EMDR Treatment of Children and Adolescents With a Choking Phobia

201 © 2008 EMDR International Association DOI: 10.1891/1933-3196.2.3.201 D evelopment-related fears are normal in childhood (Field & Davey, 2001). During infancy, children tend to fear stimuli within their immediate environment such as loud noises, objects, and separation from a caretaker. When, however, a fear continues and is provoked by the presence or anticipation of a certain object or a specifi c situation, then one speaks of a specifi c phobia (American Psychiatric Association [APA], 2000). The prevalence reported in the literature shows a large bandwidth, ranging from 1.7%–16%; however, most studies suggest a prevalence rate between 7%–9% (Silverman & Moreno, 2005). An example of a well-defi ned phobic condition is swallowing phobia, also known as choking phobia, an extreme fear of choking. Since 1980 there have only been a few publications about choking phobia in adults, children, and/or adolescents. Epidemiologic data about the prevalence of choking phobia are lacking. An important reason seems to be that the disorder can hide behind diagnostic labels all related to swallowing problems. Over time, professionals from various disciplines, such as general practitioners, otorhinolaryngologists, pediatricians, neurologists, psychiatrists, and psychotherapists have given different names to the same phenomenon: choking phobia, fago phobia, disphagia, traumatically acquired conditioned dysphagia, posttraumatic eating or feeding disorder, childhood onset eating disorder, and food avoidance emotional disorder (Bailly & de Chouly de Lenclave, 2005). In short, the use of a term for one and the same disorder largely depends on the diagnostician and is thus a poor refl ection of the underlying pathology. Also, due to the wide variety in names, the choking phobia often appears to be unrecognized. After an extensive literature study, McNally (1994) states that so far only 25 case descriptions of adult choking phobics had been published. Although descriptions of choking phobic children are more or less completely lacking, Bailly and de Chouly de Lenclave (2005) report a total of 36 cases, of which 6 are adults and 30 are children or adolescents. These include cases published earlier as EMDR Treatment of Children and Adolescents With a Choking Phobia