I am working with a nonpsychotic client who is terrifed of swallowing, such that she even spits her saliva into a towel, instead of swallowing it. She is not eating much of anything, and avoids any amount of liquid except forcing down a nutritional supplement. A colleague and I have tried some direct interoceptive exposure (i.e., creating sensations of throat-tightening, etc.), with little success. Diagnostically, we are now proceeding as if this problem is more a symptom of panic disorder, and utilizing the various CBT strategies for the treatment of panic, rather than directly targetting the swallowing problem, per se. There may be some progress underway, but am wondering if anyone has any further comments or ideas. Any thoughts would be much appreciated.
Any thoughts would be much appreciated.
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