Re: How do I cope with fear of upcoming surgery using ACT?

[Guest guest]

Since you are posting on a ACT for the public board, I have no qualms about

offering my non-professional opinion ;-)

Let's see you can dedicate a lot of time thinking about this surgery a head of

time ... wait no that sounds like cognative therapy. Perhaps you can reflect on

what is at the root of your fears ... hmmm, that would be psychoanalysis and

could take years and we don't have that kind of time!

How about re-reading your email and seeing if you find any fused

thoughts/beliefs? You may have some good fodder for defusion technics ala

workbook. While you're at it throw in a few mindfullness exercises ... mining

carts, leaves on a stream ... as long as you keep noticing what is happening

here and now you'll feel more certain that you won't get stuck in any one

experience. Feels like ACT to me.

Salubrious.

~Em

>

> Hello comrades,

>

> I'm going to have abdonminal, pretty extensive hernia surgery (and

> then be sent home same day--financial reasons) in a few days. I live

> alone and I'll be here to care for myself and my own pain on my own

> afterwards.

>

> I'm having problems with more anxiety than the usual. I'm bipolar

> type II, btw. (My " mania " shows up as aggitation and anxiety and

> insomnia, not spending sprees nor painting the ceiling at midnight,

> etc.). My meds help me greatly, believe me, but this is a lot to

> handle, since I also had to recently undergo colonoscopy and endoscopy

> and they couldn't get me sedated (I'm awfully hard to sedate). Thus,

> another reason for the anxiety. I really don't think any pain med I

> will be given will work for me. What I need is a circus hammer to do

> the trick, not Vicodin!

>

> All ideas would be most helpful. My email is katesacutup <at> msn.com

> if you'd like to write me personally.

>

> Thanks.

>

> Margie

>

[Guest guest]

Thank you, EM, for your suggestions. I'm still open to any and all

brainstormed ideas from the other members on this list. This seems

quite elusive to me right now. Like it doesn't fit into the mold of

ACT somehow, but yet I know that all of life's experiences are

supposed to go with ACT. I'm still learning.

Thank you in advance for any input,

Margie

> >

> > Hello comrades,

> >

> > I'm going to have abdonminal, pretty extensive hernia surgery

(and

> > then be sent home same day--financial reasons) in a few days. I

live

> > alone and I'll be here to care for myself and my own pain on my

own

> > afterwards.

> >

> > I'm having problems with more anxiety than the usual. I'm

bipolar

> > type II, btw. (My " mania " shows up as aggitation and anxiety

and

> > insomnia, not spending sprees nor painting the ceiling at

midnight,

> > etc.). My meds help me greatly, believe me, but this is a lot

to

> > handle, since I also had to recently undergo colonoscopy and

endoscopy

> > and they couldn't get me sedated (I'm awfully hard to sedate).

Thus,

> > another reason for the anxiety. I really don't think any pain

med I

> > will be given will work for me. What I need is a circus hammer

to do

> > the trick, not Vicodin!

> >

> > All ideas would be most helpful. My email is katesacutup <at>

msn.com

> > if you'd like to write me personally.

> >

> > Thanks.

> >

> > Margie

> >

>

[Guest guest]

This does fit right in ACT's mold. Seems to me that you are fused

with the thoughts of what may happen, instead of what is going on

right now, in the present. You are not in surgery, nor have you had

surgery. Thank your mind for all of it's help in telling you how

things may be, and become present. Live now, not later. Later will

happen, live in that moment when it happens. Just observe it. Pain

is just pain. It is not bad or good. You don't even know if you will

have pain. Your mind tells you it knows, but it really doesn't.

When you do have the surgery and IF there is pain, then experience

it fully. Reval in it. It is something to experience and not run

away from. After all pain can't hurt you.

Greg P

> > >

> > > Hello comrades,

> > >

> > > I'm going to have abdonminal, pretty extensive hernia surgery

> (and

> > > then be sent home same day--financial reasons) in a few days.

I

> live

> > > alone and I'll be here to care for myself and my own pain on

my

> own

> > > afterwards.

