Fear plays a critical role when it comes to our survival, motivating us to maintain a safe environment and minimize exposure to threats. While a certain dose of fear is healthy and beneficial, occasionally, this emotional response kicks into overdrive and becomes disruptive.
In general, the more control over our environment we have, the safer we feel. For many people, that means keeping their feet firmly planted on the ground and avoiding situations—airplane travel, standing on a bridge or balcony or climbing a ladder—that could alter how much control they have over their safety and balance.
A fear of heights is a topic that’s been studied for thousands of years and across numerous cultures. For some people, the experience, or even the idea of being high up, can produce sweaty palms, dizziness and a faster heart rate. For others, it can bring on a panic attack. About a third of the population admits to feeling squeamish at the idea of being very high up, and between 3-6% of the population has acrophobia.
Understanding the Fear of Heights
It’s normal to feel uneasy when you’re standing in high places such as the top of a tall ladder or a high balcony. This fear serves an obvious purpose: It prevents you from getting too close to a life-threatening situation. Generally speaking, people develop a fear of heights during childhood, sometimes as a response to seeing or experiencing a trauma related to falling. It may also develop in a child when they see fear-driven behaviors in caregivers.
For most people, this fear isn’t enough to keep them from day-to-day activities or fun experiences. On the other hand, the sight or thought of a high balcony, a cliffside trail or a tall ladder is enough to cause feelings of anxiety in some. When someone has an extreme fear of heights, they may receive an acrophobia diagnosis. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, lists this condition as an anxiety disorder. For the DSM-5 to consider something a phobia, it has to meet certain criteria including:
- Marked fear related to a specific situation
- Exposure consistently causes immediate fear or anxiety
- The fear is disproportionate to the danger the situation presents
- The individual actively avoids triggering situations
- The fear is disruptive to day-to-day life
- The fear lasts for at least six months
- The fear doesn’t stem from other mental health disorders
The Symptoms of Acrophobia
Someone living with acrophobia may experience a range of symptoms when they’re exposed to situations or images related to high places, including:
- Increased heart rate
- Chest pain or tightness
- Digestive issues
- Feelings of panic
- Extreme fear or anxiety
- Preoccupation with thinking about encountering heights in the future
Because of these symptoms, someone with a fear of heights may go out of their way to avoid situations where falling from a high place is theoretically possible. This may mean avoiding driving routes that require them to cross over a bridge or staying away from balconies.
Not all phobias require professional treatment. Oftentimes, someone can simply avoid their trigger—such as snakes (ophidiophobia) or dogs (cynophobia)—without altering their lifestyle or environment. However, if a fear becomes disruptive and keeps someone from completing necessary tasks or things they want to experience, several types of treatment techniques and strategies are available.
Gradual Exposure Techniques
Exposure therapy is one of the most common forms of heights phobia treatment and can be effective for treating varying degrees of anxiety related to high places. When someone is fearful of something such as heights, they tend to avoid certain activities and situations. Exposure therapy allows someone to face their fear in a safe, controlled environment. It essentially desensitizes someone to their fear, reducing their feelings of uneasiness when they’re exposed to certain situations. The more someone interacts with their trigger and has a positive, non-threatening experience with it, the less likely their brain is to continue perceiving that trigger as a threat.
Using exposure therapy for conquering acrophobia may involve a variety of activities, including:
- Reading stories that take place in high places
- Using virtual reality to experience heights while remaining on the ground
- Watching video clips of people safely navigating high places
- Writing about your fear in detail, including the first time you remember feeling afraid of high places and how your body feels when you think about heights
- Looking at photos of high places such as balconies or cliffs
- Imagining yourself in a high place
These may be the first steps of exposure therapy for a fear of heights. Along with these, there are several ways to interact with your fear in person. These include:
- Standing on a small step stool
- Walking to the top of a hill
- Climbing to the top of a ladder
- Looking out a second- or third-story window
- Standing on a balcony
- Looking over the banister of a stairwell
- Walking over a wobbly bridge at a playground
- Riding on a ski lift
- Using an escalator
Cognitive Strategies for Conquering Acrophobia
There are several cognitive strategies and tips for facing a fear of heights that individuals can incorporate into their daily lives or that therapists may use as part of their treatment plan.
- Relaxation techniques, which some mental health experts reinforce through biofeedback therapy, can help you learn to calm your mind and reduce your stress response when you come in contact with high places. This may include mindfulness meditation, controlled breathing and progressive muscle relaxation.
- Challenging negative thoughts can also help you conquer acrophobia by identifying negative thoughts and replacing them with more positive and realistic ones. By asking yourself whether your fear is based on facts or on irrational beliefs can help you gain a more objective perspective.
- Visualization techniques can help you train your brain to remain calm and in control when you encounter high places.
- Positive affirmations can help to reinforce a positive mindset when you’re in a situation that makes you uneasy. They can build your confidence and help you replace negative self-talk with reminders of your strengths and capabilities.
- You aren’t likely to overcome your fears overnight, but setting realistic goals can help you make progress toward being more comfortable in high places. For example, you may set a goal of replacing the batteries in your smoke alarms, even though that requires using a ladder. Alternatively, you may make it your goal to cross over at least one bridge on a daily walk, or you may schedule a lesson at your local climbing wall.
Seeking Professional Help for Height Phobia
Avoiding high places isn’t always feasible, and a fear of heights can put you at a greater risk of injury if you experience a panic attack while walking up a flight of stairs or crossing a bridge near a busy road. For that reason, professional help may be necessary for conquering acrophobia.
One of the most common ways mental health care professionals treat heights phobias is cognitive behavioral therapy. With CBT, the client and the therapist work together to challenge and reframe negative thoughts about heights. This usually happens with the safety of a therapy session and is an effective first step for someone who’s not ready to take on exposure therapy.
Acrophobia is one of the most common phobias, but the good news is that it’s highly treatable. While it may take time, many people are able to navigate heights-related situations with professional help and consistent exposure therapy.
At Restore Mental Health, our compassionate mental health care professionals provide a variety of treatment options for this and other phobias, helping you build confidence and discover the tools you need to overcome fears.