Phobias, and the urge to drive off a cliff

 

"Last month, on a clear cold afternoon, I drove alone along a narrow winding road just south of Christchurch, fighting a powerful urge to swing the wheel sharply to the right and hurtle off the steep unfenced bank to certain death."

Sunday Star Times article
Sunday Star Times article Nadine Isler

That's how journalist Adam Dudding begins his excellent article on phobias, and his personal experience with the sudden onset of a fear of heights. I was the psychologist interviewed for the article, and I think he's done a great job turning the concepts I explained to him, into a really accessible and interesting article.

"Last month, on a clear cold afternoon, I drove alone along a narrow winding road just south of Christchurch, fighting a powerful urge to swing the wheel sharply to the right and hurtle off the steep unfenced bank to certain death."

You can read the article online on the Stuff website here. I've also reproduced it below (with some of the pictures) in case the online version moves or goes down. 


You have nothing to fear but fear itself. Well, apart from heights, rats, needles, clowns and escalators...

Last month, on a clear cold afternoon, I drove alone along a narrow winding road just south of Christchurch, fighting a powerful urge to swing the wheel sharply to the right and hurtle off the steep unfenced bank to certain death.

I was feeling entirely non-suicidal. I was in good health and had plenty to live for. There was a perfectly pleasant interview subject waiting for me at journey's end, and he would have been inconvenienced by my fiery death at the bottom of a valley.

In fact, apart from the cold sweat, the shallow breathing, the prickly scalp, the grinding teeth, the strange watery sensation in my legs and a general sense of mortal terror, I was feeling pretty cheerful.

"Ah," I thought, in the pauses between choruses of a song I'd just composed called Don't Drive Off the Cliff, Don't Drive Off the Cliff, Everything Will Be OK If You Don't Drive Off the Cliff, "I guess that'll be my fear of heights again."

I'm sort of getting used to it. After a lifetime of being the person who leans out over a hotel balcony to see what a 14-storey drop looks like, the person who happily tried skydiving, paragliding, ballooning, bungee-jumping, rock-climbing and eating at the revolving restaurant at the top of Auckland's Sky Tower, I've started to notice in the past year that heights – even the idea of them – give me a rather strange feeling.

In particular, the feeling that if I don't actively resist it, I may just leap (or drive) to my death.

Mostly, my newfound acrophobia has been an irritant of little importance – a minor mid-40s failure of nerve that goes nicely with my recent mid-40s failures of eyeball (hello reading glasses!) and cochlea (hello tinnitus!). Who cares that driving on the outer lanes of the Auckland Harbour Bridge now makes me feel uneasy? There are six inner lanes I can still use.

Also, my wife reckons this new vulnerability might help me develop "a bit more empathy for other people's foibles". (To be clear, the "other people" she means is herself, and the "foibles" are her extreme reactions to rats, food scraps after they've gone mushy in the kitchen sink plughole, and undercooked fried eggs.)

But on that Canterbury afternoon, as I finally reached a stretch of road with sensible edges and took some deep calming breaths, I realised this was becoming a nuisance. It was time, one might say, to figure out what the hell was going on.

First stop, Facebook. I asked if anyone else had become newly fearful of something or, conversely, had anyone stopped being afraid of something that once terrified them?

It was a surprisingly fruitful question: it turns out almost everyone I know is, or used to be, afraid of something. Some were familiar: rats, mice, sharks, spiders, dentists, clowns, needles, getting trapped in burning buildings or in confined spaces in general, escalators, flying in planes, and falling off a yacht at sea and not being noticed as the sharks (or rats or mice or clowns) start to circle.

Other fears seemed very reasonable in light of what had triggered them: phobias about shopping malls and rumbling trucks after the Christchurch quakes; a fear of taxis in someone whose driver once fell asleep on a motorway.

