Life Outside The Net

How to Fly Without Getting Drunk

Welcome back, cybersurfers! Last time I presented some general information on phobias. Now I intend to ramble on about a very common phobia, fear of flying, and how it can be easily treated.

Fear of flying is probably the second most common fear/phobia after fear of public speaking (aka stage fright). But, it is easily treated in just a few sessions with a qualified therapist using a procedure known as systematic desensitization. This procedure pairs relaxation training with an increasing hierarchy of mental imagery involving the fear stimulus, until the person can "see" themselves actually facing whatever the phobic behavior is while fully relaxed. If the person is relaxed, he/she cannot experience a phobic reaction. The idea is that fear-->anxiety-->muscle tension, and if the muscles are relaxed one cannot experience uncontrollable anxiety/fear. Sometimes EMG (electromyograph) biofeedback training is combined with the relaxation training.

Fear is not logical, but then, we're humans, not logical Vulcans. Using logic, that flying is much safer than being in a car, rarely helps by itself. Fear of flying sometimes relates to a feeling of loss of control, of helplessness; you sit there passively while someone else flies the plane. Some people even experience some of this in a car, when someone else is driving; they don't like to give up control. But going through the systematic desensitization procedure restores a sense of control to the person; they now have control over their anxiety and fear, even if the pilot won't let them in the cockpit to fly the plane.

There are, of course, anti-anxiety medications that can help as well, generally ones in the benzodiazepam class, e.g. xanax, valium, librium, etc. Some people use alcohol to calm them, but usually they have to get at least "two sheets to the wind" to be able to get on the plane. I don't recommend alcohol as the "cure" but do believe that medication can be an effective adjunct to the therapy. Since helplessness may be involved, I believe it better helps to train a person to have control over their own anxiety rather than rely on alcohol or drugs to artificially do this for them. However, I have seen cases where having a pill, prescribed by a physician, is a good back-up to the therapy, and some people have reported feeling safer just knowing that the pill is there.

Systematic desensitization has been used to successfully treat thousands of people to where they could fly with only a minimum of anxiety. Often, as the therapist does relaxation training with a client in the office, he/she will make a cassette tape of the training for the client to play on the plane; people frequently report that just the sound of their therapist's voice had a calming effect. It's not the therapist's voice that is calming per se, but rather that they felt that it was like having the therapist along on the plane with them, to calm them.

An alternative to systematic desensitization is a procedure known as flooding or implosion. This is almost the opposite of systematic desensitization, where the client is faced with the strongest dose of the anxiety-causing stimulus that they can tolerate, either through imagery or in reality. Implosion is also a short-term therapy that can be highly effective in treating phobias, but it is generally not as popular with clients since it starts out with so much anxiety. So, if you have a fear of snakes, just do like Indiana Jones and jump into a boxcar full of--never mind!

Many "simple" phobias can be treated in only a few sessions using these behavior therapy techniques. There are, however, more complicated phobias that can require much more time in therapy. (Sorry managed care; you can't treat everything in six sessions or less.) One example is what as known as "social phobia"--literally a fear of people and social situations. This type of phobia is generally much more "ingrained" in the person's personality structure, and may also require more traditional forms of psychotherapy to treat. There is also what is known as "generalized anxiety disorder" (GAD), where the client experiences anxiety from multiple sources and causes, or experiences anxiety all the time. People with GAD may have numerous phobias, but the treatment is more complicated than trying to treat each phobia independently.

Another week, another column. Be sure to e-mail your questions about phobias or suggestions for future topics to 74124.2046@compuserve.com. If you have any complaints...well, here's a new phobia I just dreamed up to curse you with. It's called angoraphobia, a fear of angora sweaters.

Cheers! :)

Front Page