Greetings Gatecrasher,
Acrophobia
===========
?Acrophobia is a fear of heights. There is little or no distinction
between this and bathophobia, fear of depths; both involve fear of
falling.
People who suffer from acrophobia can often become habituated to
particular high places, i.e. they lose their fear of them, but the
fear returns when they go somewhere new. A surprising number of
rock-climbers suffer intermittent acrophobia.
Acrophobia can be dangerous, because sufferers can experience a panic
attack in a high place and be unable to get themselves out of it. Some
acrophobics also suffer from urges to throw themselves off high
places, despite not being suicidal.
Curiously, there is no correlation between fear of flying and
acrophobia. The difference seems to be that when flying, there is no
visual connection between the aircraft and the ground beneath:
fearless and successful pilots who are acrophobic have reported that
their fear suddenly emerges if such a connection is made, e.g. by
flying near a cliff or a tall building.? Because of copyright
limitations, I may only post part of this article. Please see the link
below for the entire article.
http://www.answers.com/topic/acrophobia
?People who suffer from acrophobia can often become habituated to
particular high places, i.e. they lose their fear of them, but the
fear returns when they go somewhere new. A surprising number of
rock-climbers suffer intermittent acrophobia.
Acrophobia can be dangerous, because sufferers can experience a panic
attack in a high place and be unable to get themselves out of it. Some
acrophobics also suffer from urges to throw themselves off high
places, despite not being suicidal.?
?Acrophobia is a specific-object phobia and like most such phobias is
relatively easily addressed by behaviour therapies such as systematic
desensitization or flooding. It is probable that acrophobic
rock-climbers have in effect undergone a successful self-administered
course of such behaviour therapy.?
http://en.wikipedia.org/wiki/Acrophobia
?The general symptoms of phobias include the following:
· Feelings of panic, dread, horror, or terror
· Recognition that the fear goes beyond what is considered normal and
is out of proportion to the actual threat of danger
· Reactions that are automatic and uncontrollable, and seem to take
over the person?s thoughts
· Rapid heartbeat, shortness of breath, trembling, and an overwhelming
desire to escape the situation
· Extreme measures taken to avoid the feared object or situation?
http://community.healthgate.com/GetContent.asp?siteid=mclean&docid=/hic/anxiety/phobias/phobias
?A link between dizziness and phobic avoidance of certain environments
has been discussed for millennia, but interest waned after the
identification of agoraphobia as a psychiatric disorder in 1874.1
Recent research, however, has re-established links between this
avoidance pattern and vestibular dysfunction.2 Specifically, patients
with vestibular or balance disorders often report fear of heights.3-5
This fear tends to be embedded in a larger symptom pattern that has
been labeled "space-and-motion discomfort" (SMD).3,6,7
Space-and-motion discomfort occurs in patients with anxiety disorders,
particularly agoraphobia,8 a disorder in which fear of heights is
common. Patients with agoraphobia have been found to have an increased
prevalence of vestibular or balance dysfunction.9-12 In a study by
Jacob et al,6 patients with anxiety plus fear of heights and other
symptoms of SMD were found to be unusually sensitive in their body
sway to full-field visual motion (ie, optic flow). The subjects stood
in front of a large screen on which patterns of black and white
squares or stripes were projected that created the illusion of vection
("subjective self-motion") while postural sway was recorded. The
results suggested that people with anxiety plus fear of heights were
visually dependent in a manner similar to that of patients with
vestibular disorders examined in an earlier study.? (The same
copyright restrictions apply here.)
http://www.ptjournal.org/PTJournal/May2005/v85n5p443.cfm
Rational/Irrational
===================
?The fear is considered excessive because it is out of proportion to
the actual level of danger associated with the situation. When an
individual with a phobia is exposed to the feared stimulus (the object
or the situation) or related cues (things that remind us of the object
or situation), an immediate anxiety response is triggered that can
sometimes grow into a full-blown panic attack. Consequently, people
with phobias either avoid the feared situations or objects or they
endure a lot of distress.
