The Mask of Fear – How Your Brain Can Learn Calm During Radiotherapy
- Brainz Magazine
- Oct 13
- 9 min read
Written by Sharon Clare, Clinical Hypnotherapist
Sharon Clare is an accredited Solution-Focused Clinical Hypnotherapist. She is the founder of Sharon Clare Hypnotherapy, which helps professional women overcome stress, burnout, and sleep struggles using neuroscience-backed approaches to rewire how they think, feel, and respond to life. She also specialises in easing fears of surgery.
Learn how your brain can relearn calm, and how hypnotherapy can support you and your healthcare team in creating a calmer, more confident treatment experience. Discover why fear can arise unexpectedly during radiotherapy, how your nervous system interprets safety and danger, and how techniques like breathwork, visualization, and hypnosis can retrain your brain’s response. By understanding what’s happening inside your mind and body, you can move from fear to focus and approach each session with greater ease and self-trust.
When fear catches you by surprise
If you’re preparing for radiotherapy, especially if it involves wearing a treatment mask, you may be surprised by how much fear shows up. You know the treatment isn’t painful. You know the team is skilled and kind. And still, a thought keeps looping, What if I can’t do it? What if I “make a show” of myself in the room?
Sometimes it begins at the mask fitting. Warm mesh is moulded to your face and shoulders. You lie still while it cools and firms. Outwardly, you’re cooperating. Inside, your heart climbs, your breathing shortens, your mind says, get me out. Afterwards, you might feel shaken, confused, even embarrassed that something “simple” felt so hard. The dread of the first treatment grows.
If that’s you, there’s nothing wrong with you. Your brain is doing exactly what it was designed to do, protect you, fast.
Why your brain reads safety as danger
In unfamiliar situations that restrict movement or control, your primitive safety system, including the amygdala, acts before you have time to think. It scans for ancient danger signals such as stillness, confinement, or breath restriction. The moment it detects one, it flips your body into fight, flight, or freeze.
Your intellectual brain, the part that knows this is safe and necessary, comes online a beat later. In that brief gap, your body is already preparing to escape a threat that isn’t there. This is why telling yourself to “stay calm” rarely works in the moment. It’s not a failure of character, it’s the timing of the system.
What changed at mask fitting: The stress bucket in real time
I often describe stress as a bucket your brain uses to store pressure. Living with cancer fills more of that bucket than usual, appointments, waiting, treatment decisions, tiredness, uncertainty, the sheer effort of coping with the unknown.
On the day of the mask fitting, your bucket may already be high. The fastening of the mask becomes the final drop that makes it overflow, not because the moment is dangerous, but because your system is already stretched.
Two things matter here:
Your bucket is unique. It’s shaped by your history, your body that day, your sleep, your worries, your support, and your past experiences of hospitals. Comparing yourself to someone else only adds weight.
Your bucket changes day to day. You might cope well on Tuesday and feel undone on Thursday. That variability is human, not a verdict on your strength.
When the bucket spills, your appetite can dip too. Loss of appetite is common during radiotherapy, the brain shifts the body toward protection, away from digestion. It isn’t permanent, it’s your system trying to help.
How imagination trains your nervous system
Here’s a cornerstone I teach in the initial consultation, your brain doesn’t clearly distinguish imagination from lived experience. Think of a lemon, really picture slicing it, bringing it to your lips, and saliva arrives on cue. Remember a shock, and your heart ticks up, even in a quiet room. The nervous system responds to meaning, not just events.
So, the inner pictures and the words you speak to yourself matter.
When you rehearse “I’ll panic, I’ll mess this up, I can’t breathe,” your brain practises panic. Muscles tighten. Breath shallows. The alarm learns to fire earlier.
When you rehearse “I will be held safely, my breath stays slow, the team’s voices guide me, the mask helps me heal,” your brain practises calm. Breath deepens. The alarm learns there’s no fire here.
