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Ralph LMHC
Ralph LMHC, Therapist
Category: Mental Health
Satisfied Customers: 872
Experience:  20+ years as therapist, supervisor, clinic director at mental health, substance abuse treatment ctrs
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Ive been diagnosed with a mild form of agoraphobia and although

Resolved Question:

I've been diagnosed with a mild form of agoraphobia and although I am on medication that for the most part helps, there is still one phobia that I can't seem to get over. I have an irrational feer of driving on the Highway and even on some particular city streets. This phobia manefests inself in a feeling of not being able to swallow. I know this seems very specific but it is quite debilitating and depressing. I used to be a fearless driver in any situation and having this restriction in my life for so long has become beyond frustrating. I would like to note that I have a good job, drive to work every day (not on a highway) and in most other areas of my life am highly functional. Do you have any advice? Is the feeling of not being able to swallow part of being agoraphobic?
Thanks, Susan
Submitted: 6 years ago.
Category: Mental Health
Expert:  Ralph LMHC replied 6 years ago.

Hello,

The difficulty swallowing or the feeling of a lump in the throat is definitely a sign of anxiety, but I would check it put to make sure that there is no underlying physical problem. As far as your phobia. I would contact a behavioral therapist. They specialize in getting you comfortable for small steps with each step leading to your ultimate goal of being able to drive without fear. A schedule is set up and once you are comfortable with a step you then progress to the next step until you are comfortable with driving. Remember you do not move on until you are comfortable with the previous step. The therapist, usually a psychologist, constructs a list of "successive approximations" and uses relaxation, imagery, etc to help you achieve each step until you are fear free of driving. Best wishes.

 

 

Sincerely,

Ralph LMHC

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Customer: replied 6 years ago.

Hello Ralph,

Thanks for responding so quickly, but I have a few more questions. I do not generally have the feeling of an inability to swallow; it is just when I contemplate highway driving and/or driving on particular city streets (for some reason going down large hills bothers me). I have been to my GP and there doesn't appear to be any medical issue. Is this proceived inability to swallow in these circumstances related to agoraphobia? Is this truly how my anxiety is manifesting itself in these circumstances. I used to suffer from Panic attacks on a fairly regular basis, but since being on medication these have practically gone away. I still have the occassional attack (one every 6 months or more). The meds I am on are Paxil, Effexor and Attivan. Is there anything I can do while driving that could help. Is it even possible to stop swallowing if this is in effect a sign of my anxiety?

Thanks for your help, I look forward to your reponse ... Susan

Expert:  Ralph LMHC replied 6 years ago.

The difficulty in swallowing is a sign of anxiety which is evoked by the fear of driving. So yes it is probably related to the agoraphobia and is one way your anxiety manifests itself. Swallowing is a reflex that you really have no control over. The important thing is to keep on driving as much as possible and although uncomfortable not allow the discomfort preclude you from driving.

 

Sincerely,

Ralph LMHC

Customer: replied 6 years ago.

Hi Ralph,

 

Again, thanks for your prompt response. I just want to super clear on a couple ofthings.

When I feel as though I can't swallow when driving, is there a possibility that this could actually happen? or would my reflex's kick in and force my body to swallow.

 

Sometimes when I feel like I can't swallow, I get a bit lightheaded at the same time. I assume this is me hyperventelating a bit?

 

Am I in any danger when I feel either of these 2 things?

 

Thanks, Susan

Expert:  Ralph LMHC replied 6 years ago.

Hello,

I am not a physician but I have never heard that one could lose the ability to swallow )not the feeling). You will swallow if the cause is psychological. It is like a roller coaster, It feels scary, but it isn't dangerous-so fear not and try to relax. Best wishes. LMHC

 

Sincerely,

Ralph LMHC

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