Every day, we all carry out 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 positioning both feet so that the body moves in space without hitting the ground or hitting 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 making a mistake in this “simple” process, and suffering a spectacular fall as a consequence. This fear, more common than you think, is known as basophobia
In this article we will talk about this specific fear, its causes and treatments, as well as which group is most at risk of suffering from it.
Basophobia is a specific phobia, and therefore can be considered an anxiety disorder. The person who suffers from it refers a very disabling fear of stumbling and falling while moving from one place to another The fact that wandering is an absolutely common act, necessary to develop daily life, turns this fear into a problem that significantly limits autonomy and participation in activities of daily life.
Symptoms
This fear usually has a number of identifiable causes, which we will discuss in detail in the next section, and 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 spend a long time in situations of extreme sedentary lifestyle, suffering physically while the fear continues to increase.
It is important to keep in mind that most people who live with basophobia (also known in the literature as fear of falling) are older adults with additional physical problems, especially in the musculoskeletal system , so it is a problem that can exacerbate the decline in your health or the risk of complications in other organs or systems. This is why its early detection and treatment are of capital importance.
People with basophobia can also report difficult emotions very frequently, since the inactivity that results from it implies a succession of important losses (social, work, etc.). For this reason, it is common for mood disorders or a painful feeling of loneliness to occur.
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, enhancing 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 tripping 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 one’s own skin, the truth is that the majority of those who suffer from it report having done so.
A relationship is established in two directions: people who have fallen at some time are more afraid of falling than those who have never done so, but it also happens that those who fear a fall more intensely have a greater risk of suffering it than those who feel safer. . 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 occurs, the sufferer pays excessive attention to the entire process involved in moving from one place to another, causing them to lose the normality with which they developed until 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 functioning at many levels. We know that people with basophobia adopt greater rigidity in the muscle groups involved in walking ; limiting the range of movements and altering the center of balance through contraction of 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 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, a unevenness in the terrain or dizziness. That is why it is more common in those people who live with anxious symptoms in which there is constant worry about what may happen in the future.
Even in an upright position, in which there is no anticipated need to walk, people with basophobia feel fearful and see their confidence in their own balance diminished, precipitating hyperactivation of the autonomic nervous system (and more specifically its sympathetic branch). This physiological phenomenon is linked to sensations such as tachycardia, tachypnea, sweating, feeling of unreality and instability ; and 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 of this happening to them, when a simultaneous activity that requires cognitive effort is added to walking. This is why they may feel unsafe in unknown places, since there they must dedicate many more attentional resources to assessing the properties of the physical environment (presence of obstacles and support elements, for example).
This circumstance also implies that people who suffer from some deterioration 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 ambulation aids
People who perceive themselves to be physically limited (due to accident, surgery or pathology) may be at greater risk of developing this phobia. In this case, movement self-efficacy can be seriously altered, losing confidence and shaping a generalized sense of insecurity. This problem increases when walking aids, such as crutches or a cane, are required.
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 he trusts in his own ability, and considers that his body is in good shape. Institutionalization of older people may increase the risk of basophobia especially if the residential center they are in does not have information about this problem.
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 when administering compounds that could cause dizziness or instability in people who suffer from basophobia.
Sometimes, in order to treat the anxiety that is directly associated with basophobia, it is decided to administer benzodiazepines. This is a subgroup of drugs with muscle relaxant, hypnotic and anxiolytic properties. Well then, In some cases they can cause drowsiness and undesirable 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 must be extremely monitored.
Basophobia treatment
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 aimed at improving the feeling of balance have been proposed. They include sitting and standing movements, stepping in all directions while maintaining a standing position, tilting the body to explore the limits of stability, lying down and standing up (since orthostatic hypotension sometimes contributes to fear), and practicing team sports (adapted).
Regarding psychotherapeutic strategies, the use of psychoeducation is chosen (offering 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).
Protective measures involve modifying the physical environment in order to increase the feeling of security in the spaces of normal 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 vulnerable or fragile, such as the head or knees).
Among all these strategies, Those that have shown greater effectiveness are those that combine both physical exercises and psychological intervention , making it necessary to develop 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 quickly as time passes.