This isn’t positive thinking for the sake of it. It’s neuroplastic training, pairing the idea of the mask with felt safety often enough that your brain updates its map. The story you tell yourself isn’t fluff, it’s input your biology takes seriously.
This is also why hypnotherapy can be so powerful in helping you create change. In everyday life, your conscious mind often argues with new ideas, “I know I should be calm, but I’m not.” It’s like trying to overwrite an old programme while it’s still running. In hypnosis, however, the mind becomes deeply focused and relaxed, and communication happens directly with the subconscious, the part of the brain that stores patterns, emotional responses, and learned associations.
When suggestions for safety, control, and calm are experienced in this state, they bypass the brain’s usual filters and become new reference points for future experiences. It’s not about being “put under” or losing awareness, it’s about working with the part of your mind that actually runs the show.
Self-compassion and the physiology of breath
Change begins with how you speak to yourself. Many people going through treatment notice that their inner voice becomes harsher just when they most need gentleness. You might find yourself saying things like, “I should be coping better,” or “Other people manage this, what’s wrong with me?” Those words might sound small, but the brain listens carefully. Each self-critical thought adds a few more drops to your stress bucket.
A kind, steady inner voice, on the other hand, does the opposite. When you say, “This is hard, and I’m doing my best,” your brain releases soothing neurotransmitters that help to quiet the same alarm circuits that amplify panic. Self-criticism keeps the bucket topped up, self-compassion lets it drain.
You don’t have to be endlessly positive. Compassion isn’t pretending things are fine, it’s acknowledging that what you’re facing is difficult and allowing that to be okay. You might simply tell yourself, “It’s understandable to feel scared right now,” or “I can be kind to myself, even in this moment.”
And then there’s the breath, your body’s built-in signal for safety. Longer exhales nudge the parasympathetic system to take the wheel. You don’t have to master a technique or chase perfection. Allow your breathing to become a little slower, a little deeper, and your nervous system hears, stand down, we’re safe.
This combination of kindness and breath isn’t about trying to control every thought or feeling, it’s about creating the right inner conditions for calm to return. That state is the soil where new learning takes root.
The science and practice of positive visualisation
Once you’ve begun to speak to yourself more kindly, the next step is learning to show your brain what safety feels like. Positive self-talk becomes even more powerful when it’s paired with mental imagery, pictures, sounds, or sensations that represent calm.
When you imagine lying beneath the mask while your breathing stays steady and your body feels supported, your brain’s sensory and motor regions light up almost exactly as they would if it were happening. The subconscious stores these calm “rehearsals” as reference experiences, ready to draw on during the real procedure.
You might repeat phrases such as:
“I can feel my body soften as I breathe.”
“The team around me are helping me heal.”
“This mask keeps me safe while I rest.”
These aren’t wishful thoughts, they’re neuroplastic instructions. Each time you combine compassionate self-talk with a calm inner picture, you strengthen the neural pathway for safety.
Research in psychoneuroimmunology shows that these emotional states influence immune regulation and inflammation. Similarly, studies published in Frontiers in Immunology suggest that chronic stress can suppress immune function, while calm, positive states promote immune balance and better recovery.
This isn’t about replacing medical treatment, never that, but about helping your mind and body work together. Positive self-talk and visualisation act like a dialogue between your conscious mind and your body’s healing systems, reminding them both that you are safe enough to rest, recover, and receive care.
Related: Psychoneuroimmunology – How To Tackle Underlying Emotional Blockages Of Illness And Activate The Body's Self-Healing Powers
Mark’s story: From fear to focus
When I first met Mark (name changed for privacy), he was close to giving up radiotherapy altogether. The idea of lying under the mask filled him with such terror that he was considering surgery instead. Even with diazepam, he couldn’t get through a session.
During our first meeting, we spent time understanding what was happening in his brain, that the fear wasn’t his fault but a survival response misfiring. We used hypnosis and calm breathing to help him experience safety again and visualised him completing the treatment while feeling in control.
