February 3, 2023 • 17 mins
It’s an all-too-common phobia, but if fear of flying is keeping you from traveling by air, Dr. Saltz has easy, practical tips that can allow you to relax and enjoy the ride.
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Episode Transcript
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Speaker 1 (00:05):
Bees are challenging times, but you don't have to navigate
them alone. Welcome to how can I Help? I'm Dr
Gale Salts. I'm a clinical Associate Professor of Psychiatry at
the New York Presbyterian Hospital, a psychoanalyst, and best selling author,
and I'm here every week to answer your most pressing questions,
(00:26):
hopefully with understanding, insight, and advice. Fear of flying, also
known as aviophobia or aviotphobia, is a common phobia that
can cause severe anxiety and discomfort for people who have
to fly. It is often characterized by feelings of panic, anxiety,
(00:50):
and fear when faced with the prospect of flying or
being in an airplane. Today, I'm answering a listener's question
about her fears of flying. There are many potential causes
of fear of flying, including a lack of understanding about
how planes work, a fear of heights or confined spaces,
(01:16):
or a past traumatic experience related to flying. Some people
may also be more prone to anxiety in general, which
can make them more susceptible to developing a fear of flying.
People who have a fear of flying can be fearful
of one of or an entire range of elements of flight.
(01:42):
It may only be taking off, or it may be
only landing. It could be just turbulence or only if
there's a thunderstorm. It could be sitting in a plane
in general, or just being in the air. There is
no specific cause of avia phobia, as the fear usually
(02:04):
originates from a combination of factors. The fear of heights
can actually be genetically inherited. The fear of flying might
be modeled to kids from their parents. Increased exposure to
media that show plane crashes or other incidents can also
(02:25):
play a role. Most commonly, people fear of flying because
they feel that they have no control over the situation
and therefore over their safety. The longer person avoids flying
due to their fear, the more the fear tends to increase. Sometimes,
(02:49):
the sphere is also associated with other phobias, such as
a fear of vomiting in metaphobia, a fear of heights
acrophy phobia, or the fear of enclosed spaces claustrophobia. Sometimes
working on these specific phobias themselves can help resolve overall
(03:13):
the fear of flying. This phobia can affect people of
any age, gender, or cultural background. However, research suggests that
certain factors may make some people more prone to developing
a fear of flying. These include a history of anxiety
(03:34):
or another mental health condition. People with this history may
be more likely developed a fear of flying. A history
of trauma. If you've experienced a traumatic event like a
car accident or a natural disaster, you are more likely
to develop a fear of flying. A lack of exposure
(03:58):
to flying. If you have very limited experience, you may
be more prone to developing a fear of it, particularly
if you've never flown before or have only flown on
a very rare occasion. Symptoms of fear of flying can
vary from person to person, but they tend to include
(04:18):
physical symptoms like rapid heartbeat, sweating, trembling, dizziness, nausea, difficulty breathing,
and chest pain. Emotional symptoms anxiety, panic, worry, avoidance behaviors,
difficulty concentrating, and feelings of helplessness or loss of control.
(04:43):
Also behavioral symptoms refusing to fly, canceling plans to fly
at the last minute, avoiding discussing or thinking about flying
with anybody, and seeking reassurance from others like am I safe?
Is is okay? Is this right? These symptoms, all of them,
(05:04):
can occur before or during a flight, and they can
actually even occur when you're thinking about flying. It is
difficult to determine exactly how common a fear of flying is,
as many people who have this phobia do not seek
treatment or disclose their fear to other people, but it
is believed to be a relatively common phobia, with estimates
(05:28):
suggesting that as many as of people may experience some
level of anxiety or fear related to flying. People also
handle their fear of flying in different ways, many of
them not healthy or that actually make their phobia worse,
(05:49):
such as avoiding flying, using sleeping pills to knock themselves
out on a flight, over drinking alcohol. None of these
treat the issue or help them to be better for
another flight, and actually they may serve to increase their
anxiety for the next flight, because avoidance of your fearful
(06:11):
thoughts actually increases the fearful thoughts in the long run.