For example, an individual with a phobia of snakes experiences an
anxiety reaction in a number of situation including seeing a snake on
television, being outside in grassy or wooded areas where snakes may
live, and seeing things that resemble a snake such as a coiled garden
hose in the yard.?
http://www.cpa.ca/factsheets/phobias.htm
?Fear and stress reactions are essential for human survival. They
enable people to pursue important goals and to respond appropriately
to danger. In a healthy individual, the stress response (fight,
fright, or flight) is provoked by a genuine threat or challenge and is
used as a spur for appropriate action.
An anxiety disorder, however, involves an excessive or inappropriate
state of arousal characterized by feelings of apprehension,
uncertainty, or fear. The word is derived from the Latin, angere,
which means to choke or strangle. The anxiety response is often not
attributable to a real threat; nevertheless it can still paralyze the
individual into inaction or withdrawal. An anxiety disorder persists,
while a healthy response to a threat resolves, once the threat is
removed.?
http://www.healthandage.com/PHome/122!gm=0!gc=5!gid6=2801
?Many phobias are based on rational fears but are taken to irrational
levels. For example, acrophobia, the fear of heights, seems like a
pretty reasonable fear. Gravity is a strong force, and getting
squished is not fun. So if you are too afraid of heights to go bungee
jumping, you probably do not need to worry that your fear is
irrational. However, some people are so afraid of heights that they
cannot climb ladders or look out third story windows; this is rather
irrational. More importantly, such an extreme fear can interfere with
day to day life. Likewise, achluphobia, or an irrational fear of the
dark, and bacteriophobia, a fear of disease, are understandable but
still quite debilitating.?
http://www.finetuning.com/articles/986-phobias-common-fears-and-treatments.html
?What are specific phobias?
Specific phobias are an intense fear of something that poses little or
no actual danger. Some of the more common specific phobias are
centered around closed-in places (agoraphobia), heights (Acrophobia),
escalators (escalaphobia), tunnels, highway driving, water
(hydrophobia), flying (Aviophobia or Aviatophobia), dogs, and injuries
involving blood. Such phobias aren't just extreme fear; they are
irrational fear of a particular thing. You may be able to ski the
world's tallest mountains with ease but be unable to go above the 5th
floor of an office building. While adults with phobias realize that
these fears are irrational, they often find that facing, or even
thinking about facing, the feared object or situation brings on a
panic attack or severe anxiety.?
http://www.npadnews.com/phobias.asp
Therapies
==========
?How Are Phobias Treated?
Only about 20% of adult phobias go away on their own. When phobias
interfere with a person?s quality of life and life decisions,
treatment is essential. And treatment is very successful?most people
who seek treatment completely overcome their phobias.
Successful treatment involves behavioral therapy, medication, or a
combination of both.?
http://community.healthgate.com/GetContent.asp?siteid=mclean&docid=/hic/anxiety/phobias/phobias
?Some phobias appear to diminish with age and may disappear altogether
when someone reaches his 50's or 60's, Dr. Asnis said, while more
complex phobias, like agoraphobia, can last a lifetime if untreated.
Dr. Barlow said that up to ninety percent of younger people suffering
specific phobias, like claustrophobia, can reduce their symptoms
through treatment. About half of those will never have another attack,
he said.
Experts say that everyone with an anxiety disorder has places or
objects that make them feel safer and less vulnerable. "We call them
talismans" Dr. Barlow said. "For some people it is a stuffed animal.
Others a printed prayer they read when they begin to feel anxious.
Some will carry around empty pill bottles. They are fine as long as
they have the objects nearby. If they forget, the symptoms can return.
It's one of the many mysteries associated with anxieties. How people
who are perfectly ration can behave so irrationally."
http://drsanderson.com/nytimes.html
The ADAA says this about therapies:
?Anxiety disorders are real, serious and treatable. Experts believe
that anxiety disorders are caused by a combination of biological and
environmental factors, much like other disorders, such as heart
disease and diabetes.
