Getting High: Surmounting 30 Years Of Acrophobia

Decades ago, I was too afraid of heights even to take my three-year-old on the teeniest, tiniest roller coaster in Disney World’s Magic Kingdom. Neither could I sit in the bleachers at the elementary school softball field to watch my children play. Recently, though, I climbed 161 exterior stairs to a small, outdoor platform that is about 1270 feet higher than the street below, and I leaned off the platform. The staircase and platform have no protective rails. Was I terrified? Well, sure, my knees trembled, and not just a little. Even so, my City Climb adventure atop 30 Hudson Yards in New York City showed me that the counter-phobia tricks I had been practicing for decades still help (kinda) under extreme circumstances. Trying to surmount my acrophobia by using old exposure therapy tricks made me curious about how phobias are treated today.

First, let’s get a few things straight.

1.    While it’s true that there is no protective railing on the outside edge of the stairs, there is one on the interior side. What’s more, I was wearing a halter tethered to a trolley that was bolted firmly onto the stairs and then the building. The trolley is capable of stopping a 10,000-pound object from falling. I weigh less.

2.    This means that, while I might have been a little brave to go as high as I did, it was my fear that I had to manage, not my safety.

Phobias in General and Acrophobia in Particular

The Diagnostic and Statistical Manual of Mental Disorders classifies phobias as anxiety disorders and says that specific phobias (like my fear of heights) affect 7-9% of the population in the United States. According to the website of the Anxiety and Depression Association of America (ADAA), phobia symptoms can include:

• a feeling of imminent danger or doom
• the need to escape
• heart palpitations
• sweating
• trembling
• shortness of breath or a smothering feeling
• a feeling of choking
• chest pain or discomfort
• nausea or abdominal discomfort
• feeling faint, dizzy or lightheaded
• a sense of things being unreal, depersonalization
• a fear of losing control or “going crazy”
• a fear of dying
• tingling sensation
• chills or heat flush

Phobias can be disabling. I know a woman who didn’t go outdoors for two years for fear of what, in general, might be out there. She eventually got help and overcame her agoraphobia. A less extreme example is a man I knew who could no longer drive to work because it would require him to drive over a bridge that he’d traversed for years but of which he had become newly afraid. He, too, got professional help and overcame his fears. Some phobias are just annoyances. That’s what my acrophobia was. I couldn’t take my children on even the kiddie rides at amusement parks. I had to stand while I watched them play sports.

I haven’t always been afraid of heights. The problem struck out of the blue (as many phobias do) about five years after I happened to have learned counter-phobia tricks as part of the research I was doing for a documentary that I was making about anxiety disorders. I started using the tricks almost right away. I relied on them increasingly as the phobia gained strength. My single favorite counter-phobia trick has always been this one:

1.    Rate your anxiety on a scale of one to ten.

2.    Concentrate on your heart rate. Is it fast?

3.    Try, just with your thoughts, to make it go faster. Really. Try. It won’t work right away, so try some more.

4.    Pro tip: It probably won’t work at all.

5.    Once you give up, rate your anxiety level again and get a new sense of how quickly your heart is beating. You may find that everything’s much better.

For me, concentrating on ramping up my heart rate takes my mind away from the source of my fear. That’s what lets the rate drop. Decreasing the rate interrupts the cycle in which rapid heart rate creates shallow breathing, which feeds anxiety, which accelerates heart rate, and so on. All of this is to say that, paradoxically, when I try to make my anxiety worse it usually gets better.

A few days ago, I talked by Zoom with Ken Goodman, LCSW. He is a therapist on the board of the Anxiety and Depression Disorders Association of America. He is also the creator of the self-help audio programs that constitute The Anxiety Solutions Series. In our conversation, he pointed out that, while my self-calming trick works for me, it might not work for everyone.

“Some people’s anxiety isn’t most apparent in a racing heart,” Mr. Goodman explained. “It could be lightheadedness, for example, or difficulty breathing or a choking sensation. And even if you were to generalize and advise people to try to make whatever symptoms they are having worse, the approach has potential pitfalls. If someone with a phobia tries it and it doesn’t decrease the symptoms, they may become even more anxious. So, while that strategy can be useful, people need to know that there are plenty of other counter-phobia options to use.”

