Tomophobia (phobia of surgical operations): symptoms, causes and treatment

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 it is actually more common than we think. It is a phobia of surgical operations.

Why does it occur and what are its typical symptoms? And finally, what psychological treatments are available to combat it? In this article we will answer all these questions in relation to tomophobia.

Tomophobia: what is it?

Tomophobia is a phobia of surgical operations.. On the other hand, phobias are intense, irrational and disproportionate fears of a specific 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, there is an excessive fear of surgical operations. Although it could seem to us a normal fear (because it is very frequent to be afraid of surgical operations), we insist that, in phobias, this fear becomes pathological. That is to say that phobia of surgical operations goes far beyond the normal fear, really interfering in the life of the patient.It really interferes in the person's life and, in severe cases, it can even incapacitate him/her.

Fear before surgical operations

It is normal and usual to be afraid of a surgical operation, since it is a complex process. where someone gains access to our body (although, logically, some operations are simpler than others).

We can be operated on practically any part of the body, to solve a problem, a pathology, to remove a tumor, etc. There are operations with more risk than others, obviously it is not the same to have an appendicitis operation than an open heart operation or to remove a brain tumor.

Considering all this, and going to the most rational part, we can understand that there are people who feel a real panic to undergo surgery, either because of a previous bad experience, or because they have heard stories of operations that have gone wrong, or because they are afraid of hospitals, etc.

However, in tomophobia we are talking about an intense panic that occurs at the thought of having surgery when the risk levels are reasonably low.. This panic sometimes translates into strong anxiety, psychophysiological symptoms, hyperarousal...

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; through physical (psychophysiological), cognitive and behavioral symptoms.

At the physical level, various symptoms appear at the idea of having surgery (or even at images of an operation), such as: excessive sweating, hyperarousal, dizziness, nausea, vomiting, vertigo, choking sensation.…

At the cognitive level, dysfunctional ideas or catastrophic thoughts catastrophic thoughts in relation to the operations ("everything will go wrong", "everything will go wrong", "everything will go wrong"). ("everything will go wrong", "all operations go wrong", "I will not be able to wake up", etc.).

Finally, at the behavioral level, there appears avoidance of the phobic stimulus (e.g. not wanting to watch medical programs on television, not wanting to go near a hospital, not wanting to listen to 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.

Causes

The main cause of tomophobia is a traumatic experience with surgical operations.. For example, having undergone an operation where complications arose, suffering sequelae from an operation, medical malpractice, difficulty waking up, severe pain, etc.

Tomophobia can also be acquired by vicarious conditioning, if we see someone suffering a lot from an operation. Finally, the stories we hear about 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 have an impact on 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.

Treatment

The treatment of tomophobia, like that of all phobias, focuses mainly on two types of therapy: exposure therapy and cognitive-behavioral therapy.. Here, however, we will also look at a third one: 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 is difficult; that is why, in this particular case, we can resort to virtual reality (VR) exposure therapy. exposure therapy using 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 side that he/she is never in danger and can always "escape" from the situation.

This type of therapy is increasingly used and is ideal for some phobias where the phobic object is difficult to simulate, represent or use, as in 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 the surgical operations, as well as to adopt habits of management of the patient.as well as adopting stress management and prevention habits.

In other words, the patient should be able to rationalize his or her fears and replace catastrophic thoughts with more realistic ones. Examples of thoughts associated with tomophobia, which should be reviewed with the patient, are: "if I go into surgery I will die", "if I go into surgery I will not wake up", "I am going to come out worse than when I went in", "my body will not withstand it", etc.

3. Psychoeducation and other techniques

The use (and teaching) of specific strategies to cope with anxiety will also be important.These are, for example: relaxation techniques, breathing, meditation, pleasant images....

In the case of children with tomophobia, symbolic modeling techniques can be used (through videos, stories... where fictitious characters undergo successful surgery).

It will also be convenient to carry out psychoeducation sessions, so that the patient really understands the operation to be performed (if this is the case).. In addition, in the latter case, it will be important to resolve all their doubts regarding the operation they are to undergo, so multidisciplinary work with the medical team will be essential.

Bibliographic 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 de Psicopatología. Volume I and II. Madrid: McGraw-Hill.
• Pérez, M., Fernández, J.R., Ferández, C. and Amigo, I. (2010). Guide to effective psychological treatments I and II:. Madrid: Pirámide.