Fear of Flying

 And if after what you have seen and read on this site you still have a fear of flying. that niggling feeling telling you its just not natural. Read on this may help if not then rest in the fact that your 29 times more likely to die in your car than a plane. Apparently!!!!!!!!!

 The Facts . . .and the Problems

 Flying is generally considered to be one of the safest forms of public transportation currently available in the United kingdom . Statistics compiled by the Department of Transport have led to the conclusion that airline travel is 29 times safer than driving a car.

 The problem with the above statistics is that they do not stop people from being afraid of flying.

Statistics do not help because the fear of flying actually has little to do with risk as such. If the fear of flying were actually caused by the potential for an accident, then everyone who fears to fly would be even more afraid—29 times more afraid, to be statistically exact—to drive or ride in an automobile. But that is clearly not the case.

Anyone who flies—even someone not afraid of flying—understands that there is always some chance of an accident, just as with any life activity. Relatively few accidents happen in aviation because pilots are specifically trained to stay calm and to think clearly in an emergency—and they are trained to handle just about every emergency imaginable.

But, without their own specialized training, many passengers sit in the cabin worrying about the dangers of flight. Despite the safety statistics, they become disabled by fear and experience the psychological symptoms that make flying a misery.

 Vulnerability

 If you carefully read the information on this webpage, you will learn that, although the fear of flying isn’t really about the risks inherent in aviation, it is based in the uncomfortable awareness that life is fragile and vulnerable, and that none of us—much like the passenges on many of the flights on this site.—has any real control over it, whether in the air or on the ground.

Because we were not designed to fly like birds, whenever we get into a “flying machine” we have to confront our deepest fears of human vulnerability. It’s not so much that flying is “unnatural,” but that in finding ourselves way up in the sky, sealed in a machine, we can hear our deepest whisperings of vulnerability more clearly than anywhere else.

Still, even though none of us is ever “in control” of anything, we can learn to be psychologically in command of our thoughts and feelings—and trust in something greater than ourselves—more than we think. We can learn to not be overwhelmed by fear itself.

Continue reading, therefore, to experience your own “specialized training” in flying without anxiety.

 Components

 Technically, the fear of flying is a Specific Phobia, one of several kinds of Anxiety Disorders. As an anxiety, the “fear” of flying is more concerned with what might happen than with what actually is happening.

If, for example, you were sitting in a plane with smoke coming out of the engines while the captain was trying to make an emergency landing, there would be a clear and present danger, and anyone would be afraid. But if you were sitting in a plane with all systems functioning normally and you felt afraid that something threatening could happen, that would be anxiety.

The fear of flying has many components, not all of which are specific to flight itself. Some of these components are anxieties about

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Heights

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Enclosed spaces

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Crowded conditions

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Sitting in hot, stale air

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Being required to wait passively

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Not understanding the reasons for all the strange actions, sounds, and sensations occurring around you

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Worrying about the dangers of turbulence

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Being dependent on unknown mechanical things to maintain your safety

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Being dependent on an unknown pilot’s judgment

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Not feeling in “control”

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The possibility of terrorism

If your fear of flying derives from a past trauma or accident, you might consider a consultation with a psychologist specifically to resolve those “underlying” issues. You might also be interested in Wings of Light, an organization formed as a support and information network for persons whose lives have been touched by aircraft accidents.

 

 

 Symptoms

 No one can be in control of his or her future, and so anyone who worries unnecessarily about the future will cause physical and emotional reactions just as if something dangerous really were happening.

Generally, people who experience a fear of flying report two basic kinds of symptoms.


Physiological reactions to fear and stress include

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Muscle tension; tremors

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Heavy, labored breathing

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Heart palpitations; chest pain

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Abdominal and intestinal discomfort

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Sweating, weakness, dizziness, prickly sensations, dry mouth, flushed or pale face

Psychological  symptoms include

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Impaired memory

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Narrowed perceptions

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Poor or clouded judgment

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Negative expectancies

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Perseverative thinking

 Medical Issues

 

Anyone who flies should be aware that certain medical conditions—conditions not caused by psychological anxiety—can produce symptoms that mimic the physiological reactions to anxiety or cause additional anxiety.

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Vestibular (inner ear) problems can cause disorientation, dizziness, and nausea.

Ear Pain

The middle ear is connected to the throat by a pathway known as the eustachian tube; this tube equalizes the pressure between ambient air pressure and air trapped within the middle ear. If the tube gets blocked, you can experience pain known as “middle ear block” or barotitis. (Remember that when an aircraft ascends, ambient air pressure drops, and when the aircraft descends the air pressure increases; this is why ear pain is encountered at either of these two times of flight.)

