Basophobia: symptoms, causes and treatment

All of us carry out, every day, actions that do not require our attention. One of these acts is walking, which despite being subject to a notable degree of motor coordination, tends to become automated from a very early age.

When we walk we shift our weight forward, changing the axis of gravity and placing both feet so that the body moves in space without hitting the ground or against a 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 making a mistake in this "simple" process, and suffer a spectacular fall as a consequence. Such a fear, more common than is believed, is known as basophobia..

In this article we will talk about this specific fear, about its causes and treatments, as well as about the group with the greatest risk of suffering from it.

• Related article: "Types of Phobias: Exploring Fear Disorders"

What is basophobia?

Basophobia is a specific phobia, and therefore can be considered as an anxiety disorder. The person who suffers from it refers

a very disabling fear of tripping and falling while moving from one place to another. The fact that wandering is an absolutely common act, necessary to develop daily life, makes This fear is a problem that significantly limits autonomy and participation in life activities daily.

Symptoms

This fear usually has a number of identifiable causes, which we will discuss in detail in the next section, and it tends to be maintained through a process of deliberate avoidance.

There are many people with basophobia who, faced with the experience of this irresistible fear, make the decision to stop walking permanently. Thus, they come to stay for a long time in situations of extreme sedentary lifestyle, suffering on a physical level while the fear continues to increase.

It is important to bear in mind that most people who live 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 derives from it implies a succession of important losses (social, labor, etc.). For this reason, it is common for mood disorders or a painful feeling of loneliness to occur.

• You may be interested in: "Types of Anxiety Disorders and their characteristics"

Causes of basophobia

Next we will present the main causes of basophobia. Both physical and psychological aspects will be included, which can often occur together or even interact with each other, enhancing each other.

1. Previous history of falls

Most of the research on basophobia indicates that 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 the majority 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. fact, but it also happens that those who fear a fall more intensely have a greater risk of suffering it than those who feel more insurance. As a consequence it is drawn a vicious cycle between experience and expectation, whose resolution requires a personalized therapeutic procedure.

2. Anxiety and posture control

When the fear of falling sets in, the person who suffers from it pays excessive attention to the entire process involved. move from one place to another, causing it to lose the normality with which it 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 the functioning of the gait 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 tibialis anterior, soleus, and gastrocnemius muscles. This variation can increase the risk of a new fall (or the first one in someone who has never experienced one before).

Such deliberate alteration of the gait is a behavior that is difficult to control, through which the person tries to anticipate some unexpected situation that increases the risk of falling: an obstacle that stands in the way, an unevenness in the terrain or a dizziness. That is why it is more common in those people who live with anxious symptoms in which there is a constant worry about what may happen in the future.

Even in an upright position, in which the need to walk is not anticipated, people with basophobia feel fearful and diminished ability to walk. confidence in their own balance, precipitating a hyperactivation of the autonomic nervous system (and more specifically of its sympathetic branch). This physiological phenomenon is linked to sensations such as tachycardia, tachypnoea, sweating, feeling of unreality and instability; and they themselves increase the risk of falling.

3. Increased cognitive demand

Older people with basophobia have a greater risk of falling, as well as a greater fear that this happens to them, when a simultaneous activity that requires an effort is added to the fact of wandering cognitive. That is why they may feel insecure in unfamiliar places, since they must dedicate many more resources there. attentional 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 some impairment of their cognitive functions have a higher risk of falling than those who have them preserved, since in the first case it is easier for the resources available for information processing to be exceeded. This is one of the reasons why patients with dementia fall more frequently than individuals who do not suffer from these neurodegenerative problems.

4. Poor physical function or need for aids with ambulation

People who perceive themselves to be physically limited (by accident, surgery or pathology) may be at greater risk of developing this phobia. In such a case, the self-efficacy for the movement can be seriously altered, losing confidence and forming a general feeling of insecurity. This problem is increased when assistance with walking is required, such as crutches or a cane.

Many studies highlight that what is really important to explain the fear of falling is not the objective physical state, but rather the person's perception of it. Thus, a subject with less mobility may not have this problem as long as he trusts his own ability, and considers that her body is in good shape. Institutionalization of the elderly can increase the risk of suffering from basophobia, especially if the residential center they are in does not have information on this problem.

5. drug use

Older people eliminate drugs more slowly than younger people. Likewise, they also report more side effects than these (and of a greater intensity), so it is necessary to be caution in the administration of compounds that could cause dizziness or unsteadiness in people suffering from basophobia.

Sometimes, in order to treat the anxiety that is directly associated with basophobia, it is decided to administer benzodiazepines. It is a subgroup of drugs with muscle relaxant, hypnotic and anxiolytic properties. Well then, 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 in these specific cases should be monitored to the extreme.

Basophobia treatment

Basophobia can be treated through therapeutic programs that include four main components: physical exercises, psychoeducation, exposure and the use of protective or security measures.

Regarding physical exercises, activities aimed at improving the sense of balance have been proposed. They include sitting down and standing up movements, taking steps in all directions while maintaining a standing position, leaning the body to explore the limits of stability, lying down and getting up (since orthostatic hypotension sometimes contributes to fear), and playing team sports (adapted).

Regarding psychotherapeutic strategies, the use of psychoeducation is chosen (offer information about the problem that reduces the presence of preconceived and harmful ideas), cognitive restructuring (identification and discussion of irrational ideas) and exposure (both in vivo and in imagination or through the use of new technologies).

The protective measures imply 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 anticipated potential consequences of a potential fall (protection in areas of the body that the person perceives as vulnerable or fragile, such as the head or the knees).

Among all these strategies, those that have shown greater efficacy are those that combine both physical exercises and psychological intervention, being necessary 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 fade quickly as time goes by.

Bibliographic references:

• Seonhye, L., Eunmi, O. and Gwi-Ryung, S.H. (2018). Comparison of Factors Associated with Fear of Falling between Older Adults with and without a Fall History. International Journal of Environmental Research and Public Health, 15, 1-12.
• Stojanovic, Z., Kocic, M., Balov, V., Milenkovic, M., Savic, N. and Ivanovic, S. (2016). Fear of falling. Praxis Medica, 44(3), 61-66.
• Young, W.R. and Williams, M. (2015). How fear of falling can increase fall-risk in older adults: applying psychological theory to practical observations. Gait Posture, 41(1), 7-12.