Childhood phobias that had been grown out of included wooden toilet seats and the jokers in packs of cards, and current adult phobias included seaweed, people dressed as animals, the sound of apples being crunched, and grit (though "it's gotten a bit better of its own accord over the last five years and I'm happy to report I can now walk on gritty concrete").

This was all nice to know, but I was especially pleased to learn that no fewer than six Facebook friends had, just like me, developed acrophobia relatively late in life. Sometimes it came out of the blue, and sometimes it was triggered by a particular event. One friend lost her head for heights after stepping out onto the top floor of The Bottle Opener in Shanghai, and another dates it to the day she took a bungee jump from a Swiss cable car.

Tourists on China’s “Coiling Dragon Skywalk” – a glass-bottomed path winding around a 300m cliff. If this photo doesn’t make you feel weird, you’re not as acrophobic as the writer of this article.

Tourists on China’s “Coiling Dragon Skywalk” – a glass-bottomed path winding around a 300m cliff. If this photo doesn’t make you feel weird, you’re not as acrophobic as the writer of this article.

I can't pin down my acrophobia to a specific day, but it was certainly starting to bite during a family holiday last June, during which we cycled the Golden Gate Bridge, climbed a viewing platform at the Tate Modern, rode a Ferris wheel in Edinburgh and climbed a rickety 14th-century tower in San Gimignano (actually, I freaked out halfway up and went back down).

Triggers are unpredictable things: one friend told me she'd developed a fear of flying only since becoming a mother, which she attributed to her subconscious awareness that her death mattered more now she had a dependant. But another new mum said she'd recently lost her old fears while flying because "I'm too busy dealing with their demands and tantrums to worry about the fact I'm flying".

THE CALL OF THE VOID

With a bit of googling, and after a long chat with the very reassuring psychologist Nadine Isler from the Anxiety New Zealand Trust (formerly the Phobic Trust), I learnt that my fear of heights is boringly normal – around one in 10 people have it. It's also quite standard for acrophobia to suddenly appear or get worse with age, possibly because of a general decline in the state of the "organs of balance" in your inner-ear (in other words, I"m getting doddery at the advanced age of 46). On the upside, your body produces less adrenaline with age, so some scary situations – dark alleys, meeting a spider etc – may in fact be less likely to cause wobbly legs and a racing pulse than they used to.

Even the death-wish I feel on high balconies or Canterbury hillscapes turns out be a fairly common manifestation of acrophobia. The French even have a phrase for it: l'appel du vide (call of the void) – a term that also encompasses that urge some people get to swerve into oncoming motorway traffic, or say something unforgivably inappropriate at an important social occasion, or throw a newborn baby out a window, or murder your family with the knife you suddenly notice in your hand as you're chopping carrots for dinner (come on, don't tell me these aren't familiar to you too).

I also called Auckland University psychology researcher Dr Nathan Consedine, who knows a lot about fear.

Fear is the emotion evolution gave us for dealing quickly with an immediate physical threat, usually by dumping cortisol and adrenalin into the bloodstream so we're ready to run like hell or fight. Your heart races, your strength increases and your attention narrows to the source of the threat. As Consedine puts it, "there's nothing more mindful than being truly scared out of your wits".

Funnily enough, Consedine freaks out around heights in the same way as me. He's been like this for about a decade, finds it completely strange, and on occasion has had to remove himself from a high place because the vide wouldn't stop appeling.

Actually, said Consedine, there's an interesting (if unfashionable) psychological concept called "terror management theory" (TMT) which says many human behaviours are driven by the fundamental conflict between wanting to live and knowing death is inevitable. Maybe, he suggested, the urge to jump is connected to that.

Or maybe, said Consedine, speculating freely, the acrophobia we're both experiencing in our mid-40s is a kind of midlife crisis thing. Leaping off a cliff isn't something you actually want to do, but at a stage in your life where career and relationships and circumstances are becoming quite stable, it would certainly shake things up a bit.

"Maybe unconsciously you feel all these doors gradually closing, and you're afraid that you're going to kick one of them open and jump through, then off a balcony with a small baby."

