’ve switched out of your sympathetic nervous system into your parasympathetic nervous system. You’ve let go of what just happened, and you’re ready for what happens next. Because every patient wants to feel that you’re with them, not with the person before. That’s an incredibly simple technique.

Dr. Ben Bernstein: And the dentists that have done it have reported back to me: “Dr. B, that was kind of magic.”

I have to tell you one more thing, which is that dentists aren’t taught about the visual system. The visual system is separated into central vision and peripheral vision—foveal vision and peripheral. Central vision is hardwired to your sympathetic nervous system. So when you are in a patient’s mouth, and you’re looking through loupes, you are in your sympathetic nervous system—fight or flight. It’s happening. You don’t even realize that it’s happening.

So that’s essential—you’ve got to be there—but you have to switch out of that occasionally. How do you do that? Just look at the tray. Look out the window. Just open up your peripheral vision even for a few seconds. It’s very restorative.

So those things are small, but they’re very effective. And these small, effective things—when done repeatedly—will keep stress at a much better, optimal level.

Dr. Eric Block: I feel like that is a great tip for especially endodontists that are looking through microscopes, and they have to keep their heads so still—yeah, absolutely. And they’re hyper-focused on that central… um…

And I just wanted to tag on the appreciation tip. Yeah, yeah. I found it extremely powerful to show appreciation to a staff member in front of the patient.

Dr. Ben Bernstein: Yes.

Dr. Eric Block: Another staff member.

Dr. Ben Bernstein: Beautiful.

Dr. Ben Bernstein: That’s great. Yeah, just make sure you spread it out.

Dr. Eric Block: Yeah, yeah, exactly. Um, why—

Dr. Ben Bernstein: "Do you appreciate her more than me?" And I—

Dr. Eric Block: Yeah. Yeah, yeah. You gotta be careful of that.

Um, all right. Um, this was an amazing episode. I want to wrap up with two final questions.

Dr. Ben Bernstein: Yeah, please.

Dr. Eric Block: Um, number one: how do we find out more about what you’re up to? And you can leave, you know, an email, phone number, website—you know, where to really find your books.

And then the final question: what advice would you give to the young dentists out there right now?

Dr. Ben Bernstein: Sure. So, um, let me start with that, which is the advice—if it’s okay with you—with the advice I give to them. Um, your health is absolutely paramount. You’re a healthcare professional. You’re entering into a very, um, important field that you’re responsible for, contributing to other people’s health. You can only really do that well, the healthier you are. And I just have to encourage everybody—every young dentist—pay attention to your health. Get the exercises you need, eat the right foods, get enough sleep. It’s very easy to slide into all the pressures and to give yourself over to that. However, if you are not healthy, it’s very hard to really minister—and I say that, I use that word, um, uh, purposely—it’s really hard to minister to other people fully.

And I know this from my own experience. I’m a person who suffered from two serious addictions for years—years ago. Still in recovery, still go to 12-step meetings. The healthier I’ve gotten over the years, my work gets better and better and better. Take care of yourself.

Okay, so, um, about—uh, what do you have to say about that, Eric? I gotta ask you that.

Dr. Eric Block: I think that’s great. Uh, and guess what else? You know, burnout—it ain’t good for business. You know, if you’re a stressed out, burned out dentist, you’re not gonna be productive. Um, so it’s—it’s win-win for your mental health and your productivity.

Dr. Ben Bernstein: Exactly. So, let me say one more thing about that, which is—we talk about mental health, physical health. We don’t talk about spiritual health. And I don’t—I’m not bringing in religion here. I’m bringing in the human spirit. Human spirit is what fires you up. That’s what makes you want to be a great dentist.

And paying attention to those three—I use a model of the three-legged stool: mind, body, and spirit. Usually we don’t talk about the spirit. When all three legs are equally strong, it’s a very sturdy platform. When one of the legs starts to slip, the whole thing starts to topple. So in my work, what I work with people is—we get a reading on this right away. Where is it wobbly? In your body? Your mind—are you giving yourself negative messages, positive? Or your spirit?

Dr. Ben Bernstein: You have goals? Are you following your goals? Um, okay. How to contact me? Uh, best way, most comprehensive way, is my website drbyourbest.com. Um, everything is on there. Um, you can order my books, you can, uh, contact me.

Last couple of years I started to train people to do what I do. And so, if you have a team and you want to talk about how do you train the whole team in these three things—it’s how to be calm and confident and focused when you’re facing any challenging situation—definitely contact me. Because I am so enjoying working at this new level of, of, uh, experienced professionals, um, who wanna now carry this work forward.

So I so appreciate talking with you, Eric, and, uh, you’re inspiring me, so thank you.

Dr. Eric Block: Oh, thank you, Dr. Ben Bernstein. Uh, excellent episode. Thanks so much for joining us.

Dr. Ben Bernstein: My pleasure.

Dr. Eric Block: Thanks again for listening to the Stress Free Dentist Podcast. And don’t hesitate to get in touch with me at info@thestressfreedentist.com.  And if you haven’t already, please subscribe on your favorite platform and leave us a review.

Until the next episode, I’m Dr. Eric Block, the Stress-Free Dentist.