Fear Of Swallowing(Phagophobia)

I am 43 and started having panic attacks about a year ago. I have been having panic attacks daily for nearly 2months now and i am having great difficulty swallowing. At first i could swallow food following each mouthful with water  but it has got worse. I would chew my food as small as i could and end up having 2 spit it out because no matter how much i told myself to swallow, i just couldnt. Now i am just taking liquids. Please help. I cant go on like this. I want to feel normal again!!!!

The above is an example of many E. Mails and comments posted to an article about the fear of swallowing.

 The original posting and responses can be found at the following URL:

http://www.mentalhelp.net/poc/view_doc.php?type=advice&id=3931&at=7&cn=1&ad_7=1&submit=I+Agree#ad15913

Some people experience a lump in their throat upon swallowing food. Others fear that, if they eat or drink, they will choke to death. What ever the specific fear is, they all fear swallowing and this is called Phagophobia.

It is important to distinguish this psychological fear from those them stem from a real blockage or injury in the throat and trachea. There are many conditions that cause extreme pain upon swallowing and one of the common ones is the strep infection that, if it happens with great frequency, sometimes results in the surgical removal of tonsils. This is why it is never safe to assume that an adult or child who is complaining about being fearful about swallowing is simply having a psychological fear. Quite to the contrary, there are many head, neck and throat illness that create real pain and blockages that obstruct the ability to swallow. A thorough examination is always necessary to rule out anything physical or organic in nature.

Case Study (fictionalized)

During my thirty years if psychotherapy practice, I had several patients with the complaint that they feared swallowing. These individuals had each been to multiple numbers of medical doctors who ordered all types of tests and examinations that yielded nothing but good physical health.

When he came for psychotherapy, this man was filled with anxiety and depression and was losing weight. He was skeptical about the ability of psychotherapy to help him and was even more skeptical about the usefulness of medications. It should be noted that the death of an important relative seemed to have set off his anxiety and depression.

However, Cognitive Behavioral Psychotherapy combined with teaching him meditation and encouraging him to begin a good program of aerobic exercise really helped. He was accustomed to exercise but stopped when his symptoms worsened. Ultimately, he was seen by a psychiatrist who prescribed a low dose of anti depressant medication. That, combined with the psychotherapy, helped him put the swallowing anxiety and all of the symptoms to rest and he was able to resume a normal life.

Discussion:

Phagophobia or the fear of swallowing is usually forms one aspect of people who are overwhelmed with anxiety. In the case of the patient above, there was no incidence earlier in his life that served as catalyst for what became his fear of swallowing. Rather, he always experienced a mild anxiety, a symptom that was familiar throughout his family of origin.

However, there are people who go through something traumatic that can set them on the road to phagophobia. Surgery to remove tonsils with its painful aftermath can be the motivating factor for some people. Others may have a relative who suffered from head and neck cancer and that became the catalyst for their worry and fears about health and swallowing. Certainly, a tendency towards being a hypochondriac (worrying about being sick despite being in good health) along with strong tendencies to worry by obsessing about everything, all add to the likelihood of developing this type of phobia.

There is psychological treatment for this and all phobias and it involved cognitive behavioral therapy, learning meditation and deep relaxation and experiencing a gradual desensitization to these fears.

Your experiences and questions about this awful phobia are encouraged. Please write in.

Allan N. Schwartz, PhD.

Comments
  • Kathy Sheridan

    My granddaughter recently developed this fear. Her parents divorced a year ago. She is 9. The divorce forced her father to move out. She was very close with him. Her mother is a hypochondriac and my son and I are seeing signs of Munchausens by Proxy. This little girl wants to spend more time with her father, but her mother desperately wants to find a physical cause for her problem. Is there a good possibility that she can overcome this fear or is there a poor prognosis for her recovery to health?

  • Anonymous-1

    7 years ago I got a chicken bone stuck in my throat. I went through a procedure where a lge tube thing was put down my throat. That was what made swallowing solid foods and some drinks impossible. The pain was incredible and lasted months. I felt like someone had their hands around my throat 24/7. I then got whooping cough. I now can't eat solid food, only liquids. I'm too scared now to try eating solids. Doctors just don't understand.