The vast majority of people with an anxiety disorder can be helped
with professional care. Success of treatment varies with the
individual. Some people may respond to treatment after a few months,
while others may take a year or more. Treatment is sometimes
complicated by the fact that people very often have more than one
anxiety disorder, or suffer from depression or substance abuse. This
is why treatment must be tailored to the individual.?
Therapies:
Behavior Therapy
Cognitive Therapy
Cognitive-Behavior Therapy (CBT)
Relaxation Techniques
Medication
?Anxiety Disorders can be treated by a wide range of mental health
professionals, including: psychiatrists, psychologists, clinical
social workers and psychiatric nurses. Primary care physicians are
also becoming increasingly aware of the problems of anxiety disorders
and depression and are making these diagnoses with more frequency. A
primary care physician may prescribe medication, or may refer a
patient to a mental health provider.
Finding the right therapist can be tricky, as satisfactory credentials
are not the only factors to take into consideration. It is important
to feel comfortable with one's therapist. Speak to the therapist,
either on the phone or in his/her office, and do not be embarrassed if
you feel uncomfortable and would rather see someone else.?
http://www.adaa.org/GettingHelp/Treatment.asp
?Specific phobia ? Cognitive-behavioral therapy can help, especially a
procedure called desensitization therapy, also called exposure
therapy. This technique involves gradually increasing your exposure to
the thing you fear, at your own pace, under controlled circumstances.
As you are exposed to the object, you are taught to master your fear
through relaxation, breathing control or other anxiety-reducing
strategies. For short-term treatment of phobias, your doctor may
prescribe an antianxiety medication, such as lorazepam (Ativan). If
the phobia is confronted only occasionally, as in a fear of flying,
the use of medication can be limited.?
http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/31038.html
More about CBT
http://media.wiley.com/product_data/excerpt/22/04700213/0470021322.pdf
Comparing Virtual and Real Worlds for Acrophobia Treatment
http://www.emotrics.com/people/milton/papers/compareworlds/
?A person can often cope with a specific phobia by avoiding the feared
object or situation. When treatment is needed, exposure therapy is the
treatment of choice. A therapist can help ensure that the therapy is
carried out properly, although it can be done without a therapist.
Even people with a phobia of blood or needles respond well to exposure
therapy. For example, a person who faints while blood is drawn can
have a needle brought close to a vein and then removed when the heart
rate begins to slow down. Repeating this process allows the heart rate
to return to normal. Eventually, the person should be able to have
blood drawn without fainting.
Drug therapy is not very useful in helping people overcome specific
phobias. However, benzodiazepines (antianxiety drugs) may give a
person short-term control over a phobia, such as the fear of flying.?
http://www.merck.com/mmhe/print/sec07/ch100/ch100e.html
?NAMI says talk therapy is often effective in treating anxiety
disorders such as phobias. The most common forms of talk therapy are
behavioral therapy and cognitive-behavioral therapy. Behavioral
therapy involves relaxation techniques and gradual exposure to the
thing or situation that causes the anxiety. Cognitive-behavioral
therapy tries to help people figure out why they're reacting as they
are, and then change the thought patterns that lead to that reaction.
APA says cognitive behavioral therapy techniques can desensitize
patients to the triggers of anxiety, and help them to confront their
fears.
Exposure to the feared situation can be actual or imagined. Recently,
exposure can even be done through computer simulations. For example,
APA says Virtual Reality Exposure (VRE) allows a user to be an active
participant within a computer-generated three-dimensional virtual
world. VRE can be useful is situations such as fear of flying or fear
of heights.?
http://www.stayinginshape.com/3osfcorp/libv/m11.shtml
Finding a therapist:
?It is important to feel comfortable with your therapist. It is a good
idea to talk to more than one professional before choosing the one
with whom you will work. See the Guide to Treatment for a list of
questions you may want to ask a therapist before beginning treatment.