> > >

> > > I'm having problems with more anxiety than the usual. I'm

> bipolar

> > > type II, btw. (My " mania " shows up as aggitation and anxiety

> and

> > > insomnia, not spending sprees nor painting the ceiling at

> midnight,

> > > etc.). My meds help me greatly, believe me, but this is a lot

> to

> > > handle, since I also had to recently undergo colonoscopy and

> endoscopy

> > > and they couldn't get me sedated (I'm awfully hard to

sedate).

> Thus,

> > > another reason for the anxiety. I really don't think any pain

> med I

> > > will be given will work for me. What I need is a circus

hammer

> to do

> > > the trick, not Vicodin!

> > >

> > > All ideas would be most helpful. My email is katesacutup <at>

> msn.com

> > > if you'd like to write me personally.

> > >

> > > Thanks.

> > >

> > > Margie

> > >

> >

>

[Guest guest]

My thought would be to sit, breathing in

and out. Focusing

on the pain, or focusing on the anxiety, whichever wants to be first.

Breathing in the pain, breathing out peace. Breathing in

pain, breathing out peace. Letting it in. Loving it. Embracing it in on the in breath.

Letting out beauty on the out breath.

In, out, deep, slow, present moment,

wonderful moment.

Hello my little pain. Welcome. I embrace you and hold

you within me. I

am very spacious inside of me. I have room to breath in pain, breath in

anxiety. Everybody in. Come in to the spaciousness.

The pain is here. The anxiety is here, in the present

moment. Welcome

it in. Embrace

it. Breath with it.

Smile with it.

From: ACT_for_the_Public [mailto:ACT_for_the_Public ] On Behalf Of Margie (Pettis)

Sent: Friday, June 23, 2006 1:12

AM

To: ACT_for_the_Public

Subject: How

do I cope with fear of upcoming surgery using ACT?

Hello comrades,

I'm going to have abdonminal, pretty extensive hernia surgery (and

then be sent home same day--financial reasons) in a few days. I live

alone and I'll be here to care for myself and my own pain on my own

afterwards.

I'm having problems with more anxiety than the usual. I'm bipolar

type II, btw. (My " mania " shows up as aggitation and anxiety and

insomnia, not spending sprees nor painting the ceiling at midnight,

etc.). My meds help me greatly, believe me, but this is a lot to

handle, since I also had to recently undergo colonoscopy and endoscopy

and they couldn't get me sedated (I'm awfully hard to sedate). Thus,

another reason for the anxiety. I really don't think any pain med I

will be given will work for me. What I need is a circus hammer to do

the trick, not Vicodin!

All ideas would be most helpful. My email is katesacutup <at> msn.com

if you'd like to write me personally.

Thanks.

Margie

[Guest guest]

Hi Margie,

Wow,well,it sure sounds to me like are experiencing some real fearful

sensations and thoughts about your upcoming surgery, and that's got to

be very uncomfortable for you--especially noticing that pain

medications in the past haven't been as effective as you would like

them to be.

I'm not sure what to say, but you can help by first answering some

questions.

Can you say a bit more about your experience and interest in ACT? Have

you read the " Get out of your Mind " book? What specifically is it

about ACT appeals to you? What motivated you to write us here on this

forum? What other venues of support have you tried? (Therapists,

other forums, friends, relatives?). You mentioned you live alone. What

is your support network like? When you had the other surgeries, what

happened afterward? How did you cope after those?

Peace,

Joanne

>

> Hello comrades,

>

> I'm going to have abdonminal, pretty extensive hernia surgery (and

> then be sent home same day--financial reasons) in a few days. I live

> alone and I'll be here to care for myself and my own pain on my own

> afterwards.

>

> I'm having problems with more anxiety than the usual. I'm bipolar

> type II, btw. (My " mania " shows up as aggitation and anxiety and

> insomnia, not spending sprees nor painting the ceiling at midnight,

> etc.). My meds help me greatly, believe me, but this is a lot to

> handle, since I also had to recently undergo colonoscopy and endoscopy

> and they couldn't get me sedated (I'm awfully hard to sedate). Thus,

> another reason for the anxiety. I really don't think any pain med I

> will be given will work for me. What I need is a circus hammer to do

> the trick, not Vicodin!

>

> All ideas would be most helpful. My email is katesacutup <at> msn.com

> if you'd like to write me personally.

>

> Thanks.

