All people do things every day that do not require our attention. One of these acts is walking which, although subject to a remarkable degree of motor coordination, tends to become automatic from an early age.
When we walk, we shift our weight forward, changing the axis of gravity and positioning both feet so that the body moves through space without facing the ground or against an obstacle. Everything happens without the need to think in detail about what is going on.
It is for this reason that many are surprised to discover that it is possible to be afraid of going wrong in this “simple” process, and to suffer a dramatic fall as a result. Such fear, more common than previously thought, is known as basophobia.
In this article, we will talk about this particular fear, its causes and treatments, as well as which group is most at risk of suffering from it.
What is basophobia?
Basophobia is a specific phobia, which is why it can be considered an anxiety disorder. The person who suffers from it makes a very debilitating fear of the possibility of tripping and falling while moving from one place to another. The fact that walking is an absolutely common act, necessary to develop daily life, makes this fear a problem that very significantly limits autonomy and participation in activities of daily living.
This fear usually has a number of identifiable causes, which we will discuss in detail in the next section, and tends to linger through a process of deliberate avoidance.
Many people with basophobia who, faced with this overwhelming fear, make the decision to stop walking for good. Thus, they become for a long time in situations of extreme sedentarism, resentment on the physical plane while the fear keeps increasing.
It is important to note that most people with basophobia (also known in the literature as fear of falling or “fear of falling”) are older people with additional physical problems, especially in the musculoskeletal systemIt is therefore a problem that can worsen the deterioration of your health or the risk of complications in other organs or systems. This is why its early detection and treatment is of utmost importance.
People with basophobia can also very often report difficult emotions, because the resulting inactivity leads to a succession of significant losses (social, professional, etc.). This is why it is common for mood disorders or a painful feeling of loneliness to occur.
Causes of basophobia
Below we will introduce the main causes of basophobia. Both physical and psychological aspects will be included, which can often present themselves at the same time or even interact with each other, empowering each other.
1. History of falls
Most research on basophobia indicates that the history of falls in the past is one of the main reasons why this form of fear can develop. Thus, the memory of tripping and falling would be stored as an emotional imprint in the life story, which would condition the ability to walk normally. While it is possible to develop a phobia without having suffered a severe fall on your own skin, the truth is that most people who suffer from it report having it.
A two-way relationship is established: people who have already fallen are more afraid of falling than those who have never fallen, but it can also happen that those who fear a more severe fall are at a greater risk of suffering than those who have fallen. . feel more secure. Accordingly, it is plotted a vicious circle between experience and expectationResolution requires a personalized therapeutic procedure.
2. Anxiety and posture control
When the fear of falling is established, the sufferer pays excessive attention to the whole process of moving from one place to another, causing him to lose the normalcy with which he has developed up to that point. Consequently, this automated coordination would be conditioned by a perception of threat or danger, which would imply a harmful need for control and security.
This monitoring modifies the operation of the machine on several levels. We know people with basophobia they adopt greater rigidity in the muscle groups involved in walking; limit range of motion and alter center of balance by contracting the tibialis anterior, soleus, and twins. This variation can increase the risk of another fall (or the first for someone who has never had one before).
Such a deliberate alteration in gait is behavior that is difficult to control, in which the person tries to anticipate an unexpected situation that increases the risk of a fall: an obstacle preceding the road, a slope on the ground, or dizziness. This is why it is more common in people who live with anxiety symptoms in which there is constant concern about what might happen in the future.
Even in an upright position, in which no need to walk is anticipated, people with basophobia fear and see a decrease in confidence in their own balance, precipitating hyperactivity of the autonomic nervous system (and more particularly of its sympathetic branch. ). This physiological phenomenon is linked to sensations such as tachycardia, tachypnea, sweating, unreal feeling and unsteadiness; and increase the risk of falling on their own.
3. Increased cognitive demand
Older people with basophobia have a higher risk of falling, as well as a greater fear of it happening to them, when in addition to wandering is added simultaneous activity that requires cognitive effort. This is why they can feel insecure in unfamiliar places, because they have to devote much more attentional resources to valuing the properties of the physical environment (presence of obstacles and support elements, for example). .
This circumstance also implies that people who suffer from impaired cognitive functions they have a higher risk of falling than those who kept them, because in the first case it is easier to exceed the resources available to process the information. This is one of the reasons why patients with dementia fall more often than people who do not have these neurodegenerative problems.
4. Poor physical function or need for walking aids
People who feel physically limited (by accident, surgery or pathology) may be at an increased risk of developing this phobia. In this case, the self-efficacy for the movement can be severely impaired, lose confidence and shape a feeling of generalized insecurity. This problem increases when a walking aid is needed, such as crutches or a cane.
Many studies point out that what is really important in explaining fear of falling is not objective physical condition, but the person’s perception of it. Thus, a subject with less mobility may not have this problem as long as he relies on his own abilities, and considers that his body is in good shape. Institutionalizing the elderly may increase the risk of basophobia, Especially if the residential center in which they are located does not have information on this problem.
5. Drug use
Older people eliminate drugs more slowly than younger people. They also report more side effects than these (and of greater intensity), so caution should be exercised when administering compounds that may cause dizziness or instability in people with basophobia. .
Sometimes, in order to treat the anxiety directly associated with basophobia, it is decided administer benzodiazepines. It is a subgroup of drugs with muscle relaxant, hypnotic and anxiolytic properties. So good, in some cases, they can cause drowsiness and unwanted muscle laxity in those who live with this phobic problem (especially in the early hours of the morning), its use and effects in these specific cases should therefore be monitored to the extreme.
Treatment of basophobia
Basophobia can be treated with treatment programs that include four main components: physical exercises, psychoeducation, exposure and use of protective or safety measures.
Regarding physical exercises, activities have been proposed to improve the feeling of balance. They include sitting and standing movements, taking steps in all directions while maintaining a standing position, tilting the body to explore the limits of stability, stretching and standing (as sometimes orthostatic hypotension contributes to the fear) and team sports (adapted).
Regarding psychotherapeutic strategies, opts for the use of psychoeducation (Provide information about the problem that reduces the presence of preconceived and harmful ideas), cognitive restructuring (identification and debate of irrational ideas) and exposure (both in vivo and in the imagination or by the use of new technologies).
Protective measures involve modifying the physical environment in order to increase the feeling of safety in areas of normal operation, as well as the use of elements that minimize the anticipated potential consequences of a potential fall (protection in areas of normal operation). areas of the body that the person perceives to be vulnerable or fragile, such as the head or knees).
Of all these strategies, those who have shown greater effectiveness are those who combine both physical exercise and psychological intervention, Being necessary the development of multidisciplinary programs that address the reality of the whole person. Using one or the other separately has also shown positive effects, but they tend to wear off quickly over time.
- Seonhye, L., Eunmi, O. and Gwi-Ryung, SH (2018). Comparison of factors associated with fear of falling in older people with and without a history of falling. International Journal of Environmental and Public Health Research, 15, 1-12.
- Stojanovic, Z., Kocic, M., Balov, V., Milenkovic, M., Savic, N. and Ivanovic, S. (2016). To fall. Praxis Medica, 44 (3), 61-66.
- Young, WR and Williams, M. (2015). How fear of falling may increase the risk of falling in the elderly: application of psychological theory to practical observations. March Posture, 41 (1), 7-12.