Fear of Flying Advice: How Good Is it, Really?

[Capt Tom Bunn LCSW]

The web is full of advice for fearful fliers. Pilots say “knowledge is power." They believe, perhaps naively, that if a people understands how safe flying is, their fear will disappear. But this view ignores that fact that any situation where a person is not in control and escape is blocked causes huge anxiety.

Mental-health professionals aren't much better. They offer CBT (cognitive behavioral therapy), a stock solution that works well for ground-based anxiety, but not for flight-based anxiety. CBT is a "top-down" approach based on the principle that thoughts are the cause of unwanted feelings. Though some flight anxiety is caused "top-down," most is caused "bottom-up" when the plane's movements and noises trigger stress hormone release. CBT provides little if any relief for the ”bottom-up" distress, particularly that caused by turbulence.

Many anxious fliers are concerned about in-flight panic. Panic can usually be stopped by going some other place. But in a plane, getting relief from panic by escape is not possible. Panic comes on without warning. It is caused by processes outside of consciousness. Since CBT does not deal with conscious processes, sufferers are asked to simply accept it. They are told to recognize that panic will not cause harm, and to "relax and float through panic." This advice - to practice acceptance - is just lame. If in-flight panic were not preventable, such advice might be acceptable. But advanced methods of treating flight phobia prevent in-flight panic.

I scan the web daily to see what advice is being offered for flight phobia. I came across an syndicated column written by a well-established physician. Unfortunately, it consisted of one piece of questionable advice after another.

The writer recommended CBT, saying it “helps people change patterns of thinking that prevent them from overcoming their fears.” Changed patterns of thinking cannot prevent distress caused when stress hormones are released by motions and noises of the plane. Whatever the pattern of thinking, there is no way for a person to be absolutely sure he or she is safe. No pattern of thinking can change the fact that the passenger is not in control and has no means of escape.

The article also recommended desensitization, saying it is “particularly effective for phobias and panic disorders.” There are two types of desensitization. Systematic desensitization requires carefully adjusted exposure to stimuli that trigger the phobic response. That is obviously not possible on an airliner.

The other form of desensitization, exposure, is intended to help clients learn that the thing they fear causes no harm. Since planes crash rarely, exposure to a flight that lands successfully proves nothing about harm that might take place on a future flight.

The writer then suggests lorazepam and clonzepam, apparently unaware that Stanford University School of Medicine research shows benzodiazepines make flying worse.

Topping off the questionable advice, the writer recommends deep breathing though current research finds deep breathing useless, and possibly counterproductive.

We live in a world where advice of all kinds abound. Free advice is often worth what you pay for it. No. It's worth even less than that, because when bad advice sets you up for failure, you may believe the failure is due to your inadequacy - not inadequate advice.

Bad advice causes anxious fliers to give up. If you give up, you will not learn that effective help is available. As both an airline captain and a licensed therapist, I've spent 35 years specializing in the treatment of flight phobia. As a result, anyone - no matter what they have tried - can fly comfortably and confidently. What I've learned is detailed in my book, SOAR: The Breakthrough Treatment for Fear of Flying.

A free app on fear of flying is available at www.fearofflying.com/app which is particularly helpful with turbulence, since it includes a g-force meter that measures the turbulence and prove the plane is safe.