Phagophobia (fear of swallowing): symptoms, causes and treatment

This anxiety disorder can generate serious malnutrition disorders.

Currently there are an infinite number of specific phobias related to all kinds of objects, behaviors, people or situations; some of them more unusual than others. Although most phobias do not always have to involve serious consequences for health, there are specific cases in which they can end up causing other types of much more severe conditions.

This is the case of the phagophobiawhich we will discuss in this article and which can be associated with cases of anorexia and severe weight loss. Next, we will describe which are its main characteristics, symptoms, causes and possible treatments.

What is phagophobia?

Phagophobia falls into the category of specific anxiety disorders, also called specific phobias. Like other phobias, it is characterized by the occurrence of severe episodes of fear and anxiety at the appearance of a specific stimulus. In this case the fear is experienced before the act of swallowing..

Like the rest of anxiety disorders provoked by a specific stimulus, the person who suffers from phagophobia experiences a strong reaction of fear, accompanied by the physical manifestations typical of anxiety states. physical manifestations typical of very high states of anxiety..

The main characteristics that distinguish a phobic fear are specified in the following points:

• The person experiences fear and dread disproportionate to the actual threat posed by the stimulus.
• It is a completely irrational a completely irrational fear. In many occasions, the patient himself is unable to find a logical explanation to justify his fear.
• It is an uncontrollable fear, so the person is unable to avoid the appearance of phobic symptoms.
• It is stable over time. Although it only manifests itself at the appearance or imagination of the phobic stimulus, the person maintains the phobia over time.

As a consequence and if no treatment is received, the patient may suffer severe complications. may suffer from severe complications related to a deficient diet.. In some cases, phagophobia can lead to disinterest in food, severe weight loss or anorexia.

Differences with other phobias

It is common that phagophobia is sometimes confused with other types of specific phobia such as pnigophobia or excessive fear of choking or drowning. Although they may seem very similar, since both are linked to the act of swallowing, in phagophobia the phobic stimulus is the mere act of swallowing, while in pnigophobia the fear lies in the possibility of choking. in pnigophobia the fear lies in the possibility of choking and drowning as a result of and choking as a consequence of swallowing.

In both cases, the physical symptoms can be confused with those of other conditions such as dysgafia and odynophagia, in which the person suffers from a psychological alteration that makes it impossible to swallow or makes it very painful.

What symptoms does it manifest?

Because phagophobia is classified within the category of specific phobias, its symptomatology is similar to that of the rest of anxiety disorders of this type.. The clinical picture of an anxious nature is characterized by the appearance of physical, cognitive and behavioral symptoms every time the person must face the feared act, in this case swallowing.

Sometimes, the phobia can be so strongly rooted that the patient manifests symptoms only when thinking or imagining swallowing any food, drink or even medication.

Therefore, the following symptoms will appear in phagophobia, which are arranged by categories:

1. Physical symptoms

Some of the first symptoms of which the patient is aware are physical or organic symptoms. These are due to hyperactivation of the nervous system in response to the appearance of the feared stimulus. As a consequence of this increase in functioning, all kinds of alterations and changes in the organism may appear.

When this physical symptomatology appears the person may experience:

• Increase of the cardiac rate..
• Increase of the respiratory rate.
• Sensation of choking, suffocation or shortness of breath.
• Increased Muscle tension.
• Headache.
• Gastric alterations and stomach pains.
• Increased sweating.
• Dizziness or lightheadedness..
• Nausea and/or vomiting.
• Fainting.

2. Cognitive symptoms

In addition to the physical symptoms, phagophobia is also characterized by the presence of a series of cognitive symptoms that manifest themselves through thoughts, beliefs and speculations regarding possible dangers that may occur or be related to the that may arise from or be related to swallowing or swallowing.

These distorted or irrational ideas and beliefs drive the development of this phobia and are distinguished because the person integrates a series of illogical thoughts and imaginations that are constantly maintained in his or her mind.

3. Behavioral symptoms

Finally, like other phobias, phagophobia also presents a series of behavioral symptoms. This symptomatology related to the person's behavior is manifested as follows through avoidance behaviors and escape behaviors.

In avoidance behaviors, the person carries out all kinds of acts or behaviors with the main objective of avoid encountering the phobic stimulus. With them, he/she manages to avoid experiencing the sensations of anguish and anxiety that the situation generates.

However, in the case of escape behaviors, these appear when the person has not been able to avoid the occurrence of the feared situation, so he/she will perform any kind of act or behavior necessary to escape from the situation in which he/she is involved.

What causes it?

Discovering the origin of a phobia can be a really complicated task, since in many occasions the person himself is not able to determine what experience may have conditioned the appearance of such fear.

In spite of this, it is known that there are several factors that can predispose or enhance the onset and development of an anxiety disorder of these of these characteristics. It is the case of the existence of a genetic predisposition that aggravates the effects that anxiety has on the person, accompanied by the experience of a highly traumatic or emotionally charged situation or event.

These factors or the possibility of a vicarious learning or by imitation can very probably trigger the appearance of this or any other phobia.

Is there a treatment?

Due to the dangerousness of the possible effects of this phobia (extreme weight loss or anorexia), it is essential that the patient undergoes an intervention to reduce the intensity of the symptoms and even make them disappear completely.

There are a number of psychological treatments that can bring about a considerable improvement in the person. These interventions include three different and complementary types of actions.

The first one consists of an intervention through cognitive restructuring, which allows modifying all those distorted thoughts and beliefs that the person has in relation to the act of swallowing.

This intervention is accompanied by techniques of in vivo exposure or systematic desensitizationby means of which the person is gradually exposed to the feared stimulus, either live or by means of the imagination.

In order to reduce the physical symptoms typical of the confrontation with the feared situation, a training in relaxation skills is carried out, which allows to reduce the levels of excitation of the nervous system and helps the person to face his/her fears in an effective way.