Tomophobia: symptoms, causes and treatment

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, at a psychological level, to combat it? In this article we will answer all these questions in relation to tomophobia.

• Related article: "Types of Phobias: Exploring Fear Disorders"

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 the 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 might 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 the normal fear

, truly interfering in the life of the person and, in serious cases, becoming incapacitated.

Fear of surgical operations

It is normal and usual 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 easier than others).

They can operate on practically any part of the body, to solve a problem, a pathology, extract a tumor, etc. There are operations with more risk than others, obviously it is not the same that we are operated on for appendicitis with an 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 a real panic about having surgery, since be it because of a previous bad experience, because of having heard stories of operations that have gone wrong, because of fear of hospitals, etc.

However, in tomophobia we talk about 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, hyperactivation...

• You may be interested in: "Fear of needles (belonephobia): causes, symptoms and treatment"

Symptoms

The main symptom of tomophobia, as 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 an operation (or even at images of an operation), such as: excessive sweating, hyperarousal, dizziness, nausea, vomiting, dizziness, choking sensation…

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

Finally, at the behavioral level, it appears avoidance of phobic stimulus (for example, not wanting to watch medical programs on television, not wanting to go near a hospital, not wanting to hear stories about 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 negligence, difficulties waking up, a lot of pain, etc.

Tomophobia can also be acquired through vicarious conditioning, if we see someone suffer a lot from an operation. Finally, the stories we hear about medical negligence, operations that have gone wrong, 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 appearance of tomophobia (or coexist with it), such as example: the phobia of blood (hemophobia or hematophobia), the phobia of injections (trypanophobia), the phobia of hospitals, the 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 see a third: psychoeducational 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 particular case, we can go to the exposure therapy using virtual reality (VR).

This type of therapy, increasingly on the rise, simulates fictitious situations through technology. The patient may experience the sensations associated with the phobic stimulus in a rather realistic, and has the positive part that he is never in danger and can always "escape" from the situation.

This type of therapy is 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 with tomophobia.

2. cognitive behavioral therapy

On the other hand, the cognitive-behavioral therapy used for cases of tomophobia would be focused on eliminate or modify the negative and irrational thoughts that the patient has in relation to surgical operations, as well as to adopt stress management and prevention habits.

That is to say, it would be that he could rationalize his fears and replace catastrophic thoughts with more realistic ones. Examples of thoughts associated with tomophobia, and that should be reviewed with the patient, are: “if I go into operating room I will die", "if I enter the operating room I will not wake up", "I will come out worse than when I entered", "my body will not bear”, etc.

• You may be interested in: "Cognitive Behavioral Therapy: what is it and what principles is it based on?"

3. Psychoeducation and other techniques

Using (and teaching) specific coping strategies will also be important., being these, for example: relaxation techniques, breathing, meditation, pleasant images...

In the case of children with tomophobia, you can opt for symbolic modeling techniques (through videos, stories... where fictional 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 your doubts in relation to the operation to which that must be submitted, so that 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: Pan American.
• Belloch, A, Sandin, B. and Ramos, F. (2010). Manual of Psychopathology. Volume I and II. Madrid: McGraw-Hill.
• Pérez, M., Fernández, J.R., Ferández, C. and Friend, I. (2010). Guide to effective psychological treatments I and II:. Madrid: Pyramid.