As anyone who has a fear of heights will tell you, the experience of height phobia is an unusually frightening one—and yes, I’m one of them. As adventure blogger Zabdiel Scoon explains, “As we go through our everyday lives, we naturally avoid our fears to the point that it becomes an unconscious action. It’s only when you’re faced with those fears that you really start to consciously consider how they impede what it is you wish to do."
In my case, I didn’t realise how debilitating a fear of heights could be when coupled with long-term travel. In La Boca, Buenos Aires, I had another confrontation with my fear of heights. After looking around this stunning museum, we were asked if we would like to view the sculptures on the roof terraces and take in views of the harbour from the balcony on the top roof. This all sounded terrific, and was indeed impressive, until I had to climb a very tall, open spiral staircase to the top balcony. Looking up I thought that it wasn't very solid. My hands felt incredibly clammy and my heart beat faster as I climbed the staircase.
There’s a compelling mix of catastrophic thoughts and physiological manifestations of anxiety in this quote, but height phobics aren’t people who’ve suffered trauma by falling off a ladder or a similar event. Yet they are now frightened of heights because of it; they would never have gone up a ladder in the first place. The only trauma that height phobics have ever experienced is being at a high height, so we need a radically different kind of theory to explain how some people develop height phobia and other people don’t.
One key to understanding height phobia is its link to panic and to panic attacks, and many of the physical manifestations of height phobia are very similar to panic symptoms—trembling, sweaty palms, nausea, dizziness, for example. Another important fact is that phobias of situations (such as heights or enclosed spaces) often share many characteristics in common with panic symptoms.
For instance, height phobia appears to have a preponderance of spontaneous onsets typical of panic disorder, and if someone is height phobic they’re significantly more likely than a non-height phobic individual to also have a diagnosis of panic disorder.
The link between panic symptoms and situational phobias such as height phobia and claustrophobia also extends to cognitive factors; height phobics also think like people who have panic attacks. Certain types of cognitive predispositions can often precipitate panic attacks, and two of the most important predispositions are a tendency to be acutely aware of one’s bodily sensations, and a bias towards interpreting ambiguous bodily sensations as threatening.
Just think about what it means to hold these two types of cognitive biases. It means you’re much more likely to be tuning into your various bodily sensations, are more likely than the average person to notice changes in bodily sensations, and even when you notice one that’s ambiguous, you’re more likely to think it means something bad is happening to you—there’s a catastrophe waiting to happen in your mind. It’s quite likely that this style of thinking triggers a vicious cycle that increases anxiety that in turn increases bodily sensations that are interpreted as threatening. Final outcome: Panic.
In the case of the height phobic, this process has become specific to heights, and detection of bodily sensations and interpretation of them as threatening is channeled into negative thoughts related to heights: “I will lose my balance.” “If I stand on the edge I’ll be tempted to jump.” “I will get dizzy or have a heart attack and fall.”
As a height-phobic, each of those thoughts is familiar to me—but how odd these thoughts are. How odd it is to think “I’ll be tempted to jump” when at a high height, but you wouldn’t dream of thinking that or any other related self-destructive thought anywhere else. Yet it’s a thought that’s been created out of two very simple cognitive biases and is a thought shared by many millions of otherwise sane height phobics worldwide. That’s how the mind can play some devious tricks on you when anxiety’s involved.
The link between situational phobias such as height phobia and panic is important. We now know that height phobia itself is associated with a bias towards interpreting ambiguous bodily sensations as threatening, and also that height phobia in early adolescence is a vulnerability factor for panic disorder later in life. I’ve argued that height phobia and claustrophobia probably have their origins in this link to panic and to cognitions associated with panic, and I wouldn’t be at all surprised if most cases of water phobia weren’t also developed in a similar way.
The process that creates people with height phobia is primarily cognitive and shaped by ways of thinking that rarely enter into conscious awareness. So it’s not surprising that most height phobics can’t articulate how their phobia began. But this is anxiety in its most devious form, creating delusional fears with the most basic of tweaks to our thought processes. Now that’s genuine brainwashing for you.
Himle, J.A., Crystal, D., Curtis, G.C. & Fluent, T.E. (1991). Mode of onset of simple phobia subtypes: Further evidence of heterogeneity. Psychiatry Research, 36, 37–43.
Starcevic, V. & Bogojevic, G. (1997). Comorbidity of panic disorder with agoraphobia and specific phobia: Relationship with the subtypes of specific phobia. Comprehensive Psychiatry, 38, 315–320.
Davey, G.C.L., Menzies, R.G. & Gallardo, B. (1997). Height phobia and biases in the interpretation of bodily sensations: Some links between acrophobia and agoraphobia. Behaviour Research and Therapy, 35, 997–1001.