E VERY dentist has wondered on occasion why some patients are difficult to treat even when the procedure makes only a small demand on their cooperation while other patients are cooperative even under procedures that are quite taxing. There are, of course, many external factors that influence the immediate response, but over a period of observations, he must speculate as to whether there are not some basic factors that might determine the patient's level of cooperation during treatment. This disparity in cooperation might be more pronounced in the psychiatric patient and presents a challenging problem in accomplishing treatment. Some factors that could influence basic cooperation might be personality determinants, early influences, such as attitude of patient's parents toward dental treatment, and the patient's own experiences, particularly the initial or childhood episodes of treatment. Since, at this hospital, we had the services of psychologists, and since the patients were hospitalized long enough to carry out the extensive testing, it was decided that our original inquiry might best center upon the question of the effect of personality factors. It was expected that such factors would be influential, but not necessarily decisive, in this problem of cooperation, since the picture was probably the result of other influences indicated previously as well as the personality components under investigation.The factor selected for the center of the psychological investigation could be designated as the oral aggressivity-passivity element. This area was selected because of the oral zone's primary importance in the individual's personality formation. Certainly, anyone observing a small child is aware of the primary importance of the mouth. The child experiences satisfaction through this zone by nourishment and affection. These are receptive or passive oral responses. In addition to this, through the mouth, the child expresses himself and tries to influence his world by crying, by perhaps refusing to eat, and later, when he has teeth, he finds he is able actually to inflict pain by biting. These are orally aggressive responses. With teething a primary problem, frustration may be precipitated since the child wants to eat (pleasure) but finds that he is prevented from doing so because of the soreness of his mouth (pain).These are factual observations that have been taken by various schools of psychology and developed with different theoretical interpretations. The

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