The safest and most common method of clearing an ear block is to move the jaw and swallow at the same time—which is what happens when chewing gum.

The next thing to try if gum doesn’t work is the Valsava maneuver: when you feel a block developing, hold your nose shut and then blow gently as in trying to exhale. The back pressure can force open the eustachian tube.

If this maneuver doesn’t help the pain, you can try using a decongestant nose spray or an oral decongestant (such as pseudoephedrine) about an hour before departure or an hour before arrival. (Avoid any medication that combines the pseudoephedrine with an antihistamine, because this can cause drowsiness that lingers for several hours. But then, maybe you want to sleep on the flight—just don’t try driving afterward.)

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Sinus Pain or, when it is very serious, “Barotrauma of Sinuses.” This pain often appears around or above the eyes, as in a headache on one side of the head. The pain results from atmospheric pressure changes, just as with inner ear pain (described above), only the pain involves congested sinus cavities. It usually happens during descent, when the pressure of the air trapped in the sinuses cannot equalize with the pressure of air in the cabin. Just as with ear pain, relief can often be found by taking a decongestant (to open up the sinus cavities) approximately an hour before arrival, before descent begins.

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Muscular pain, joint pain, and tingling, can be a symptom of decompression sickness (DCS). DCS can result from flying in an unpressurized aircraft at high altitudes, but in commercial aviation, with its pressurized planes, DCS isn’t likely to be seen except in scuba divers who have made recent dives. Nitrogen dissolved in body tissues from the dive may not cause problems at sea level, but at altitude the nitrogen can begin to emerge from tissues as bubbles. Such a condition requires immediate medical attention. Oxygen treatment on-board may help, but hyperbaric treatment on the ground may be required to recompress the nitrogen bubbles. (Just remember: waiting less than 24 hours after a dive before flying can increase the risk of DCS considerably.) [1]

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Traveller’s Thrombosis or, in popular jargon, “economy-class syndrome.”

“Deep vein (or venous) thrombosis is a condition in which a small blood clot (thrombus) or clots (thrombi) develop(s) in the deep veins, usually of the leg. The condition itself is not dangerous, but the complication of pulmonary embolism (venous thromboembolism — VTE), can, of course be life threatening.” [2]

It can be life-threatening because that little blood clot can be carried in the bloodstream to another part of the body where the clot can block the flow of blood to a critical organ, such as the heart—causing a heart attack—or brain—causing a stroke.

Actually, deep vein thrombosis (DVT) has occurred as much in first class and business class as in economy class, so calling it “economy-class syndrome” is a misnomer.

Common sense can explain why. All scientific evidence seems to point to the origin of the problem as restricted mobility for long stretches of time. So think about it. In cars and busses we stop for rest breaks every couple hours; in trains we are free to walk around from car to car; and cruise ships are like floating hotels. Only in airplanes are we literally strapped to our seats for hours on end; even food is brought to us, because there is no dining car. So it’s no wonder that DVT is associated with (not caused by) air travel.

And consider one other fact. If you make a long flight anywhere, you’re likely to make a long flight back home—and the risk of DVT seems to be associated with that second flight.

So if you have the option, leave several days between long flights. Move around in your seat as much as possible. And if you have predisposing conditions—such as a blood disorder affecting clotting; cardiovascular disease; current or history of malignancy; recent surgery; use of oral contraceptives; recent lower limb trauma; pregnancy; age over 40 yr.; previous DVT; family history of DVT—see your physician before travelling.

Which is worse? Risking DVT by staying in your seat, or risking injury from sudden, unexpected turbulence when not secured in your seat? Only you can decide.

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Mitral valve prolapse (MVP) can cause chest pain and may contribute to panic sensations. (There may not be a clear link between MVP and panic, so ask your physician for details.)

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Hypoglycemia (low blood sugar) from not eating—commonly due to loss of appetite because of a “nervous stomach”—can cause faintness, irritability, muscle tension, and anxiety.

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Allergic reactions to plastics, carpeting, perfumes, etc. can cause varying degrees of discomfort.

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Side effects from prescribed or over-the-counter medications can cause a variety of uncomfortable and anxiety-like feelings.

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A lack of oxygen at altitude may cause any number of symptoms of altitude sickness, such as headache, irritability, nausea, muscle weakness, fatigue, slightly blurred vision, and faster or shallower breathing.

That’s right—a lack of oxygen, technically known as hypoxia, can be noticed because even though the aircraft cabin is pressurized, it is usually pressurized only to about 8,000 feet. Unless you’re used to living in the mountains, the physiological effects of even this modest altitude can be significant. The effects of hypoxia may not be noticed on short flights, but many persons can experience symptoms on long flights; that is, after 5 hours at altitude.