Because the media has a tendency to cover bad news
much more frequently than any other news, and tends to
really hype up and focus in on a plane crash
of any kind, anywhere. Many people with fears already overestimate
(06:34):
the risks of flying. It's safer to fly somewhere than
to drive somewhere. Looking at flight statistics from two thousand
and twelve to two thousand and sixteen, there was a
one in three point three billion chants of dying in
a commercial airline plane crash. N eight point six percent
(06:58):
of crashes did not resolve in a fatality, and of
the hundred forty plane accidents during that time, only two
involved any fatality. That was one point four percent. Commercial
plane incidents caused death only once in twenty million flights,
(07:20):
and between two thousand and eight and two thousand and
seventeen it was one death per seven point nine million
people boarding a flight. These statistics make it clear flying
is not dangerous, but a phobia of flying is your
brain and nervous system telling you that it is, which
(07:43):
is typical for any phobia, or for that matter, any
anxiety disorder. So with that, be back in a minute
with my listeners question on their fear of flying. Welcome
(08:05):
back back with my listener's question, Dear Doctor Saults. Over
the holidays, I flew home to see my family as
much as I looked forward to being with them. I
had so much anxiety about flying. I was not always
like this. I used to fly and enjoy it. But
(08:26):
over the last few years I have noticed that I
feel a little nervous on flights, and actually if the
weather is bad, I feel very nervous. And of course
I can't control the weather, so I'm constantly worried about
the weather is going to go downhill, and then feeling
panicked about it. For two days before my flight home,
(08:49):
I found myself worrying about flying and thinking about whether
there might be another way to go home. This seems
like a real problem now, and I'm not happy about it.
Is there anything I can do? Yes, there is. Fear
of flying is not uncommon, but getting help with it
(09:10):
often is, and leading it untreated means it's likely to
grow worse, as it has in your case. The key
to improving a phobia is actually exposure to the thing
you fear, but with methods of relaxing such that you
are not flooded by fear. Identify your particular trigger to
(09:33):
the fear. Is it beforehand, is it boarding, taking off, storms, landing?
For the part that is your trigger, you'd ideally like
to develop some combination of distractions like reading, watching a movie,
playing a video game, so that you are mentally less
(09:54):
focused on the trigger. Then you'd like to have several
techniqu to relax yourself through the trigger time. That can
be something like paste, deep breathing, progressive muscle relaxation, or
even practicing meditation. The point is not to push away
(10:16):
your scary thought, but to simply acknowledge that, yes, you
have the thought. Let it be, don't argue with it,
don't engage with it, and do something that relaxes your
body at the same time while you let the thought
just sit there. Due to the mind body connection, when
(10:38):
you relax your body, you are also relaxing your mind.
This could help you reverse course in terms of how
anxious you feel during and then before flying. However, if
this doesn't work well enough, then you might consider getting treatment.
(11:01):
The main type of therapy for a fear of flying
is called exposure and response prevention. It is a form
of cognitive behavioral therapy and it will be aimed at
simulating a flying experience while at the same time the
therapist helps you to tolerate and relax to the anxious thoughts.
(11:23):
The more you do this, the more desensitized to the
thoughts you become, and over time the thoughts decrease substantially.
A fear of flying can often be treated in as
few as eight to ten sessions, even better as treatment
(11:44):
using virtual reality exposure. Here you wear a headset designed
to visually simulate being on a flight, and the therapist
is able to speak to you at the same time
and work with you through the simulated flight. The earlier
(12:05):
you tackle this problem, the more likely treatment will reverse
it in a relatively short amount of time. So I
really hope that you attend to this as soon as possible.
I hope that was helpful. If you have a fear
of flying, there are several steps you can take to
manage your anxiety and make the experience of flying more comfortable.
(12:29):
These include educating yourself about how plans work. Understanding the
physics and mechanics of flying can help reduce anxiety by
showing you that plans are designed to be safe and reliable.
They are designed to tolerate bad weather, they are designed
(12:50):
to tolerate turbulence. Once you understand that from a physics
and intellectual point of view, it can help reduce your anxiety.
