Fear of the Surgery

It is entirely natural and understandable to feel concerned and perhaps even fearful about undergoing surgery. There is no need to be self-critical about these emotions. Surgery inherently carries an element of uncertainty. If you are anxious about your upcoming procedure, some strategies can assist. These approaches are valuable, as research indicates that maintaining a sense of calm before surgery can positively impact the body, contributing to improved wound healing and reduced pain, among other benefits [3].

To start, many individuals find maintaining an “anxiety diary” beneficial. In this diary, you can record situations that trigger anxiety and the thoughts and feelings linked to them. The practice can assist you in gaining a more in-depth understanding of your current sources of stress.

You must feel well-informed by your medical team, and all your questions should have been thoroughly addressed before the surgery. This practice is logical and supported by research [1,9]. Being well-informed is valuable because fear often distorts our perception. When anxious, we tend to hyper-focus on potential threats as a protective mechanism. We concentrate on information that heightens our concerns, like noticing if our doctor seems tense that day while blocking out reassuring info, such as the doctor’s extensive experience in this type of surgery.

This distorted perception can set off a cycle of anxiety [4]. It starts with negative thoughts, ideas, and future scenarios related to potential dangers, like thinking, “The surgery will surely go wrong.” These thoughts trigger feelings of fear, leading to physiological changes and physical sensations of anxiety, such as palpitations, muscle tension, or shortness of breath. These sensations are intensely felt, fueling the cycle of anxiety, like worrying, “I’m not feeling well at all; how will I manage the surgery?”

Abb. 1: Angstkreislauf [4]

Fig. 1: Fear Cycle [4]

Strategies to Overcome Fear

Thankfully, you can disrupt this cycle of anxiety through a range of strategies:

  • First, becoming aware of the possibility of your perception being distorted is essential. Strive to view the situation realistically and comprehensively. Consider the arguments in favor of your surgery and envision the best-case scenario. Reflect on how a successful surgery could enhance your well-being. Seek out reassuring thoughts that resonate with you, such as “I have overcome many challenges before, and I have the strength to handle this,” “Numerous other women have successfully undergone similar procedures, so I am confident I can, too,” or “I trust in the expertise of my medical team.” Focusing on the present moment and taking it one step at a time can be highly beneficial. Often, our anxiety is fixated on future events rather than the current circumstances. It is not the immediate situation causing stress but our thoughts and interpretations. For more guidance on managing excessive rumination, you can explore additional tips here.
  • Another highly effective strategy for combating anxiety is relaxation. Relaxation techniques have the potential to disrupt the anxiety cycle, mainly by inducing pleasant and calming physical sensations. Engaging in relaxation exercises can significantly reduce anxiety in the period leading up to surgery. The good news is that you can acquire specific relaxation skills, including techniques like progressive muscle relaxation or yoga, which can be immensely beneficial.
  • Distraction is another valuable way to interrupt the anxiety cycle. Even in the days leading to the surgery, you can purposefully engage in positive distractions. Whether through reading, taking a leisurely walk, pursuing a craft or hobby you enjoy, or listening to music, find activities that resonate with you. Listening to music, in particular, has been shown in studies to be effective in reducing anxiety before surgery. Additionally, it modestly positively impacts heart rate and blood pressure [2]. The mechanisms behind this include positive distraction, relaxation effects, and the release of feel-good hormones.
  • Moreover, engaging in physical exercise can be a potent weapon against anxiety. Research consistently demonstrates that exercise and physical activity can reduce stress [5,6,7,8]. Movement brings about profoundly positive effects on both the body and the mind. Physical activity helps prevent pressure and can be a valuable tool in managing specific anxiety-inducing situations. For instance, taking a brisk walk around the block or climbing stairs before a doctor’s appointment or when feeling anxious can be beneficial. These activities reduce fears, stress, and tension while triggering the release of endorphins, the body’s natural feel-good hormones. They also enhance your self-confidence and foster trust in your body’s capabilities. Furthermore, scientists propose that exercise stimulates specific brain regions crucial for processing and mitigating stress and anxiety. Lastly, the physical sensations often associated with anxiety, such as rapid heart rate and sweating, are recontextualized as positive and under your control during exercise.
  • Lastly, do not underestimate the significance of emotional support from your loved ones. If you are grappling with significant fears leading up to the operation, it is essential not to keep them bottled up. Instead, share your concerns with someone you trust. In the days preceding the surgery, make a deliberate effort to be exceptionally kind and nurturing to yourself. Engage in self-care and activities that bring you joy and comfort. This approach can help you face the surgery with a sense of calm, relaxation, and confidence.

Just as we cannot prevent birds from flying over our heads, but we can prevent them from nesting on our heads, so we cannot prevent evil thoughts, but we can prevent them from taking root in us. – Martin Luther

References

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Caumo W, Ferreira MBC. Perioperative anxiety: psychobiology and effects in postoperative recovery. The Pain Clinic [Internet]. 2003 [cited 2021 Oct 26];15(2):87–101. Available from: http://www.tandfonline.com/doi/full/10.1163/156856903321579217
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In-Albon T, Margraf J. Panik und Agoraphobie. In: Klinische Psychologie & Psychotherapie. 2nd ed. Berlin: Springer; 2011. p. 291.
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Teresa Götz