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What a visit to the dentist taught me about trust

How trust can change the way you look at the world.

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My dentist’s office is located in a busy street, just off of the Parliament Square in the city of Santiago de Compostela, in the north of Spain. Santiago’s population doesn’t reach 100,000, but each year, 3 times that number of people walk up to 800 Kms to reach its breath-taking and tear-inducing cathedral, on a pilgrimage which can take any of 10 different routes, crossing mountains, bustling cities, hamlets, rivers, seaside locations, and more. Whether people do it for religious or non religious reasons, we can be certain of one thing: the journey is of the transformative kind.

That crossed my mind several times while I sat in the dentist’s chair, for 2 hours that felt as long as 4, while my dentist harvested my blood to create new gums, and then carefully stitched up 4 tiny membranes – sewing in much the same way as am experiences seamstress might with a patch of cloth. A procedure known in the industry as gum graft. It was then that I realised to what extent the future aspect of my mouth and my ensuing well-being were in the hands of this dentist. More than in my own hands. Was this a person that I could trust?, I asked myself, again and again.

What is trust?

According to one definition, trust is the “intention to accept vulnerability based on positive expectations of the intentions or behavior of another” (Rousseau et al., 1998, p. 395). Put simply, I put my mouth in the dentist’s hands simply because I expected him to have the very best intentions (To make it healthier) and that he would behave accordingly. In this sense, trust is a decision, although one driven by the limbic brain, which evolved with the appearance of mammals to generate states of pleasure or discomfort, what we usually call “emotions”. And because trust is a decision, it warrants the question: why and when, do I decide to trust? And what’s the effect of the opposite decision, i.e. the decision not to trust?

When I had decided, a few weeks back, that I would go ahead and let this dentist perform my surgery, he’d not only been recommended to me by someone I trust, but his clinic, one of the largest ones I’d ever set foot into, had conveyed to me the kind of authority that success commands. Nonetheless, as I sat in the chair, and the agony of 15 minutes of surgery turned into that of 30 minutes and then 80 – I realised that my level of trust was starting to waver. Had my decision to trust this dentist been a good one?

A few years ago, I read, avidly, “The Speed of Trust”, by Stephen Covey. According to him, most people are blind to trust – not seeing it for what it is – a fundamental, pervasive factor in everyday life, a form of capital which you either acquire (Through trust dividends) or lose (Through trust taxes). Covey argues that, to some people, trust is like a quality, intrinsic to every relationship: it’s something you either have or don’t have. To him, however, trust is negotiable, something that can be built, lost or earned over time. But trust is also endowed with a field-dependent quality: I might trust somebody in some circumstances but not others, with one type of information but not another. And what might prompt me to trust more or less may be, simply, the quality of the field: whether or not, I and the other, together, have created a field of vulnerability, of deep listening, and therefore, of trust.

The Cost of Not Trusting

For the 2 hours that I lied on the dentist’s chairs, I was tied to a machine, my mouth held firmly by 2 people at a time, while all sorts of objects were being used to drill things in different places in my mouth. At one point, I started to fantasize how my escape might look like, should I, at any point, feel overwhelmed – all while breathing deeply in what I tried to make into a mindfulness state, and telling myself that that was the best thing I could do. You’d think the mental exercise ludicrous – but it is not. Because a surgical procedure is an invasive act, and as such, it triggers an alert reaction: a tendency to flee, fight or freeze.

And this is why it is interesting: because while I had been absolutely sure of my trust in the dentist only a few weeks before, now that I was triggered, the way I started to look at the surgery I was undertaking – the way I started to look at the world – changed. While, intuitively, I wanted to trust the dentist, inside I was torn, suspicious, tense and contracted. In spite of everything I was telling my rational mind, the body felt invaded, and because it felt invaded, I started to feel that the trust I had conceded to this dentist was, in some ways, dangerous.