  • Tara

    I had this phobia really bad about ten years ago. I was moving into my new home and I think the stress of it all just got to me and manifested itself in a fear of chocking. I was even afraid to swallow water.

    Now, this phobia comes around every so often - when I am in between jobs. But I try to distract myself with exercise and the computer.

  • S.B.

    I've had phagophoabia for over a year now. I know I have a tendency for anxiety and perfectionism. But I am not the typical fearful anxious person. I am rather optimistic on the whole and have a strong will. Yet, I have not been able to overcome this pathology. Even less put my finger on what caused it. I can't get back to normal and suffer from it daily. I am almost constantly starving and fall ill easily because I don't eat well enough. I don't know if psychotherapy can help me and in which ways it can. Ive heard that exposure to the cause of fear can help. I've learnt to manage my fear, but I am never totally comfortable while eating and desperately want to get back to normal. I also know that this is the kind of fear that I will never unlearn . It can come back anytime.

  • Victoria

    When I was 11 I came home from school to find my grandmother on the floor after a severe stroke, she was choking on her false teeth. Luckily my neighbour was at hand to help. Since then any time I have been i the presence of anyone and they have coughed at the dinner table I have panicked and stopped. It has worsened to the point that I can only eat when I have drunk alcohol. My health has been incredibly bad, I am now 33 and completely at a loss.

  • Evgenia

    I have tihis problem for 3 years now.I have been taking anti depresants for about 2 years an da half and 3 months ago I tought I overcame my fear,but it`s back.I don`t know what to do so I`m not sure they treat me right. The phagophobia brought with it and panic attacs,I usually have them at night when I fell asleep or when I go to a new place. I`m totally afraid not to become in the same condition as 3 years ago when I lost 10 kg and ate 30-50g of food per a day.Somebody to help me?!Thx!

  • Just Me

    I too have a fear of swallowing, well its not an extreme case. But I at times feel like oh no I have to swallow but feel like I cant.. and soemtime when I drink things that are luke warm.. I have a hard time drinking.. my drinks need to be real hot or real cold... but sometime I can drink warm drinks.. ugh im sorry I think after writing this out It is a brain thing.. thanks for listening

  • Anonymous-2

    When I was 7 years old, I developed a fear of choking. At first, I would eat solids in small bites with lots of liquid. It got worse, though, and I eventually consumed only liquids. This went on for two years. I saw a therapist, had a scope of my throat done, and the like. Nothing was wrong with me. I don't know what brought on the fear, but I was absolutely terrified of eating, or rather, choking. I hated the prosepect of talking to a therapist, but I really do think it helped. The breakthrough point for me was at my 9th birthday party. I had invited my friends, and everyone was eating pizza. This is when I thought to myself, "That looks good!" So, I plopped a slice of pizza on my plate. And I ate it. It took me a good half hour with plenty of drinks in between, but I did it! And just like that, I wasn't afraid anymore. Now, when I eat, I still drink lots of liquids, but knowing that I overcame something this bad makes it all okay. If I did it, you can do it to! Best of luck and God bless! :)

  • Anonymous-3

    I had a choking indicent back in 1994. I am now 41 years old. After the incident, about a month later I was at McDonalds with co workers and I all of the sudden could not swallow food. To make a long story short, I went from 190 lbs to 140lbs. I could have died from this fear of choking. I had every test available and discovered it was all mental. And I loved to eat. It took me a few years to adapt to the way I ate and went back to normal weight. But even 18 years later, it takes me an hour to eat a full meal bc I chew my food over and over again until I feel comfortable swallowing it. And no one understands what I'm going through and when they make fun of how slow I eat, it makes it even more torturous for me to eat so I stop. At restaurants, I choose the things that I know I can eat at a normal pace and have a few drinks before eating. That helps with the anxiety. This is unbelievable that other people have this same condition. It's like a dark secret that I choose not to share with anyone. Daily torture where I ask myself why me? But for those are first experiencing this, you can get better. You have to just realize first, it's all mental. Exercise helps tremendously as well. Drinking is not the answer bc acid reflux issues makes swallowing worse in the long run. Are there online support groups for this?

