This article written by Dr Zainab Noor describes some of the possible experiences related to pulling away from social life related to the challenges of living with an ostomy, and how small habits meant to protect you can keep you isolated.
The Fear of Being Seen: How to Overcome Social Avoidance After Stoma Surgery
The reality of living with a stoma sometimes leads to pulling away from social situations. Fears about how you might appear to others and the practical needs of managing a stoma bag can make even simple plans feel overwhelming. Invitations come, and you pause, not because you don’t want to accept and connect, but because you can’t yet picture yourself feeling at ease. You start scanning for risk in the otherwise ordinary such as queues, hugging loved ones, tight or fitted clothes. You might imagine a sound from the stoma bag and a shift in someone’s expression if they notice. So, you tell yourself that you’re not ready.
You hold off participating in things until you feel more confident, which is absolutely understandable. But avoidance tends to grow roots, and over time, it becomes the norm. The aim becomes control or withdrawal. And while avoidance protects you from discomfort, it can slowly flatten your life. Familiarity replaces novelty. And somewhere along the way, safety begins to feel like something that can only be found in very few places indeed.
This article describes some of the possible experiences related to pulling away from social life related to the challenges of living with an ostomy, and how small habits meant to protect you can keep you isolated. The article suggests some psychologically relevant ways to rebuild confidence and feel connected again.
When avoidance becomes its own signal
Sometimes, the habits we form to keep us safe can eventually limit our freedom in ways we barely notice. Even once you’ve stepped outside your comfort zone, avoidance can persist camouflaged by routines that appear social but are laced with control. For example, you might avoid eye contact, stay only in certain areas, wear oversized clothing to hide your shape, or avoid physical closeness like hugs. Some of these acts may be what psychologists call ‘safety behaviours’ which are subtle adjustments we make in an effort to reduce our exposure to risk of embarrassment. They serve a protective purpose in the short term, offering control and helping us feel less exposed. But kept for too long, they can quietly reinforce the message that you are not safe or acceptable as you are, or that you’re not capable of handling discomfort.
Left unchecked, safety behaviours can deepen anxiety. They limit your experiences and reduce opportunities to learn that social situations can be more manageable than feared. The key is to notice them, and ask, “What would it be like to loosen my control of this one habit, just a little?” You may find that loosening one safety behaviour, like choosing a slightly more fitted shirt, or staying five minutes longer than you planned, can reveal more about your strength and resilience than you expect: you might find increased tolerance for unease, or prove to yourself that discomfort while difficult is not unmanageable.
Gradually stepping back into the world
You don’t need to reappear all at once. Small exposures to social life help the mind and body recalibrate, gradually discovering what feels safe and possible again. Start where there is a hint of safety already. Maybe a friend who knows, a familiar café, or a walk at a time of day when the streets are quiet. Let yourself notice what you miss, not just what you fear. Whose company brings ease? What places help you feel grounded? Remember that participation itself is a form of care, both to oneself and others.
These acts are rehearsals for trust with yourself, which are the building blocks on which you can grow.
Expanding your window of tolerance
As you move forward, feelings of discomfort will appear, this is expected and normal. When it does, you can begin to build a new response, one that has the capacity to tolerate the discomfort rather than avoid it. In psychological terms, distress often follows a predictable arc: it rises, peaks, plateaus, and then naturally falls. This is sometimes called the ‘anxiety curve’ – a pattern where your body reacts intensely to a perceived threat.
Most people retreat from anxiety at the very point where growth is possible, right at its peak. This is understandable because the discomfort feels overwhelming, and the urge to escape feels immediate. But leaving too soon only teaches us that we can’t cope. If, however, we stay just a little longer, or long enough to let the adrenaline subside, to ride out the racing heart, we begin to learn something different – we begin to expand on our ‘window of tolerance’. If you do this, you might start to trust that the wave of discomfort does peak, but it also falls if you stay long enough to find out. You may learn that you can remain present without falling apart. By staying with the discomfort rather than avoiding it, your nervous system begins to learn that ‘this is survivable.’ That even if the bag made a sound, or there was a moment of awkwardness or doubt, you endured it. You coped, and you are capable.
Over time, this repeated experience of staying, enduring, and recovering, builds inner trust. You are not aiming to feel perfectly calm, but to expand your ability to tolerate discomfort and function alongside it. This is how confidence is rebuilt, not by removing fear but by showing that you can carry it and still move forward.
Making room for a kinder internal voice
What can help us tolerate the peak of anxiety or discomfort is the way we talk to ourselves when we are in the middle of it. You may find yourself second-guessing every move, harshly scrutinising how you sound, look, or take up space. The mind can become its own spotlight. This is where self-talk matters. Not in grand affirmations, but in small recognitions that “This is hard, and I’m trying”, “I don’t need to get it perfect.” When fear surfaces, meet it with the same steadiness you would offer a friend, a child, or a loved one. You are carrying a body that has survived something. You are learning how to live in it.
This type of internal voice soothes our otherwise stressed nervous system. Though sometimes it may seem indulgent, when directed at something you find difficult, it can actually help you to tolerate discomfort while encouraging progress. In this way, supporting yourself through difficulty can strengthen your resilience, rather than weakens it.
This kind internal voice is especially important as rebuilding your sense of safety requires repetition, returning again and again to the places of discomfort with a tone of internal warmth. In this way, self-talk becomes not just commentary or a way to bully yourself into uncomfortable situations, but rather a trusted and warm guide.
Small steps towards reconnection
Below are possibilities, or ways to move gently through fear, and rebuilding connection at your pace:
Name the fear when it surfaces: If you hesitate before leaving home or joining a conversation, pause and identify the thought. For example, “I’m worried they’ll notice my bag.” You might then respond with something encouraging but kind, such as “…and this is how I will tolerate and survive this.” Naming gives fear boundaries.
Ease into the change: Choose one current habit that may keep you restricted, like wearing oversized clothes. Experiment with shifting it just a little. And notice the arc of anxiety, wait for the eventual fall that comes after a peak. How do you feel about your ability to tolerate discomfort now?
Shift focus outward: In social situations, we can often become self-conscious and focused on how we may appear. This type of focus can amplify anxiety. Try focusing on the environment instead, such as the sound of cutlery, the colour of someone’s coat. This will interrupt the cycle of self-surveillance and give you a chance to enjoy yourself more.
Speak to yourself as someone worth soothing: When negative self-judgment creeps in, speak to yourself as if speaking with a loved: “This feels scary, but I can tolerate this unease. I am more than this moment in time.”
Choose one act that connects to meaning: Return a friend’s call. Sit in the park. Go to a face-to-face meeting. Not to be fearless, but because you are choosing life, not avoidance.
Moving forward
The process of riding the anxiety arc and finding your ‘window of tolerance’, acknowledges that fear and discomfort are natural parts of adjustment, not flaws to be eliminated. Through small, deliberate steps that challenge avoidance and safety behaviours, combined with developing a compassionate inner dialogue, you expand your capacity to tolerate unease.
This gradual rebuilding of trust in yourself and your social environment enables you to engage more fully in life despite the ongoing presence of fear. And with each step forward, you reclaim a little more of the life you deserve.
About the author
Dr Zainab Noor
Dr Noor is a Clinical Psychologist specialising in the emotional impact of surgery and chronic illness, particularly the adjustment to life with a stoma.
