Social powerlessness primarily associated with embarrassment
Feelings of powerlessness related to the embarrassment of revealing years of dental neglect to dentist and staff had developed as the main reason for dental treatment avoidance for this category, even though there may have been other reasons at the beginning of the avoidance history. Symptoms of embarrassment were also manifested outside clinical settings, indicating that complexities of shame and guilty conscience about avoiding treatment were not the only manifestations of this type of social powerlessness. Embarrassment was the main reason for seeking therapy, where other usually highly motivating factors such as pain, were not. These complexities are illustrated in the following case