  • Olivia

    I don't really know what started my fear but it's been getting worse lately. I'm 17 years old and I can eat fine when I forget that I am eating. But when I focus and realize what I'm doing thats when the fear hits me. I have to stop eating no matter how good the food looks. I get so afraid and I tense up not allowin myself to swallow anything. I know I could take anxiety medication but I can't swallow pills either. It's getting worse and as stupid as it sounds, it's an awful fear. I just want to be able to live without fearing when the next time I will be able to eat a full meal is.

  • Anonymous-4

    I always had the fear of swallowing pills and have always been quite anxious but since a few months, after some quite hard events in my life, I started to feel a lump in my throat. From there, now and then, when I was eating, I had the feeling that the food in my mouth would not travel down my throat. I was petrified for a few seconds and then ok. Now it is almost constant to the point when I eat I masticate forever and feel I just can't swallow the food... and then I even spit some food while trying to control what is going down my throat. Right now, I feel I don't even remember how it feels to eat normally... like having a mouthful and just "send" it down. It's like my whole mouth doesn't "know" how to do... My tongue doesn't feel normal, my jaws are tight etc... Am I the only one to have this feeling that even if I try it is not working?

  • Kya

    About 4 years ago I began to choke on my supper one night. I coughed it out and cried - I consider myself a hypochondriac, not to a far extent. Anyway I was scared silly for about 2 weeks after, I remember I swallowed next to nothing in that time. I dropped pounds and my mom forced me to eat. I remember sitting at the supper table long after my family was finished, I took small portions, and ate very slowly. I have the problem today, I somehow got into the habit of spitting my food out, every meal. I think its progressed from an anxiety, into a complete fear. I dont get a "lump" in my throat. It's like the texture of the food on my tongue doesnt feel right and i chew the crap out of each bite. Sometimes, when its a really good meal I pack the food in only to spit it out. Im constantly at battle with myself. Some foods are easier to eat, strangely enough its things like poptarts and toast. Lately, ive noticed slight weight loss and i cant even remember what it feels like to be full after a meal. I cant go on dinner dates, thats just uncomfortable. It has taken over my life, I pray for the strength to overcome this but its a long process. Its gross, I hate eating out. I carry extra napkins to spit in. This week I thought buying ensure drinks would be a good choice, I would still try to eat foods, but the drinks will ensure i get the proper nutrition. If anyone has any advice or anything, I'd truly appreciate it. I never knew people had the same fear.

  • Julie

    I was very relieved to find this forum. For the first time in a very long time I realize, I am not alone but above all I am not crazy. About 8 years ago I experienced my first episode. It happened while having lunch at a local diner with friends. Out of no where I just could not swallow. It would come and go and then it went away. It reared it's ugly head once again about 2 years ago. At first I could not eat anything, only liquids. Then there came a point, where I could pretty much it anything but bread, Steak and Cheese. Around 8 months ago, I woke up one morning and could not even swallow water. For several day, it was very extreme to where I could not even swallow my spit. I ended up in the hospital on IV's. Needless to say I have seen countless doctors, including 2 Ear, Nose and Throat doctors. I have had every test under the sun, some of which twice. I have had Accupuncture, been seen by a Chiropractor. Nothing!! I diagnosed myself with Phagaphobia after stumblin across a few websites. This being one of them. But now I need to figure out how to fix it. One other strange thing I have discovered, when I drink a few(sometimes more than a few) glasses of wine, I can eat anything in site. So now that has become my 2nd problem... too much alcohol. I just need answers. This is ruining my life and my health. Don't even remember normal anymore. My diet consist of mostly liquids and protein drinks. Hope I will find an answer and the help I need with this post. Thanks for listening...

