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I choked 7 months ago and am struggling with phagophobia. I…

Hi, I choked 7 months ago...
Hi,
I choked 7 months ago and am struggling with phagophobia.
I chew solid food until it is liquid, and it sits in my mouth for minutes before I can swallow successfully. Once I swallow, a wave of anxiety takes over my body. My back muscles tighten, my chest tightens, and I desperately breathe to make sure I can take a full breathe.
I have days where it is easier, and I make progress using some techniques such as imagining myself eating in a relaxed state of mind and thinking positively.
Progress is painfully slow and it currently takes me 2-3 hours to eat a meal.
It feels like no one I have talked to knows how to fix this fear. Do you have any advice? How long do you think it will take to get better? I get frustrated daily with not improving fast enough to return to a normal life.
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Answered in 7 hours by:
3/8/2018
LeahMSWuofm
LeahMSWuofm, Clinical Social Worker
Category: Mental Health
Satisfied Customers: 962
Experience: 10 years post-MSW experience
Verified

Hi, thank you for writing. My name is ***** ***** I totally relate as the same thing happened to me at a fancy steak house last summer!! It really derailed my love for prime rib for a time. I am sorry you had the same scary experience.

In order for you to move past this, I would lead you to try exposure work with a therapist. Exposure therapy is a type of CBT but it is really aimed at direct "practice" which can help reset your anxiety by doing behaviors that promote the anxiety, but rolling with the anxiety rather than trying to accommodate it. Exposure therapists can be experts at crafting exposures catered to your stage in the process. For example, I can foresee that exposure work aimed at chewing less and swallowing faster would help target the blaring alarm system so you can get back to a place where you can eat more confidently. Exposure work with food would be incremental, starting with foods easiest to chew and swallow and moving up in a hierarchical way to finally get to foods that are currently causing you the most distress and are proving to be the most time-consuming physically and emotionally. The goal of exposure therapy is to directly confront and work through your fears and in doing so, your anxiety alarm around these things that is currently blaring and disruptive will get reset to a far more manageable level so your tolerance for eating can go back to normal.

Exposure therapy can be taxing work but it can also be really effective quickly. The tricks to exposure therapy are 1) duration of exposure over intensity 2) never bail on an exposure and 3) roll with the anxiety from start to stop, not doing any safety behaviors to protect yourself from the uncomfortable feelings. My guess is if you did start a regimented/structured exposure therapy process around this, your fear/behavior would be significantly impacted for the positive in a matter of weeks, with ideal outcomes probably after 8-12 weeks of therapy.

I hope this helps give you something else to think about! If you want to chat more, let me know!

-Leah

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Customer reply replied 1 month ago
I haven't tried exposure therapy and it sounds like that would be useful and effective.I have a question about the 3rd trick to exposure therapy.What do I do when the anxiety gets to high and I have to incorporate safety behaviors because I am on the verge of having a panic attack? Should I keep going as long as I can until I trigger a panic attack? Should I take a break to relax and then attempt it again?

You have to completely and fully allow a panic attack to happen. I know that sounds scary but panic attacks are just a cluster of uncomfortable symptoms that have a start and stop point, and last about 10-20 minutes. they aren't dangerous even tough they feel like they are. Clinicians will love the chance to work you through a panic attack because the coaching is all about going with it, not freaking out, and having faith that not only will it stop, but you can handle it. Safety mechanisms that try to interfere with panic are like food for anxiety - they make the brain feel like the panic is catastrophic as you force yourself to fight or flee from the anxiety. That keeps panic attacks intense and long. Rolling with them depowers them and they get less intense and frequent as a result. So no - no breaks, you just keep on going, rolling with the panic, recognizing the symptoms but keeping cool and calm knowing it will stop and it isn't actually dangerous.

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Hi! Just checking back in with you since this question is still open due to being unrated. Can I help further? I hope things are moving in the right direction for you!

-Leah

LeahMSWuofm
LeahMSWuofm, Clinical Social Worker
Category: Mental Health
Satisfied Customers: 962
Experience: 10 years post-MSW experience
Verified
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LeahMSWuofm
LeahMSWuofm
LeahMSWuofm, Clinical Social Worker
Category: Mental Health
Satisfied Customers: 962
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Experience: 10 years post-MSW experience

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