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Fear of Flying -- Part 1.
--Frank Gillingham, MD

While most of us find travel at least mildly travel stressful, fearful flyers dread even the most routine flight. Pre-trip anxiety can hinder the fearful flyer's preparation for a trip and anxiety about the return leg of the trip can ruin a vacation or make the fearful flyer less effective during a meeting. Travelers avoid as many as six million flights per year due to fear of flying!

No one knows exactly how many people are afraid of flying but a well-done Boeing Company study published 20 years ago reported that one in three to four adult Americans is either anxious or afraid to fly. Other sources suggest that one in eight Americans purposely avoid commercial air travel because of anxiety.

Fear of flying increases with age, according to R. Reid Wilson, Ph.D., a psychologist in Chapel Hill, North Carolina who specializes in anxiety disorders and founded the American Airlines Fearful Flyers program (, Dr Wilson's website, is a wealth of information and self-help tools). The average age of onset of fearful flying is 27 years. Fearful flyers often report that their anxiety developed after the birth of a child. Others develop fear after a bad experience on a previous flight, a reaction to negative stories about flying, after developing related problems like panic attacks, or as a result of a general increase in stress. If your job is stressful, or if you just don't like it anymore, you may notice more anxiety during business flying.

Fearful flyers often experience a heightened sense of hearing and perk up anxiously at every subtle changes in engine noise or wing shape, sounds that comfortable travelers may not notice. Some fearful flyers begin to believe that their actions affect the outcome of the flight. They follow a superstitious set of behaviors before and during the flight, believing that sitting in a window rather than an aisle, drinking Sprite rather than Coke, or getting up to use the bathroom might lead to an accident. Many fearful flyers self medicate with alcohol or valium-like agents in an effort to control their symptoms.

Two main reasons people fear flying
Fearful flyers generally fall into two groups, according to Dr. Wilson. One group doesn't believe that air travel is safe. The second group has strong emotions and feelings when they fly and they primarily fear their own behavior on the plane. They fear they'll vomit, feel trapped, "freak out," have a panic attack or otherwise embarrass themselves.

Can fearful flying be treated?
Unquestionably yes. But remember the old joke: "How many psychiatrists does it take to change a light bulb?" Answer: "Only one, but the lightbulb has to want to change." To overcome a fear of flying, you must have a strong motivation to change. You have to carefully examine the fear and acknowledge all the ways it negatively impacts your professional and personal life. You also have to consider ways that you may benefit from your fear. For example, if you really don't like visiting your wife's family, fear of flying may provide you with just the excuse you need to avoid doing so.

Dr. Wilson believes that many fearful flyers don't get help because they doubt they can change, a belief that contrasts sharply with Dr. Wilson's experience as a clinician. The fearful flyers program he ran for American Airlines averaged 25 students in an intensive weekend course. On average, 23 of the students successfully took the graduation flight -- and about 80% of them felt comfortable doing so. Some fearful flyers are so successful at conquering their condition that they become pilots!

Learning to Fly Comfortably
For the largest group of fearful flyers, the first step towards comfortable flight is to learn to trust the industry. "People frighten themselves by thinking of the possibility of a problem during a flight," says Dr. Wilson. Instead, they must learn to think of the probability of a problem, which is extremely low. "Statistically speaking, you could board a plane every day and it would take 26,000 years for your number to come up," reports Dr. Wilson. A fully loaded 727 would have to crash every day of the year for the number of airplane fatalities to equal the number of automobile fatalities in a year. Anyway you look at it, the numbers suggests that flying is extremely safe.

Many fearful flyers also benefit by learning as much as they can about air travel. Here are a few key facts:

  • Modern airplane systems are built with redundant systems. Important control mechanisms have one or even two back ups.
  • Planes are strong. Boeing once set out to destroy one of its jets, on the ground. They were able to bend the wings more than 20 feet before they broke.
  • Turbulence is not a safety issue. It may make you uncomfortable, and for this reason pilots avoid turbulence, but turbulence has never caused a plane to crash.
  • Maintenance is extraordinarily thorough. For every one hour of flying time, jet aircraft receive 11 to 12 person-hours of maintenance. The performance of many modern jet engines is monitored in real time using computers, so problems can be detected early.
  • Pilots are a highly selected and educated individuals who are trained very rigorously and receive extensive ongoing education using flight simulators and on-board monitors. Imagine how careful your doctor would be if he or she had the same medical condition you have. Pilots are on the plane with you and have lives and families to return to just as you do.
  • Airplanes can glide -- and do so well. An airplane that loses all engine power at 35,000 feet (a common cruising altitude) can fly more than 100 miles and land safely. Remember, the space shuttle is a glider -- it lands without any engine power at all.
  • The Air Traffic Control system is extremely well developed in the United States. Like pilots, Air Traffic Controllers are also highly trained professionals.

In addition, learning how planes operate can go along way to relieving anxiety:

  • There are distinctive noises that planes make on runways. Some people confuse the sound of an airplane tire hitting the elevated runway lights for a flat tire.
  • Pilots often reduce engine power after the initial climb -- sometimes for noise abatement, to reduce engine wear and fuel consumption, or to comply with air traffic instructions. The plane will feel as if it's falling but it's not.

Once you've learned to trust the industry, there are additional behavioral steps that are of great assistance to the fearful flyer -- more on these next time.

For more information, see Fear of Flying -- Part 2