>

> Margie

>

[Guest guest]

I'll answer each question within the message with a // before it:

> >

> > Hello comrades,

> >

> > I'm going to have abdonminal, pretty extensive hernia surgery

(and

> > then be sent home same day--financial reasons) in a few days. I

live

> > alone and I'll be here to care for myself and my own pain on my

own

> > afterwards.

> >

> > I'm having problems with more anxiety than the usual. I'm

bipolar

> > type II, btw. (My " mania " shows up as aggitation and anxiety

and

> > insomnia, not spending sprees nor painting the ceiling at

midnight,

> > etc.). My meds help me greatly, believe me, but this is a lot

to

> > handle, since I also had to recently undergo colonoscopy and

endoscopy

> > and they couldn't get me sedated (I'm awfully hard to sedate).

Thus,

> > another reason for the anxiety. I really don't think any pain

med I

> > will be given will work for me. What I need is a circus hammer

to do

> > the trick, not Vicodin!

> >

> > All ideas would be most helpful. My email is katesacutup <at>

msn.com

> > if you'd like to write me personally.

> >

> > Thanks.

> >

> > Margie

> >

>

[Guest guest]

Hi Margie,

It sounds to me like you are doing fine. You are after all about to

have surgery so I think its OK to feel anxious. Who wouldnt be

anxious? The thing is, often when you try to " do something " about

the anxiety the feelings just get worse...kind of like trying to put

out a fire with gasoline. So you might try meeting your fear with

calm acceptance and understanding -- maybe you can get to where

whatever you are feeling is OK. And thats usually a pretty-good

place to be.

What would you do if your child was about to undergo surgery? Try to

give yourself the same calm acceptance, understanding and compassion.

regards,

[Guest guest]

First let me say that this is purely my opinion, but I think you should allow yourself to be scared, to be anxious and so on. There is NO reason not to feel this way -- it is utterly human. As far as pain goes, I disagree with the suggestion that you "revel" in your pain or that you happily embrace it in the belief that pain can't hurt you. My limited understanding of ACT (and again I could be totally wrong) would suggest a slightly different approach. You would say to yourself that yes, you are in pain, physically and that it is something you are going through and that you want it to end as soon as you can make it end. You would do everything your doctor suggested to stop the physical pain but also realize that it is physical pain -- that there is no stigma attached to it, there is nothing wrong with you, nothing bad about you -- it's something happening to your body that is extremely unpleasant but there is a "you" that is apart from this pain. And

if there is anything that connects that "you" to your values and makes you feel like you are on your path, perhaps you can do this even while you are in pain. (When I went to the hospital for a catscan on my lung -- the doctors suspected cancer but they were wrong -- I brought a favorite book with me and some music -- just small things that reminded me that there was something more to me than my fear). Pogue wrote: Hi Margie,It sounds to me like you are doing fine. You are after all about to have surgery so I think its OK to feel

anxious. Who wouldnt be anxious? The thing is, often when you try to "do something" about the anxiety the feelings just get worse...kind of like trying to put out a fire with gasoline. So you might try meeting your fear with calm acceptance and understanding -- maybe you can get to where whatever you are feeling is OK. And thats usually a pretty-good place to be.What would you do if your child was about to undergo surgery? Try to give yourself the same calm acceptance, understanding and compassion.regards,

Sneak preview the all-new Yahoo.com. It's not radically different. Just radically better.

[Guest guest]

Margie, my two cents:

I think everyone is giving you good advice, e.g. accept your anxious

thoughts rather than push them away. And I like lostnightmusic's

suggestion that even now you can look for ways to act on your values.

If it were me, and the situation were a really scary one, I might

sometimes find myself still over-thinking - maybe not all the time but

now and then. For me it goes like this: " I'm supposed to be accepting my

anxiety, but I'm still anxious! OK, now I'm really going to try and

accept it - nope, still anxious. What's wrong with me? Why can't I have

calm acceptance and understanding? " Etc.

If I'm this stressed, I find it helpful to return to a more basic level

- rather than insist to myself that I have to be accepting and then get

frustrated if I'm not, I just practice labelling thoughts and body

sensations.

I find the leaves/parade/trains kind of exercise to be especially good

for this, since it allows me to monitor three different kinds of stuff

as separate events - body sensations, thoughts, and urges. " Emotions "

are usually made up of body sensations plus thoughts, and being able to

separate the components makes a big difference for me in terms of moving

me toward defusion. The imagery with this sort of exercise is also good

as it allows me to imagine my experience as being separate from me,

moving into the distance even as I watch it.

