Fear of Flying
This leaflet aims to describe the features of those people who suffer with a fear of flying, different options for treatment, and how one form of treatment - Cognitive Behavioural Therapy (CBT) can be of help. It is hoped that this leaflet will be useful for those who have a fear of flying and possibly also for their partners.
THE EXTENT OF THE PROBLEM
Fear of flying is believed to affect one in ten of the population, though some studies put the proportion as much higher. Women more frequently report it than do men. Individuals affected can be divided into 3 groups. One group avoids all flights. Another restricts flying to an absolute minimum, and experiences considerable discomfort prior to and/or during each flight. Another group show continuous mild or moderate apprehension about flying, but do not avoid it, even though it remains an unpleasant experience. The problem can have a substantial impact on professional life, social life and family life.
Fear of flying can be either limited to just one difficulty, aeroplanes, or be part of a wider picture of other psychological problems such as panic attacks, claustrophobia, or post traumatic stress disorder. It is characterised by a marked, persistent, and excessive fear that is triggered by the experience or immediate prospect of air travel. The person reports feeling intensely anxious, sometimes to the point of having a panic attack. The level of response is recognised as unreasonable, and the person often reports distress resulting from their fear.
WHAT IS A FEAR OF FLYING?
People can be afraid of many aspects of flying. Examples are: crashing, dying, heights, confinement/being enclosed, suffocation, turbulence/bad weather, panicking, lack of control, losing control, air sickness, fainting and the subsequent humiliation, fear of being separated from a caretaker, being far from home, or experiencing a serious disorder such as a heart attack. One person said that he was so terrified that he might make a fool of himself if he could not escape that he found himself almost wishing the plane would crash.
The above list can be divided into two main groups - with some people experiencing fears from both categories. In the first group, the person fears some form of internal catastrophe, where in some way they will go "out of control". They are unable to escape from the situation, and therefore remain terrified of the frightening prospect. The second group report a fear of a "loss of external control" - something happening to the plane. This includes heights, turbulence, bad weather, and all of the runners up to crashing.
CAUSES
A fear of flying may have at its core a previous frightening experience. Sometimes people can't remember this, and it is not usually important to remember it. What is important is that once the fear of something has started, people get into a pattern of avoiding the thing that frightens them. As they repeatedly avoid it, they never give themselves the opportunity of testing out, and disproving their predictions of catastrophes. The fear begins to take on a life of its own. Sometimes people may scan the plane for noises and movements that suggest danger and are therefore acutely ‘wound up' during the flight. For many, this state of arousal can itself be the thing that is feared. Others have pointed to the terminology used in relation to flying - Terminal, Departure lounge, Last and final call, Flight Terminating at it's Final Destination: All this does very little to reassure the nervous flyer!
DIFFERENT TREATMENTS FOR A FEAR OF FLYING
Before psychological treatment can begin, any medical problems such as heart problems need to be ruled out if there are clear physical symptoms. For example, if there is a history of actually fainting, rather than just feeling faint, it is necessary to exclude physical disorders, before concluding that the fainting attacks are caused specifically by perhaps over-breathing, brought on by anxiety. If the identified fear is one of a heart attack, or other collapse, then a medical examination and reassurance as to the state of their good health can be sufficient for some people to stop worrying, and to start to rebuild their confidence. Medication to control the anxiety can be useful but there can be a number of problems. These include side effects and the risk of dependency on some medications such as tranquillisers if they are taken for more than a short period.
Some treatments try and teach control these include hypnosis, relaxation and re-breathing techniques.
CBT FOR FEAR OF FLYING
CBT proposes that it is not events themselves, but rather a person's interpretation of them that is responsible for the production of feelings such as anxiety and/or depression. Treatment often involves the following: -
1. Specific techniques are used to modify those thoughts of danger that flood into our heads. This in turn can help us feel less anxious.
2. The perceived risks not only of external events such as the plane but also the risks of the person's responses such as fainting or having a heart attack can be explored.
3. Once individuals have labelled a situation as dangerous, they tend to selectively scan and misinterpret situations in ways that make them feel even more frightened. Scanning needs to be stopped.
4. Sometimes relaxation techniques can be taught.
5. Exposing the person to the feared situation is often the best way to overcome the fear. There are a number of ways of doing this but taking small steps is often found to be the best. The first step may be to learn more about the whole process of flying and the true risks involved. Some sufferers arrange to sit in planes and even use the technique of virtual reality which allows individuals to become active participants as if they were flying whereas they are interacting through sight, sound and touch with a computer generated three-dimensional world.