GLOBUS HYSTERICUS

The Lump In Your Throat That Is Not 'Just In Your Head'… 

 Sigmund Freud by Sidney Chafetz

You feel it. You really do. The lump moves up your esophagus and stops short. Something is stuck in your throat – leaving you with frightening thoughts: ‘Is this lump blocking my airway? Will it choke me?  Do I have cancer?’  In all likelihood, your doctor will tell you there is no physical cause. Still, the lump is real.  It’s just not what you think.

That lump in your throat is known by two different medical terms: Cricopharyngeous spasm and Globus Hystericus. Some say it is “stress related”. And, it is. But, when there is no organic cause, some misinformed doctors, or friends, might pass it off as, “made up”,  “bogus” or “just in your head”. Don’t believe them.  The lump in your throat is much more complicated than that. It’s a symptom. An emotional symptom – a lump of unexpressed feeling - converted into a physical sensation.

Neuroscientists and neurologists are beginning to take seriously that these physical sensations are quite real and not imagined. (Newsweek Daily Beast, November 28, 2011) The original diagnostic name was conversion hysteria, dating back to the days of Freud and his cohorts, Charcot and Breuer; hence, the “Hystericus” in Globus Hystericus. Hysteria, in the public arena, has a bad name. It arouses visions of overly dramatized emotional reactions. Even worse – putting on a show for attention. Really, though, the basis for hysteria is something quite different: anxiety.

Yes, Globus is an anxiety reaction. But, defining something as ‘anxiety’ is a catchall phrase that says nothing about the person who is suffering. Anxiety, like Globus, is a symptom. Freud understood symptoms in an interesting way.  As a compromise between two different parts of your mind: One that wants to openly communicate a feeling. The other that says something like: ‘That’s stupid, weak, or unacceptable’– and bars the feeling from your awareness. These opposing parts have no choice but to make a deal. They ‘agree’ on a form of expression that isn’t the real thing. A symptom. The symptom conveys the feeling, but in a disguised way. So, what could that lump in your throat be trying to say? 

You all know the expression: “I have a lump in my throat” when you feel like crying and can’t. It’s, also, pretty common to choke back angry words. What, then, might be involved in the onset of Globus?   Something happens that stirs up old feelings – feelings you probably aren’t aware of. A loss is re-experienced; one that happened long ago. It could be the death of a parent; a parent leaving; feeling less favored than a sibling; or other early deprivations that made you feel unwanted or left out. The feelings of sadness and anger surrounding these old losses have been pushed aside; the loss left not fully mourned. 

When feelings have no place to go and no one to hear them, they are put in that category of  ‘unacceptable’. If they try to come out and are stopped – they get stuck. So – the lump in your throat that won’t go away, but has no medical diagnosis? Don’t let anyone, including you; write it off as ‘nothing’.  Think about what was happening before you first realized it was there. Did something make you sad?  Did you feel abandoned? Pushed aside? Angry? If you aren’t sure, and the troubling lump persists – consider seeing a therapist. You might be surprised. When therapy helps you replace the symptom with the real feelings behind it - that lump in your throat no longer has a reason to exist.