Dallas Counseling & Psychotherapy

STEVE B. REED, LPC, LMSW, LMFT

Fear of Flying

CONQUERING FEAR OF FLYING
By Ronald Ruden, MD, PhD

If you are afraid to fly, you may be suffering form a specific phobia known as aviaphobia.

A phobia is defined as a marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation.  In your case the situation occurs when you are on an airplane. Thought, like one of the five senses, can also activate the fear response just by bringing the situation to mind, hence anticipation of being on a plane or flying can produce fear.

This brief introduction to conquering the fear of flying will not provide statistics about safety, not explain the funny sounds you hear when you are flying and not get you familiar with the aircraft at all.  That would be a waste of time.  Fear does not lend itself well to amelioration by rational calculation.  What we will do today is to understand how the problem was encoded in your brain and how we can get rid of it.

In many programs designed to change behavior, motivation, the desire to get rid of something or improve something is critical. Motivation plays little role here.  Little hard work or effort is required and we have a 96% success rate.  Does this sound too good to be true?  Let me explain.

What is fear?  Fear is a survival response.  It makes us ready to fight or run for our lives.  It tenses our muscles, makes us breathe harder and can make us aware of our heart.  It makes us sweat.  It is very uncomfortable.  Being scared decreases one’s ability to evaluate a situation.  We get racing thoughts, obsessive thoughts that say ‘get away’.  Indeed this biological orchestration is meant to improve our chances of survival literally causing us to feel our life is at stake.  It works great if survival is at stake.  Sitting in business class, cruising at 35,000 feet with a drink in one’s hand hardly qualifies.  Yet one can become terrified.  In medical terms it’s called a panic attack and you may think you are going to die.  It is very uncomfortable and it is difficult to explain it to someone who has not experienced it. You can try to explain to yourself that the plane is safe, there is no danger, but your body tells you differently.  Your body always wins.  You are afraid.

How does this fear response get generated and in the case of flying, why can’t we shut it off by ourselves?  Here is an example, you are walking in the woods and something moves by your feet. You jump, startled, you are frightened for a moment and you look down and it’s just a twig. Your fear goes away.  That’s how the fear system should work, but in a phobia the system does not shut off.  To understand this we must introduce a little biology.

Since fear is a response to a survival need, rapid action is required.   Sometimes, like the example I just gave, we respond then think.   This is an important few seconds for if it were a poisonous snake instead if a twig we might have saved our life by jumping out of the way. Here’s how it works.

Sensory input is first sent to an area called the thalamus.  This is the first stop before information is sent to our thinking and evaluation part of the brain called the cortex.  When we experience what we call an Unconditioned Fear Stimulus (UFS), the thalamus branches part of this signal directly to an area that is involved in producing the fear response.  This area is called the amygdala and it was designed to protect us.  

SENSORY INPUTà   THALAMUSà AMYGDALA

                 (UFS)

For survival, no thought is needed, only avoidance is required. It makes us jump, duck and produces that funny feeling in our gut.

AMYGDALA STIMULATIONà FEAR RESPONSE

                  (UFS)

The signal also goes from the thalamus to the cortex where we figure out what’s going on.  This take a few seconds longer and the cortex sends a signal that can either inhibit the amygdala from continuing the fear response or sustain it.

SENSORY INPUTàTHALAMUSà CORTEXà +/-  AMYGDALA

                  (UFS)

In order to maximize survival, the system needed to identify threats the first time.  Sometimes you don’t get a second chance.  It needed to have hard wired patterns that shouted danger, no training required.  Well, there are fear stimuli that evoke a need for action and vigilance in all animals.  These are called Unconditioned Fear Stimuli and they include:

UNCONDITIONED FEAR STIMULI (UFS)

• A closed space
• An open space
• Loud noises
• Low-pitched sounds (think Jaws)
• Heights
• Creepy crawly slithery things
• Things out of left field

When evaluation of these signals proves not to be of any danger, the cortex sends an inhibitory signal to the amygdala and the fear response is stopped.  This is a very clever and simple solution.

