Coping With Phagophobia (Fear of Swallowing)

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Phagophobia, or the fear of swallowing, is a relatively rare and quite specific phobia. It is sometimes confused with pseudodysphagia (the fear of choking). The major difference is that those with phagophobia are afraid of the act of swallowing, while those with pseudodysphagia are afraid that swallowing will lead to choking. Both fears are sometimes confused with medical conditions such as dysphagia and odynophagia, in which a physiological disorder causes difficult or painful swallowing.

Causes of Phagophobia

Phagophobia is often, though not always, triggered by a negative experience while eating and may surface in people who experience other food fears.

Ironically, phagophobia is one of the few phobias that can actually bring about the feared condition. Anxiety and tension can cause the throat muscles to constrict, feeling to some like "a lump in the throat." Those who fear swallowing may find themselves physically unable to do so once they become too anxious. This, in turn, can worsen the fear, creating a perpetuating cycle that is difficult to break.

Phagophobia can also occur in the absence of any identifiable triggers.

Coping Strategies

Since the throat muscles often constrict during bouts of anxiety, coping strategies generally focus on remaining calm. Some people find that watching TV or listening to music while eating provides a welcome distraction that makes chewing and swallowing a less intense experience.

Others find that taking a sip of liquid with each bite eases the swallowing process. Others still avoid foods that they find scratchy or hard. Finding your comfort zone is often a matter of trial and error.

Clinical Treatment Options

If your fear is more serious, professional assistance may be required. Phagophobia sometimes worsens over time, leading to gradually more restricted eating habits. This, in turn, can affect your overall health, as it is can be difficult to maintain a healthy diet when you are afraid to swallow.

Find a therapist who will work with you to develop a treatment plan that addresses your phagophobia and any related disorders. Developing a relationship with a health provider who comes to know you well can be very helpful, as your phagophobia treatment plan will need to be designed to meet your specific needs.

A 2013 review found only 12 studies related to therapeutic intervention or diagnostic examination of phagophobia and found "severe methodological shortcomings" in each, making it challenging to make general claims regarding the efficacy of one treatment modality as compared to another.

As a starting point, there are case reports documenting the positive influence of particular therapies on individual clinical patients.

One 25-year-old woman, whose initial episode lasted one year, began to manifest phagophobia symptoms whenever she was under stress or had difficulty solving a problem. A treatment plan was devised for her in which she was gradually exposed to various triggering situations. Cognitive therapy was also employed along a training to teach coping skills.

After 20 sessions of therapy, she has been without symptoms for more than a year without relapse.

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Article Sources
  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Arlington, VA: American Psychiatric Publishing, Inc.

  • Baijens LW, Koetsenruijter K, Pilz W. Diagnosis and treatment of phagophobia: a review. Dysphagia. 2013;28(2):260-70. doi: 10.1007/s00455-013-9454-0

  • Suraweera C, Hanwella R, De silva V. Phagophobia: a case report. BMC Res Notes. 2014;7:574. doi: 10.1186/1756-0500-7-574