Tomophobia (phobia during surgery): symptoms, causes and treatment

Have you ever heard of tomophobia? It is a phobia considered “weird”, although in reality more common than we think. It is the phobia of surgical operations.

Why is this happening? What are your typical symptoms? And finally, what treatments exist, on the psychological level, to fight it? In this article, we will answer all these questions related to tomophobia.

    Tomophobia: what is it?

    Tomophobia is the phobia of surgical operations. In contrast, phobias are intense, irrational and disproportionate fears about a particular object or situation, and are part of anxiety disorders, classified as such in the DSM-5 (Statistical Manual of Mental Disorders).

    In the case of tomophobia, surgical operations are too dreaded. While this may seem like a normal fear (as it is very common to be afraid of surgery), we emphasize that in phobias this fear becomes pathological. Which means the phobia of surgery goes far beyond the normal fear, Genuinely interfering with a person’s life and, in severe cases, neutralizing it.

    Fear of surgery

    It is normal and common to be afraid of surgery because it is a complex process where someone accesses our body (although, logically, some operations are simpler than others).

    They can operate on us practically on the whole body, to solve a problem, a pathology, to extract a tumor, etc. Some operations are more risky than others, obviously it’s not the same as operating for appendicitis on an open heart or removing a brain tumor.

    Seeing all this, and moving on to the more rational part, one can understand that there are people who feel a real panic in surgery, either because of a bad previous experience, for hearing stories of operations that went wrong, for fear of hospitals. , etc.

    However, in tomophobia we are talking about intense panic that occurs with the idea of ​​surgery when risk levels are reasonably low. This panic sometimes results in severe anxiety, psychophysiological symptoms, hyperactivation …

      symptoms

      The main symptom of tomophobia, as with any specific phobia, is anxiety and / or intense fear. This anxiety or fear can manifest itself in different ways; by physical (psychophysiological), cognitive and behavioral symptoms.

      On a physical level, various symptoms appear before the idea of ​​surgery (even pictures of an operation), such as: excessive sweating, hyperactivation, dizziness, nausea, vomiting, dizziness, suffocation

      At the cognitive level, dysfunctional ideas appear or catastrophic thoughts of operations (“Everything will be bad”, “all operations are bad”, “I will not be able to wake up”, etc.).

      Finally, at the behavioral level, it appears avoidance of the phobic stimulus (For example, not wanting to watch medical programs on television, not wanting to go to the hospital, not wanting to hear stories of operations …). On the other hand, if avoidance does not appear, the situation is resisted (in this case, the operation), with great discomfort and intense anxiety associated with it.

      the causes

      The main cause of tomophobia is a traumatic experience with surgeries. For example, having undergone an operation where complications have occurred, suffering from the after-effects of an operation, medical malpractice, difficulty waking up, a lot of pain, etc.

      Tomophobia can also be acquired by vicarious conditioning, if you see someone suffering a lot for an operation. Finally, the stories we hear about medical malpractice, operations that did not go well, etc., can also have a lot to do with the origin of tomophobia.

      On the other hand, other phobias related to medical situations can also affect the onset of tomophobia (or coexist with it), such as: blood phobia (hemophobia or hematophobia), phobia during injections (trypanophobia), phobia in hospital, phobia among doctors, etc.

      treatment

      The treatment of tomophobia, like that of any phobia, mainly focuses on two types of therapy: exposure therapy and cognitive behavioral therapy. Here, however, we will also look at a third: psychoeducational techniques.

      1. Exposure therapy (and virtual reality)

      In the case of exposure therapy applied to tomophobia, it’s a bit complex, like how to simulate a medical operation to expose the patient? It’s difficult; this is why, in this particular case, we can go to virtual reality (VR) exposure therapy.

      This type of therapy, more and more widespread, simulates fictitious situations using technology. The patient can feel the sensations associated with the phobic stimulus quite realistically, and has the positive side that he is never in danger and can always “escape” the situation.

      This type of therapy is used more and more, which is ideal for certain phobias where the phobic object is difficult to simulate, to represent or to use, as it would be the case with tomophobia.

      2. Cognitive-behavioral therapy

      In contrast, cognitive behavioral therapy used for cases of tomophobia, would focus on eliminate or modify negative and irrational thoughts that the patient has in relation to the surgical operations, In addition to adopting habits of stress management and prevention.

      In other words, it would be that he could rationalize his fears and replace the catastrophic thoughts with more realistic ones. Examples of thoughts associated with tomophobia, which should be examined by the patient, are: “if I go for surgery I will die”, “if I go for surgery I will not wake up”, “I will get worse. entering “,” my body will not take it “, etc.

        3. Psychoeducation and other techniques

        Using (and teaching) specific strategies for dealing with anxiety will also be important, By being for example: relaxation techniques, breathing, meditation, pleasant images …

        In the case of children with tomophobia, one can opt for symbolic modeling techniques (through videos, stories … where fictitious characters undergo successful surgeries).

        It will also be practical to conduct psychoeducation sessions, so that the patient understands the operation to be performed (if this is the case). In addition, in the latter case, it will be important to remove any doubt about the operation to which it must be subjected, so that multidisciplinary work with the medical team will be essential.

        Bibliographical references:

        • American Psychiatric Association -APA- (2014). DSM-5. Diagnostic and Statistical Manual of Mental Disorders. Madrid: Panamericana.
        • Belloch, A, Sandín, B. and Ramos, F. (2010). Manual of psychopathology. Volumes I and II. Madrid: McGraw-Hill.
        • Pérez, M., Fernández, JR, Ferández, C. and Amic, I. (2010). Guide to effective psychological treatments I and II :. Madrid: Pyramid.

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