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Anxious Pre-Surgery Patient Asks Everything You Ever Wanted to Know about Guided Imagery for the O.R.

11 Aug

We saw this from a very anxious woman about to have a 6 hour surgery. She asks a lot of very good questions – some of them we hear frequently – so we thought this would be a good one to post.

It also gave us the opportunity to make the point about not being too obsessive or perfectionistic about using guided imagery or you can undermine the whole process.

Check it out:

Please help ASAP! Surgery in 12 days! I will be in surgery for over 6 hours and I am allowed to take in my iPod to listen to your imagery and music etc. I purchased the surgery pack and listened to the "successful surgery" first.

However, I am concerned about what to do in terms of lining up a playlist for that length of time, since your music goes just under an hour.

What would you suggest? To just play the same music for six hours?



Also, I remember reading you suggested only doing guided imagery pre and post op and listening to music during. Maybe I'm confused.

And, this may sound hard to believe, but I am having a very hard time coming up with a safe place - real or imagined. Everywhere I try to go in my mind, it morphs into something with strings attached.

There has been a lot of trauma in my life and I have often felt alone and unsupported. In the last 5 years, I have lost my immediate and all but two members of my extended family. I've been a 24/7 caregiver for 7 years. Now my mother and grandmother have passed, and I find myself with support only from my spouse.

I want this surgery and guided imagery/music experience to be the best it can be.

I'm feeling like until I can find that space and a couple of people to imagine in the OR, I won't be ready to start listening. It's actually very upsetting to me, that this has become so difficult.

Any suggestions?

Do u offer any other music I can add to the mix? 6 hours is a long time.
Post op, I could have the nurse switch the track to something else.

I know u are busy but any additional guidance around this is greatly needed and more than appreciated.

Warm thoughts and a smile,

Dear Terry,

First of all, the most important, impactful thing you can do to prepare is pre-op, not during the surgery. Focus for now on listening to that surgery imagery once or twice a day before the surgery.

Not only is 10-12 days plenty - we have evidence from a big study that 335 surgery patients, who were only able to listen an average of 2.5 days before their very complicated surgeries, did really well on outcomes (anxiety, pain, blood loss, length of stay, etc etc.). Many of them did not listen to anything during surgery.

So know that you're in good shape and you have plenty of time.

Even if, for some reason, you could not play anything in the O.R., you'd still be fine, because all those positive images and suggestions will be thoroughly embedded inside of you by that time. So think of the playing time during surgery as an added bonus and not even strictly necessary.

As for what to load up your iPod to play during surgery, I'd say play the surgery imagery, some music, maybe the General Wellness imagery, and even the Healthful Sleep imagery from your pack would be fine - then maybe play the surgery imagery again - really, it's up to you. There's no rule that says you can only play music during your surgery – it's just that at the time that imagery was first made, a lot of hospitals didn't allow patients to bring in their own players, and the only way to play something was over the speaker system. Plain music was better for the staff – we didn't want them getting distracted!

Also, just so you know: two other studies showed that the more anxious patients were, the better able they were to use guided imagery to help get relaxed, confident and calm. Surprising but true!

You're in good company about not being able to land on a safe place. Many people have trouble finding one. And when that combines with an obsessive nature (as in: gotta be absolutely correct, gotta do it right, gotta be perfect), the mind can have a field day with perversely twisting any place you come up with into something not safe.

So, here's my suggestion, which I hope you take:

Totally toss this idea of this experience being'the best it can be'. ....Because that very perfectionism is your culprit.

All you need, Terry, to do really, really well in preparing for this surgery is for this experience to be 'good enough'!! Cross my heart & sweartogawd. I've been practicing and researching this for 30 years, and I'm here to tell you that good enough is absolutely good enough!

So, pick out a simple place or time that was okay - pleasant enough, safe enough. Not great, not fantastic, not the best ever. Just good enough. A time with friends, or with your husband or by yourself, in a pretty place. Pick your husband, Jesus and the dog to surround you - or maybe just the decent surgeon you found with a couple of kind, capable nurses. Again, don't make this a bigger deal than it needs to be. All you need is 'good enough'!!

Then, if your mind starts playing its perverse tricks on you, just say to yourself, 'Oh, that's just my obsessive brain, doing what it does.... it doesn't mean anything....' You'd be surprised how often that works!

And if you can't make it stop, then just skip past that part of the audio and move on... you don't have to cover every single part of the audio... you can skip around and get a little spacey - it still works fine.

As for music, any calming, nourishing, pleasing music of yours can be interspersed with the other segments. Again, it doesn't have to be the absolute best selection ever! Just good enough!!

So, Terry, let 'Good Enough' be your war cry and healing mantra!! You are good enough, your selections are good enough, and this surgery will be plenty good enough to get the job done!

Hope this helps! Wishing you well.


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Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award.