The professionals on this list are not screened by the ADAA and the
descriptions of their practices are their own.?
http://www.adaa.org/GettingHelp/FindATherapist.asp
http://www.adaa.org/GettingHelp/Treatment.asp
ADAA Home page:
http://www.adaa.org/
?A drug used to treat tuberculosis may help people overcome their fear
of heights and other phobias.
Researchers found adding the drug to behavioral therapy using virtual
reality helped people with a fear of heights (acrophobia) overcome
their phobia and anxiety faster and more effectively than without it.
Researchers say the tuberculosis drug, known as D-cycloserine (DCS),
acts on a region of the brain called the amygdala, which governs the
fear response. Previous studies of DCS have shown that it helped fight
fear in rodents. This study shows it appears to have the same effect
in humans with a fear of heights when combined with psychotherapy.?
http://aolsvc.health.webmd.aol.com/content/article/96/103893.htm
Virtual Reality Medical Center has an interesting therapy:
?At the VRMC, acrophobia can be treated with the use of virtual
reality exposure therapy. After relaxation training and discussion
about what situations produce anxiety, the client is exposed to
progressively higher anxiety virtual environments. These may include a
virtual construction elevator, hotel elevators. As the client
progresses, stimuli such as wind, vibration and sound can be added to
create further realism.?
http://www.vrphobia.com/heights.htm
?Virtual reality (VR) is a concept that uses multiple novel approaches
to allow interaction with human sensorimotor and cognitive systems. It
is a global approach toward the temporary fusion of experience and
function with an artificial environment in which the links to reality
fall to a large extent under the control of the VR designer. To
achieve these ends, VR systems produce high levels of immersion, or
the perception that the subject has entered into the "world"
constructed by a set of computer-generated stimuli. Moreover, the
computer (which in the strict etymologic sense refers to a thinking
aid) takes on the additional role of an experience enhancer.?
?In the treatment of acrophobia, taking a patient to the edge of a
virtual high building in a nonthreatening environment presents several
advantages. The brainstem cues involving vestibulo-ocular mismatch
that produce physical symptoms when the individual with acrophobia is
placed in the offending environment (eg, ledge high above the street)
can be reproduced with sufficient fidelity in a known nonthreatening
environment (ie, VR laboratory). This produces nausea and vertigo and
evokes sympathetic responses. Conversely, the patient is aware that he
or she is in fact in a safe environment. Thus a cognitive dissonance
is evoked, ie, the sensorineural perception of height juxtaposed with
knowledge of the actual safe environment. Neuroplastic mechanisms then
can come into play to begin resetting the brainstem-visual
interaction.
The symptoms remain overpowering if the cognitive damping effect of
knowledge of the actual safe environment is absent. In this situation,
the patient is unable to endure the exposure to the height necessary
for the neuroplastic response to develop.
Moreover, the patient can be exposed to a gradually increasing level
of stimulation by increasing the perceived height of the building or
decreasing the distance to the ledge. The patient also can control the
configuration of the environment by walking closer to the virtual edge
or by looking up or down. In each case, the virtual environment is
recalculated in essentially real time to produce the needed
environmental consistency. Deconditioning in such environments has
been quite effective.? It appears that virtual reality is highly rated
as an effective therapy for acrophobia.
http://www.emedicine.com/NEURO/topic463.htm
?Virtual Therapy utilizes a theoretical rational underlying cognitive
therapy which concerns the way in which individuals structure the
world (Beck, 1967, 1976, 1991). In cognitive theory, individual
cognitions are based upon schema or assumptions or beliefs. When
individuals make "negative cognitive shifts" (Beck, 1991), a change in
cognitive organization occurs such that positive information important
to the individual is cognitively blocked while negative information
become predominant in the individual's field of awareness.
Research of Virtual Therapy (Lamson, 1994) suggests immersing
individuals in simulated environments may influence fear producing
automatic thoughts of heights and associated beliefs. The theory
underlying cognitive therapy hypothesizes that beliefs are cast into a
structure from early experiences. Virtual Therapy research reveals
that fear of height beliefs may emerge at any time during the
lifespan. When present events stimulate and activate the belief
structure, the individual may experience depression or anxiety. One
structure may be stimulated by heights. In this case, the individual
may start a "cognitive shift" by thinking "I'm not going to be ok. I
can't do this. Something awful is going to happen. I won't be ok". In
this manner, the individual experiences threat and helplessness.