Talking to a therapist or joining a support group can
be helpful in also managing your anxiety and finding various
coping strategies. Then gradually exposing yourself to flying. Start by
(13:13):
taking short flights and gradually increasing the length of your trips,
which can help you build up your tolerance and confidence
to manage your anxiety. Techniques like deep breathing, meditation, and
progressive muscle relaxation can help reduce anxiety and panic symptoms,
(13:34):
and actually you can seek help from an airline. Many
airlines offer support for travelers with a fear of flying,
including pre flight briefings and in flight assistance. Cognitive behavioral
therapy is one of the most common therapeutic approaches for
fear of flying. In it, you learn to reframe your
(13:56):
thoughts and challenge the beliefs that you have ab out
your fears and exposure and response prevention a CBT technique
is useful because it involves exposing you to the feared situation,
then training you to cope with those feelings in a
healthier way. Use of virtual reality to help accomplish this
(14:21):
with those who have a fear of flying can be
especially effective. The virtual reality will walk you through waiting
at home, having a cab pick you up, driving to
the airport, waiting at the gate, walking into the plane,
and being on the plane itself. These all look so
(14:42):
very real while wearing the headset. Some practices can even
try to personalize your virtual reality experience by capturing and
using footage from the particular airport that you fly out of.
When using exposure response prevention with virtual reality, a therapist
might ask you to recreate the physical feeling of being
(15:04):
anxious by doing jumping jacks to increase your heart rate,
or by hyperventilating so you're breathing abnormally, and then they
will equip you with techniques like deep breathing to learn
how to calm those physiological signals that your body is
experiencing that are contributing to your anxiety. The goal overall
(15:27):
is actually to get used to your anxiety, not get
rid of it. We keep ourselves anxious by interpreting our
physiological symptoms like high heart rate or shortness of breath
as dangerous. But your body can learn that something is scary,
but it can also unlearn that something is scary. If
(15:52):
your flight anxiety is really affecting your life, it's important
to get a psychological assessment, because that is the way
to work towards overcoming that fear. You can even just
google fear of flying therapy near me, or look through
resources of people who treat fear of flying, for example
(16:13):
on Psychology Today. Anyone who specializes in anxiety, phobias and
panic attacks probably treats fear of flying, and the right
therapist can help you work on your coping skills through
CBT and help you identify if something you're not aware
of is contributing to your fear of flying, and explain
(16:35):
if you might need anti anxiety medication when you fly.
It's important to remember that a fear of flying is
a common and treatable phobia, and with the right tools
and support, you can learn to manage your anxiety and
enjoy flying. Do you have a problem I can help with?
(16:57):
If so, email me at how can I help? At
Seneca Women dot com. All centers remain anonymous and listen
every Friday too. How can I help with me? Doctor
Gale's salts
Bees are challenging times, but you don't have to navigate
them alone. Welcome to how can I Help? I'm Dr
Gale Salts. I'm a clinical Associate Professor of Psychiatry at
the New York Presbyterian Hospital, a psychoanalyst, and best selling author,
and I'm here every week to answer your most pressing questions,
(00:26):
hopefully with understanding, insight, and advice. Fear of flying, also
known as aviophobia or aviotphobia, is a common phobia that
can cause severe anxiety and discomfort for people who have
to fly. It is often characterized by feelings of panic, anxiety,
(00:50):
and fear when faced with the prospect of flying or
being in an airplane. Today, I'm answering a listener's question
about her fears of flying. There are many potential causes
of fear of flying, including a lack of understanding about
how planes work, a fear of heights or confined spaces,
(01:16):
or a past traumatic experience related to flying. Some people
may also be more prone to anxiety in general, which
can make them more susceptible to developing a fear of flying.
People who have a fear of flying can be fearful
of one of or an entire range of elements of flight.
(01:42):
It may only be taking off, or it may be
only landing. It could be just turbulence or only if
there's a thunderstorm. It could be sitting in a plane
in general, or just being in the air. There is
no specific cause of avia phobia, as the fear usually
(02:04):
originates from a combination of factors. The fear of heights
can actually be genetically inherited. The fear of flying might
be modeled to kids from their parents. Increased exposure to
media that show plane crashes or other incidents can also
(02:25):
play a role. Most commonly, people fear of flying because
they feel that they have no control over the situation
and therefore over their safety. The longer person avoids flying
due to their fear, the more the fear tends to increase. Sometimes,
(02:49):
the sphere is also associated with other phobias, such as
a fear of vomiting in metaphobia, a fear of heights
acrophy phobia, or the fear of enclosed spaces claustrophobia. Sometimes
working on these specific phobias themselves can help resolve overall
(03:13):
the fear of flying. This phobia can affect people of
any age, gender, or cultural background. However, research suggests that
certain factors may make some people more prone to developing
a fear of flying. These include a history of anxiety
(03:34):
or another mental health condition. People with this history may
be more likely developed a fear of flying. A history
of trauma. If you've experienced a traumatic event like a
car accident or a natural disaster, you are more likely
to develop a fear of flying. A lack of exposure
(03:58):
to flying. If you have very limited experience, you may
be more prone to developing a fear of it, particularly
if you've never flown before or have only flown on
a very rare occasion. Symptoms of fear of flying can
vary from person to person, but they tend to include
(04:18):
physical symptoms like rapid heartbeat, sweating, trembling, dizziness, nausea, difficulty breathing,
and chest pain. Emotional symptoms anxiety, panic, worry, avoidance behaviors,
difficulty concentrating, and feelings of helplessness or loss of control.
