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Eating anxiety - Fear of choking

Hi all,

I've always had a fear of choking. I never actually choked, but I did accidentally swallow a jumbo-gumball sized candy back in middle school which put the fear of god into me. I've always been a slow eater. I have a partially open bite so not all of my teeth make contact. To compensate, I chew more than normal, both out of necessity and for fear of choking reasons.

Anyway, I'm 35 now, and within the past couple of months, my fear of choking has come back with a vengeance. I believe it was triggered by a couple of large chunks of food that I inadvertently swallowed. This brought back memories of the gumball incident and my anxiety has basically spiraled out of control since. It's gotten to the point where I don't even enjoy eating anymore, because I think I'm going to die with each swallow. And the thing about this type of anxiety is that it leads to awkward swallows, so I'm probably even more likely to choke. This has made me an even slower eater than I already was. For example, it took me 45 minutes to finish a sandwich.

So lately I've been teaching myself to swallow more like a normal person. My typical eating behavior involves chewing my food to mush, stuffing a lot of that mush into my cheeks, and then having to do multiple swallows to get it all down.

This got me thinking. Have I been eating wrong my entire life? I've been experimenting with letting more food collect at the back of my throat before swallowing, and this has been working pretty well. But it's also scaring me. Some swallows are super smooth but I feel that others are mistimed which makes them not so smooth.

Perhaps if I understood how other people eat and swallow it may ease my anxiety. So here's my questions to you guys.

1) If I'm using my tongue to manipulate my food bolus towards the back of my throat, what's keeping gravity from making it fall down into my windpipe? Just how far back am I supposed to push that bolus toward the back of my throat before swallowing? Is it possible to push it too far back to the point of no return where it just falls into my windpipe? I know the epiglottis swings down to cover the windpipe during a swallow, but my fear is that food will fall down my throat before I initiate a swallow.

2) Do people normally clear a bite with a single swallow? Like if I take a big bite out of a burger, am I supposed to chew that up and swallow the entire bolus whole? It seems like too much for one swallow. Yet I feel like this is what people do because they eat so fast. For me it takes at least 3 swallows per bite.

Anyway, I rambled on long enough. If you guys can shed some light on how you eat and swallow, perhaps it will ease my anxiety. Thanks for reading!
4 Responses
Avatar universal
Have you been diagnosed with "partially open bite" or is it your hunch? I would see a doc to discuss your fears. Perhaps he can explain the mechanics of how people eat and check to see if you really have a problem.
2 Comments
No need to be diagnosed. There's an obvious vertical gap on the right side of my mouth. Only my wisdom teeth and the molars in front of them make contact. The rest don't touch. Not much I can do about that. I had braces which somewhat tightened the gap but it wasn't long before they separated again. Jaw surgery is another option but that's a major surgery and usually reserved for more extreme open bites than mine.
It's up to you. I have seen people spend long times dealing with self diagnosed issues that are different than what they think, so would see an expert (including a dentist) for solutions as well as the diagnosis.
Avatar universal
Hi there. I see you worry an awful lot about something to most people seem so automatic. I have never thought about chewing or swallowing. I would say that most people take a bite, chew it a few times (like 5-6 chews) then swallow. I would say that some things like beef jerky have to be chewed a lot more before swallowing.  I totally understand how your candy incident caused anxiety then and again now. I don’t know what kind of advice I could offer to help you. But to answer your question, I do believe the ‘normal’ process is to take a bite and chew 5-6 times then swallow the entire mouthful. My mother in law eats her food and packs her cheeks so she can talk with food in her mouth on the sides, then swallows parts of it at a time. It’s enough to make me lose my appetite every time if I watch her eat! Lol.  But, I understand how this is difficult for you. I choked on a full sized pickle as a kid. I was slurping the juice off of it and the whole pickle went down my throat and lodged. I did a instinctual reflex of trying to hack it up and dislodge and it worked after a few tries. I think I was around 7. So I totally understand your fear. But I hope you realize intellectually that you are not likely to choke if you eat your food without rushing, and especially since you are in a habit of iverchewing, you probably won’t choke again. Like the other person said, even if you think you don’t need it, a doctor may be able to offer you another opinion on normal chewing and swallowing. At least you probably won’t ever have to worry about a being overweight! You aren’t under weight are you? As long as you aren’t underweight I’d say you have managed this phobia well. ~ Erin R.
1 Comments
Had to comment on my post. I was paying attention today to my chewing. I chew everything about 12 times before swallowing. Not 5-6 times like I posted.
Avatar universal
We've all choked on things -- and as you age you will choke a little on more and more things, even saliva.  The throat, as the rest of our bodily functions, works automatically until you start to overthink it, which is what happens with phobias.  Therapy that teaches relaxation exercises and how to retrain your mind, such as CBT, might prove to be helpful.  But you've got the chewing part all wrong -- you're actually eating the way we're all supposed to eat and don't.  Saliva is the first part of our digestive system, and food needs to be thoroughly chewed to maximize that function.  Almost nobody does this, but you do, and whatever the reason you're doing it, it's actually the proper way to eat.  Bet you didn't expect to hear that!  Americans in particular tend to be in a hurry all the time and wolf down their food, but it isn't the best way to eat.  Taking your time when you eat is healthier and also, if you weren't doing this for phobic reasons, more enjoyable, as you get to enjoy your meal longer.  So health wise, you're eating more properly than the rest of us on here most likely, but your reasons are driving you nuts and that's the part that needs to be worked on.  
973741 tn?1342346373
So this is a real thing that it doesn't appear all understand.  It's called gag memory.  My son has a developmental delay that involves his ability to chew properly especially when young.  He had a few choking incidents.  He then began gagging when he put foods of a certain texture in his mouth. This included ALL meat.  And I would cut this meat up into the tiniest little morsels. I mean, I'd shred chicken!  And still, the gag. We finally worked with a professional on it who said that our we can indeed begin to have anxiety and react.  Avoiding foods, gagging when certain trigger foods are attempted to be eaten.  We worked with a therapist on it.  A book called "Food Chaining" is helpful.  It helps you build up to eating what you want to eat in steps.  My son, to this day, is extremely careful about things he eats and still will avoid certain things. We had steak last night for dinner and he said it tasted good but was not his favorite because it made him feel like gave him that choking sensation and made him feel like gagging. He didn't.  We've come a long way.  :>))  