Also, if you’re a smoker, the carbon monoxide in tobacco smoke diminishes your blood’s ability to carry oxygen, and so the hypoxic effects of altitude will be more intense for you than for a nonsmoker.

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Dehydration from the very dry air in the aircraft cabin may cause headache, dizziness, and fatigue. Protect yourself by drinking plenty of plain water: about a cup (8 oz—or 250 ml) per hour. In general, unless you have kidney problems, this moderate water intake should be beneficial.[3] Avoid alcohol, colas, and caffeine.

If you believe that any of these conditions may apply to you, discuss them with your physician.

Never take any medication inflight which you have not first tested for adverse reactions while safely on the ground.

 Trapped ?

 Clearly, the fear of flying can be associated with many different symptoms. You might even experience some of these symptoms in situations other than flying and not be nearly as incapacitated as when you are flying in an airplane.

In fact, this is the key to the whole problem. In other situations, you have much more freedom to change things. If it’s stuffy in a car, you can open a window. You can talk to the driver. You might be the driver. Even riding in a bus or train is usually less troubling than flying.

The reality is that flying can feel like being trapped—trapped in the airplane until it lands.

And so it might be said that your symptoms are your “out-of-control” reactions to feeling trapped and out of control.

 Freedom

 A person who has overcome the fear of flying still knows that anything could go wrong with the flight—just as someone driving a car surely knows that an accident could happen at any time. What this person has overcome, therefore, is the escalating spiral of ever-worsening symptoms triggered by one or more of the anxiety-provoking components of airplane flight

 Cognitive Coping Strategies

Research that has examined the cognitive coping strategies used by persons who are afraid to fly tells us that, in general, four specific coping strategies seem to be most associated with flight anxiety:[4]

1.

Rumination, which refers to thinking over and over again about the situation

2.

Self-blame, which refers to thinking a lot about mistakes you have made

3.

Acceptance (or resignation), which refers to thinking that you have no other option but to helplessly accept things as they are

4.

Catastrophizing, which refers to thinking about how awful the situation is or could become

This means that if you are afraid to fly, you are likely to spend a lot of time being preoccupied with worries about flying before the flight even happens, and you can get caught up in dwelling on all the physical and psychological symptoms you’re feeling once the flight begins. Plus, you will likely blame yourself for your failures and weaknesses, you will be telling yourself that you are helpless to do anything about those weaknesses, and you will be thinking of all the bad things that could happen.

Here, then, is some advice about how to change these anxiety-provoking ways of thinking.

Rumination—expand your awareness beyond the unpleasant situation:

I’m thinking about the flight again, and it’s still two days away. Let it go. Take a deep breath. Come on, get back to work.

Look. It’s a nice view. Sitting here paralyzed won’t make the plane any safer.


Self-blame—remind yourself that you are doing the best you can and that progress takes time:

Yes, I was very nervous the last flight. But since then I have learned some new techniques for coping with anxiety.

I did the best I could. I’ll get better with practice.


Resignation—give yourself credit for your own good sense:

I’m not really helpless. I can take slow, deep breaths. I can practice progressive muscle relaxation or autogenics.


Catastrophizing—acknowledge your fear, and then challenge it:

OK. I will be afraid as I’m boarding. But have I ever run away from other problems before? No.

OK. Maybe I will feel nervous. But I do have things I can do to relax. All things will pass.

Yes, I can imagine a lot of awful things that could happen. But the reality is that none of these things is likely to happen.

 Children And Fear Of Flying

 Sometimes children develop a fear of flying. But unless the fear can be traced directly to a trauma or accident, before seeking treatment specific to the child, it would be advisable to think of the child as just one part of a larger family system.

So consider whether the child’s anxiety relates in some way to family conflicts.

For example, children who have to fly from one divorced parent to another for visitation can develop anxiety about flying which relates primarily to feelings of helplessness and abandonment. In other words, the fear is not about flying so much as about what flying signifies: the despair of being shuttled from one parent to another like a sack of potatoes.

A child’s fears can also be an unconscious expression of a parent’s anxieties. It’s odd, but sometimes a child’s symptoms reflect things the parents are struggling with but are trying to keep hidden.

So always consider what the child’s symptoms mean psychologically within the greater family context. The child’s fear of flying may not be about flying at all.

 Other Issues To Consider

 When someone flies across the country, it’s not usually for the benign reason the chicken crossed the street: to get to the other side. Human travel usually involves desires and expectations. And often those desires and expectations involve unpleasant emotions such as hurt, anger, and uncertainty about fulfilling obligations.

