Traveling by airplane is one of the fastest, safest and easiest modes of transportation. It enables people to travel vast distances unthinkable just a few short decades ago.
While most people enjoy the convenience of air travel, people with a flight phobia have an intense fear of flying. This fear may prevent a person from going on vacations or visiting family and friends. It can cripple the careers of businesspeople by preventing them from traveling on work-related business.
Fear of flying, also known as aviophobia, is an Anxiety Disorder classified as a situational Specific Phobia. The person with fear of flying has a continuing and excessive fear triggered by flying or the thought of flying. Typically, flying is avoided or endured with intense anxiety, which may take the form of a panic attack.
Famous people afraid to fly include John Madden (NFL coach and commentator), Stanley Kubrick (filmmaker), Kim Jong-Il (North Korean leader), Whoopi Goldberg (actress), Joseph Stalin (past ruler of the Soviet Union), and wrestler Andre the Giant.
Several studies have found that up to 40 percent of people have some degree of anxiety about flying. According to the National Institute of Mental Health, about 6.5 percent of Americans — 20 million — have a fear of flying so intense that it qualifies as a Specific Phobia. More women than men suffer from fear of flying.
In addition to those with flight phobia, there are individuals who fear and avoid flying because they suffer from Panic Disorder with Agoraphobia—they fear having a panic attack while on an airplane. However, unlike those with a specific flying phobia, people with agoraphobia also fear other situations from which escape may be difficult if they have a panic attack.
What are the causes for fear of flying?
The cause for fear of flying is disputed. While most researchers believe it is a learned fear, the factors that make one vulnerable to its development may vary.
The way each individual processes threatening stimuli may help determine whether a fear of flying develops. If a person tends to catastrophize outcomes based on unfamiliar stimuli such as loud noises and turbulence, and adds to that an overreaction to other fears, such as the fear of terrorism, they may be well on the way to developing a flight phobia.
The components of a fear of flying are created from other phobias and fears:
- Fear of heights (acrophobia)
- Fear of closed in spaces (claustrophobia)
- Loss of personal freedom and control, or being dependent on technology or other people
- Fear of having Panic Attacks in places where escape would be difficult or embarrassing (Agoraphobia)
- Fear of being over water
- Fear of the dark (flying at night)
- Fear of the unknown
- Fear of accidents that might cause injury or death
- Fear of terrorism, skyjacking or other deliberate attacks
- Being idle for long periods of time
- The security screening process
- Concerns about turbulence and other weather conditions
- Not understanding the activities associated with a normal flight
- Underlying issues from past psychological or physical trauma
In addition, other factors that may predispose someone to developing a flight phobia include:
- Stressful life events
- Personality factors, such as individuals who find it difficult to give control to another
- Misinformation about the danger of flying
- A biological predisposition
What is the treatment for fear of flying?
Treatment for fear of flying has three components: education, therapy, and medication. Not all are required for every person.
Education
In some cases, educating people with a fear of flying about the “nuts and bolts” of aviation can considerably diminish their irrational fears. Understanding what a certain sound is or that an encounter with turbulence will not destroy the aircraft is beneficial to easing the fear of the unknown.
Even so, when airborne and experiencing turbulence, terror can result, despite the person knowing logically that the plane is not in danger. In such cases, therapy — in addition to education — is needed to gain relief.
Therapy
The primary treatment for fear of flying is Cognitive-Behavioral Therapy (CBT). This involves exposure therapy, cognitive restructuring and relaxation techniques. These rest on the theory that a phobia is due to an initial sensitizing event (ISE) that has created the feelings of fear. The initial sensitizing event was the first time that the person felt those intense feelings of fear.
A trained professional can help an individual develop a treatment plan to extinguish a phobia through either graded exposure (desensitization) or intensive exposure (flooding).
Traditionally, exposure therapy has had to be carried out on actual airplanes. Patients faced their fear gradually by meeting at an airport and boarding a stationary plane several times before taking an actual flight. Success rates for exposure therapy are about 90 percent.
However, this type of exposure therapy has declined since the World Trade Center attacks of Sept. 11, 2001, as airport security has tightened.
Virtual-reality programs are now being used experimentally. They offer a computer-generated simulation of flying that is three-dimensional and lifelike. Dr. Barbara Rothbaum of Emory University in Atlanta, who has studied virtual-reality treatments for fear of flying, says that the success rate is comparable to more traditional exposure therapy.
Medication
Aside from sedatives, such as the benzodiazepines Xanax, Valium, Ativan, most drug therapy efforts have been unsuccessful in treating fear of flying. Passengers often self-medicate with alcohol, as well. But sedatives and alcohol typically only provide short-term relief.
The one exception to the ineffectiveness of drug therapy would be when the fear of flying is secondary to Panic Disorder with Agoraphobia. In this case, antidepressant medications may be used in combination with the behavioral therapy for maximal benefits.
What do you think?
- Do you or someone you know have a fear of flying?
- Have you sought treatment? If so, what kind of treatment did you receive?
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Further reading:
For Fear of Flying, Therapy Takes to the Skies, New York Times July 24, 2007
Fear of Flying Tips website
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