Anxiety disorders like phobias are often accompanied by other mental health problems including depression. This is why the ADAA advises beginning treatment by seeing a clinician who can create a comprehensive plan. That being said, one highly respected method for treatment of uncomplicated phobias is exposure therapy—experiencing the feared object or situation in a safe and calibrated way that helps build tolerance. For example, Mr. Goodman says that one of the approaches he takes with clients who have a fear of heights is to bring them one floor at a time up a 20-story hotel building in Los Angeles, which is where he lives. Floor by floor, they step out on the fire escape and manage the sensations that ensue. There’s no rush, no pressure. In between sessions, Mr. Goodman has them do homework. His clients watch videos, look at pictures, and lead themselves through imagined exposures, all to season themselves to the emotional impact of being up high.

City Climb

My climb to the top of 30 Hudson Yards was safe (because of the halter) and calibrated (I climbed 161 steps one at a time with a climbing guide who was exceptionally patient and unhurried). To be clear, however, climbing that day was not intended as therapy. I can manage situations most people with acrophobia cannot. At City Climb, I was just looking to have a high [pun intended] time.

My climb started on a huge terrace called The Edge that is 1,131 feet in the air and that has a partially see-through floor. We only stayed there for a moment. As my climbing guide put his security card in the lock and opened the gate that would give us access to City Climb, I heard him say to me, “When we go past the gate, some people get ....”

To be honest, I couldn’t make out the rest of his sentence, probably because my blood was pounding in my ears. He may have said, "Some people get scared out of their wits.” He may have said they “get an urgent need to urinate.” I’ll never know.

What I got was elated.

My guide was Enzo Gentile. He is one of the first employees hired at City Climb and one of the people who’d trained other guides and helped institute safety procedures.

My euphoria was all about the weather. It’s different up there. As Enzo and I walked through the gate, I noticed it was snowing. Far from a picturesque snowfall, it was more like little drifts of wet, white stuff. Even so, it felt like a gift. Looking down, I could see that it was not, for example, falling on the people on the streets below. Enzo and I were experiencing a private snowfall!

Visibility was not perfect that day. Because of that, I was the only person on the noon tour. I had hoped to see how a City Climb guide handled panic if one of my tour mates turned out to be more acrophobic than I. That wasn’t going to happen. The good news, though, was that, if I panicked and needed help, Enzo was going to be fully available.

Spoiler alert: I had some strong waves of discomfort. Even so, NOTHING. BAD. HAPPENED. Here’s the play by play:

1.    From the moment I had walked off the elevator and stepped onto the 100^th floor, I’d realized that the Edge and City Climb employees were trained to keep fear away from the forefront of my mind. They did it by giving me not a moment to myself. A woman chatted with me as she gave me my breathalyzer test (nope; you can’t be drunk and go up). She then guided me to the station where a man scanned me for metals (no bombs or weaponry allowed). He then walked me to the station where I met Enzo, who took my phone and watch (because they don’t want ANYTHING dropped onto some unsuspecting soul below). After I put my phone, watch, and bag into a locker, Enzo helped me into a blue jumpsuit and hooked me into the safety halter. Together we went to a station where another man checked and tightened my halter and from there we went to another station where yet another man checked and tightened my halter and from there we went to a third station where it all happened again. At that last station, Enzo applied zip ties to the halter latches. That meant I couldn’t get myself out of the halter. I experienced only a moment of “the heck?” But as it turned out, I found all of the safety measures and theatrics calming. They kept me busy. With everyone talking to me about the importance of checking, double-checking and zip ties, I didn’t retreat into fear.

