Ch. 16 Overcoming the Fear of Choking: Pseudodysphagia
Chapter Sixteen
The fear of choking, also known as pseudodysphagia, is an intense and often debilitating phobia. Individuals struggling with this fear may experience significant anxiety when faced with the thought of choking on food, drinks, or even their own saliva. This phobia can lead to avoidance behaviors, impacting daily life and well-being. Here, we’ll explore what pseudodysphagia is, its causes, and the most effective treatment options for overcoming this fear.
Table of Contents
What is Pseudodysphagia?
Pseudodysphagia is an intense and irrational fear of choking. People with this phobia often avoid certain foods or even drinking fluids due to their fear of choking, which can lead to physical symptoms like shortness of breath, heart palpitations, and an overwhelming sense of panic. This avoidance behavior can severely impact daily life, limiting social interactions and nutritional intake.
Fear of Choking vs. Fear of Swallowing
Although the fear of choking (pseudodysphagia) and the fear of swallowing (phagophobia) may seem similar, they are distinct phobias. Pseudodysphagia is specifically centered on the fear of choking on something becoming lodged in the throat, potentially causing suffocation. On the other hand, phagophobia involves an irrational fear that the act of swallowing itself is unsafe or physically impossible.
Pseudodysphagia: Focused on the fear that something will get stuck while eating or drinking, leading to choking.
Phagophobia: Rooted in the belief that swallowing is inherently dangerous or impossible, even when there is no risk of choking.
These differences are subtle but important, as they shape the types of avoidance behaviors individuals may develop and influence treatment approaches.
Phobias vs. General Anxiety
While both phobias and general anxiety stem from feelings of fear, they differ in focus and intensity. Generalized Anxiety Disorder (GAD) involves chronic, excessive worry about various aspects of life, such as work, relationships, or health, often without a specific trigger.
In contrast, phobias are highly specific and situational. Someone with pseudodysphagia may experience intense fear and anxiety only when faced with eating or drinking, or even thinking about it. The fear response in phobias tends to be more acute, often resulting in panic attacks and physical symptoms such as trembling, nausea, or difficulty breathing. Understanding these differences is essential, as phobias typically require targeted interventions to address the specific focus of the fear.
Causes of the Fear of Choking
The fear of choking can arise from various factors, which may include:
Traumatic Experiences: A past incident of choking or witnessing someone else choke can create a lasting fear.
Health-Related Anxiety: Concerns about throat health or breathing issues can exacerbate the fear of choking.
Panic Disorder: Individuals prone to panic attacks may develop fears related to breathing or throat sensations.
Learned Behavior: Children exposed to caregivers’ anxiety about choking may adopt similar fears.
These causes often combine to create a cycle of avoidance and fear reinforcement, making it challenging for individuals to confront the phobia on their own.
How Pseudodysphagia Impacts Daily Life
Pseudodysphagia can lead to significant lifestyle changes as individuals go to great lengths to avoid choking. Common impacts include:
Avoidance of Specific Foods or Textures: Certain foods, especially those perceived as difficult to swallow, may be entirely avoided, which can limit dietary variety.
Social Isolation: Fear of choking in social settings can lead to avoiding restaurants or gatherings where eating is involved.
Nutritional Deficiencies: A restricted diet may result in poor nutrition, weight loss, or other health complications.
Reduced Quality of Life: Daily anxiety surrounding meals can diminish enjoyment and increase stress, impacting overall well-being.
These behaviors highlight the pervasive influence of pseudodysphagia on various aspects of life, from social interactions to physical health.
Treatment Options for Pseudodysphagia
Fortunately, pseudodysphagia is treatable with several effective therapeutic approaches. The most successful treatments often involve psychological therapy combined with gradual exposure to feared situations:
Cognitive-Behavioral Therapy (CBT): CBT helps individuals challenge irrational beliefs around choking, replacing them with healthier, more realistic thoughts. Techniques like mindfulness may also be incorporated to manage anxiety symptoms.
Exposure Therapy: This involves gradual exposure to eating or drinking in a safe environment, helping individuals reduce fear responses over time. Exposure might start with soft foods and gradually include a variety of textures.
Intensive EMDR Therapy: Eye Movement Desensitization and Reprocessing (EMDR) can be beneficial for individuals with trauma-related choking fears. EMDR helps reprocess distressing memories, reducing their emotional intensity.
Ongoing Therapeutic Support: Regular therapy sessions or support groups can provide a space to address underlying causes and reinforce coping strategies, promoting long-term healing.
These treatment options can be tailored to meet individual needs, fostering a sense of safety and empowerment when approaching meals.
Although pseudodysphagia can be deeply distressing, effective treatments are available to help individuals regain confidence and comfort around eating and drinking. By exploring therapeutic options such as CBT, exposure therapy, and EMDR, it’s possible to overcome this fear and reclaim a sense of normalcy. With the right support and strategies, individuals can move toward a life free from the constraints of pseudodysphagia, finding renewed joy in daily experiences and a healthier relationship with food.
Until next time, don’t forget to take care of yourself.
– – Cat
Getting Started
Catherine Alvarado, LMFT is a licensed psychotherapist, Certified EMDR Therapist, and Consultant-in-Training (CIT) in Redondo Beach, CA. Beyond the pages of self-help blogs, she offers Individual Therapy, EMDR Therapy, Intensive EMDR, & Adjunct EMDR for teens and adults with anxiety disorders, specific phobias, trauma & stress related issues, & somatic complaints.
If you are experiencing distress, contact Cat to schedule a free phone consultation.