UFS in the Amygdala               à                  / NO FEAR

(unconditioned fear stimulus)             BLOCKED BY THE CORTEX                                                  

The system alerts us, and if danger is not present, calms us.  But what happens in a phobia?  Why does a seemingly benign situation turn frightening?  Let’s look at flying specifically.

If there were never a plane crash or near miss or other mental image of this big bird falling out of the sky you would think that we would not have fear of flying.  But we are in an aluminum tube 35,000 feet above the ground traveling at 500mph with no way of getting off until the plane lands.  There are plenty of other reasons to be afraid to fly.

So how is a phobia encoded?           

UFS (e.g. Closed Space) à FEAR à PLANEà MEMORY

ENCODING A PHOBIA

You are on a plane and the doors to the plane close.  You hear a strange noise or turbulence makes you feel that you will crash and die. You look out the window.  You become afraid.  Interestingly, you may or may not be aware of why you are frightened.  Now your mind associates the fear generated with being on the plane.  You now fear being on the plane.   This association is true for any anxiety state you experience on the plane be it during take off, in flight or landing.

There is one big problem, you cannot avoid being on the plane, so the fear continues, there is no escape.  The association becomes stronger by the minute.  Now every time you bring the thought of being on the plane you have been conditioned to have a fear response.  Schematically we can look at the plane as a conditioned stimulus (CS).  In the replay, sitting at home in your chair, thinking about the plane produces a fear.   You have been conditioned.

THOUGHT OF PLANE (CS) àUFS (e.g. closed space) àFEAR

(AMYGDALA)

EXTINGUISHING A PHOBIA

So how does one cure a phobia?  There are several ways that have been typically utilized. They include:

• Exposure Therapy
• Cognitive Therapy
• Systematic Desensitization

However, I believe the best way to do this is to de-link the Conditioned Stimulus from the Unconditioned Fear Stimulus.  Is this possible?  The answer is yes!  We want to de-link the thought of being on the plane from whatever Unconditioned Fear Stimulus it hooked up with.  These ideas have been developed by two groups Joseph LeDoux’s group in NY and Roger Callahan in California.  In essence these researchers and therapists have found that when a thought can activates a fear response it had to be re-stored so that it could fire again.  Under normal circumstances this occurs.  As mentioned earlier, thought can be just like a sixth sense.  It can activate a fear response.  Now if I think about being on a plane and can activate a fear we can, by using certain sensory inputs prevent the link between being on the plane and the fear from being re-stored and the fear of flying is cured.  What Roger Callahan found was that by tapping on certain acupuncture points, this connection could be prevented from being re-stored.  This work was later confirmed by LeDoux.

This will seem quite remarkable to you and some will not believe it at first.  How can something so embedded as a phobia be removed so readily.  (For those interested in the biology of the process see Why Acupressure-Enhanced Psychotherapy Works from a Western Scientific Perspective.)

In the hundreds of individuals I have treated, not just for fear of flying, but all phobias and trauma’s this has been the most remarkable therapy. It has led me to an understanding of a broader group of treatment modalities that I call Psycho-Sensory Therapy.  They include the application of non-specific sensory input, such as: light therapy for SAD, massage, yoga, acupuncture, acupressure and the like.  In my view Psycho-Sensory Therapy will ultimately constitute a third pillar, along with the psychotherapies and pharmacotherapies in the treatment of disorders arising from the mind/brain/body connection.

The forms of Psycho-Sensory Therapy practiced by Steve B. Reed, LPC, LMSW, LMFT include: the REMAP process, EFT (Emotional Freedom Techniques), and TFT (Thought Field Therapy).

Useful Resources: 

Books:  On EFT, Energy Psychology, TFT, EMDR, TIR 

Videos:  See these listings 

Seminars:

1.      EFT (Emotional Freedom Techniques) Level 1 and 2 (open to the public)

2.      REMAP module 1  (open to the public)

3.      Professional Training in the REMAP process

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