The phobia of surgical operations is an anxiety disorder that can cause many problems.
Have you ever heard of tomophobia? It is a phobia considered “rare”, although, in reality, more common than we really think. It is the phobia of surgical operations.
Why is it produced? What are your typical symptoms? And finally, what treatments exist, on a psychological level, to combat it? In this article we will answer all these questions in relation to tomophobia.
Tomophobia: what is it?
Tomophobia is the phobia of surgical operations. On the other hand, phobias are intense, irrational and disproportionate fears of a certain 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 excessively feared. Although it may seem like a normal fear (because it is very common to be afraid of surgical operations), we insist that, in phobias, this fear becomes pathological. That is, the phobia of surgical operations goes far beyond normal fear, truly interfering in the life of the person and, in severe cases, even incapacitating them.
The fear of surgical operations
It is normal and common to be afraid of a surgical operation, since it is a complex process where someone accesses our body (although, logically, there are operations that are simpler than others).
They can operate on practically any part of the body, to solve a problem, a pathology, remove a tumor, etc. There are operations with more risk than others, obviously it is not the same that we operate for appendicitis than for open heart or to remove a brain tumor.
Seeing all this, and going to the most rational part, we can understand that there are people who feel authentic panic about having surgery, either due to a bad previous experience, having heard stories of operations that have gone wrong, fearing hospitals, etc. .
However, in tomophobia we speak of an intense panic that occurs with the idea of having surgery when the risk levels are reasonably low. This panic sometimes translates into strong anxiety, psychophysiological symptoms, hyperarousal …
The main symptom of tomophobia, as it occurs in any specific phobia, is anxiety and / or intense fear. This anxiety or fear can manifest itself in different ways; through physical (psychophysiological), cognitive and behavioral symptoms.
On a physical level, various symptoms appear at the idea of having surgery (or even images of an operation), such as: excessive sweating, hyperarousal, dizziness, nausea, vomiting, dizziness, a feeling of suffocation. ..
At the cognitive level, dysfunctional ideas or catastrophic thoughts appear in relation to operations (“everything will go wrong”, “all operations go wrong”, “I will not be able to wake up”, etc.).
Finally, at the behavioral level, avoidance of the phobic stimulus appears (for example, not wanting to watch medical programs on television, not wanting to go to a hospital, not wanting to hear stories of operations …). On the other hand, if avoidance does not appear, the situation (in this case, the operation) is resisted, with great discomfort and intense associated anxiety.
The main cause of tomophobia is a traumatic experience with surgical operations. For example, having undergone an operation where complications arose, suffering sequelae derived from an operation, medical negligence, difficulty waking up, a lot of pain, etc.
Tomophobia can also be acquired by vicarious conditioning, if we see someone suffer a lot from an operation. Finally, the stories we hear in relation to medical negligence, operations that have not gone 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 influence the appearance of tomophobia (or coexist with it), such as: phobia of blood (hemophobia or hematophobia), phobia of injections (trypanophobia), phobia of hospitals, phobia of doctors, etc.
The treatment of tomophobia, like that of all phobia, focuses mainly on two types of therapy: exposure therapy and cognitive-behavioral therapy. Here, however, we will also see a third: psychoeducation techniques.
1. Exposure therapy (and virtual reality)
In the case of exposure therapy applied to tomophobia, it is somewhat complex, since how to simulate a medical operation to expose the patient? It `s difficult; That is why, in this specific case, we can go to exposure therapy through virtual reality (VR).
This type of therapy, increasingly on the rise, simulates fictitious situations through technology. The patient can experience the sensations associated with the phobic stimulus in a quite realistic way, and has the positive part that he is never in danger and can always “escape” from the situation.
This type of therapy is increasingly being used more and more, which is ideal for some phobias where the phobic object is difficult to simulate, represent or use, as would be the case of tomophobia.
2. Cognitive behavioral therapy
On the other hand, the cognitive-behavioral therapy used for cases of tomophobia, would be focused on eliminating or modifying the negative and irrational thoughts that the patient has in relation to surgical operations, as well as adopting stress management and prevention habits.
That is, it would be that he could rationalize his fears and replace catastrophic thoughts with more realistic ones. Examples of thoughts associated with tomophobia, and which should be reviewed with the patient, are: “if I go to the operating room I will die”, “if I go to the operating room I will not wake up”, “I will come out worse than I entered”, “my body will not He will bear it ”, etc.
3. Psychoeducation and other techniques
The use (and teaching) of specific strategies to deal with anxiety will also be important, these 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 surgical operations).
It will also be convenient to carry out psychoeducation sessions, so that the patient really understands the operation that is going to be performed (if this is the case). In addition, in the latter case, it will be important to resolve all your doubts in relation to the operation to which you must undergo, so multidisciplinary work with the medical team will be essential.
- 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. Volume I and II. Madrid: McGraw-Hill.
- Pérez, M., Fernández, JR, Ferández, C. and Amigo, I. (2010). Guide to effective psychological treatments I and II :. Madrid: Pyramid.