Boringly, research from 2012 suggests that rather than arising from philosophical angst, the urge to jump may be due to a cognitive error caused by a competing perceptual systems. A (very fast) instinctual decision to step back from a high place interacts with a (relatively slow) rational understanding that there's no real danger, then our brain resolves the contradiction by retrospectively creating a belief that you must have been thinking about jumping. (No, this makes little sense to me either, but that's what the study said).

BLAME EVOLUTION

The thing about phobias, apart from exotic ones concerning grit, wooden toilet seats or people dressed as animals, is that they're mostly built on fears that once really mattered.

Our emotional systems evolved a few hundred thousand years ago when we were still nesting up trees in Africa, so snakes and spiders and falling off things were major dangers. But evolution is slow while human progress has been fast. As Richard Dawkins points out in his latest book, phobias of spiders and snakes are commonplace, but we're seldom scared of the things that are actually likely to kill us such as electric bulb sockets, or cars. When I'm driving across the Harbour Bridge, the real danger is not that my car and I will spontaneously vault the two-metre siderail, but that I'll plough into the car in front at 90km/h while fiddling with my smartphone.

But the other thing about phobias is that by definition they're excessive and irrational, which is why the bloody-minded logic of someone like Dawkins is of little help.

Far more useful is what Nadine Isler told me: that for a relatively straightforward phobia like mine, 10 to 12 sessions with a psychologist using cognitive behaviour therapy (CBT) may be enough to knock it on the head. The evidence is especially good for "exposure response prevention", where you expose yourself to the scary thing in incremental doses, starting very small. So someone with a dog phobia might start with a photo of a dog then graduate to watching a film clip, then meeting a small, super-friendly dog and so on.

I asked Isler what she thought of the techniques I instinctively used to get through my hilltop panic attack: slowing to 35km/h; straddling the centre-line to avoid the road-edge; winding down the window for a blast of fresh South Island air, turning off the radio; and, most importantly, loudly singing my self-penned ditty about how I wasn't planning to die today.

Well, said Isler, congrats on getting through it, but actually all of those strategies are bad ideas in the long run.

Distractions, rituals and efforts to avoid the scary thing are called "safety behaviours", and while they might seem logical, they can in fact worsen a phobia if you keep using them, "because they don't allow you to disconfirm your belief that something bad will happen". It's far better to confront your fear in increments, while doing nothing special at all, so it just becomes normal.

Safety behaviours can get confusing. For example, fear triggers shallow breathing, so deep breathing might seem desirable, but if you deliberately breathe deeply every time a phobia's triggered, the breathing itself may become linked with the phobia. Humans are weird.

As Isler pointed out, we have lots of perfectly reasonable fears that keep us safe. Its only when a fear turns into a phobia and prevents you from achieving your goals that it becomes an issue. If it's not causing a problem, don't worry about it, and if it is a problem go to your GP and get a treatment referral.

I'm not an office-block window-cleaner or a trapeze artist and I'm seldom required to drive along winding mountain passes, so I'm not rushing to find a therapist yet.

For now I'm doing some DIY "exposure reponse prevention" of my own. Since talking to Isler I've been choosing the outside lanes of the Harbour Bridge during my daily commute, while scrupulously avoiding safety behaviours: no tight gripping of the wheel, no deep breaths, no whistling a happy tune or a cheerful song of my own composition.

After all, I'm just driving over a sturdily-built bridge that's only 45 metres above the water, in a vehicle travelling at 23 meters per second, inside an aging assemblage of bones and skin and fragile organs that, even by the most optimistic of projections, is going to be wormfood in little over half a century, all on a planet whose polar caps are melting and which could at any time be hit by a comet like the one that killed the dinosaurs. What, really, is there to be afraid of?

* Anxiety New Zealand: www.anxiety.org.nz. Helpline 0800 ANXIETY (0800 269 4389)

 - Sunday Magazine