Later that same day, he returned to the hospital and completed his full session. He told me afterwards, “I still didn’t like it, but I knew I could do it.” Over the next sessions, his anxiety eased, his confidence grew, and he began approaching each treatment with steadier calm.
That’s what this work is about, not removing fear entirely but giving your brain new evidence that you can be safe, even in difficult moments.
The radiotherapy pilot: Partnership in action
At the Macmillan Support & Information Centre at Belfast City Hospital, I’m currently running a pilot project offering hypnotherapy support for people who experience radiotherapy anxiety, often those who have struggled to tolerate treatment, even with sedation.
This pilot is built on collaboration. I share with the radiotherapy team the exact words, phrases, and steps that I use in hypnotherapy sessions so that patients hear the same language of calm during treatment. We even use the same music that features on my hypnosis audio, creating a bridge between practice and procedure. The brain recognises the soundscape and more quickly accesses that familiar state of safety.
The early results are promising. Patients who once couldn’t complete sessions are now tolerating full treatments, often without diazepam. Staff describe the treatment room as calmer, and patients report feeling more supported and in control.
We’ll be tracking outcomes formally, looking at reduced medication use and increased treatment completion rates, with the aim of sharing this approach more widely within Northern Ireland’s Health and Social Care system.
At present, I also offer private sessions in Northern Ireland and online for people preparing for, or currently undergoing, radiotherapy who would like personalised support outside the hospital setting. These sessions follow the same approach used in the pilot, combining neuroscience education, hypnosis, and self-help techniques tailored to each stage of treatment.
My hope is that, in time, this kind of psychological support will be funded for all patients who need it as part of an integrated care model. Until then, being able to offer it privately means no one has to wait for help when fear feels overwhelming.
It’s encouraging to see that elsewhere in the UK, NHS trusts are also incorporating hypnotherapy into oncology and diagnostic care. And while the NHS notes that hypnotherapy isn’t yet routinely available everywhere, its recognition is growing, supported by systematic reviews showing that hypnosis can significantly reduce anxiety and pain in cancer settings, though more research is always welcome.
What’s emerging is a picture of integrated care, where medical and psychological support work together for better outcomes.
And while that joined-up approach is developing within hospitals and clinics, calm and reassurance often begin much closer to home. Whether you’re the one receiving treatment or someone sitting beside them, small human moments of understanding make an enormous difference.
If you’re supporting someone through treatment
If you’re beside someone who feels fearful, you might feel helpless. You want to reassure them, but words don’t always reach through panic, because the fear isn’t logical, it’s neurological. The most helpful thing you can offer is your calm presence.
When you breathe slowly, stay grounded, and speak gently, their nervous system starts to mirror yours. Shared calm can be contagious in the best way. These quiet moments, sitting together, steadying the breath, sharing a small smile, are not small at all. They help both of your stress buckets empty, one breath at a time.
From fear to calm focus
Radiotherapy is one of the most demanding experiences a person can face, physically, emotionally, and psychologically. Feeling frightened doesn’t mean you’re weak, it means your brain is trying to keep you safe in an unfamiliar situation.
The hopeful truth is that the same brain that once triggered panic can learn calm again. With understanding, self-compassion, and consistent support from your care team, from complementary therapies like hypnotherapy, and from your own kind self-talk, calm becomes something you can choose, not something you chase.
The mask may hold your body still, but your mind remains free, to find calm, to feel safe, and to trust in your strength.
Read more from Sharon Clare
Sharon Clare, Clinical Hypnotherapist
Sharon Clare is an accredited Solution-Focused Clinical Hypnotherapist specialising in mindfulness and stress management. She combines her expertise with decades of leadership experience in the NHS and not-for-profit sector to support her professional clients. Leading a social care organisation through COVID was an immense responsibility that deepened her understanding of stress and resilience, She also has a passion for helping people overcome fears around surgery and medical procedures. She volunteers at her local cancer care centre. When she's not helping others, Sharon can be found sea swimming year-round on the beautiful Northern Irish coast, a ritual that continues to keep stress at bay. Her mission is helping women thrive.