Of course you may already be beyond this stage and able to work on

defusion and willingness more directly. Once you learn the basics of

ACT, you can choose between different strategies according to the

situation.

[Guest guest]

Just to add a few bits.

The pain you may experience during and after surgery seems to have a very different quality compared to the pain you are experiencing now before the surgery. The pre surgery pain is evaluative/mindy pain and it won't help you heel one bit.

The real pain associated with surgery can be a gift -- a sign that you are healing, a sign that you are moving yourself in vital valued directions by taking care of you -- your health. You can opt for the real pain without buying into the mindy pain. -john

P. Forsyth, Ph.D.

Associate Professor of Psychology

University at Albany, SUNY

Department of Psychology, SS369

1400 Washington Avenue

Albany, NY 12222

Ph:

Fax:

Email: forsyth@...

Web Sites:

www.albany.edu/~forsyth

www.acceptanceandmindfulness.com

www.act-for-anxiety-disorders.com

www.contextualpsychology.org

Re: Re: How do I cope with fear of upcoming surgery using ACT?

First let me say that this is purely my opinion, but I think you should allow yourself to be scared, to be anxious and so on. There is NO reason not to feel this way -- it is utterly human. As far as pain goes, I disagree with the suggestion that you " revel " in your pain or that you happily embrace it in the belief that pain can't hurt you. My limited understanding of ACT (and again I could be totally wrong) would suggest a slightly different approach. You would say to yourself that yes, you are in pain, physically and that it is something you are going through and that you want it to end as soon as you can make it end. You would do everything your doctor suggested to stop the physical pain but also realize that it is physical pain -- that there is no stigma attached to it, there is nothing wrong with you, nothing bad about you -- it's something happening to your body that is extremely unpleasant but there is a " you " that is apart from this pain. And if there is anything

that connects that " you " to your values and makes you feel like you are on your path, perhaps you can do this even while you are in pain. (When I went to the hospital for a catscan on my lung -- the doctors suspected cancer but they were wrong -- I brought a favorite book with me and some music -- just small things that reminded me that there was something more to me than my fear).

Pogue wrote:

Hi Margie,

It sounds to me like you are doing fine. You are after all about to

have surgery so I think its OK to feel anxious. Who wouldnt be

anxious? The thing is, often when you try to " do something " about

the anxiety the feelings just get worse...kind of like trying to put

out a fire with gasoline. So you might try meeting your fear with

calm acceptance and understanding -- maybe you can get to where

whatever you are feeling is OK. And thats usually a pretty-good

place to be.

What would you do if your child was about to undergo surgery? Try to

give yourself the same calm acceptance, understanding and compassion.

regards,

---------------------------------

Sneak preview the all-new Yahoo.com. It's not radically different. Just radically better.

[Guest guest]

Hi Margie,

I really don't have professional advise or any quick easy answers

to give you, but I do have some observations and suggestions to share.

You mentioned you will be released from the hospital same day, will

be caring for your pain alone, that you haven't seen your therapist in

a month and have somewhat limited social support to tap into. You

also mention troubling memories of the pain medications not working.

I am no expert, but it sounds like (at least in part) what is going on

is this sense of being alone. Alone with what you are experiencing and

alone with what you are about to experience, frustrated further by

medications not working. More alone-ness.

I noticed you said you felt better already to dialogue with me. That's

something you may want to take notice of! Look how you reached out for

help and were receptive to that. Reaching out here, using the ACT

workbook, seeing a therapist, trying

medications (which do help somewhat) are all ways you are making acive

attempts toward connectiing with others and healing your physical and

social self. Who knows--maybe these are even values for you that

you've yet to identify as such? Maybe this whole painful uncomfortable

experience will begin to inform of you of what matters most to you in

your life?

I hope this doesn't sound trite, I don't mean to minimize what you are

going through. But when I'm

really honest, and let myself linger enough in my discomfort (in a

loving and interested way), I notice I sometimes find little flickers

of wisdom, lovely pearls piled under all those layers of fused

thoughts, judgements, feelings, sensations, memories. I suppose that's

why at least in part you find ACT appealing too.

