cartoon of a man afraid to fly

Cabin fever

Some people who believe they have flight phobia (sometimes called aviophobia) might actually be suffering more from claustrophobia. Their fear is not so much of flying but rather of being confined in a small space for several hours with no possibility of escape. For someone with tendencies toward this anxiety, the relatively small cabins of most business jets could be problematic. 

One of the seven official criteria for phobias according to the Diagnostic Statistical Manual for Mental Disorders is that “the fear or anxiety is out of proportion to the actual danger posed by the specific object or situation.” So, someone telling you repeatedly that you have nothing to fear doesn’t help. In fact, trying to suppress or hide the phobia only makes it worse. Franklin Roosevelt’s famous “fear of fear itself” amplifies the anxiety.

And it’s anxiety that’s at the root of phobias, though the fact that someone has a phobia doesn’t necessarily mean that the person is anxious in other ways. Normally confident, relaxed, and unflappable people can find themselves reduced to a bullet-sweating blob when confronted with a specific clinical fear such as claustrophobia.

Not to confuse the issue, but claustrophobia and aviophobia can go together, overlapping their effects. In fact, three quarters of phobia sufferers have multiple phobias. And though claustrophobia and fear of flying are different, it makes sense that one of these conditions could magnify the other. 

The fear of being in a closed-in space is hard to understand for those not afflicted. What do they worry will happen? Fear of flying, by contrast, is really a fear of crashing; and the consequences of that are clear to everyone. For that reason, I don’t understand how anyone can call aviophobia “irrational,” no matter what the statistics show. It seems rational to me—and I’m a pilot.

So, if you’re prone to panic attacks when a business jet door closes behind you, what can you do about it? A Google search turns up lots of advice: visit a psychologist the day before a flight; get on the airplane last; think relaxing thoughts; distract yourself with music; wear loose clothing and remove your shoes; and practice deep breathing. All are good strategies, especially the last one.

But perhaps the best advice to attack the root of the problem comes from The Anxiety and Phobia Workbook, by Edmund Bourne, Ph.D. The most effective way to overcome a phobia, he writes, is to face it head on. That doesn’t mean just sucking it up, but rather, trying incremental strategies in confronting the fear. Part of overcoming the phobia can involve desensitizing yourself to the stimulus. Maybe you once had an unrelated panic attack in an enclosed space, and that stimulus is now triggering your anxiety.

Unlearning that association starts with baby steps. One good thing about claustrophobia is that you can confront it in small increments. Start closing doors in progressively smaller spaces and/or for longer and longer periods. And for issues directly related to flying, you could visit your company’s flight department for help—or look around for a charter operator whose staff would be willing to assist you. Many of these people are trained to deal with fear of flying and/or claustrophobia related to flying. 

They can help you slowly face down your phobia by getting on board the airplane, literally step by step. Start by standing on the bottom of the airstair with the door open, then standing in the doorway, then sitting in a seat near the door, progressively working your way to being comfortable with the door closed behind you.

It’s like a physical workout for your psyche. And like physical conditioning, it isn’t supposed to happen all in one session. Take your time and work up to your goal.

Bourne also proposes using your imagination to desensitize yourself to the anxiety. “Much of the anxiety you have…about flying…is connected with your thoughts and fantasies,” he writes. “Becoming desensitized first to thoughts and scenes experienced in fantasy can pave the way toward handling the phobic situation in real life. Even if the real-life situation continues to evoke some anxiety, this anxiety may be considerably reduced after having practiced imagery desensitization.”

Show comments (1)

Much good guidance here, especially the idea that fear of flying has multiple presentations.

But those of us who specialise in treating these presentations de-emphasise seeking to become more comfortable, and emphasise self-regulation and putting oneself in challenging situations *despite* the presence of uncomfortable sensations. Distraction room has its uses - it comes naturally for many - but should not be relied upon because it's unreliable! But exposure trials with the focus on new learning about self-management techniques will ultimately prove effective for many.

Les Posen
Clinical psychologist