Fear of elevators: a step-by-step ladder you can edit
If elevators make your chest tight, you need not start with a long ride. Below is an example ladder of twelve steps, from watching a video to the rides you find hardest. It is a starting point, not a tested program: reword the steps and replace the fear numbers with your own. Pick the first step that feels uncomfortable but doable, and repeat it until you have tested what you fear and it feels manageable enough to repeat safely.
Elevators
Easiest first. The suggested steps, their order, times and distances, and the fear numbers are illustrative examples, not a tested program. Rate each step yourself from 0 (no fear) to 100 (the most afraid you can imagine), change the wording to fit your life, and add your own steps.
Watch a 5-minute video showing the inside of an operating elevator cabin.
Stand in a spacious building lobby 10 feet away from the elevator doors and watch people enter and exit.
Stand next to the elevator doors on the ground floor and look inside when an empty cabin opens.
Start here — uncomfortable but doable
Step inside an empty elevator, hold the door-open button yourself for 30 seconds, then step out.
Step inside alone, let the doors close on the ground floor, press the door open button, and step out.
Ride one floor up with a trusted companion in a modern, well-lit building at a quiet time.
Ride two to three floors up and down with your companion, who stays quiet so you notice the ride itself.
Ride one floor alone at a quiet time of day, noticing your feet flat on the floor.
Ride three floors alone, letting your arms hang loose at your sides instead of hovering over the buttons.
Ride five to eight floors alone in an office building or shopping center outside rush hours.
Ride five floors with unfamiliar passengers sharing the cabin.
Ride at a busier time with several passengers getting on and off, letting any car that looks full go by.
Keep your ladder
Stay safe while you practice
- If you feel chest pain, pain spreading to your arm or jaw, or you faint, stop and call 911.
- Don't practice after alcohol, cannabis, or medication that makes you drowsy.
- If your fear goes above 80 and stays there, stop safely, breathe out slowly, and pick a lower step next time. Stopping is not failing.
- If a panic attack starts, get somewhere safe first (if you are driving, stop the car), then use the free Panic Reset.
- Keep taking any medication as prescribed. Talk to your prescriber before changing anything.
- Only practice in public passenger elevators that are in normal working order.
- If the elevator stops between floors, press the alarm or call button, stay inside and wait for help to arrive.
- Never try to force the doors open or climb out, and never touch service panels.
A self-help tool. Not a medical device or a substitute for professional care.
Why elevators triggers panic
Elevators combine a small space with a loss of control. Once the doors close, you cannot step out until the car reaches a floor. For a nervous system that is scanning for danger, that short stretch without an exit can feel like being trapped, and the alarm often goes off before the elevator has even started to move.
Small spaces also make body sensations easier to notice. There is little to look at, so a faster heartbeat, shallow breathing or a warm face stand out. The slight dropping feeling when the car starts or stops can feel like dizziness, and anxious thoughts are quick to read it as a sign of fainting or losing control.
Taking the stairs keeps the alarm alive. The stairs bring instant relief, but every time you use them to avoid the elevator, your brain misses the chance to learn that you can feel anxious with the doors closed and still step out at your floor. A gradual ladder lets you collect that evidence in small steps.
What you might be predicting
Before an exposure, our minds predict the worst possible catastrophe. Here are the predictions people often have:
- •“The elevator will get stuck between floors for hours”
- •“The cables will snap and the car will fall”
- •“I will run out of air inside”
- •“I will have a panic attack and make a scene in front of others”
- •“The doors will not open when we arrive”
- •“I will pass out and nobody will know what to do”
Safety behaviors to drop, one at a time
Safety behaviors give quick relief, but they convince the brain that you only survived because of the crutch. As you move up your ladder, aim to drop them gradually. Only drop what anxiety adds; anything that genuinely keeps you or others safe stays:
- 1Always taking many flights of stairs, even with heavy bags or luggage
- 2Only getting in if the stairwell door is right next to the elevator
- 3Standing right next to the buttons and staring at the floor numbers
- 4Refusing to get in unless a trusted person comes along and keeps talking to you
- 5Holding your breath from the moment the doors shut until they open again
- 6Checking the alarm button and emergency phone over and over before the doors close
- 7Waiting in the lobby for an empty car so nobody can see you are anxious
Tips for this situation
- Plant your feet on the floor and feel your weight in your heels. It gives your attention somewhere steady to rest while the car moves.
- Breathe out a little longer than you breathe in, for example in for four and out for six. A slow, steady out-breath gives you something to focus on while the doors close.
- Elevator cars are not airtight. Air keeps reaching the car even when it is standing still, so it may feel warm or stuffy with other people in it, but the air does not run out.
- If you hold the handrail for balance, keep holding it. If you grip it only because of fear, try loosening your hand a little on later rides and notice what happens.
- Practice during quiet periods first, such as early weekend mornings, so you control the timing and the number of floors.
When to get professional care
Self-help ladders are helpful for manageable avoidance, but some situations call for professional evaluation and support:
- •You cannot reach your workplace, doctor appointments, or home because there is no stair option you can use.
- •Avoiding elevators comes with avoiding many other places, or you find it hard to leave your home.
- •Your fear began after being trapped in an elevator and comes with nightmares or flashbacks. A therapist who works with trauma can help, and this ladder is not the right place to start.
- •You have ever fainted or lost awareness. Talk to your doctor before practicing.
Frequently asked questions
Can you run out of air if an elevator stops?
No. Elevator cars are not airtight, so air keeps reaching you even while the car is stopped. It can feel warm or stuffy, especially with other people inside, and that can feel alarming, but the air does not run out.
What happens if the elevator cables break?
Passenger elevators hang from several steel cables or belts, and each one can hold the full weight of a loaded car on its own. On top of that, a device called the overspeed governor triggers mechanical safety jaws that grip the guide rails if the car ever moves too fast.
How do I handle the dropping sensation in my stomach?
The slight sinking feeling when an elevator starts moving down is ordinary acceleration. When anxiety is high, it is easy to read it as danger. Keep your knees softly unlocked, breathe out slowly, and name the feeling for what it is: the car speeding up, not a fall.
How many times should I repeat a single floor ride?
Repeat a step until it feels clearly more manageable, or until what you feared has not happened a few times in a row. You do not have to wait for the anxiety to disappear completely before moving up.
- •Phobias (NHS inform)
- •How Safe Are Elevators? 10 Things You Should Know About Modern Safety Standards (Elevator Escalator Safety Foundation)
- •Say goodbye to elevator fear (KONE)
- •DOB Launches "Stay Safe. Stay Put." Campaign for Elevator Safety (NYC Department of Buildings)
- •Maximizing exposure therapy: An inhibitory learning approach (Craske et al., 2014) (Behaviour Research and Therapy)
A self-help tool. Not a medical device or a substitute for professional care.
Take your ladder with you
We're building a companion mobile app that keeps your ladder and practice log on your phone, so you can record each practice once you're done.