ACROPHOBIA: SYMPTOMS, CAUSES, TREATMENTS - ECONOMÍA - 2024

The acrophobia or fear of heights is a phobia or irrational fear of heights. People who suffer from it experience panic attacks in high places and are agitated to try to get to safety.

It generally affects recreational activities, although in some cases it can affect daily life. For example: avoid railings, elevators and stairs, avoid going to high floors, avoid going over bridges…

Between 2 and 5% of the population suffers from this disorder, with twice as many women affected as men. The word "vertigo" is often used as a synonym for this phobia. However, vertigo refers to a feeling of dizziness or that the environment is spinning when the person is not actually spinning.

Vertigo can be caused by:

• Look down from a high place.
• Look up to a high place.
• Movements such as getting up, sitting down, walking…
• Changes in visual perspective: going up or down stairs, looking out the window of a moving car or train…

When dizziness occurs from heights, it is classified as "vertigo at heights."

Symptoms

For acrophobia to occur, the fear of heights must be excessive and unrealistic. Therefore, the symptoms must be exaggerated compared to the situation in which they appear. As with other types of phobias, acrophobia is associated with three main types of responses: anxiety, fear, and panic.

Although they are usually used interchangeably, anxiety, panic and fear are different:

• Anxiety: it is an emotion focused on a possible danger in the future. It is associated with the tendency to worry and anticipate possible dangers. The physical symptoms are muscle tension, tachycardia, headache, dizziness…
• Fear: it is a basic emotion that is felt when a situation is interpreted as threatening. The physical symptoms are tremors, tachycardia, sweating, nausea, feeling out of touch…
• Panic: it is a wave of fear that grows quickly. Its symptoms can be fear of death, fear of losing control, dizziness, shortness of breath, tachycardia…

Depending on the situation, a person can experience anything from medium levels of anxiety or fear to a full-blown panic attack. In addition to anxiety, panic, and fear, several physiological responses can be generated:

• Muscle tension.
• Headaches.
• Palpitations
• Dizziness
• Shortness of breath.
• Lost of control.

Behavior

The emotion of fear is usually accompanied by some type of behavior that reduces the feeling of fear. In most cases that answer is escape or avoidance.

People with a fear of heights usually avoid being in tall buildings, balconies, high seats in theaters or sports stadiums… Other people can avoid even looking at people who are in high places or looking at high places.

If someone with acrophobia is in a high place, they usually carry out safety behaviors such as: avoid looking down, avoid approaching windows or balconies, avoid someone approaching them…

Causes

It seems that the fear of most people with acrophobia is not related to a conditioning based on previous experiences. Evolutionary theory states that fear of heights is a natural adaptation to a context in which falling can result in death or great danger.

From this theory all human beings are afraid of being at great heights. The degree of fear varies between each person and the term phobia is reserved for irrational fear.

On the other hand, according to a study published in the journal Psychological Science, acrophobia depends on the peripheral vision we have when we move.

Previous experiences

In some cases the fear of heights can develop through direct, vicarious (observing) or informative (recounted) experiences.

• Direct: having a traumatic or stressful experience in a high place. For example, if a person suffers a panic attack on a balcony, they can associate that attack with being in a high place.
• Vicarious Experiences (Observe): Someone can develop acrophobia by observing that another person is afraid at a high altitude or that that person has a bad experience. For example, if a child observes that her father is always afraid of heights, the child may develop it as well.
• Information: Someone can develop a fear of great heights because they have read or have been told that it is very dangerous to be at great heights. For example, fearful parents may tell their child to watch out for heights.

Negative thoughts

Fear of heights tends to be associated with phobic thinking or negative thoughts about the dangers of being in high places.

If you are sure that you are safe in a high place, you will not be afraid. However, if you think that a place is unsafe and that it is likely to fall, it is normal to experience anxiety or fear.

The thoughts that accompany fear can be so rapid and automatic that you are not aware of them. Some normal examples of acrophobia are:

• I will lose my balance and fall.
• The bridge is unsafe.
• The elevator is unsafe and can fall.
• If I get too close to the balcony, someone will push me.
• If I am in a high place, I will approach the edge and fall.

Consequences

In some cases, this phobia is not a problem in life. For example, if a person is afraid to climb mountains and does not do mountaineering, nothing happens.

However, in other cases it can influence and have negative consequences in daily life. For example, someone with acrophobia may live in a city and be constantly avoiding elevators, tall buildings, bridges, or stairs.

In the latter case, the phobia could affect the type of work that is sought, the activities that are carried out or the places to which one goes.

Treatments

Cognitive behavioral therapy

Cognitive behavioral therapy is the main treatment for treating specific phobias.

Behavioral techniques are used that expose the patient to the feared situation gradually (systematic desensitization, exposure) or rapidly (flooding).

Virtual reality

One of the first applications of virtual reality in Clinical Psychology has been in acrophobia.

In 1995 the scientist Rothbaum and colleagues published the first study; the patient managed to overcome the fear of heights by exposing himself in a virtual setting.

Exposition

In this section I will specifically explain the exposure technique, which is often used in cognitive-behavioral therapy. With exposure, the person with a fear of heights faces this situation progressively and with various activities. A hierarchy is used for this.

The goal is desensitization, that is to say that the person feels less and less to the heights. This therapy consists of:

• Forget the association between heights and the fear, anxiety or panic response.
• Get used to heights.
• Reassociate feelings of relaxation and tranquility with heights.

Create a hierarchy

The hierarchy is intended to create a scale from low to high, from the least feared situation to the most feared. This hierarchy will mean the steps that will bring you closer to the maximum feared situation, for example being on a balcony or going up and down floors with an elevator.

In this way, the first step will cause minimal anxiety and the last step will cause maximum anxiety. It is recommended that the hierarchy consist of 10-20 steps. On the other hand, if the person with a phobia has an excessive fear of heights, a person can accompany him to perform the steps.

Example with an elevator:

1. Observe how people go up and down in elevators.
2. Entering an elevator standing next to someone.
3. Entering a stationary elevator alone.
4. Going up or down a floor with someone.
5. Go up or down a floor alone.
6. Go up or down three floors with someone.
7. Go up or down three floors together alone.
8. Increase the number of floors with someone.
9. Increase the number of floors only.

In this case, if you have a fear of heights when using elevators, you would have to perform those steps several times a week until the fear or anxiety has almost completely subsided.

Ideally, it should be done 3-5 times a week. Longer sessions tend to produce better results than shorter ones.

It is recommended that you withdraw from the situation if the anxiety you feel is prominent. That is, you feel dizzy, heart rate racing, muscle tension, fear of losing control…

If you feel uncomfortable but feel in control, you can continue to expose yourself to the situation.

Imaginary desensitization

It is important that to overcome fear you expose yourself to real situations. However, to begin you can expose yourself in imagination.

It is about visualizing the situations that you have put in the hierarchy, although in the imagination.

Tips for dealing with resistance

You usually have a resistance to being exposed to anxiety-provoking situations. To overcome that resistance:

• See if you are delaying exposure sessions.
• Recognize that it is normal to experience strong emotions during exposure to feared situations.
• Avoid negative thoughts like "You will never get over the fear", "It's dangerous."
• See therapy as an opportunity for improvement.
• Think about the rewards of overcoming fear.
• Recognize that feeling bad about the exhibition is the way to overcome fear.
• Do not oversaturate: if you feel excessive anxiety, withdraw momentarily or repeat the next day.
• Prepare solutions: for example, as a precaution against a possible elevator stop, an emergency telephone can be carried.
• Reward yourself for small successes.