2.    At the last harness check station, my halter got tethered to a heavy C-shaped clamp that, unlike regular C-clamps, had no tightening or loosening device. Enzo slid the clamp onto a rail that perfectly filled the C. He called the clamp/rail configuration a “trolley” and explained that the rail itself had no interruptions from start to finish. This meant there was no way to get the C-clamp off other than to finish the course. There would be no point at which the clamp could accidentally drop off the rail and let me fall to the ground below. Neither would there be any point at which I could remove the clamp and run in a panic to an exit.

3.    I mention “run in a panic to an exit” only because I had once almost done the scuba diving equivalent of that. It was during my first in-ocean diving lesson. We went quickly to a depth of about 30 feet. Uncomfortable with the whole experience, I almost (almost) took a big breath of air, ripped the regulator out of my mouth, and swam quickly to the surface. Doing that can explode your lungs.

4.    High up at 30 Hudson Yards, I remembered my scuba diving near-fiasco and mentally tipped my safety helmet to the City Climb course designers. Some people panic. Even so, they can’t wrestle themselves out of their halters, and they can’t detach the halters from the trolley. Panic can’t kill.

5.    The trolleys aren’t motorized. Enzo and I would each be pulling our trolleys during the climb. They’re heavy because they’re strong. With both of our clamps firmly on the rail, we started on our way.

Fear and Beauty, Way Up High

6.    To be honest, the first set of exterior stairs that we climbed was not beautiful. Nor did it instill fear. It is surrounded by enough piping and bolstering to resemble basement stairs. I was bored. That was probably good.

7.    When we got to the flight of 161 stairs that would take us to the very top (the “Cliff”), my excitement began to pick up. The stairs rise at a 45-degree angle. I’m in fairly good physical shape, so the incline and length of the staircase wouldn’t in and of itself be a problem for me. However, dragging the trolley up was going to take effort.

8.    Across level areas, the trolley runs smoothly. But when the rail ascends with the staircase, it is notched. This is so that the C-clamp can't slide backward. This struck me as enormously good planning. Without those notches, if I had accidentally let go of my trolley it would have slid down to the bottom and pulled me calamitously behind it. Because I was tethered, such an accident wouldn't have knocked me off the building. Even so, I was glad to learn that the trolley couldn’t slide freely in reverse and that I couldn’t hurt myself by accidentally letting go of it.

9.    At the same time that I again mentally tipped my safety helmet to the course designers, I realized that the notched trolley comes with a kind of poetic justice side effect. Once anyone starts climbing the stairs, there’s no going back. The trolley won’t go in reverse and the halters will let no one get free of the trolleys. If anyone panics on those stairs, the only way out of fear is up. (And, yes, there’s a metaphor in there somewhere.)

10. Enzo climbed backward, facing me. This let him see that I was OK. Meanwhile, we could talk as we enjoyed our private snowfall. Conversation kept my anxiety level low.

11. About mid-way up the stairs, Enzo suggested that we stop and rest. He also suggested that I take my attention away from the trolley and look at the view. When I did, my voice began wobbling in time with my knees.

12. Enzo just kept me talking. As we did, I remembered that the Siamese cat I’d had as a kid was so unnerved when we moved to a new house that she spent three days sitting next to a radiator, twisting her neck so as to keep her head in the dark space behind the metal. That’s essentially what I’d been doing at nearly 1270 feet when looking resolutely at the metal trolley and refusing to look down at the river or at the tops of tall buildings that were far below me.

13. Unfortunately, when I looked out at the buildings and river again, I added stomach lurching to the wobbly, knee-and-voice chorus that my body was already singing. Silently, I tried to calm myself by focusing on my heart rate and willing my heart to beat faster. It didn’t work.

14. That didn’t matter. I had other options to calm myself. I stretched my thumb away from the rest of the hand to see how far I could get it to go.

15. Not far, was what I discovered, and the stretching didn't abate my anxiety. (Note: The thumb stretching is an actual counter-phobia trick someone taught me once. You think I make this stuff up on the spot?)

16. Soon enough, I realized that the best thing that I could do for my anxiety would be to re-enter the conversation I’d been having with Enzo. I started chatting as well as I could at a measured pace.

17. I don’t know for sure when the panic left me. I probably was only at peak anxiety for 10 seconds, each of which felt like a year.

