Most people eat naturally and never consider what they have to do to be able to swallow. They put food in their mouth and simply swallow.
However, the normal swallowing process can be affected by some factors, such as experiencing a choking episode, increased muscle tension in the throat area, wounds, canker sores, fungi located in the posterior area. of the throat, and others.
Throughout our lives we will all experience some episode of choking with different degrees of discomfort. Different textures, fatigue, uneven laughter when swallowing, or even a scare can be some of the causes of this.
Depending on the tendency to perceive dangers and how objectively serious the episode experienced is, the fear of food getting stuck in the throat may settle in the head, and even of dying in this way. It must be added that this fear can become very intense, even without having experienced an episode of these characteristics firsthand. Sometimes just witnessing it is enough for the fear to reach the level of phagophobia.
The fear of choking: When is it dangerous to swallow?
It is important to understand that the swallowing process is closely connected to emotions for a mere matter of survival. The brain wants to make sure that if there is a food that is spoiled, or has an inappropriate flavor or texture, we can get rid of it as quickly 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 blocking the passage of food in the throat. The glottis becomes blocked through increased muscle tension and spasm-like responses. Thus, not letting food pass in some situations is the way to attend to one’s own survival instinct.
Voluntary vs. automatic responses of the body
There are countless automatic responses that the body regulates itself and that we normally do not have to attend to. Within these we can mention the dilation of the pupils, sweating, or the cardiac response. There are some of them that They can be regulated automatically but in which we are also able to take control whenever we decide. Among them, the respiratory rate, the relaxation of different sphincters, and of course the swallowing of food stand out.
The main brain area responsible for automatisms is the brain stem and the cerebellum. When we take voluntary control, it becomes the brain itself that is in charge of coordination. This change gives us the possibility of addressing more aspects and needs but is very relevant when it comes to understanding how in cases of phagophobia, the swallowing process is complicated.
When the brain takes charge of the act of swallowing, it must coordinate responses that normally synchronize themselves , and in moments when there is also underlying fear, it makes us become more clumsy and suddenly nothing flows when swallowing. In situations like this, we are giving ourselves contradictory instructions. Some say “swallow” and others say “be careful.” The normal thing is that the greater the sensation of danger, the more one avoids bringing food to the back of the mouth. The aim is to allow food to enter, but from the area of ​​the incisors.
Threat of drowning and drawing attention to a weakness
The realization that something normal like swallowing cannot be done as usual changes the person. and it only makes the negative feeling more complicated. When we also add to this the fear of attracting attention in social environments for something that we do not want to show, the experience of the problem tends to become more aggravated and makes it more likely to become a blocking fear.
Greater sensitivity to the opinions of others makes it more necessary to want to make sure that everything is fine 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 weakness. Therefore, When fear grows, it is easy for difficulty swallowing to grow as well.
Solutions and treatment
To treat phagophobia, psychologists help the person identify the emotional variables that prevent normal swallowing. We favor simplifying the swallowing process initially letting the brain take charge, and as the blockage is reduced we encourage the cerebellum to take charge of this action again.
Like any psychotherapeutic treatment, it requires repetition and involvement. Depending on the intensity of the fears and the person’s ability to collaborate with the guidelines, an improvement is observed from the fourth session, with between 10 and 30 sessions being necessary to achieve maintainable improvement over time. Working with someone who does not usually have fears is not the same as working with someone who barely faces and who normally focuses on getting away from everything they see as dangerous.
