How and why does the fear of choking arise?

Most people eat naturally and never wonder what to do in order 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 an episode of choking, increased muscle tension in the throat area, wounds, canker sores, fungi located in the posterior area of the throat, and others.

Throughout life we are all going to experience a choking episode with different degrees of discomfort. Different textures, fatigue, an out-of-tune laugh when swallowing, or even a fright can be some of the causes of this fact.

Depending on the tendency to perceive the dangers and how objectively serious the episode experienced is, it is possible to settle in your head the fear that food will get stuck in your throat, and even die from it mode. It should be added that this fear can become very intense, even without having experienced an episode of these characteristics in the first person. Sometimes it is enough to witness it for the fear to reach the degree of phagophobia.

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Fear of Choking: When is Swallowing Dangerous?

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

In this way, If we do not like something, rejection responses are rushed so that nothing bad entered the body. The easiest way to do this is by nauseating and blocking food in the throat. The glottis it is blocked by increased muscle tension and spasm-like responses. Thus, not letting food pass in some situations is the way to attend to one's survival instinct.

Voluntary vs. Automatic Body Responses

There are countless automatic responses that the body regulates itself and that we don't normally have to attend 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 in which we are also able to take control whenever we decide. Among them, the respiratory rhythm, the relaxation of different sphincters, and of course the swallowing of food stand out.

The main brain area in charge of automatisms is the brain stem and the cerebellum. When we take voluntary control, the brain itself becomes the one 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 normally synchronize themselves., and in the moments in which there is also a deep fear, it makes us become more clumsy and that suddenly nothing flows at the moment of swallowing. In situations like this, we are giving ourselves contradictory instructions. Some say "swallow" and others say "careful". The normal thing is that the greater the sensation of danger, the more it is avoided to bring the food to the back of the mouth. It is intended that the food enters, but from the area of the incisors.

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Threat of drowning and drawing attention to a weakness

The realization that something normal such as swallowing cannot be done as usual, is altering the person And it only makes the negative feeling more complicated. When to this is added the fear of attracting attention in social settings for something that is not desired show, it tends to aggravate the experience of the problem and makes it more likely to be a fear blocking.

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

Solutions and treatment

To treat phagophobia, psychologists help the person to identify the emotional variables that prevent normal swallowing. We favor the simplification of the swallowing process, initially letting the brain take charge, and as the blockage is reduced we empower 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 capacity of the person to collaborate with the guidelines, a improvement from the fourth session, being necessary between 10 and 30 sessions to achieve a sustained improvement in the weather. It is not the same to work with someone who is not usually afraid, to do it with another who barely faces and who usually focuses on getting away from everything he sees as dangerous.