To the unhappy souls so afflicted, it begins days before the anticipated event. The vivid imagination kicks into that dreaded high gear. Every feared scenario is played in the mind again and again. Heart rate goes up; breathing increases. Those cute butterflies in the stomach give way to some other species, something menacing, like a swarm of stinging hornets. Muscle tension increases, creating anything from headaches to muscle cramps. As the loathsome day approaches, there is often a loss of sleep, and with it, irritability, and lowered immunity to stress and physical illness. By the time the actual feared situation arrives, they are beyond exhausted. Their over-done imagination has wiped them out long before the real battle begins. Now once actually in the dreaded situation, the desperation rises, eyes start darting for some means of escape. When none appears, all of these symptoms of anxiety join forces into one mighty tidal wave of panic. Heart rate is now 160+. It feels like the heart is going to pound itself right through the chest wall. Normal breathing becomes hyperventilation, creating that tingling sensation in the fingers and toes, soon followed by dizziness and more nausea. The world seems to swirl sideways in a tornado of fear. Heart attack seems imminent, or worse, there’s some kind of pending psychic implosion. Now, there’s a more desperate search for escape. Anything to get out of the situation that they believe is causing this. Peer right into the eyes of someone at this moment, and you will have the image of pending death forever etched in your mind.
For those of us enchanted by flight, welcome to the other side of the world – the fear of flying. It is no coincidence that there’s little hole-in-the-wall liquor establishments doing quite well thank you, every ten gates or so at the major airports. Any cocktail mixed with some kind of prescription tranquilizer bought or borrowed will be tried if it’s likely to reduce or take away the anxiety.
There is nothing more disheartening than discovering that a loved one either won’t fly at all, or when they attempt bravely to fly anyway, are possessed by the demons of anxiety and panic. This often results in family vacations involving long car rides to avoid flying, or in trips not made at all because of a family member's fear of flying. Or when the family member decides to fly, they have worn themselves out as well as the family who has been exposed to their fear. When the fearful flier drinks or takes tranquilizers to get through the ordeal, they are worn out, passed out, or essentially hung over when they reach the destination.
For those anxious fliers who mst fly as a requirement of their job, it’s like having threatened execution as part of their daily job description. I’ll never forget the look on the face of one of my fear-of-flying patients. That morning his new boss told him that he would need to make a few trips to China each year. Or the tormented 13 year old who knew that her fear of flying held back her family from taking many wonderful vacations. Or the 63-year-old immigrant woman who was nearly homebound with anxiety. She couldn’t get herself to travel back to her homeland to see her dying mother, even by boat.
Too often, the solution comes down to avoiding flying altogether. In psychological parlance, it’s known as avoidance conditioning. And it is one of the most potent forms of conditioning that can shape behavior. Avoid the situation that triggers the fear and the outcome is universal: the fear of the dreaded situation gets worse. If you avoid something and in the process, avoid anxiety and panic, no other conclusion occurs in the mind of the anxiety sufferer. It must have been the flying that caused the anxiety and panic. So, avoid flying. While this solution may seem relatively harmless, in truth such a strategy tends to spread to other areas. Most phobic fliers have other phobias as well. Once you learn to avoid situations as a means of keeping the fears under control, the natural course of events is to avoid more and more things. Left untreated, some phobic-prone people over the course of several years end up housebound, concluding that it is safest not to venture out at all.
Instead of referring to it as the fear of flying, I find it much more helpful to refer to the fears of flying. This is because while you may have two people who both dread leaving terra firma, the basis for their fears can be quite different. And hence, the treatment varies as well. The three fears are as follows:
The Claustrophobic Fearful Fliers
By far and away, the largest proportion of people with a fear of flying are claustrophobic. They don’t like being in any room that they can’t get out of immediately. The greater the difficulty of making a quick exit, the greater the fear. So in general, crowded spaces, and especially locked spaces, all heightened the fear. Hence, such fearful fliers generally don’t like elevators, crowded buses, or crowded anything for that matter. Their credo is, get out of the situation and you get out of the anxiety and panic. If a two minute ride in an elevator is enough to inspire panic, how about being locked in an aluminum tube for four hours, in row 33 with a couple of hundred people crammed between you and that locked exit, and at 33,000 feet and 500 mph? Small aircraft don’t engender such fears on the ground. The small plane has the familiar feel of a car. Lots of windows, a door within reach, and the illusion of control. Once the plane leaves the ground, however, the panic-prone individual will begin to get very anxious, knowing that they cannot get out whenever then want.
