Verified by 
Fear of Flying is a term that encompasses many different “sticky mind” conditions that need very different treatment approaches. The white knuckle flier in the seat next to yours might be experiencing very different fears than your own.
The following book segment (Seif and Winston, 2014) illustrates why details make such a huge difference in getting over your flying fears.
Flight 702 from New York to Los Angeles has boarded. Six frightened fliers are seated in row 17, seats A through F. Each responds “yes” to the following four questions.
- Are you afraid to fly?
- Are you anxious anticipating a flight?
- Would you prefer to avoid flying if you can?
- Are you feeling anxious right now?
In seat 17A, the passenger is thinking “I don’t know if I can stand it when the doors close. I am going to feel trapped, I won’t be able to leave, I am going to get that unbearable overwhelming rapid heart rate and I don’t know if I can control my reaction and I could just either go crazy or even cause myself a heart attack. What if I lose it and open the door in the middle of the flight? I wonder if there is a defibrillator on the plane.”
This person has panic disorder. He is terrified of panicking while on the plane, and his fear of flying is a fear of experiencing a panic attack.
Seat 17B is occupied by someone who feels sensations similar to the first person--rapid heart rate, difficulty breathing-- but the focus is interpersonal rather than intrapsychic. He is thinking “I am getting anxious and I feel like I might throw up or get pale and fidgety and the person next to me is going to turn to me and say ‘are you alright?’ Everyone in the plane will know there is a nutcase on this plane. I don’t know if I can keep my anxiety hidden. What if a flight attendant comes over to try to help me--then everyone in this plane will be focusing on me and wondering what is going on. What if I start to look weird and crazy to them? What if someone thinks I am a terrorist?”
This person is afraid that his anxiety could show and someone will judge him badly, exposing him to humiliation, inadequacy, and shame. This person’s fear of flying is an aspect of his social anxiety disorder.
In seat 17 C is someone with the following thoughts: ”I know that they clean the planes in a deep way with antibacterial solution every two weeks and that they spray room freshener into the air when they are on the ground, but in between flights, they just pick up the trash. I have really been trying to keep my arms and hands off the seat rest because you never know who was sitting here and what germs they could have -- it could even be AIDS -- and they are only 99% sure that it can’t be transmitted this way and you can’t be sure that this passenger did not have an open wound on their hand. I’m trying not to breathe too deeply on this plane, because the inside of the cabin is just one big incubator of germs, and I don’t want them inside of me.“
This person, who in former times might have been incorrectly labeled “germophobic”, suffers from OCD. Their compulsion to avoid contact with germs is an attempt to avoid anxiety. Repeated attempts to reassure themselves are not helping, as these are compulsions too. While the idea of the plane crashing may also scare them right now, they are focused on the possibility that being on this flight might harm themself and their children.
In the next seat over, Seat 17 D, sits someone whose older brother went down in a plane in Vietnam. Every time she flies, she has dreams about fiery crashes, reliving that horrible moment when her mother told her that her brother was dead. She is hyperventilating right now; feels overwhelmed with fear and grief and would rather be anywhere else. Half of her is presently on the plane and half of her is in the past.
For this person, flying triggers intensely painful memories, and crowds out the present moment. This woman suffers from post-traumatic stress disorder.
Seat 17 E is occupied by someone worried about the plane crashing, whether or not the pilot has a hangover, and if that rattling sound underneath her seat is normal. But she is also worried that she may have a scratchy throat and what if it ruins her vacation, and what if the airline loses her baggage and what if the person who is supposed to pick her up gets stuck in traffic or forgets. And—wow—are her muscles going to be sore after sitting for six hours!
This person is in an ongoing toxic worry state, known as GAD, generalized anxiety disorder, a relentless and rambling set of “what if” worries, which is characterized by—in addition to worry—muscle tension, autonomic arousal, anxious mood, and episodes of panicky feelings.
And finally in seat 17 F is the person with aviophobia—fear of flying—that is a specific phobia where the fear is of something going terribly wrong. This person is focused primarily on plane safety, the possibility of weather making his flight more dangerous, how his children might survive his death and the horror of the image of going down during the crash.
Your “fear of flying” can be a very different disorder from your fellow frightened flier. The best treatment focuses on the specific fears that set you off. That is why it is so important to get the details, because it might not be quite what you think.
References
Seif, M & Winston, S. What Every Therapist Needs to Know about Anxiety Disorders, Routledge, 2014
