HAYATTA KALMA SUÇLULUĞU
22 Eylül 2023
Migren Tedavisinde EMDR Terapisi
29 Eylül 2023
Yutma/Boğulma Fobisi
Yutma fobisi, kişilerin yiyecek ve içecekleri tüketirken, hatta bazen tükürüklerini yutarken yaşadıkları zorluk ve yoğun kaygı olarak kendini gösterir.
Diğer fobilere göre daha nadir görülen bir fobi türüdür. Bu fobinin ortaya çıkışı genellikle bir boğulma/yutkunamama yaşantısıyla birlikte olur. Kişi daha önce boğulma tehlikesi geçirmiş olabilir ya da böyle birine şahit olmuş olabilir. Ancak bu fobiye sahip bireylerin yaşamlarında genellikle halihazırda stres veren faktörlerin de olduğu görülmüştür.
Kişi kendisini çok korkutan bu boğulma durumunu tekrar yaşamaktan kaçınmak için güvenlik davranışları geliştirir ve bu zamanla alışkanlık haline gelir. Bu güvenlik davranışlarına örnek olarak; özellikle katı yiyecekleri yiyememe, yerken yanında su ya da başka sıvılar bulundurma, çorba ya da yoğurt gibi sıvı yiyeceklerden yardım alma, hap gibi büyük ilaçları içmekten kaçınma, katı besinleri blenderdan geçirerek tüketme, pipet kullanma, dışarıda ve insanların kalabalık olduğu yerlerde yemek yememe, yemek yerken özel bir postürde durma gibi belirtiler gösterilebilir. Kişilerin bu korkularıyla yüzleşmekten kaçınmak için uyguladıkları güvenlik davranışları, aslında bu korkuyu pekiştiren ve besleyen davranışlardır. Kaygılanır, kaygısını gidermek için güvenlik davranışında bulunur, bu davranış onu rahatlatarak kaygısını sağaltır ve böylece bu davranışı yapmaya devam eder. Ancak böylece -adeta bir kısır döngü şeklinde- korkusundan ve korkusunun gerçek dışılığıyla yüzleşmekten kaçmış, onu büyütmüş ve geçerli kılmış olur.
Bilişsel-davranışçı terapi, genelde fobi türlerinde başarı gösteren bir terapi türüdür
Yutma fobisinin bilişsel-davranışçı terapiyle çalışılması kişinin mantık dışı inançları ve davranışlarıyla olur. Kişinin hangi besinleri tüketemediği, en çok hangi durumlarda bu kaygıyı hissettiği, bunun nedenleri ve bununla baş etmek için neler yaptığı öğrenilir ve bir yol haritası oluşturulur. Kişinin bu inançları üzerine konuşularak farkındalık kazandırma amaçlanır ve mantık dışı inançlar mantıklı düşüncelerle değiştirilir. Aynı zamanda yukarıda bahsedilen güvenlik davranışları, belli egzersizlerle birlikte kişiyi kaçındığı davranışlara maruz bırakarak aşamalı olarak azaltma yoluna gidilir.
Fobilerde görülen bir başka durum ise fobisi olan kişinin bu durumundan bir ikincil kazanç sağlaması durumudur. İkincil kazanç, kişinin psikolojik rahatsızlığı sayesinde elde ettiği ayrıcalıklar, ilgi ya da kazanımlar olarak tanımlanır. Fobisi olanların bu ikincil kazanca sahip olmaları, aslında fobilerini pekiştiren durumlardır. Kişilerin bu kazançları, onlar bu durumun bilinçli bir şekilde farkında olmadan da fobilerini sürdürmeye hizmet edebilir. Hatta tedaviye direnç göstermelerine de yol açabilir.
Bu fobiye sahip olanlar çok az porsiyonlar tüketebildiği için zamanla kilo kayıpları yaşayabilir. Yaşam kalitesini oldukça olumsuz etkilemesi ve kişiye fazlasıyla rahatsızlık vermesinin yanı sıra fiziksel sağlığını da tehdit eden bir durum haline gelebilir. Bu nedenle yemek yerken buna benzer zorluklar yaşayan bireyler; öncelikle bir gastroenteroloji ya da KBB doktoruna muayene olarak durumun organik mi yoksa psikolojik mi olduğunu öğrendikten sonra psikolojik bir rahatsızlık olması halinde uygun bir psikoloğa başvurmalıdır.
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