How and why does the fear of choking arise?

These are the causes of the fear of choking, a disorder that can turn into a phobia.

Most people eat in a natural way and never think about what they have to do to swallow. They put the food in their mouth and simply swallow.

However, the normal swallowing process can be affected by some factors, such as the experience of a choking episode, increased Muscle tension in the throat area, wounds, canker sores, fungus located in the back of the throat, and others.

Throughout life we will all experience some episode of choking with varying degrees of discomfort. Different textures, tiredness, an uncomfortable laughter at the moment of swallowing, or even a scare can be some of the causes of this event.

Depending on the tendency to perceive the dangers and the objectively seriousness of the episode experienced, the fear of food getting stuck in the throat, and even of dying as a result, can settle in the head. It is necessary to add that this fear can become very intense, even without having lived in first person an episode of these characteristics. Sometimes it is enough to witness it so that the fear reaches the degree of phagophobia..

The fear of choking: When is it dangerous to swallow?

It is important to understand that the swallowing process is very connected to the emotions for a purely survival issue. The brain wants to make sure that if there is a food in a bad state, or with an inappropriate taste or textures, we will be able to get rid of it as soon as possible.

Thus, if we don't like something, rejection responses are precipitated so that nothing bad enters the body. The easiest way to achieve this is by producing nausea, and closing the throat to food. The glottis is blocked by increased muscle tension and spasm-like responses. Thus, not letting food pass through in some situations is the way to attend to one's own survival instinct.

Voluntary vs. automatic responses of the organism

There are an infinite number of automatic responses that the organism regulates by itself and that we normally do not have to pay attention to. Among these we can mention the dilation of the pupils, sweating, or the cardiac response. There are some of them that can be regulated automatically, but we are also able to take control of them whenever we decide to do so.. Among them are the respiratory rhythm, the relaxation of different sphincters, and of course the swallowing of food.

The main brain area in charge of automatisms is the brain stem and the cerebellum. When we take voluntary control, it is the brain itself that is in charge of coordination. This change gives us the possibility to attend to more aspects and needs but it is very relevant when it comes to understanding how in cases of phagophobia, the swallowing process is complicated.

When the brain takes over the act of swallowing, it has to coordinate responses that are normally synchronized on its own, and in the moments in which the swallowing process is complicated.When the brain is in charge of swallowing, it has to coordinate responses that normally synchronize themselves, and in moments when there is also an underlying fear, it makes us more clumsy and suddenly nothing flows at the moment of swallowing. In situations like this, we are giving ourselves contradictory instructions. Some say "swallow" and others say "be careful". Normally, the greater the sensation of danger, the more food is avoided in the back of the mouth. The food is sought to enter, but from the area of the incisors.

Threat of choking and drawing attention to a weakness.

The realization that something normal such as swallowing can not be done as usual, is altering the person and only makes the negative sensation more complicated. When to this is added the fear of attracting attention in social environments for something that one does not want to show, the experience of the problem is usually aggravated and turns it more likely into a blocking fear.

The increased sensitivity to the opinion of others makes it more necessary to want to make sure that everything is all right and that nothing is going to happen. Sometimes this fact will make us want to eat more slowly or we will not want to meet other people so as not to show that we have a difficulty or a weakness. Therefore, as the fear grows, so does the difficulty in swallowing, when the fear grows, it is easy for the difficulty in swallowing to grow as well..

Solutions and treatment

To treat phagophobia, psychologists help the person to identify the emotional variables that prevent swallowing normally. We help the person to simplify the swallowing processInitially, we let the brain take over, and as the blockage is reduced, we encourage the cerebellum to take over this action again.

Like any psychotherapeutic treatment, it requires repetition and involvement. Depending on the intensity of the fears and the person's capacity to collaborate with the guidelines, an improvement is observed after the fourth session, being necessary between 10 and 30 sessions to achieve a sustainable improvement over time. It is not the same to work with someone who does not usually have fears, as it is to work with someone who hardly faces them and who usually focuses on moving away from everything he/she sees as dangerous.

If you are interested in getting psychological treatment for phagophobia, I invite you to contact me.