The Pygmalion effect is the term used to describe a type of self-fulfilling prophecy which determines behaviour aligned with the observer’s expectations. In studies of management, it was found that when managers have lower expectations of their subordinates, they tend to offer less coaching, encouragement and supportive behaviour than when they have higher expectations, leading their reportees’ to perform worse and to want to quit more, largely because of their own expectation that they will. And while trust between two actors doesn’t have to be mutual, performance outcome tend to be better when trust goes both ways: a study looking at levels of trust between managers and employees, found that if managers trusted their employees but the opposite wasn’t true, all efforts that managers were making to grant higher autonomy to the employees were seen as offloading work, rather than opportunities for growth.

So, I kept telling myself while lying on the chair: trust the dentist. Trust the dentist. He’ll do better. Act as if you’re fine. Give him the time to do this slowly, as slowly as he needs to.

And meanwhile I pondered: what happens when suspicion becomes the norm, rather than trust? How can I trust this dentist more?

Trust as social capital

I think my dentist felt my apprehension, because he kept asking how I was doing, and largely making sure I was ok. The field was one which communicated trust… but that didn’t stop my mind from imagining potential disastrous outcomes every time I saw a pair of scissors.

What to do in such a situation?

Although it might seem counterintuitive, it seems to be the case that – because trust is a form of relational capital based on beliefs -, it can be “manipulated”, by manipulating beliefs. As I sat there, I came to the conclusion that something that was missing on my part was some kind of social proof: I was neither in a position to properly assess the dentist’s work, nor had I spoken to anyone who’d undergone the same procedure with him. But I needed the surgery (So, I was dependent on the dentist) and I needed the trust. The only thing I could manipulate, was the level of trust that I could put in the dentist. By this, I hope it comes across clearly that I am not suggesting that one should go around trying to manipulate others’ beliefs to gain trust, but rather, that it may be an interesting exercise – when immersed in a low trust situation, to do exactly the opposite: to manipulate one’s own beliefs so that one can trust the other more.

Trust as a collective good

Trust is something that, particularly when we are trust-blind – unaware of its pervasivenss and importance – we think of, as seen from an individual perspective. We live in a social and economic system which is based on competition, and so, we understand trust as another scarce good: something which affects our negotiating power. And in terms of the latter, it is the uneven distribution of trust which benefits the individual, rather than it’s even distribution. If everyone is equally trustworthy, nobody is more trustworthy than another. And trust has more economic value than we realise: after all, as Stephen Covey argues, when there is trust, transactions happen faster, more seemlessly: higher trust directly correlates with more money. But while from an individual perspective we might benefit from the concentration of trust, from a collective perspective, we would all prefer a different field: one in which we could trust all professionals and all people equally. After all, wouldn’t it be great if we never had to wonder if the decision we’ve made to put our mouth in this dentist’s hands is better or worse than the one to opt for another dentist?

Every kind of peaceful cooperation among men is primarily based on mutual trust and only secondarily on institutions such as courts of justice and police.

Alber Einstein (1950)

Trust and beliefs as leadership skills

It turns out then, that trust is largely contigent on beliefs. But beyond the beliefs we entertain that relate to our expectations of another’s behaviour, we might pause for a second and ponder:

  • What do I believe about trust?
  • Where do my beliefs in trust come from?
  • Am I ready to trust others and be open? And how can I safeguard my boundaries when doing so? How will I respond, when I will feel triggered? For or against my own good?

Sitting in the dentist’s chair, I found that, ultimately, the best response towards myself was to trust the dentist: while the triggers might have been justified when faced with a surgical procedure which wasn’t pleasurable, they were conjuring up a situation making it worse than it really was. The trick was to breathe deeply, mindfully observe and not let myself be caught up in the horror stories my mind was conceiving. It was taking a mindful distance to my own triggers that allowed me to open up to trust: to the trust that the dentist would do the best job ever done on earth. The one that would get rid of my gum recession problem once and for all, and give me back that teeth model smile that I’ve never had.

When the pilgrims embark on their 800 kms walk to Compostela, nothing guarantees that their journey will be transformational. That everything will be smooth and easy for them. But I believe that trust makes them move forward. Because nothing can transform, nothing can move or change, without trust.

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