Every person carries out, every day, actions that do not require our attention. One of these acts is walking, which despite being subject to a remarkable degree of motor coordination, tends to become automated from a very young age.
When we walk we move our weight forward, changing the axis of gravity and positioning both feet so that the body moves in space without hitting the ground or against an obstacle. Everything happens without the need to think in detail about what is happening.
It is for this reason that many are surprised to discover that it is possible to be afraid of erring in this “simple” process, and suffer a dramatic fall as a consequence. Such fear, more common than is believed, is known as basophobia .
In this article we will talk about this specific fear, its causes and treatments, as well as which is the group with the highest risk of suffering it.
- Related article: ” Types of phobias: exploring fear disorders“
What is basophobia?
Basophobia is a specific phobia, and therefore can be considered an anxiety disorder. The person suffering from it reports a very disabling fear of the possibility of stumbling and falling while moving from one place to another . The fact that ambulation is an absolutely common act, necessary to develop daily life, turns this fear into a problem that very significantly limits autonomy and participation in activities of daily life.
This fear usually has a number of identifiable causes, which we will discuss in detail in the next section, and it tends to be sustained through a process of deliberate avoidance.
Many people with basophobia, faced with the experience of this irresistible fear, make the decision to stop walking permanently. Thus, they get to stay a long time in situations of extreme sedentary lifestyle, resenting themselves physically while the fear continues to increase.
It is important to note that most people living with basophobia (also known in the literature as fear of falling or “fear of falling”) are older adults with additional physical problems, especially in the locomotor system , so It is a problem that can exacerbate the decline in your health or the risk of complications in other organs or systems. That is why its detection and early treatment are of paramount importance.
People with basophobia can also report difficult emotions with great frequency, since the inactivity that results from it implies a succession of important losses (social, work, etc.). This is why it is common for mood disorders or a painful feeling of loneliness to occur.
- You may be interested: ” Types of Anxiety Disorders and their characteristics“
Causes of basophobia
Below we will present the main causes of basophobia. Both physical and psychological aspects will be included, which can often occur at the same time or even interact with each other, empowering each other.
1. Previous 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 stumbling and falling would be stored as an emotional imprint in the narrative of life, which would condition the ability to walk normally. Although it is possible to develop the phobia without having experienced a serious fall on the skin itself, the truth is that most of those who suffer from it report having done so.
A two-way relationship is established: people who have ever fallen are more afraid of falling than those who have never, but it is also the case that those who fear a fall more intensely are at greater risk of falling than those who feel more secure . As a consequence, a vicious cycle is drawn between experience and expectation , the resolution of which requires a personalized therapeutic procedure.
2. Anxiety and posture control
When the fear of falling is established, the person who suffers it pays excessive attention to the whole process that involves moving from one place to another, causing them to lose the normality with which they developed up to that moment. Therefore, this automated coordination would be conditioned by a perception of threat or danger, which would imply a harmful need for control and security.
This supervision alters gait operation on many levels. We know that people with basophobia adopt greater rigidity in the muscle groups involved in walking ; limiting the range of motion and altering the center of balance by contracting the anterior tibial muscle, soleus, and calves. This variation can increase the risk of a new fall (or the first one in which you have never experienced one before).
Such deliberate alteration of the gait is a behavior of difficult control, by means of which the person tries to anticipate some unexpected situation that increases the risk of falling: an obstacle that stands in the way, a change in terrain or dizziness. That is why it is more common in those people who live with anxious symptoms in which there is a constant concern about what may happen in the future.
Even in an upright position, in which no need to walk is anticipated, people with basophobia feel fearful and their confidence in their own balance is diminished, causing an overactivation of the autonomic nervous system (and more specifically of its sympathetic branch). This physiological phenomenon is linked to sensations such as tachycardia, tachypnea, sweating, a feeling of unreality and instability ; and they themselves increase the risk of falling.
3. Increased cognitive demand
Older people with basophobia have an increased risk of falling, as well as a greater fear that this will happen to them, when the act of wandering adds a simultaneous activity that requires cognitive effort. That is why they may feel insecure in unknown places, since there they must dedicate many more attentional resources to assess the properties of the physical environment (presence of obstacles and support elements, for example).
This circumstance also implies that people who suffer from a deterioration in their cognitive functions have a higher risk of falling than those who have them preserved, since in the first case it is easier to exceed the resources available for information processing. This is one of the reasons why patients with dementia fall more frequently than individuals without these neurodegenerative problems.
4. Poor physical function or need for ambulation aids
People who feel physically limited (by accident, surgery or pathology) may have a higher risk of developing this phobia. In such a case, the self-efficacy for the movement can be seriously altered, losing confidence and shaping a feeling of general insecurity. This problem increases when help is required to walk, such as crutches or a cane.
Many studies emphasize that what is really important to explain the fear of falling is not the objective physical state, but the perception that the person has of it. Thus, a subject with less mobility may not have this problem as long as they trust their own capacity, and consider that their body is in good shape. Institutionalizing older people can increase the risk of basophobia , especially if the residential center where they are does not have information about this problem.
5. Use of drugs
Older people eliminate drugs more slowly than younger people. Likewise, they also report more side effects than these (and of greater intensity), so it is necessary to be cautious in the administration of compounds that could cause dizziness or instability in people suffering from basophobia.
Sometimes, in order to treat anxiety that is directly associated with basophobia, it is decided to administer benzodiazepines. It is a subgroup of drugs with muscle-relaxing, hypnotic, and anxiolytic properties. Well, in some cases they can cause undesirable drowsiness and muscle laxity in those who live with this phobic problem (especially first thing in the morning), so its use and its effects must be closely monitored in these specific cases.
Basophobia can be treated through therapeutic programs that include four main components: physical exercises, psychoeducation, exposure, and the use of protective or safety measures .
Regarding physical exercises, activities have been proposed to improve the feeling of balance. They include sit-up movements, taking steps in all directions while maintaining a standing position, bending the body to explore the limits of stability, lying down and getting up (since orthostatic hypotension sometimes contributes to fear) and practice team sports (adapted).
As for psychotherapeutic strategies, the use of psychoeducation (offering 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 imagination or through the use of new technologies).
Protective measures involve modifying the physical environment in order to increase the feeling of security in the spaces of habitual operation, as well as making use of elements that minimize the potential anticipated consequences of a potential fall (protection in the areas of the body that the person perceived vulnerable or fragile, such as the head or knees).
Among all these strategies, the ones that have been most effective are those that combine both physical exercises and psychological intervention , requiring the development of multidisciplinary programs that address the reality of the person as a whole. The separate use of one or the other has also shown positive effects, but they tend to dilute rapidly over time.