Don't feel like you have to have it all " figured out " before you go

into surgery. There is no perfect way to do this, and the reality is

you will likely experience some pain and discomfort. Don't panic if

you don't " understand ACT " , don't feel you have to rush through and

finish the book. Just notice some of the exercises that resonate with

you--the thought diffusing and mindfullness ones, and practice those.

I listen to harp and classical music a lot, and notice this brings me

to a calmer place. AS does the very simple Zazen sittng meditation

described in the book. I like the cubbyholing exercise. You can even

make up your own exercises.

I use writing a lot to get better aquainted with parts of me. You may

want to dialogue with your body about the surgery. This sounds goofy,

but it's worth a try if it appeals to you. Ask it what's going

on--what is it thinking and feeling? What does it want from you, the

doctors? You may want to also have a conversation with your hernia or

other parts of your self. Your fear--what does it look like? What

color, shape, size is it? Just notice what comes up.

I suppose what I am saying is come to this with an open spirit. Be

curious. Be willing to be surprised on all levels--physical,

emotional, social, spiritual. Be willing to try some new approach.

Ask yourself:

am I willing to be surprised? Am I willing to be wrong? Maybe the

medications will be more effective this time, who knows--and maybe

they won't. Be present for the experience without attatching yourself

too much to anything. Maybe you'll have pain but you'll also notice

the surgeon looks goofy and the nurse's voice sounds silly.

With regard to aftercare help: Let everyone know-- the doctor, the

social workers,the physical therapists, nurses--those who can arrange

for aftercare visits--that you live alone and will not have help.

Here in the states, this is typically included --but you do need to

remind them, tell them you live alone and want aftercare help. And

make sure it is written clearly in the after-care instructions.

Get names and phone numbers for the home-health agency--don't wait for

them to call you, because sometimes they forget or delay in doing

this. And you'll probably want to discuss your aftercare requests with

your doctor or nurse before the surgery--not after.

If you have church friends or others who can pick up prescriptions or

groceries for you, drive you somewhere-- you may want to arrange for

that ahead of time.

Have a phone by your bed with a list of phone numbers. Watch funny

movies, hug a teddy bear, stay in your jammies, stock up on books or

favorite foods--treat yourself as you

would a wounded child--lovingly, compasssionately, with patience and

persistence.

You will likely remain fearful and uncomfortable before, during and

after surgery. Or not. But the point with ACT I suppose is that it

doesn't have to be who you are. Indeed, it is not who you are. Yes,

you have discomfort and anxiety.

But true too, you are larger than your fear, larger than your pain.

Hold it all gently, lightly, compassionately. Remember deep breaths,

remember the pain will come and go and it won't last forever.

Congratulate yourself on loving yourself enough to take

care of your health, moving toward healing your body. May this

stepping stone ultimately serve to further you along toward your

valued directions, toward a more vital life.

Oh wow--sorry for the ramble! LOL--Are you still awake?

Best to you on this journey. Please do let us

know how it all goes, O.K.?

Peace,

Joanne

> > >

> > > Hello comrades,

> > >

> > > I'm going to have abdonminal, pretty extensive hernia surgery

> (and

> > > then be sent home same day--financial reasons) in a few days. I

> live

> > > alone and I'll be here to care for myself and my own pain on my

> own

> > > afterwards.

> > >

> > > I'm having problems with more anxiety than the usual. I'm

> bipolar

> > > type II, btw. (My " mania " shows up as aggitation and anxiety

> and

> > > insomnia, not spending sprees nor painting the ceiling at

> midnight,

> > > etc.). My meds help me greatly, believe me, but this is a lot

> to

> > > handle, since I also had to recently undergo colonoscopy and

> endoscopy

> > > and they couldn't get me sedated (I'm awfully hard to sedate).

> Thus,

> > > another reason for the anxiety. I really don't think any pain

> med I

> > > will be given will work for me. What I need is a circus hammer

> to do

> > > the trick, not Vicodin!

> > >

> > > All ideas would be most helpful. My email is katesacutup <at>

> msn.com

> > > if you'd like to write me personally.

> > >

> > > Thanks.

> > >

> > > Margie

> > >

> >

>

[Guest guest]

LOL-- This is sort of what I was trying to say, but clearly in a much

more roundabout fashion. must have written this while I was going

on and on with my rambling post. As you can see, brevity is not my forte!

