Every surgery, large or small, is stressful. Managing your stress can affect the outcome of surgery since stress depresses the immune system and provokes fear and its attendant chemical implications, which can prolong recovery.

Researchers at Harvard and UC Davis have documented the benefits of preparing for surgery and reducing pre-operative stress. People who are mentally and physically prepared for surgery generally experience an easier surgery because the body is more relaxed. The more relaxed you are, the fewer complications you have. Relaxed patients are reported to endure more pain, need less medication and have shorter hospital stays.

Though the idea is slowly catching on, few have yet to hear about the benefits of preparation for surgery. Generally speaking, people go into surgery passively, unaware that taking charge of the experience can be tremendously empowering. From my experience, many doctors remain cool to the concept, even when presented with evidence-based data in a business setting. To be fair, on the other hand, as a patient, I found 15 years ago that even my very conservative surgeon was open to reasonable requests. He smiled and said supportively, “Do the things in the OR that make you feel relaxed… as long as they don’t interfere with my work”.

For me the need to prepare for surgery was precipitated by the discovery of pre-cancerous cells in my colon. As a patient with Crohns’ Disease for 26 years at the time, my doctor strongly recommended surgery as soon as possible.

As an LCSW-R who practices psychotherapy with a mind-body approach, I decided to go through this experience as my own guinea pig-like experiment. I scheduled my procedure six weeks hence. My goal was to concentrate on aspects of my physical, emotional, and spiritual self to see if I could make a difference with the stress and fear I was feeling. Here is what I learned:

Breathing Brings Deeper Awareness: Breathing exercises clearly had a relaxing effect on my mental state. When tense, your breathing becomes shallow, relegated to one’s upper chest. Full, deep, slow breaths were not only calming but also allowed the emotions that I had been suppressing to come into awareness. The key is to breathe consciously, that is, to focus your attention on listening to the sound of your inhale and exhale.

Experiencing Emotions Fully: By allowing myself to be with my sadness, anger, and fear rather than pushing these feelings away, I had the chance to work with each feeling by myself and with my therapist. For example, when anger arose about my surgery and the sudden change the surgery forced in my career plans, I discovered that laughter, induced by listening to comedy albums, relaxed me. As I expressed each emotion, I found that stress lifted for a time until the next feeling emerged; it was quite freeing to discover that cycling through a feeling completely often led to a relaxed state. Over the weeks, with repeated practice, I was surprised to discover that I actually was able to feel peaceful and even joyful after articulating and releasing my feelings. This was a profound new experience for me.

Drawing on the Power of Dreams: I recorded all of my dreams in a journal. This exercise paid surprising dividends. One night, I had an astonishing dream that led me to believe that I would get through the surgery successfully. In the midst of anxiety, it was extremely reassuring to find the inner sense of guidance that this dream provided. So, too, guided visualization exercises, a form of ‘waking dreaming’, helped me imagine the surgery going smoothly and reduced my fear of uncertainly and the unknown. As a result, I was relieved to find an authentic sense of confidence about the outcome.

Getting In Shape (if possible): I decided to train as if I were going to run a 5K race. I reasoned that if my body were in shape, the trauma would be better absorbed. I ran on the treadmill every day, ate healthfully, made sure I took a good regimen of vitamins and supplements and got a weekly massage.

Creating a Support Group: One doesn’t have to go through surgery entirely alone. Managing the information you decide to share is important. I asked family members, friends, and my spiritual community for prayers over the six-week preparation period, and especially on the morning of surgery. Just knowing that I had so much support buoyed me in my fearful moments and effectively balanced my anxiety. I asked a hospital nurse who was also an expert energy practitioner to join me in the OR. She was happy to whisper affirmations in my ear that all was going well.

Self-educating: I read up on basic surgical and hospital procedures. I asked my surgeon what he would allow me to bring into the OR (e.g. a music device and affirmations). I was pleasantly surprised that he was open to music, the presence of the extra nurse and keeping the atmosphere light with humor. I met my anesthesiologist beforehand and got to know the policies and procedures of the pathology slide department (you bought ‘em, you own ‘em!). I requested copies of all tests and pathology reports for my files. Some may wish to donate his/her own blood before surgery.

Connecting with spirit: Meditation, prayer and asking God to help me visualize and bring into being the desired outcome helped lift my mood, and to remain centered and calm.

Pragmatically speaking, I know that most people may not be willing or able to spend six weeks preparing for surgery as I did. Know that, essentially, anything that brings relaxation will result in pre- and post-surgery benefits, even if you begin a practice just a few days prior to surgery. No need to try to re-invent the wheel. Start with things you already enjoy. Listening to calming music. Seeing funny movies. Gardening. Painting. Sewing. Dancing. Imagining oneself full of life and energy. If possible, add only one new practice like conscious breathing or guided visualization to a daily regimen.

How did I fare? The morning of my surgery, I walked into the OR with a 110/70 blood pressure. My pulse was 65. I was feeling relaxed and confident. My stress was in the ‘green’ zone. I introduced myself to the surgical team and asked them to talk to me as if I were awake. I asked the surgeon to tell jokes in the OR. Taking some deep breaths, headset with calming music in place, I signaled the anesthesiologist to begin. My surgery went easily and I was home on my way to a complete recovery within a week.