How to Overcome Your Fear of Flying (Part 2)
In Part 1 of this series, the Savvy Psychologist covered 5 ways to get to your destination without leaving fingernail marks in the armrest. Today, we’ll learn why you freak out at 30,000 feet and do a 10-second test to see if you’re prone to panic. Plus, the skinny on Xanax and what to do next.
Ellen Hendriksen, PhD
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How to Overcome Your Fear of Flying (Part 2)
Last week on the Savvy Psychologist show, we discussed tips and tricks to get you on a plane and to your destination without the aid of the airport bar or having a panic attack. Check out How to Overcome Your Fear of Flying (Part 1) for more..
This week, we’ll tackle the reasons behind your flying fears, plus some more tips on how to manage them.
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In-Flight Panic
An in-flight panic attack can be triggered by thinking you’re in danger, fear of a panic attack itself, or even just out of the blue. And if you’ve actually experienced a panic attack on a plane, memories of those excruciating minutes are often enough to keep you grounded, or at least heavily sedated on your next flight. What you’re afraid of is no longer flying, but of panic. Your fear really is of the fear itself.
How does it start? Panic often flares from a spark in your own body—a racing heart, a tight throat, a feeling of lightheadedness. If you’re leery of flying, you may be on the edge of your seat to begin with during a flight. Then, a sensation such as popping ears due to increasing altitude, a stomach drop due to turbulence, or feeling smothered in the recycled air can all contribute to catastrophic thoughts of losing control, dying, or simply being trapped in a metal tube for hours with hundreds of strangers, a surefire way to jump-start a panic attack.
Some of us are more attuned to bodily sensations than others. You probably know someone who can’t tell if she’s hungry or has no idea how he got that bruise. On the flip side, you probably also know someone straight out of The Princess and the Pea. This awareness of one’s own body (or lack thereof) is called interoceptive awareness. Interoceptive awareness, unsurprisingly, is more sensitive in individuals prone to panic attacks.
A classic and easy way of measuring your own interoceptive awareness is try to sense your own heartbeat. To try this, sit straight up without letting your back touch your chair, put your hands in your lap, and breathe normally. If you can’t detect it, don’t despair. Either way is considered normal. That said, a 2011 study found that individuals with a fear of flying have higher interoceptive awareness than those who fly without a second thought.
The Skinny on Xanax
We don’t need a study to tell us that those who are prone to panic on a plane are more likely to take Xanax than those who get onboard easily. Indeed, if you take Xanax, you are not alone. With more than 49 million prescriptions a year, Xanax is the most prescribed psychiatric medication in history. And if Xanax is what gets you on the plane to see your grandkids, you have my blessing. Use every tool in your toolbox to get those sticky hugs—remember, the Savvy Psychologist is all about zero judgment.
Now, some folks don’t like the feeling they get on Xanax or dislike relying on a pill. Again, if it works for you, you’ve found a solution, but if it doesn’t, consider a small study where researchers asked a group of 28 women, all of whom had a fear of flying, to take two flights.
Before the first flight, half of the women took a Xanax, while the other half got a placebo pill. True to expectations, when the plane took off, those who had taken the real Xanax reported less anxiety than the placebo group. But here’s the paradox: during the flight, the women who took Xanax, oddly, had faster heart rates and faster breathing than the placebo group. The Xanax caused a dissociation between what their bodies actually did and how they felt.
A week later, when the women got on a second flight, none of them took any medication at all. Two things happened. First, 71% of the women from the original Xanax group had a panic attack on the second flight (now there’s a sight to imagine), but only 7% of the original placebo group did. Furthermore, on the second flight, those who had originally gotten the placebo felt better than on the first flight. Even though they were still frightened, their anxiety symptoms were fewer in number and intensity.
So in sum, for the placebo group, going without medication at first was rough, but it got easier on the subsequent flight. For the Xanax group, medication helped ease symptoms—sort of—in the moment, but when the medication was taken away, the fear remained as strong as ever. The researchers concluded that the Xanax hindered a phenomenon called habituation.
What is habituation? In simple terms, it is the body and mind getting used to something. Consider putting your watch on your wrist. At first, the nerves in your skin can sense the pressure and texture of the watchband, but after a few minutes, your nerves essentially get bored and stop sending the signal, so the sensation subsides. The nerves habituate, or simply adjust, to the presence of the watch.
Now, let’s translate this to fear of flying.
Use Habituation to Overcome Flying Fears
First, your body. If you know a particular sensation is your Achilles’ heel, practice feeling that sensation before you get on the flight so you can get used to it. Seriously. If you’re worried about feeling dizzy, practice spinning around in a desk chair. If you don’t like feeling lightheaded, practice by breathing through a coffee stirrer. Racing heart? Bring on the treadmill. Practice until the sensation is boring, which will take a few sessions. The sensations may be uncomfortable, but they’re not dangerous. You’re always in control. Finally, on your first Xanax-free flight, welcome in all body sensations. You’ll be trained and ready for them.
This process is called exposure, and it’s the most effective way to kick any phobia, from heights to spiders to public speaking to flying. Yes, it can be tough at the outset, as anyone who’s been through it can attest, but the results are both powerful and liberating.
Next are the airplane and the flight itself. Start small and work your way up—habituation shouldn’t have to be white-knuckled. So first, surprise all your out-of-town visitors with a personal airport pick-up to practice simply being inside the airport.
Move on to YouTube to find videos specifically for flying without fear that show typical take-offs and landings, explain turbulence, and demonstrate the source of weird airplane noises. What not to do: don’t watch a YouTube video of extreme turbulence through your fingers and then slam your laptop shut. That will only reinforce your phobia. Most of the videos won’t win any Oscars, but can help you get used to seeing typical flights and know what to expect. Watch them until you’re bored.
There are also a number of paid programs including apps, websites, and live courses. I haven’t experienced them, so I won’t recommend them by name, but you can find them with an online search.
In sum, practice your feared sensations, habituate your phobic brain, review the 5 tips from Part 1 of this series, and you’ll pass the test of your next flight with—you knew this was coming—flying colors.
References
IMS Institute for Healthcare Informatics. (2012). The Use of Medicines in the United States: Review of 2011. Danbury, CT: Author.
Vanden Bogaerde, A., Derom, E., & DeRaedt, R. (2011). Increased interoceptive awareness in fear of flying: sensitivity to suffocation signals. Behaviour Research and Therapy, 49, 427-32.
Wilhelm, F.H. & Roth, W.T. (1997). Acute and delayed effects of alprazolam on flight phobics during exposure. Behaviour Research and Therapy, 35, 831-841.
Disclaimer: All content is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your personal health provider. Please always seek a licensed physician in your area regarding all health related questions.
About the Author
Dr. Ellen Hendriksen was the host of the Savvy Psychologist podcast from 2014 to 2019. She is a clinical psychologist at Boston University’s Center for Anxiety and Related Disorders (CARD). She earned her Ph.D. at UCLA and completed her training at Harvard Medical School. Her scientifically-based, zero-judgment approach is regularly featured in Psychology Today, Scientific American, The Huffington Post, and many other media outlets. Her debut book, HOW TO BE YOURSELF: Quiet Your Inner Critic and Rise Above Social Anxiety, was published in March 2018.