Virtual Therapy provides individuals the opportunity to make positive
shifts through simulated "as if" experiences. Beck (1991) describes
people prone to anxiety disorders as experiencing threat whereas
people prone to depression experience loss or defeat.?
http://www.csun.edu/cod/conf/1994/proceedings/Laphp~1.htm
The University of Michigan is constructing a virtual reality
treatment. This page was written in 1996, so it may be functioning
now.:
?The most effective treatment for acrophobia is a technique called
"graduated exposure", whereby the patient is confronted with a series
of anxiety-provoking situations, each more challenging than the last.
So in treating an acrophobe, a psychiatrist takes the patient to the
second floor of a building and makes them look out the window, thus
exposing them to their fear. Once their fear of the second floor is
gone, the patient is slowly moved up floor by floor, each time waiting
for their fear to disappear. At the University of Michigan Department
of Psychiatry, such exposure treatments are performed in the East
elevator area of the main hospital. The hospital is nine stories tall,
providing a sufficiently strong anxiety-provoking stimulus for most
patients.?
For more information about this project, please contact Jean Schiller
schiller@engin.umich.edu
http://www-personal.umich.edu/~schiller/vrreport.html
A study of Virtual Reality therapy
http://gerwindehaan.nl/fileadmin/official/Gerwin_de_Haan_Acrofobia.pdf
Resources
===========
Freedom From Fear, link found on an Intellihealth site.
Offers a free screening and a support chat room.
?Freedom From Fear is a national not-for-profit mental health advocacy
association founded in 1984 by Mary Guardino. Ms. Guardino founded FFF
as an outgrowth of her own personal experiences of suffering with
anxiety and depressive illnesses for more than 25 years. The mission
of FFF is to impact, in a positive way, the lives of all those
affected by anxiety, depressive and related disorders through
advocacy, education, research and community support.?
http://www.freedomfromfear.org/
Acrophobia Group
http://groups-beta.google.com/group/alt.support.anxiety-panic/browse_frm/thread/fa677a62bee5d3d6/8988e8a395344ce7?lnk=st&q=acrophobia+%2B+groups+%3D+PHOBIAS&rnum=1&hl=en#8988e8a395344ce7
There you go! If this is not the information you were seeking, please
request an Answer Clarification, before rating. This will allow me to
assist you further, on this question.
Sincerely, Crabcakes
Search Terms
=============
acrophobia
levels of phobias
acrophobia + successful therapies
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acrophobia + behavior therapy |
Clarification of Answer by
crabcakes-ga
on
30 Jul 2005 00:20 PDT
Hi Gatecrasher,
Thank you for your patiences!
"Space-and-motion discomfort occurs in patients with anxiety disorders,
particularly agoraphobia,8 a disorder in which fear of heights is
common. Patients with agoraphobia have been found to have an increased
prevalence of vestibular or balance dysfunction.9-12 In a study by
Jacob et al,6 patients with anxiety plus fear of heights and other
symptoms of SMD were found to be unusually sensitive in their body
sway to full-field visual motion (ie, optic flow). The subjects stood
in front of a large screen on which patterns of black and white
squares or stripes were projected that created the illusion of vection
("subjective self-motion") while postural sway was recorded. The
results suggested that people with anxiety plus fear of heights were
visually dependent in a manner similar to that of patients with
vestibular disorders examined in an earlier study.?
This is describing a treatment for agorophobics, which are people with
a fear of outdoors, or being in public. I'm not sure whether the
article is stating that agorophobics also suffer from fear of heights,
or whether the author made a typo. In any case, part of the therapy
was having black and white patterns projected on the patient,giving
the illusion of movement, and recoring the patient's movements, such
as swaying. The study was seeing how much these people xperienced
feeling a fear of falling.