(04:43):
Also behavioral symptoms refusing to fly, canceling plans to fly
at the last minute, avoiding discussing or thinking about flying
with anybody, and seeking reassurance from others like am I safe?
Is is okay? Is this right? These symptoms, all of them,
(05:04):
can occur before or during a flight, and they can
actually even occur when you're thinking about flying. It is
difficult to determine exactly how common a fear of flying is,
as many people who have this phobia do not seek
treatment or disclose their fear to other people, but it
is believed to be a relatively common phobia, with estimates
(05:28):
suggesting that as many as of people may experience some
level of anxiety or fear related to flying. People also
handle their fear of flying in different ways, many of
them not healthy or that actually make their phobia worse,
(05:49):
such as avoiding flying, using sleeping pills to knock themselves
out on a flight, over drinking alcohol. None of these
treat the issue or help them to be better for
another flight, and actually they may serve to increase their
anxiety for the next flight, because avoidance of your fearful
(06:11):
thoughts actually increases the fearful thoughts in the long run.
Because the media has a tendency to cover bad news
much more frequently than any other news, and tends to
really hype up and focus in on a plane crash
of any kind, anywhere. Many people with fears already overestimate
(06:34):
the risks of flying. It's safer to fly somewhere than
to drive somewhere. Looking at flight statistics from two thousand
and twelve to two thousand and sixteen, there was a
one in three point three billion chants of dying in
a commercial airline plane crash. N eight point six percent
(06:58):
of crashes did not resolve in a fatality, and of
the hundred forty plane accidents during that time, only two
involved any fatality. That was one point four percent. Commercial
plane incidents caused death only once in twenty million flights,
(07:20):
and between two thousand and eight and two thousand and
seventeen it was one death per seven point nine million
people boarding a flight. These statistics make it clear flying
is not dangerous, but a phobia of flying is your
brain and nervous system telling you that it is, which
(07:43):
is typical for any phobia, or for that matter, any
anxiety disorder. So with that, be back in a minute
with my listeners question on their fear of flying. Welcome
(08:05):
back back with my listener's question, Dear Doctor Saults. Over
the holidays, I flew home to see my family as
much as I looked forward to being with them. I
had so much anxiety about flying. I was not always
like this. I used to fly and enjoy it. But
(08:26):
over the last few years I have noticed that I
feel a little nervous on flights, and actually if the
weather is bad, I feel very nervous. And of course
I can't control the weather, so I'm constantly worried about
the weather is going to go downhill, and then feeling
panicked about it. For two days before my flight home,
(08:49):
I found myself worrying about flying and thinking about whether
there might be another way to go home. This seems
like a real problem now, and I'm not happy about it.
Is there anything I can do? Yes, there is. Fear
of flying is not uncommon, but getting help with it
(09:10):
often is, and leading it untreated means it's likely to
grow worse, as it has in your case. The key
to improving a phobia is actually exposure to the thing
you fear, but with methods of relaxing such that you
are not flooded by fear. Identify your particular trigger to
(09:33):
the fear. Is it beforehand, is it boarding, taking off, storms, landing?
For the part that is your trigger, you'd ideally like
to develop some combination of distractions like reading, watching a movie,
playing a video game, so that you are mentally less
(09:54):
focused on the trigger. Then you'd like to have several
techniqu to relax yourself through the trigger time. That can
be something like paste, deep breathing, progressive muscle relaxation, or
even practicing meditation. The point is not to push away
(10:16):
your scary thought, but to simply acknowledge that, yes, you
have the thought. Let it be, don't argue with it,
don't engage with it, and do something that relaxes your
body at the same time while you let the thought
just sit there. Due to the mind body connection, when
(10:38):
you relax your body, you are also relaxing your mind.
