Fear of flying

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For other uses, see Fear of flying (disambiguation).

Fear of flying is a fear of being on a plane while in flight. It is also sometimes referred to as aerophobia, aviatophobia, aviophobia or pteromerhanophobia.

1 Overview
2 Symptoms
3 Causes
4 Treatment
5 Famous people afraid to fly
6 References
7 External resources

[edit] Overview

Fear of flying may be a distinct phobia in itself, or it may be an indirect manifestation of one or more other phobias, such as claustrophobia (a fear of enclosed spaces) or acrophobia (a fear of heights). It may have other causes as well. It is a symptom rather than a disease, and different causes may bring it about in different individuals.

Fear of flying receives more attention than most other phobias because air travel is often difficult for people to avoid—especially in professional contexts—and because the fear is widespread, affecting a significant minority of the population. A fear of flying may prevent a person from going on vacations or visiting family and friends, and it can cripple the career of a businessperson by preventing him or her from traveling on work-related business.

Despite its ubiquity, commercial air travel continues to cause a significant proportion of the public and some members of the aircrew^[1] to feel anxiety. When this anxiety reaches a level that significantly interferes with a person's ability to travel by air, it becomes a fear of flying.

There is a view that a fear of flying is entirely rational, and reveals much about the way we think about risk - concentrating on the quantity of a risk and not its quality. The British historian Dr Ian Mortimer who put this view forward has likened an individual's refusal to fly to the precautions taken by the British Government to eradicate variant Creutzfeldt-Jakob Disease - even though the risk is very small the horror of it coming true is enough to justify eliminating it. See his essay Why I do not fly.

[edit] Symptoms

A fear of flying is a level of anxiety so great that it prevents a person from travelling by air, or causes great distress to a person when he or she is compelled to travel by air. The most extreme manifestations can include panic attacks or vomiting at the mere sight or mention of an aircraft or air travel.

[edit] Causes

The fear of flying may be created by various other phobias and fears:^[2]

a fear of closed in spaces (claustrophobia), such as that of an aircraft cabin
a fear of heights (acrophobia)
a feeling of not being in control
fear of having panic attacks in certain places, where escape would be difficult and/or embarrassing (agoraphobia)
fear of hijacking or terrorism
fear of turbulence
fear of flying over water or night flying
fear of crashing resulting in injury or death

A previous traumatizing experience with air travel or somehow connected to air travel can also trigger a fear of flying. For example, the experience of flying to a meeting only to be told that one has been fired might be traumatic enough to subsequently create an association between any air travel and bad or unpleasant events.

Some suggest that the media are a major factor behind fear of flying, and claim that the media sensationalize airline crashes (and the high casualty rate per incident), in comparison to the perceived scant attention given the massive number of isolated automobile crashes. As the total number of flights in the world rises, the absolute number of crashes rises as well, even though the overall safety of air travel continues to improve. If only the crashes are reported by the media (with no reference to the number of flights that do not end in a crash), the overall (and incorrect) impression created may be that air travel is becoming increasingly dangerous, which is untrue.

Misunderstandings of the principles of aviation can fuel an unjustified fear of flying. For example, many people incorrectly believe that the engines of a jet airliner support it in the air, and from this false premise they also incorrectly reason that a failure of the engines will cause the aircraft to plummet to earth. In reality, all airliners can glide without engines, and the engines serve only to move the aircraft more quickly through the air and maintain its altitude over long distances.

[edit] Treatment

[edit] Education

In some cases, educating people with a fear of flying about the realities of aviation can considerably diminish their fears. Learning how aircraft fly, how airliners are flown in practice, and other aspects of aviation can assist people with a fear of flying in overcoming its irrational nature. Many people have overcome their fear of flying by learning to fly or skydive, and effectively removing their fear of the unknown. Some people with a fear of flying undertake education themselves; others attend courses (for people with the phobia or for people interested in aviation) to achieve the same result. Some airline and travel companies run courses to help people get over the fear of flying.

Education plays a very important role in overcoming the fear of flying. 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. Nevertheless, when airborne and experiencing turbulence, terror can result even through the person has every reason to know logically that the plane is not in danger. In such cases, therapy - in addition to education - is needed to gain relief.

[edit] Therapy for fear of flying

Behavioral therapies for fear of flying such as Cognitive behaviour therapy and Systematic desensitization rest on the theory that phobia is due an initial sensitizing event (ISE) that has created the feelings of fear. In other words, the initial sensitizing event was the first time that the person felt those intense feelings of fear.

Hypnotherapy generally involves regression to the ISE, uncovering the event, the emotions around the event, and helping the client understand the source of their fear. It is sometimes the case that the ISE has nothing to do with flying at all.

Recent neurological research by Allan Schore and others using EEG-fMRI neuroimaging suggests that fear of flying is not the result of a single sensitizing event, but - like other affective disorders - is the result of chronic exposure to emotional dysregulation in childhood which hindered development of the right prefrontal orbito cortex, rendering it unable to carry out its executive role in the regulation of affect.^[3]

When there is no history of panic attack, Cognitive behaviour therapy may be useful. But methods based on cognition are of limited value when there is a history of panic disorder. When the ability to regulate ones emotional state is dependent upon means to escape, fear of panic can be extreme when flying.

There is also promising research regarding the use of virtual reality therapy as a treatment for aerophobia.^[4]^[5] Panic often develops rapidly through processes which the person has no awareness of. Thus, techniques based on conscious intervention may not connect with - nor equal the speed of - unconscious processes involved in causing panic. The need to control panic when flying led to the development of an intervention based on Object relations theory which is intended to operate unconsciously, establishes a sequence in unconscious procedural memory through repeated viewing of video which links potentially threatening flight situations to feelings associated with empathic interactions.

Often even intense fears can be alleviated through the use of imagery in just a few hours, without needing to give therapy "in vivo" - (on the plane itself). ^[6]

[edit] Medication

Fear of flying may be treated by the use of psychoactive medications. For individuals experiencing anxiety due to a phobia, the standard psychiatric prescription might be any of a number of different psychoactive medications such as benzodiazepines or other relaxant/depressant drugs. Psychiatrists are sometimes reluctant to prescribe any medication for the treatment of fear of flying due to the need for patients to medicate irregularly.

Some individuals with fear of flying may self-medicate with other psychoactive substances—particularly alcohol, which is served in many commercial airline cabins—in order to deal with their anxiety. Most mental health professionals would advise against consuming alcohol as a medication both due to the strong risk of dependency (alcoholism) and due to the particular physiological effects on the body of air travel. In a pressurized cabin, the lower-than-normal oxygen content of the air will cause an alcoholic beverage to have a significantly enhanced effect on the body--resulting in a perhaps surprising level and rapidity of intoxication from only one or two drinks. On the other hand, some professionals believe that if an individual is capable of controlling his or her drinking—i.e. is not an alcoholic—and consumes only a small amount at a time, that an alcoholic beverage before or during a flight may be beneficial as a short-term treatment of mild fear of flying.^{[citation needed]} Most would still advise a more long-term strategy of therapy.