This fear of flying treatment example is typical of many people who come to therapy – a sudden onset in adulthood, no apparent precipitant, intense anxiety that does not happen with anything else, and a person knowing that their thoughts are at least somewhat irrational but not making a difference. Therapy for fear of flying can be very helpful and effective.
Sue is a young woman who entered therapy for fear of flying after becoming very fearful of flying soon after her first child was born. She is quite worried because her job requires travel every once in a while, and she has family in other parts of the country whom she enjoys seeing. She has no idea why this fear developed, but it has become severe, with significant anticipatory anxiety. Her symptoms include intense anxiety, mild panic, rumination, and pervasive worry.
Fear of Flying Treatment Initial Steps
There are two initial steps of a fear of flying treatment course:
Fear of Flying Treatment Step One: Gathering History
We start our fear of flying treatment by gathering Sue’s history. She tells me when the symptoms started and what was happening in her life. We discuss how the fears have evolved, including the thoughts that accompany them, the evolution of her anticipatory anxiety, and what she has done in response to the fear. Understanding the origins of the fear can be helpful as treatment moves along, however it can be elusive and understanding it is often not imperative.
Fear of Flying Treatment Step Two: Setting Goals
We continue our fear of flying treatment by setting our goals. We break the fear of flying into its component chronological parts: anticipatory anxiety, feelings that day, and sensations and thoughts aboard the aircraft. Our overarching goal is to reduce the anxiety enough not to cause undue stress, anxiety, and distraction. Our treatment method will be Cognitive-Behavioral Therapy (CBT), a widely used and effective treatment for many phobias, including fear of flying. Goals at this stage may include reducing (for example, on a scale of 1-10) the anticipatory anxiety and during flight anxiety, not hesitating to travel, and learning new coping strategies.
We aim to identify and challenge negative thoughts and beliefs related to flying and replace them with more realistic and positive ones. We will investigate what her particular worries are. For example, she lists worries that turbulence could bring the plane down and that something unexpected will happen like she’s read about happening to other aircraft.
Fear of Flying Treatment Course
It’s time to dive in and begin since Sue has set a goal of being able to fly to an important conference that is occurring in 6 weeks, so we start with three initial fear of flying treatment strategies:
Challenging Irrational Thoughts
We look at each automatic and irrational thought she has about flying so we can later challenge them individually. We talk about why her anxiety exists in the first place (in her case, because she has a greater sense of responsibility now that she is a mom and because she is much more aware of her mortality than she was when she was younger). Then we take measurements, such as how much time she dreads flying daily. These measurements will help Sue see how she is progressing in therapy for fear of flying in a measurable and therefore motivating way.
Cognitive Restructuring
The second step is using the information captured in step one to begin cognitive restructuring. She will learn to challenge her irrational and exaggerated thoughts by using flight safety data, reminding herself of the real reason she is scared, and finding ways to practice distraction. Our goal at first is not to eliminate the anxiety but to show measurable progress in reducing the time she is anxious each day.
Fear of Flying Treatment Through Gradual Exposure
We begin to expose her to flying-related stimuli, starting with less anxiety-provoking situations (such as watching videos of airplanes safely taking off and landing, using virtual reality to simulate flights, and even having her go to the airport to watch flights taking off and landing safely). She also goes to websites where she can see a diagram of all the planes safely in the air.
Conquering the Fear
The next step is actually flying. I do not push this step until Sue feels ready, but it becomes quite essential when she does. Since she does not have actual travel planned, she volunteers to take a short trip from Boston to New York for her work to go to a convention. This is ideal because the flight is short, and others from her work are going, which will provide distraction. She can also get support from a close friend who she will sit next to.
These three steps may be mixed and matched as treatment progresses, as we may return to steps one and two after she progresses in steps three and four.
Fear of Flying Treatment Adjunctive Steps
As an additional step for her fear of flying treatment, Sue joins an online support group to interact with others who share similar fears. This can provide a sense of understanding, validation, and encouragement. Sharing experiences, coping strategies, and success stories can help alleviate anxiety and build confidence. She also learned various self-help techniques to complement our formal treatment to build a toolkit she could use before and during the flight. These include deep breathing exercises, progressive muscle relaxation, easy visualization, and the practice of mindfulness meditation.
The Results and Other Possibilities
In the end, Sue’s anxiety did not completely disappear. We expected this from the beginning because taking actual flights and experiencing the relief and validation of landing safely each time is usually needed to overcome the fear entirely. Most people find that fear of flying goes away in steps, where the person realizes that the flight they are taking next is not causing as much anxiety as the last flight did. Sue will likely be no exception. She did get enough relief to make sure she did not miss a family event and a work conference, and she called after these two flights to say that getting on those airplanes accelerated her reduction in fear.
While this client decided that she could address her fear of flying without medication, she could have gone to her doctor for advice and information since medication, in some cases, can help manage anxiety symptoms associated with flight. Anti-anxiety medications, personal or short-acting sedatives, can help reduce anxiety and promote relaxation during flight decisions that should always be made with the advice and guidance of an MD.
This client also wanted to work on her difficulty in her individual fear of flying treatment, even though some think group treatment can be powerful. I have some trusted groups I refer to for those who I think would do better in group treatment. This type of treatment can also adjunct individual flying anxiety treatment.
Therapy for Fear of Flying Conclusions
Flying anxiety, also known as aviophobia, can be a challenging and distressing issue for many people, such as our fictitious client described above. Therapy for fear of flying can be a helpful and effective way to address and overcome this fear. The approaches listed above are often beneficial. In addition, therapy for fear of flying might also include:
Virtual Reality Therapy for Fear of Flying
I sometimes use virtual reality technology to simulate experiences in a controlled environment. This allows cluents to gradually face their fear and become more comfortable with the idea of flying. VR therapy does require additional technology, but it can be quite effective. VR therapy for fear of flying works particularly well when a client needs a little more help with gradual exposure before actually going on a plane.
Hypnosis as a Therapy for Fear of Flying
Hypnotherapy involves guided relaxation and focused attention to help individuals access their subconscious mind. Therapists may use suggestions to reframe negative beliefs and associations related to flying. I do not provide hypnosis as a therapy for fear of flying, but I can refer you to someone who does. In fact, this is one case where two therapists can work well, with one providing hypnotherapy and me providing the CBT structure around that approach.
It’s important to note that the effectiveness of therapy can vary from person to person, and a combination of approaches that may or may not be similar to the above may be best for you. My experience in treating phobias and anxiety disorders helps me develop a personalized treatment plan tailored to your specific needs.
My Fear of Flying Treatment Services
Please note that this and all examples on my website involve fictitious people – they describe a general treatment course, and your flying anxiety treatment may differ depending on your unique needs, circumstances, and etiology of symptoms. The steps outlined above are generally what we do in therapy for fear of flying, but we take each step at the pace with which you are comfortable. In some cases, there is a specific goal – an upcoming flight that cannot be avoided, for example – and we will discuss how to proceed to meet that goal.
Therapy for fear of flying can be interwoven with other approaches and specialties or stand-alone. It is not uncommon for executive coaching or college admissions consulting to include this form of treatment because these people often have to do some traveling.
I hope this helps give an example of what fear of flying treatment would be like. Of course, feel free to contact me to review your situation and how I might help.
