Acrophobia is an extreme or irrational fear or phobia of heights, especially when one is not particularly high up. A fear of falling, along with a fear of loud noises, is one of the most commonly suggested inborn or “non-associative” fears. The newer non-association theory is that a fear of heights is an evolved adaptation to a world where falls posed a significant danger.
If this fear is inherited, it is possible that people can get rid of it by frequent exposure of heights in habituation. In other words, acrophobia could be attributed to the lack of exposure in early times.
The degree of fear varies and the term phobia is reserved for those at the extreme end of the spectrum. Researchers have argued that a fear of heights is an instinct found in many mammals, including domestic animals and humans. Experiments using visual cliffs have shown human infants and toddlers, as well as other animals of various ages, to be reluctant in venturing onto a glass floor with a view of a few meters of apparent fall-space below it.
Although human infants initially experienced fear when crawling on the visual cliff, most of them overcame the fear through practice, exposure and mastery and retained a level of healthy cautiousness. While an innate cautiousness around heights is helpful for survival, an extreme fear can interfere with the activities of everyday life, such as standing on a ladder or chair, or even walking up a flight of stairs.
Still, it is uncertain if acrophobia is related to the failure to reach a certain developmental stage. Besides associative accounts, a stress model is also very appealing for considering both vicarious learning and hereditary factors such as personality traits (i.e., neuroticism).
Some people are known to be more dependent on visual signals than others. People who rely more on visual cues to control body movements are less physically stable. An acrophobic, however, continues to over-rely on visual signals whether because of inadequate vestibular function or incorrect strategy.
Locomotion at a high elevation requires more than normal visual processing. Research is underway at several clinics. Recent studies found that participants experienced increased anxiety not only during elevation in height, but also when they were required to move sideways in a fixed height.
Traditional treatment of phobias is still in use today. Its underlying theory states that phobic anxiety is conditioned and triggered by a conditional stimulus. By avoiding phobic situation, anxiety is reduced. However, avoidance behaviour is reinforced through negative reinforcement. Wolpe developed a technique called “systematic desensitization to help participants avoid “avoidance”.
Research results have suggested that even with an decrease in therapeutic contact densensitization is still very effective. However, other studies have shown that therapists play an essential role in acrophobia treatment. Treatments like reinforced practice and self-efficacy treatments also emerged.
There have been a number of studies into using virtual reality (VR) therapy for acrophobia.
Botella and colleagues and Schneider were the first to use VR in treatment. Specifically, Schneider utilised inverted lenses in binoculars to “alter” the reality. Later in mid 1990s, VR became computer based and was widely available for therapists. A cheap VR equipment uses a normal PC with head-mounted display (HMD).
In contrast, VRET uses an advanced computer automatic virtual environment (CAVE). VR has several advantages over in vivo treatment:
- (1) therapist can control the situation better by manipulating the stimuli, in terms of their quality, intensity, duration and frequency;
- (2) VR can help participants avoid public embarrassment and protect their confidentiality;
- (3) therapist’s office can be well maintained;
- VR encourages more people to seek treatment;
- VR saves time and money as participants do not need to leave the consulting room.
Many different types of medications are used in the treatment of phobias like fear of heights, including traditional anti-anxiety drugs such as benzodiazepines, and newer options like antidepressants and beta-blockers.