Joanne

>

> Hi Margie,

>

> It sounds to me like you are doing fine. You are after all about to

> have surgery so I think its OK to feel anxious. Who wouldnt be

> anxious? The thing is, often when you try to " do something " about

> the anxiety the feelings just get worse...kind of like trying to put

> out a fire with gasoline. So you might try meeting your fear with

> calm acceptance and understanding -- maybe you can get to where

> whatever you are feeling is OK. And thats usually a pretty-good

> place to be.

>

> What would you do if your child was about to undergo surgery? Try to

> give yourself the same calm acceptance, understanding and compassion.

>

> regards,

>

>

>

>

>

>

>

> ---------------------------------

> Sneak preview the all-new Yahoo.com. It's not radically different.

Just radically better.

>

[Guest guest]

I want to thank everyone for their responses. I have created a Word

file of them, printed it off for reference, and have it beside my

bedstand.

You are all incredible! Such great ideas and such compassionate

suggestions. Thank you again. I think I have a handle on this

now. I'm going to get busy getting my list of post surgical helpers

and their numbers, went to the store yesterday for food, am

borrowing some books, and will look through the other posts for what

else I could be doing now for next week.

Blessings,

Margie

> > > >

> > > > Hello comrades,

> > > >

> > > > I'm going to have abdonminal, pretty extensive hernia

surgery

> > (and

> > > > then be sent home same day--financial reasons) in a few

days. I

> > live

> > > > alone and I'll be here to care for myself and my own pain on

my

> > own

> > > > afterwards.

> > > >

> > > > I'm having problems with more anxiety than the usual. I'm

> > bipolar

> > > > type II, btw. (My " mania " shows up as aggitation and

anxiety

> > and

> > > > insomnia, not spending sprees nor painting the ceiling at

> > midnight,

> > > > etc.). My meds help me greatly, believe me, but this is a

lot

> > to

> > > > handle, since I also had to recently undergo colonoscopy and

> > endoscopy

> > > > and they couldn't get me sedated (I'm awfully hard to

sedate).

> > Thus,

> > > > another reason for the anxiety. I really don't think any

pain

> > med I

> > > > will be given will work for me. What I need is a circus

hammer

> > to do

> > > > the trick, not Vicodin!

> > > >

> > > > All ideas would be most helpful. My email is katesacutup

<at>

> > msn.com

> > > > if you'd like to write me personally.

> > > >

> > > > Thanks.

> > > >

> > > > Margie

> > > >

> > >

> >

>

[Guest guest]

VERRY helpful!

M

>

> Hi Margie,

>

> It sounds to me like you are doing fine. You are after all about

to

> have surgery so I think its OK to feel anxious. Who wouldnt be

> anxious? The thing is, often when you try to " do something " about

> the anxiety the feelings just get worse...kind of like trying to

put

> out a fire with gasoline. So you might try meeting your fear with

> calm acceptance and understanding -- maybe you can get to where

> whatever you are feeling is OK. And thats usually a pretty-good

> place to be.

>

> What would you do if your child was about to undergo surgery? Try

to

> give yourself the same calm acceptance, understanding and

compassion.

>

> regards,

>

>

>

>

>

>

>

> ---------------------------------

> Sneak preview the all-new Yahoo.com. It's not radically

different. Just radically better.

>

[Guest guest]

And yet, Joanne, your post was just as helpful. I need to go

roundabout sometimes to get to the place where I am going too.

Your post was saved and will be read again and again over the next

few days. Thank you.

M

> >

> > Hi Margie,

> >

> > It sounds to me like you are doing fine. You are after all about

to

> > have surgery so I think its OK to feel anxious. Who wouldnt be

> > anxious? The thing is, often when you try to " do something "

about

> > the anxiety the feelings just get worse...kind of like trying to

put

> > out a fire with gasoline. So you might try meeting your fear

with

> > calm acceptance and understanding -- maybe you can get to where

> > whatever you are feeling is OK. And thats usually a pretty-good

> > place to be.

> >

> > What would you do if your child was about to undergo surgery?

Try to

> > give yourself the same calm acceptance, understanding and

compassion.

