What We Hear Under Anesthesia Still Matters
When we think about surgery, we often focus on the technical aspects—skilled surgeons, effective anesthesia, and a successful outcome. But what we hear during the surgery may also play a critical role in how we heal.
Although research to date is inconclusive, clinical experience has repeatedly shown that not only do we register what is said while we are under anesthesia, but those words can act in the same way as potent post-hypnotic suggestions due to a state of high stress and altered consciousness.
While under general anesthesia, our eyes are closed, our sense of pain is blocked, and in many cases, our bodies are even paralyzed to prevent movement– a necessary precaution to suppress defensive impulses that might otherwise hamper the surgeon’s work. We are in a vulnerable state in which the brainstem — the primitive part of the brain that controls automatic functions including our stress response — remains highly alert.
Despite our level of consciousness, we listen for danger or reassurance, and our autonomic nervous system may activate a fight, flight, or freeze response in reaction to perceived threats. Sounds, words, or even the tone of voice in the operating room can influence our physiological state, potentially increasing heart rate, blood pressure, or stress hormone levels — all without our conscious awareness.
This underscores the importance of maintaining a calm, respectful, and reassuring environment during surgery, as the body may remember what the mind cannot.
Two Surgical Environments – Two Possible Outcomes
Compare the differences in the following operating room examples.
❌ Negative Approach: The Casual, Careless Conversation
A patient is under general anesthesia for routine abdominal surgery. The operating room is quiet except for the surgical team, who are confident and experienced. About an hour in, the surgeon encounters a small adhesion that complicates the procedure slightly.
Conversation in the Operating Room
Surgeon (irritated): “Ugh, look at this mess. Why do people wait so long to get this taken care of?”
Scrub tech (laughing): “Yeah, this is the kind of train wreck that makes me want to skip lunch.”
Nurse (sarcastically): “This one’ll be back in here in five years if they don’t change their lifestyle.”
Why It Matters
Even though the patient is unconscious, their auditory system is still processing information. These types of remarks, even when spoken casually and without malice, may be internalized by the patient’s subconscious as personal truths:
- “I’m a mess.”
- “My body is disgusting.”
- “This surgery was a train wreck. I don’t know if I’ll ever get back to where I was.”
Post-op, the patient may feel shame or confusion without understanding why. They might have difficulty recovering both physically and emotionally, feel anxiety around follow-ups, or avoid seeking care in the future—classic signs of residual trauma.
While not technically a violation of medical ethics, this situation contradicts best practices in trauma-informed care and can unintentionally harm the patient’s emotional and physical recovery.
✅ Positive Approach: Conscious, Healing Communication
A patient is undergoing a mastectomy after a breast cancer diagnosis. Prior to surgery, she shares with the anesthesiologist and surgeon that she’s been practicing guided imagery and healing affirmations. She asks that the operating room environment remain calm and supportive as part of her surgical plan.
Conversation in the Operating Room
(As the patient goes under)
Anesthesiologist (softly, to the patient): “You are strong. Your body knows how to heal. You are surrounded by people who care about you.”
(During surgery, while cauterizing tissue)
Surgeon (gently, to the team): “Let’s keep this space quiet and focused. She asked for a healing environment, and we’re going to honor that.”
(Later in the surgery)
Surgeon (to the patient’s body directly): “We’re removing what no longer serves. We’re making space for renewal.”
Why It Matters
This team respects the patient’s agency, honoring her request for a healing space. By choosing their words carefully, they reinforce:
- Safety
- Trust in the body
- A sense of being cared for
Not only does this reduce the likelihood of postoperative emotional distress, but it may enhance physical healing.
This approach reflects an evolving understanding in medical ethics: that respect, presence, and tone are part of quality care—even (and especially) when the patient cannot respond.
How to Co-Create a Healing Soundscape During Surgery
The good news? You can work with your surgical team proactively to promote a soundscape conducive to healing. Here’s how.
⭐ Use Healing Affirmations Before, During, and After Surgery
What if we leveraged the increased suggestibility of the anesthetized state to potentiate the body’s capacity for healing?
When I had hip surgery, I wrote affirmational messages to support my psychological state, and my friend Dr. Waldyvia read them to me during surgery. She even added some of her own, inspired by the moment. It was an extraordinary act of partnership in healing. 📖 Read the full story here.
At the very least, using affirmations can help you feel proactive and participatory in your own process of healing. It can help to reset your attitude about yourself, your body and your health. And at the very best, affirmations can promote faster healing and post-surgical integration.
Examples
- “All is well. This surgery is part of my healing into aliveness, health and well-being.”
- “I am safe, I am seen, and I am supported at every step of this procedure.”
- “This surgery is an act of healing, and I trust in the process of restoration.”
One Step Further: Conscious Collaboration with the Body
One of my husband’s dear friends took these ideas further, asking her surgeon to speak directly to her body during surgery. He complied, gently saying things like:
“I’m about to make an incision here—please diminish blood flow to this area.”
To the doctor’s surprise, the body responded almost immediately. The patient, already aware of the body’s innate intelligence, wasn’t surprised at all.
This story reminds us: Although the time that we are under anesthesia and being operated on is ostensibly a time over which we have no control, there are still ways that we can help the body to respond better to surgery and heal faster and more completely.
👉 Want more ideas for surgical healing affirmations?
Get my curated list of sample surgical affirmations and tips for creating personalized affirmations.
⭐ A Final Reminder: Advocate for Trauma-Informed Surgical Settings
If you’ve been following my blog, you are no stranger to the importance of collaborating with your surgical team through empowered self-advocacy. Some clinicians want to honor patient-centered care and will appreciate your clarity. With others, you may need to advocate for your preferences and needs.
👉 See my previous blog post for more tips on how to empower yourself to have a collaborative pre-op conversation with your surgeon.
Share your preferences for a healing and respectful surgical environment with your care team ahead of time. Let your surgeon and anesthesiologist know that you value a calm, compassionate tone in the operating room and would appreciate positive or neutral language while you’re under anesthesia.
Frame your requests in terms of holistic, trauma-informed care.
✅ If necessary or possible, bring an advocate with you to help reinforce your wishes and ensure they are respected in the pre-op conversations.
