Psychological Aspects of Surgical Practice†

Summary 1. Consideration of patients as whole persons functioning in a certain social environment, rather than as aggregates of diseased or healthy organs, requires an understanding of certain basic tenets of modern dynamic psychology. The concepts of unconscious motivation, the body image, narcissism and castration anxiety are vital in this connection. 2. All surgical procedures must inevitably arouse some degree of anxiety; the manner in which this is dealt with, both by patient and surgeon, will frequently have profound effects on the individual's total adjustment. Failure to recognise anxiety may vitiate an otherwise successful technical result. 3. Many surgical patients can be helped by psychiatric assessment and by brief psycho‐therapy, either in the pre‐operative or post‐operative periods or both. 4. Surgery in the aged poses special psychological problems, which may be substanti‐ 5. Surgery in childhood represents an important and potentially very harmful emotional stress; elective operations should be postponed as long as possible, and admission to hospital recommended only when strictly unavoidable. 6. There are enormous potentialities for future research in the areas of interrelationship between psychiatric and surgical practice. For this reason, in addition to the implications for therapy of such a move, there is a real and urgent need for the provision