Serendipitously, my friend and fellow airline pilot Patrick Smith and I have books coming out within months of each other.
Patrick’s book, Cockpit Confidential, offers readers an enlightened, behind-the-scenes view of life as an airline pilot.
It has gotten great reviews, not only from my fear of flying clients who have read it, but from media like the Boston Globe where Alex Beam wrote, “Patrick Smith is extraordinarily knowledgeable and communicates beautifully in English, not in pilot-ese. The ideal seatmate, companion, writer and explainer.”
A few of the subjects Patrick covers are:
• How planes fly, and a revealing look at the men and women who fly them
• Turbulence, pilot training, and safety
• Congestion, delays, and the dysfunctional modern airport
• The myths and misconceptions of cockpit automation
• Terrorism in perspective and a candid look at security
• