27 January 2014

Fear of heights (Acrophobia) and mountain running

Is it possible to run a mountain trail race or skyrunning race when having acrophobia (fear of heights)? I discussed this with a colleague over lunch today and we had contrasting views. He thought it impossible, while I am quite convinced that it is possible to run a quite technical mountain trail, including exposed rope sections, while having moderate acrophobia. Acrophobia can differ in severity, but in most cases is manifesting with for instance inner agitation, a queasy-stomach feeling, subjective postural instability with to-and-fro vertigo and weakness in the knees. Fear of heights was described as early as in the Greek Corpus Hippocraticum in the 5th century BC with “a worsening of eyesight and a feeling of uneasiness when walking along the edge of a precipice or over a bridge”.

I would not say that I am severely afraid of heights, but I have noticed that my pulse is elevated on exposed mountain sections and that I have a queasy feeling and even somehow slow down my locomotion and restrict my visual exploration. This is different from when I grow up when one of my favorite pastimes was to climb quite high trees. I had a summer treehouse in a tall pine tree at a height of around 20 meters and never felt any fear of heights. Looking at the epidemiology of acrophobia I noticed that some kind of fear of heights is very common. A cross-sectional epidemiological study of 3,517 individuals representing the German population by Huppert and colleagues entitled “Down on heights? One in three has visual height intolerance?” published in J Neurol 2013; 260: 597-604 indicates a lifetime prevalence of 28% and a higher incidence of the initial attacks during the second decade. The severity of the visual height intolerance (VHI) can vary considerably, but in up to half of the cases it can restrict daily activities. Brandt and Hubbert has recently also published a good overview of acrophobia entitled “Fear of heights and visual height intolerance” in Curr Opin Neurol 2014; 27: 111-117.

Has my objective symptoms of acrophobia restricted my running in the mountains? No, I think on the contrary it has made me even more stimulated by it as it is a great feeling to get the adrenaline rush and overcome it. I might be a little bit slower over some sections and I can be a little bit more cautious, but in general I think it is more stimulating than restricting. One dream which would really give me an adrenaline rush would be to walk to the teahouse on the South Peak of Mount Hua Shan in the Shaanxi province of China on what is known as HuaShan Plank Path or Cliffside Path Walk. Just check the pictures at this blog or this Youtube video.

HuaShan Plank Path

Another thing I long to do is to visit the new attraction Pas dans le Vide or "Step into the Void" at Aiguille du Midi over Chamonix in the Mont Blanc Massif. Apparently it took 3 years to build this spectacular, albeit somewhat touristic, attraction. Check out these pictures or this Youtube video.

Pas dans le Vide

Most of all, however, I am looking forward to PTL in August and the technical passages at that race.

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