18. Enzo pointed northward. The snow was falling faster. Even so, we could see the George Washington Bridge.

19. I don’t know why at that moment I thought of SNL’s spoof of John McCain’s running mate, Sarah Palin. “I can see Russia from my house,” Tina Brown had aped as Ms. Palin. I bleated out to Enzo, “I can see all my fears from here.”

20. He smiled politely.

21. Finally, we reached the top stair and stepped out onto the metal platform known as the Cliff. It was surprisingly small. Enzo showed me how to lean fearlessly out over the city and let go of the tether. I couldn’t take a picture of him because I’d had to leave my phone in the locker on the 100th floor. But if someone reading this knows Enzo’s mom, please tell her that it was safe for him to do so. Really it was. Even if his feet had slipped and left him dangling in mid-air, the tether would have supported him. I could have pulled him back onto the platform.

22. “Your turn,” he said.

23. Leaning against the back wall, I explained that I felt no need to do what he’d just done.

24. We talked for a while longer. I watched the snow falling on some especially tall city roofs and other snow disappearing before it hit the ground. We heard voices on the stairs. A tour group was coming. There is limited space on the platform. It was time for us to go.

25. Therapists talk about “doorknob moments.” Just when a patient is leaving the office after a session, with one hand on the doorknob he or she reveals a key bit of missing information. Unfortunately, the next patient is in the waiting room and there’s no time to tackle what is now at hand. I chose the very moment we had to go as my time to creep to the edge of the platform.

26. Mine wasn’t an Enzo-quality lean. Truly, it was minuscule. Token. But it counted, or so said Enzo when, later, he called me a "champ" and handed me my very own end-of-tour medal.

27. All right, the medal is dorky. Even so, I’ve got it on display in my apartment. I get to because I CLIMBED CITY CLIMB, FOR CRYING OUT LOUD!

28. The champ is Enzo. He brought me seamlessly through a lot up there. He knows how to help people avoid their fear and, I’m guessing, he knows how to help them with it if runs over them like a wave. Which mine did, only the waves were puny. "Nothing to see here. Move on."

The Takeaway

My guess is that the entire team of guides at City Climb are champs like Enzo. That being said, would I suggest City Climb as exposure therapy to anyone plagued with acrophobia?

Whoa, wait a minute!

I’d been successfully practicing counter-phobia techniques for three decades when I climbed those stairs to the Cliff. Homework along the lines of what Ken Goodman prescribes for clients had created for me a virtual bag of self-calming tricks that I could use when I needed them. Granted, none of them worked ... when I needed them. But just knowing that anxiety can be calmed helped me avoid getting full-throttle scared. I was pretty sure when I set my foot on the first of those 161 steps that I was not going to be overcome by panic. After all, years before I showed up at City Climb, I had gotten to the point where I could easily manage ski lifts and flying.

I would recommend that anyone with a truly dreadful fear of heights get exposure therapy before attempting anything like City Climb ... or like the British Columbia paragliding flight that I backed out of a few years ago moments before we were to run off the side of Whistler Mountain. (I will never, ever attempt that again.)

What I can tell people with a normal and eminently reasonable fear of heights is that City Climb is well-designed. To my eye it is safe. And with or without the private snowfall, if you’re prepared for it, it’s exhilarating.

How Phobias Are Treated Today

The website of the Anxiety and Depression Association of America explains many treatment options. Most common is some form of exposure therapy, which is sometimes temporarily supplemented with medication. Those measures were all in place 30 years ago when I started learning counter-phobia techniques.

That being said, there’s a new tool that therapists like Ken Goodman might want to add to their libraries of exposure therapy homework techniques. He uses pictures and videos, and he also encourages people to imagine being at heights and using the techniques he’s taught them to calm their fears. In October of 2021, the peer-reviewed American Journal of Occupational Therapy published a review of 28 studies of the use of head-mounted virtual reality displays in the treatment of phobias and other anxiety disorders. They gave VR a hearty thumbs up as a supplement to IRL exposure therapy.