Abstract
The present case study describes treatment given to a man in his 40s who was reported to have pnigophobia (fear of choking) and some physical symptoms such as dysphagia (difficulty in swallowing). The treatment was based on a behavior analysis of the link between his covert cognitive responses and swallowing. The results of the behavior analysis suggested that simultaneous presentation of food in his mouth and his pnigophobic cognitions elicited the dysphagia which, in turn, reinforced his avoidance behavior. The treatment included exposure to body sensations and reciprocal inhibition of the cognitive response during swallowing. The client was asked to describe his body sensations in all phases of swallowing continuously. After this intervention, the client's physical symptoms were reduced; at 1-month and 3-month follow-ups, this improvement was found to have been maintained.