These folks don’t fear crashing and dying. They don’t worry about mechanical problems. Their fears are greatest sometime between when the door to the airplane is locked until about mid-way through the flight. This is because during this period, they know that it is the longest stretch of time until the flight will be over and they will be able to get out. Their fears start to go down the longer they are into the flight. During descent and landing their fears really start to diminish because they are anticipating that they will be able to get out soon.
The Safety Related Fearful Fliers
In contrast, the safety related fearful fliers are not phased by the airplane door being locked. They don’t think for a minute about how to get out quickly from an aircraft that is perfectly sound mechanically and otherwise not on fire or headed into a thunderstorm. They don’t mind being stuck in the airplane on the ground for weather or mechanical delays. In fact, they prefer it any day to the possibility of encountering trouble. These fearful fliers watch the weather channel for days prior to their flight and become amateur meteorologists, figuring their odds of good treatment by the weather gods. They will get a seat near the window so that they can watch the ailerons, flaps and slats go up and down. Many have either informally read books about flying, or in some instances, have actually completed ground school for a private pilot’s license. They want every piece of information that can get that might affect the safety of a flight. They listen for every sound, smell or visual cue. They watch the faces of the flight attendants for signs that something might be amiss. Their fears are highest during any phase of flight that is most likely to result in either a mechanical or weather related problem. Put them in level cruise flight for hours in smooth air several hundred miles from the closest convective activity and their fears diminish greatly. Their fears start to rise again during descent as they anticipate the number of things that can go wrong until the aircraft decelerates and turns off the active runway. These folks don’t care much for small planes. They are well acquainted with the statistics. They know that small planes have more safety issues than big ones.
Among the safety related fearful fliers are the ones who used to fly routinely without fear. However, they went through some type of ordeal in flight scary enough to trigger symptoms of anxiety on subsequent flights. The largest subsection of this group went through bad turbulence and got shaken up. A smaller group might have been on a flight that experienced mechanical difficulties.
Temperamental Fearful Fliers
The third group are fliers who have a fear that is harder to recognize at first glance. These folks have a very high need to be in control of their lives. They don’t like to travel in cars where someone else is driving. They tend to be in leadership roles in other aspects of their lives as they don’t like others to be in a position of authority over them. They are perceived by others as ‘control freaks’ and are otherwise demanding and belittling of others. They are prone to anger when things don’t go their way, or when they are afraid. They are stubborn, opinionated, and extremely sure of themselves.
These folks don’t do very well as flying passengers. And as a flight attendant once pointed out to me, how surprised should we be that such flying passengers regress? We tell them when they can come and when they can go. We put them in their chair, belt them in and put a tray in front of them. We feed them when we decide. Seems like a toddler in a high chair scenario to me. Let’s remove every semblance of personal control over the life of someone who is fundamentally terrified not to be in control every second. Imagine adding tranquilizers and alcohol to the mix, and then put the whole kit and kiboodle into the air at a few hundred miles an hour. Guess what’s going to happen? Their (largely unconscious) fear of loss of control gets translated into being angry, ornery, demanding, and argumentative.
These temperamental fliers really have a hard time with the high chair phenomenon. This brand of fearful flier wants to be the one in control and call the shots on such factors as when the plane leaves, knowing nothing of course about such piddly little details as the weather and mechanical issues that may be delaying a flight. At the base of their anger is really a fear of being out of control of their lives and placing themselves in the hands of a relative stranger (i.e., the pilot).
The treatments…
The good news is that flying phobias can be treated very effectively, most of the time without the use of prescription drugs or home spun remedies such as alcohol. The new credo in treatment becomes: you don’t have to escape from the situation; you can learn to escape from the anxiety and panic. Very effective cognitive/ behavioral techniques provide a powerful tool to diminish these fears and in some cases, remove them completely. The use of prescription medication under the right circumstances can provide much benefit as well. See a qualified mental health care provider in your area who has experience in the treatment of specific phobias, including flying. Ask if they have backgrounds in either cognitive-behavioral therapy or evidenced-based therapy for the treatment of anxiety and phobias.
Note: I am a private pilot who treats people who have a fear of flying. For more information on how to locate us (we are in the Chicago area), see our website at http://www.heritageprofessional.com
