The Ambivalence Factor: Fear and Guilt

Dr. Kate Altork, a psychotherapist who specializes in working with cosmetic surgery patients, gave a talk at the January 1996 meeting of the American Academy of Cosmetic Surgeons. She beautifully addressed some of the emotional issues that affect the decision-making process. I have paraphrased her ideas in this section, while including some of my own.

Seldom do people unconditionally love their appearance, but the prospect of changing it brings feelings of guilt and fear. The fear is easy to identify; the guilt is a little harder. To understand each one clearly, let's look at them one at a time.

The fear begins during the initial consultation. Patients often sit in the waiting room in a state of hyper-vigilance, eyeing every patient who comes through the door, watching staff members suspiciously, and listening acutely to every sound. Their fear is not hard to understand. As a patient, you're considering having a total stranger permanently alter your face or body. There are dozens of questions going through your mind. What if something goes terribly wrong? What if there's a mistake, and you're disfigured for life? Is it going to hurt? What if the horror stories in the media are true?

The next step is meeting the doctor or counselor face to face. In the consultation room, you will have to reveal one of the most vulnerable parts of yourself to this intimidating stranger. The sagging stomach you've tried to hide with loose clothing for years is now going to be inspected closely by someone you don't even know. Or he's going to scrutinize your wrinkles, or study the bags under your eyes, and make comments about how these things can be "fixed." You feel as though you're being judged. If the doctor has an inadequate understanding of your feelings, lacks compassion, or is unable to make you feel emotionally safe, the consultation has the potential to feel humiliating.

See how your consultation day will be at Dr. Yoho's office.