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The height of fear: acrophobia

Health Matters

Close your eyes and imagine yourself walking across the Capilano Suspension Bridge. You can feel the breeze on your face and the slight swaying of the structure as others cross nearby. You lean on the railing and look down … way down. How do you feel? Are you enjoying the view (spectacular), or are you feeling anxiety and getting the sweats? Were you even able to cross the bridge?

Acrophobia, an extreme or irrational fear of heights, is among the most common of phobias and it can be debilitating. Of course, being wary of heights is a pretty normal response to a potentially dangerous situation, but if this rational fear gives way to the irrational, it can become a real problem. It may even become dangerous if a sufferer experiences a panic attack and become too agitated to get themselves down safely.

A phobia is created by the unconscious mind as a way of protecting the person from a perceived danger. At some point in the person’s past, there was likely an event that linked heights with an emotional trauma or a perceived one. The mind then works to protect the body from future trauma by creating extreme fear, in this case, of heights. Though the person knows intellectually that their fear is groundless, the effort to resist it only adds to the anxiety.

For anyone who has not experienced a phobia, it may be difficult to understand the severity of a reaction. The effects include a racing heart, shortness of breath, muscle tension, sweating, trembling and intense fear. Sufferers will avoid heights at all costs including tall buildings, bridges, balconies, bleachers, ladders, maybe even standing on a chair. At this point, the fear is interfering with everyday life.

Fear that rises to the phobia level calls for psychological assessment and treatment. Without treatment, acrophobia can persist over a lifetime and even generalize to other height-related situations.

Cognitive behaviour therapy (CBT) is the main treatment for many phobias. This exposes the sufferer to the feared situation either gradually to desensitize them or rapidly (flooding) with full-on exposure. In this safe, controlled environment, the patient learns techniques to reduce the stress. They are taught ways to stop the panic reaction and to re-interpret the perceived harmful situation as less threatening.

Computer-assisted 3D tools can provide a realistic experience without having to venture out on the bridge or cliff. Virtual reality treatment can be effective as it introduces patients to situations where they can control their environment. It is not widely used but has been shown to be effective.

Some instances of phobia may call for the use of anti-anxiety medications. Though they only cover up the symptoms, they can be helpful when used in combination with other approaches.

Feeling apprehensive when looking down a steep cliff is natural, even appropriate. However, if panic, dizziness and sweating results from walking on a balcony, climbing a ladder or driving across a bridge, the fear has become an irrational obsession. Fortunately, there are effective treatments available. The first step is to talk to a health care professional.