"Usually, persons with peripheral vestibular disorders have disequilibrium and
complain of visual blurring.10 These common symptoms may be caused by
abnormalities in the vestibulo-ocular reflex (VOR) during head
movements. In acute peripheral vestibular injuries or insults, the VOR
may decrease in efficacy by as much as 75% when the head is moved
toward the injured side and by as much as 50% toward the nonaffected
side.11 Patients can learn to adapt to vestibular injuries using
vision, particularly visual motion induced by active head
movement.6,12 The more a person with vestibular dysfunction moves,
generally, the faster they improve."
"Persons with chronic vestibular disorders often develop psychological
complications.14,15 Primary among these complications are panic or
anxiety, avoidance behaviors, and also a preoccupation with their
health. Nazareth et al16 report that there were three predictive
factors of dizziness 18 months after onset: a history of fainting
(probably a symptom of panic), vertigo, and avoidance of situations
that provoked dizziness."
http://planetjeff.net/IndexDownloads/Whitney5-5-02.pdf
"Many people with balance disorders find that they become dizzy in
environments that provide the visual, vestibular and somatosensory
systems with unusual or conflicting information. People who have
unconsciously come to rely more on visual than vestibular input for
balance may experience disorientation and instability when exposed to
large-scale movement of the visual scene (e.g., passing traffic,
moving crowds) or when the visual environment is too distant (e.g., in
open spaces or high places) to provide useful input for balance
control (Redfern et al., 2001). Similarly, people with imperfect
compensation for vestibular imbalance often find that dizziness can be
provoked by the relatively unusual and vigorous vestibular stimulation
associated with abruptly starting and stopping in elevators and motor
vehicles or the motion of planes or boats."
http://www.psychiatrictimes.com/p011066.html
What all that means is, that you may have a vestibular disorder, and
not a phobia! What's a vestibular disorder? A vestibular disorder, put
simply, is a problem with the inner ear. Sometimes people who have had
repeated ear infections develop calcium deposits in the ear.
Occasionally tiny pieces break off and float in the fluid in the
vestibular area. This tiny piece causes one's equilibrium to be off,
off balance so to speak. This can cause a dizzy feeling, a feeling of
vertigo, where it feel ss if one will fall down. It usually lasts a
few days.
There are other causes of vestibular disorders.
http://www.medicinenet.com/vestibular_balance_disorders/article.htm
http://www.medicinenet.com/vestibular_balance_disorders/page4.htm#toco
I'm not saying you have this disorder, but it can cause acrophobic
symptoms. Your best solution would be to see an ENT (Ear nose, and
throat doctor to determine if you have a vestibular disorder. If not,
you may want to consider seeing a therapist trained in acrophobia
therapy.
If you suffer this phoia only when you hike, and not in an elevator
or on a high balcony, then it may be a mild phobia. (We can't dispense
medical advice at Google Answers). On the other hand, if you enjoy
hiking and plan to hike often throughout your life, a bit of therapy
would do you well. If you overcame an unecessary fear, your hiking
expeditions would be more enjoyable.
"Of course, there are varying degrees of acrophobia. Some folks
experience it when leaning over a high balcony. Others can’t even
watch a video shot from the spires of a bridge or tower without
feeling great discomfort. But for whatever reason, fear of heights
generally doesn’t present much of a problem once someone is seated and
strapped into an airplane with hands on the controls. Being in control
seems to play a big part in diminishing, if not completely
eliminating, the effects of acrophobia.
So, if students say they have been afraid of heights since first
looking over the edge of a high chair, let them know that they aren’t
alone and this fear will most likely not keep them from successfully
flying airplanes. Explain to them that unlike most of the rest of
life, they will be in control as the pilot-in-command, and this seems
to make all the difference for most people."
http://www.aopa.org/asf/publications/inst_reports2.cfm?article=4698
I hope this has helped clarify things for you. By the way, I get a
little antsy when I peer over a high balcony myself!
Good Luck!
Sincerely, Crabcakes
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