> >

> > regards,

> >

> >

> >

> >

> >

> >

> >

> > ---------------------------------

> > Sneak preview the all-new Yahoo.com. It's not radically

different.

> Just radically better.

> >

>

[Guest guest]

Hi

I am not a professional like , but wanted to add a few thoughts to

the other great suggestions which have been made. Some of them may

veer towards more conventional cbt and rebt than ACT

It seems like there are three stages here

i) pre-op

From what you have written, you are not using your mind to come up

with creative helpful suggestions how to deal with what is going to

happen, but your mind is worrying and causing you great anxiety. You

could try 'postponing' your worrying, set aside 15 minutes during the

day (I think it should be at least two hours before you go to bed so

its not the last thing you do), and use them exclusively to worry, and

when the time is up stop!! During the day, if you notice youre

starting to worry, say to yourself 'I am not going to think about that

now, I will think about that in my worry time later on' and try to

continue as best you can living according to your values right now.

This may be a bit of a wild idea, but I am wondering if because you

have bi-polar, you have part of your brain quietly monitoring for 'out

of control' situations ie mania, and in previous ops it has decided

you are not in control, brought you round to sort it out! You could

just remind yourself that this will be a situation where you are not

in control but youre trusting those who are. (Or just dismiss this

peculiar idea).

ii) op

Sometimes you have a quick moment before the anaesthetist administers

the drug to speak to them just as you go in. Perhaps you could mention

you are worried about coming round during the op to him/her?

However, at a very basic and possibly slightly cruel level even though

it would be unpleasant to wake up and something you dont wish to

happen, if you did it would not be life threatening, as you are in the

unique position of having done this twice before and survived. (I once

was still awake when they were discussing in detail what to do and how

to proceed in a small operation, I remember it was very distressing

trying to communicate that I was still concious but unable to move!)

iii) post-op

The ACT workbook on chronic pain makes the distinction between the

physical pain, and the mental anguish you create with what you tell

yourself about the pain. I have found that physical pain often comes

in waves, the length and rhythm of them may vary, but it is not

usually at maximum intensity for the whole day. For me, it is not

present in my whole body, so I can try and contact my observer self

and be aware of the pain, and that it does not occupy my whole body.

Also I get a variation in the sensation of pain, and so physicalising

it I have different pictures of it. AS others have said, as well as

the pain, there is still the breath. Also, you will have sounds that

you can hear in the environment around you.

J

>

> Just to add a few bits.

>

> The pain you may experience during and after surgery seems to have a

very different quality compared to the pain you are experiencing now

before the surgery. The pre surgery pain is evaluative/mindy pain and

it won't help you heel one bit.

>

> The real pain associated with surgery can be a gift -- a sign that

you are healing, a sign that you are moving yourself in vital valued

directions by taking care of you -- your health. You can opt for the

real pain without buying into the mindy pain. -john

>

> P. Forsyth, Ph.D.

> Associate Professor of Psychology

> University at Albany, SUNY

> Department of Psychology, SS369

> 1400 Washington Avenue

> Albany, NY 12222

> Ph:

> Fax:

> Email: forsyth@...

>

> Web Sites:

> www.albany.edu/~forsyth

> www.acceptanceandmindfulness.com

> www.act-for-anxiety-disorders.com

> www.contextualpsychology.org

[Guest guest]

Thanks for this.

M

> >

> > Just to add a few bits.

> >

> > The pain you may experience during and after surgery seems to

have a

> very different quality compared to the pain you are experiencing

now

> before the surgery. The pre surgery pain is evaluative/mindy pain

and

> it won't help you heel one bit.

> >

> > The real pain associated with surgery can be a gift -- a sign

that

> you are healing, a sign that you are moving yourself in vital

valued

> directions by taking care of you -- your health. You can opt for

the

> real pain without buying into the mindy pain. -john

> >

> > P. Forsyth, Ph.D.

> > Associate Professor of Psychology

> > University at Albany, SUNY

> > Department of Psychology, SS369

> > 1400 Washington Avenue

> > Albany, NY 12222

> > Ph:

> > Fax:

> > Email: forsyth@

> >

> > Web Sites:

> > www.albany.edu/~forsyth

> > www.acceptanceandmindfulness.com

> > www.act-for-anxiety-disorders.com

> > www.contextualpsychology.org

>