  • Allison

    I have the same thing as Kya. I first started having the issue as a kid and went to years of therapy. I thought that I had gotten over it but then three years ago, I started a new job and the stress and anxiety from the change brought everything back. I chew all of my food to water and apparently drink too much (now I have low blood sodium). I get so frustrated with myself and it affects my overall confidence in life. Going out to eat with friends brings anxiety because I hate how I eat. I hate eating at work because I have so many work arounds to eating food that it is embarassing. Everytime I go to a therapists they want to dig in my past and I hate that. I really just want to be normal and not have to worry about food. I do the same thing of drinking protein shakes for added nutrution. I really just wish I could get over this.

  • Ifeelyourpain44

    I too share all of your pain. I actually lost my ex girlfriend my job because of it and now if I dont get fix this Ill lose my son. I can relate I literally have gone down to water. I pray that you ll will find the strength and understand it is merely a fear. Dont let it destroy you like it has destroyed me.

  • aisha mohammad

    i thiink the best soluotiion to this case is that one must keep himself busy ,because leisure make you think in bad things ,sometimes leisure lead one to dilirium.

  • mel

    I have suffered from this daily torture for 13 years. It started after a trauma in my twenties, suddenly, and has come in bouts ever since. I had 3 major choking incidents as a child: a penny, a gob-stopper and a kinder egg, each one serious and turning blue from lack of oxygen, luckily my mum saved me by turning me upside down and wacking me.

    Now at 38 I am waiting for cognitive behaviourial therapy to hopefully over come this debilitating issue. I have great sympathy for everyone with this as I know how upsetting and frustrating it is..

    Everyone Please try 'The Tapping Cure' Roberta Temes it HAS sometimes worked for me..and I am currently applying this method to my phobia..It has proven results, and I urge you to use a coping strategy like this as it helps to empower you and stop you feeling such a helpless victim of it. Also I would urge people with this fear not to be afraid of taking prescribed anti anxiety medication.. it does help..and it need not be forever, I have found beta-blockers really help with the panic attacks, and I have just started SRI (anti deppression drugs) in a bid to shift my mind about this dreadful affliction..I refuse to give up as I Love food. I have noticed that when I am feeling defeatist about it it gets worse, an when I am feeling brave, it does improve...so please be brave and keep trying to resolve it..I know how dreadful it can be, but please recognise it for what it is.. an Extreme manifestation of anxiety and treat it as such..I know the condition creates more anxiety and what a vicious cycle it is... so for people who dont want to take anxiety medication I would recomend you try it as it has brought me to a place ware I can start to tackle this issue from a less stressed place..which ultimately helps. And tackling it as an anxiety issue puts it in a better perspective, you can begin to break it down..the anti anxiety medication really can help bring you to a better place to start dealing with this, be honest and open about your fears, and stop treating it as a 'terrible secret' helps also, you are not alone, and we will get over this, my thoughts are with all of you trying to live with this

  • Concerned Flitter

    My Mom had open heart surgery which resulted in complications the day after the surgery. She was semi-comatose and she was eventually put on feeding tube, trachea and dialysis to keep her alive.

    After coming out of the semi-coma, she had several challenges to overcome prior to having the trachea removed but over time the trachea was removed and she passed her "swallow test" allowing her to gradually eat solid foods. Her feeding tube was a J-tube bi-passing her stomach and going in at the top of her intestines (she had pain with the Gtube) and it was not removed for several months after the trachea was removed because she wasn't eating enough food. The nurses would continue to feed her through the feeding tube until the tube started hurting and the doctors eventually removed it.

    Prior to her surgery she loved loved foods. Now she will drink fluids (after much convincing that she needs to) and she will have soup but any solid food she agrees to eat (which is like a battle getting her to agree) and puts in her mouth she "cheeks" meaning she chews it and then puts it in her cheeks and subsequently (may be many hours later) spits it out. This has been going on for 4 months and she has lost a lot of weight. We don't want to put a feeding tube in again.

    She says she wants to eat and that she doesn't understand why she does that. Can you help? Would hypnotherapy be an option? Any advice would be appreciated.

    She has seen the rehabilitation center pyschologist who has not offerred any advice on this matter.

    Concerned Daughter....