So, that's our story.  But you have something a bit different going on.  You seem to be a bit over thinking about it.  What about a speech therapist?  There are many who are trained to work on eating issues.

I personally chew and swallow.  :>)  That's it.  But here is something that they did with my son in therapy.  Chew and have a glass of water (or whatever you like) that you drink around the time you swallow.  It helps food go down.  My son always has water (or milk) with his meals and this is helps tremendously to take a sip as he is swallowing.  And seriously, if it takes you a while to eat because you chew a lot, so be it.  There are times maybe you don't have room for that in your schedule---  that's when you order the soup.  :>)

Do you work with a psychologist at all?  
5 Comments
Just to say, one of the most mucous building things you can ingest is milk, so that alone can cause gagging.  Not for everyone, but again, if you do have a gagging problem, be aware that dairy does this.  But again, chewing should take a fair amount of time.  Otherwise, the saliva doesn't have time to begin the digestion process.  I know, we don't do that in America, but it is the proper way to eat.  Now, this has nothing to do with either the above problem or the poster's problem, but I did notice that advice to use milk if you have this kind of problem and for many that would be the wrong thing to do because of the mucous building problem it has.  Remember, folks, no mammal other than humans consumes anything other than mother's milk until weaning, and there's a reason for that.  Peace, all.
My son's pediatrician recommends milk for her patients.  We get asked how much milk my kids drink at every well check.   And he doesn't gag on mucus.  I said milk in my post because that's what he often has with lunch or dinner.  Recommended by a board certified medical doctor.  :>)  
All medical doctors are board certified or they can't practice.  The Boards are made up of other doctors.  These same doctors were the ones who recommended when I was a kid that everyone drink 8 glasses of milk a day, or something like that.  These same doctors were the ones who told women not to breast feed, that formula was better.  These same doctors were the ones who gave antibiotics for everything until they didn't work anymore.  Advice on food from a doctor is like getting advice on your plumbing from an electrician.  Now, I explicitly said my comment didn't refer to the problem of you or the poster, it was intended for others who might have a choking problem.  It is well known that dairy products are mucous builders, but you have to talk to experts on the anthropology of food consumption to know this.  Nobody in history drank much milk until in the US in the early 10th century the gov't allied with dairy farmers to create an industry that had never existed before and put out the false propaganda that milk was good for you.  In every other culture, when milk is used, it is used fresh and usually not from a cow.  Mostly it is used fermented or cultured.  There is a reason for this.  As always, everyone gets to do what they wish, although when forced on children there might be a problem.  Not everyone is entitled to make what they wish to be true seem factual.  My generation suffered the consequences of the focus on milk consumption, and I'm hoping to help others avoid this problem.  But again, both the poster and the above situation are unusual situations that don't appear to involve mucous build-up.  Anyone still following this forum can decide for themselves, maybe do a little research about how they wish to eat.  I don't make those decisions.  But I do believe in putting out alternative evidence when someone gives generalized advice so folks know there are other opinions out there that might end up helping them. Or not.  Peace, all, and be careful out there.  
Ugh, it says 10th century, meant 20th century.  Oops.
I agree wholeheartedly that not everyone who speaks  forcefully  makes what someone wishes to be true factual.  But I'll talk to my son's pediatrician about her recommendations that kids should not have milk as part of their diet. This is absolutely derailing the member's question though.  I put milk in parenthesis because that is what my son who went through working with a professional (again not self trained) to help the choking sensation drinks.  People can drink whatever they want.  The point was to drink liquid to help get the food down easily.  
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