Now, because flying does have some risk to it, those unpleasant emotions can get psychologically transferred to the process of flying. That is, rather than acknowledge our “dangerous” emotions, we focus on something else that seems dangerous: flying itself.

So, as strange as it might sound, even an adult’s fear of flying may have nothing to do with flying per se. Consider the following case vignette.

A 32 year old woman calls the office, leaving a message in which she requests treatment for fear of flying. She says that the last time she had to fly she couldn’t board the plane, and she was such a nervous wreck that her husband had to drive her home. She now has recurring fantasies that she is on a plane which crashes.

When you call her back and request more information, she says that the last flight on which she flew encountered turbulence. One of the male flight attendants was injured by a beverage cart, and one of the female flight attendants who came to his aid started crying. The woman mentions that when she told this to her husband after the flight, he was not very sympathetic and they had an argument.

You ask if she can remember exactly what her husband said that was “not sympathetic.” She hesitates, then replies that he told her, “Oh, the flight attendant was just upset because the two of them were probably having an affair.”

You then ask for some general information about recent events in the woman’s life. She replies that she and her husband were married two years ago. For the last year they have been trying to have a baby. About six months ago the woman received a job promotion which required her to fly frequently across the country. She adds that she had no trouble making any of these flights until the problem with the turbulence.


Although this case is fictitious, there are several clinical possibilities that can be considered.

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The woman is ambivalent about her job promotion and fears that it might affect her marriage, and so the fear of flying symptoms serve unconsciously to prevent her from fulfilling the duties of her new job and call into question the promotion itself.

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The woman is afraid that her husband may be dissatisfied with the marriage and may be having an affair—or thinking of having one—and so the fear of flying symptoms keep the woman at home near her husband.

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The woman is afraid of not being able to have a baby, and the thoughts of a plane crash may be an unconscious expression of her fear that she will die childless.

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The woman may be feeling hurt by her husband’s behavior, for any of the reasons above, or for other reasons. But, because she cannot acknowledge the full extent of her angry response to feeling insulted, abandoned, and helpless, and because she may even feel guilty for having thoughts and feelings of revenge, she visualizes the plane crashing as an expression of an unconscious desire to punish her husband—or herself.

Any—or all—of these possibilities could be an explanation of the fear of flying symptoms. And none of them has anything to do with flying itself.


Therefore, if you have a fear of flying, before seeking treatment you might want to ask yourself several questions (along the lines of the vignette presented above):

1.

What exactly were the circumstances of the flight on which the fear of flying symptoms first appeared?

Why were you flying?
What happened just before the flight?
What happened during the flight?
What happened just after the flight?
(Try to recall the facts, as well as the exact words of anything that was said.)

2.

What was happening in your life before the fear of flying symptoms developed?

Did you experience any major life changes before the fear of flying symptoms developed?

Did anything happen that left you feeling uncertain or conflicted before the fear of flying symptoms developed?

Had anyone done anything to you that had left you feeling emotionally hurt and angry before the fear of flying symptoms developed?

3.

What exactly might a fear of flying prevent you from doing?

How do you really feel about not doing it?
Maybe you don’t really want to do it.
Or maybe you feel guilty about doing it.


Who knows? You might end up in treatment for something other than fear of flying, or you might be able to solve the problem yourself without professional help.

 Treatment

 Considering all that has been said on this page, treatment for the fear of flying can take several forms.

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You might simply need factual information about principles of flight and flight safety, such as turbulence. You can begin by reading my page Principles of Aircraft Flight. You can also get similar information for free from other websites, or you could buy any number of online courses, or you could participate in a group fear of flying program offered through airlines. For more information about these alternatives, see my page Fear of Flying Treatment, and its Additional Resources section.

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If information alone is not sufficient, then you might want to treat the symptoms of your fear of flying by changing your negative thinking or by learning a relaxation technique. I offer two free self-help training courses on this website, one in Progressive Muscle Relaxation and the other in Autogenics.

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If a basic symptomatic treatment is not sufficient, then you might want to try exploring the psychodynamic aspects of your anxiety, as outlined in the section above called Other Issues to Consider.

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If a basic symptomatic treatment is not sufficient, and if your own psychodynamic exploration does not help you, then you might want to add a more clinical approach. You can follow the free self-help treatment guidelines I offer for Systematic Desensitization, or you can consult with a psychologist or other mental health professional for treatment of a phobia, or you can seek treatment to help you better understand your emotional life.

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Finally, if your anxiety is based in an existential fear of death more than an anxiety about flying, you might want to consider the idea of spiritual healing.

 

 

  

 

 

 
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