  • Katrin

    Hello! My name is Catherine. 5 years I have panic disorder. Treat with Zoloft and lexotan. Some symptoms disappeared, but remained a difficult swallowing - almost impossible. I can not accept normal food and drink. Please tell me what to do to fix it.Tried hypnosis, to no avail, I went to cognitive-behavioral therapy, but no effect. Help me! Please tell me what to do! I am 20 years old and can not live fully. I live in fear that it will choke while eating!

  • Anonymous-5

    Back in 4th grade I choked on the cartilage found in crab. After that I feared all food, especially food that had touched bones. I slowly regained my ability to tolerate food with bones by gradually transitioning back to hard foods. This took several years, but with gradual but continual help from friends and family I am now fully recovered. I am, however, highly cautious when I eat.

  • Kat

    I'm 20 years old and I've been having this fear since i was 12. The most difficult things to swallow are fries, bananas, brownies, potatoes,etc because the texture feels like it gets stuck. Easier things to eat are ice cream, smoothies and cereal. What helps a lot is eating my food with water with every bite. It's so embarassing and I'm a very introverted person. I hate being like this but it is a relief that I'm not the only one...

  • Anonymous-6

    i am currently battleing with phagophobia and it sucks! none of my relatives or family members but my mum knows about it. I have been battleing with this for 2 years so far. Everyday is a struggle and its so painful to eat infront of my friends. They have no idea i have this disorder and they always push me to eat, when it reminds me of the phobia and i get even more terrified. Ive been trying to get my mom to get me protien powder so i can make protien shakes and get stronger and to help me gain weight while i control this but protien powder is crazy expensive!!! The sad thing is im pretty much anorexic and i have a feeling that everyone that doesnt know about my condition thinks that i want to be skinny but i dont, i feel so relived to know that im not alone

  • lindsay

    my fear started 13yrs ago it just came one day with no reason i lived on gravy daily for at least a yr i no longer went out for food it all stopped that day. then started anti ds and slowly recoverd and was no longer a problem all was forgotten and i lived my normal life and enjoyed all the food iv allways eaten :-) ....... happy days....... then 3 yrs ago it happened again and nothing as worked for me this time its so scary trying to swallow food i only try and eat whilst at home where i feel a bit more relaxed but also i started drinking alchol 1yr and a half ago because when i had a few gave me the dutch courage to eat now iv got two problems its so deppressing help someone please .......

  • safhsn

    I recently developed this fear when a piece if chicken stuck on my throat. First 3days since that i couldnt even drink water. I felt very helpless and worried. But i knew that if someone could help me thats me. I tried keeping positive thoughts and positive spirit...telling myself that this happened for something good. I tried being optimistic abt it. I knw it sounds funny but this has helped a lot. I m not tensed so much now. Bcz more i think abt it, more fearful i feel. So optimism helps forget that incident and kind of move on. It helps me eat, even if its little. So i wish and pray that all of you who are going through this will get out of this very soon.

    I am happy i found tis page. It somehow boosted my courage. It makes me feel i am not alone.

  • Veronica Taylor

    I have lived with this condition for 30 years and have been on medication for the same time frame. My started with at 28 years of age it came out of no where. I have learned to live with it to the best of my ability. Mine seems like the reverse of what I have read others said. My problem is drinking water and liquids it's too loose and I can't control it. I got around this with slushe mugs. It's easlier to get cold liquid down and it thickens the liquid. Five years ago I was put on 150 mgs of Elavil this medicine helped tremendously took alot of the fear away. I am now getting off of it because of the side effects. I weight 1101bs when I went on it. My weight went up to 1681bs and the constipation is the worse.This medicine also bloats you up. I am now down to 153 lbs. @ 100mgs. The fear is now getting worst again. I also take 40mgs of Paxil. I feel better the weight is coming off and not so bloated but this is the trade off. My advise is if you can handle this antidreppresant take it. It's the only one that works for this condition. My heart goes out to each and everyone of you this is a terrible condition. We all have different crosses to bear in this life. I wish there was a magical cure the mind is so powerful. I pray each and every one of you can over come this.