In the present study, patient perceptions and descriptions about powerlessness in social interactions with the dentist were of two categories: 1) Social powerlessness associated with conditioned distrust of dentists' behaviors e.g. "I am afraid of how the dentist will do what he has to do and that I can't stop him." This could also include secondary embarrassment, since subjects' own behaviors or cognitions can seem out of control, e.g. "My reactions get so out of control sometimes that it's embarrassing." and 2) Social powerlessness primarily associated with embarrassment about anxiety, dental care neglect and treatment avoidance or appearance e.g. "I am afraid of what the dentist or others are thinking about me and how bad my teeth are or how long it has been since I had treatment." This did not preclude complaints of conditioned distrust of dentists in some cases, but these were secondary to the chief complaint or reason for seeking therapy. Case studies below illustrate the two types of social powerlessness