This could help you reverse course in terms of how
anxious you feel during and then before flying. However, if
this doesn't work well enough, then you might consider getting treatment.
(11:01):
The main type of therapy for a fear of flying
is called exposure and response prevention. It is a form
of cognitive behavioral therapy and it will be aimed at
simulating a flying experience while at the same time the
therapist helps you to tolerate and relax to the anxious thoughts.
(11:23):
The more you do this, the more desensitized to the
thoughts you become, and over time the thoughts decrease substantially.
A fear of flying can often be treated in as
few as eight to ten sessions, even better as treatment
(11:44):
using virtual reality exposure. Here you wear a headset designed
to visually simulate being on a flight, and the therapist
is able to speak to you at the same time
and work with you through the simulated flight. The earlier
(12:05):
you tackle this problem, the more likely treatment will reverse
it in a relatively short amount of time. So I
really hope that you attend to this as soon as possible.
I hope that was helpful. If you have a fear
of flying, there are several steps you can take to
manage your anxiety and make the experience of flying more comfortable.
(12:29):
These include educating yourself about how plans work. Understanding the
physics and mechanics of flying can help reduce anxiety by
showing you that plans are designed to be safe and reliable.
They are designed to tolerate bad weather, they are designed
(12:50):
to tolerate turbulence. Once you understand that from a physics
and intellectual point of view, it can help reduce your anxiety.
Talking to a therapist or joining a support group can
be helpful in also managing your anxiety and finding various
coping strategies. Then gradually exposing yourself to flying. Start by
(13:13):
taking short flights and gradually increasing the length of your trips,
which can help you build up your tolerance and confidence
to manage your anxiety. Techniques like deep breathing, meditation, and
progressive muscle relaxation can help reduce anxiety and panic symptoms,
(13:34):
and actually you can seek help from an airline. Many
airlines offer support for travelers with a fear of flying,
including pre flight briefings and in flight assistance. Cognitive behavioral
therapy is one of the most common therapeutic approaches for
fear of flying. In it, you learn to reframe your
(13:56):
thoughts and challenge the beliefs that you have ab out
your fears and exposure and response prevention a CBT technique
is useful because it involves exposing you to the feared situation,
then training you to cope with those feelings in a
healthier way. Use of virtual reality to help accomplish this
(14:21):
with those who have a fear of flying can be
especially effective. The virtual reality will walk you through waiting
at home, having a cab pick you up, driving to
the airport, waiting at the gate, walking into the plane,
and being on the plane itself. These all look so
(14:42):
very real while wearing the headset. Some practices can even
try to personalize your virtual reality experience by capturing and
using footage from the particular airport that you fly out of.
When using exposure response prevention with virtual reality, a therapist
might ask you to recreate the physical feeling of being
(15:04):
anxious by doing jumping jacks to increase your heart rate,
or by hyperventilating so you're breathing abnormally, and then they
will equip you with techniques like deep breathing to learn
how to calm those physiological signals that your body is
experiencing that are contributing to your anxiety. The goal overall
(15:27):
is actually to get used to your anxiety, not get
rid of it. We keep ourselves anxious by interpreting our
physiological symptoms like high heart rate or shortness of breath
as dangerous. But your body can learn that something is scary,
but it can also unlearn that something is scary. If
(15:52):
your flight anxiety is really affecting your life, it's important
to get a psychological assessment, because that is the way
to work towards overcoming that fear. You can even just
google fear of flying therapy near me, or look through
resources of people who treat fear of flying, for example
(16:13):
on Psychology Today. Anyone who specializes in anxiety, phobias and
panic attacks probably treats fear of flying, and the right
therapist can help you work on your coping skills through
CBT and help you identify if something you're not aware
of is contributing to your fear of flying, and explain
(16:35):
if you might need anti anxiety medication when you fly.
It's important to remember that a fear of flying is
a common and treatable phobia, and with the right tools
and support, you can learn to manage your anxiety and
enjoy flying. Do you have a problem I can help with?
(16:57):
If so, email me at how can I help? At
Seneca Women dot com. All centers remain anonymous and listen
every Friday too. How can I help with me? Doctor
Gale's salts
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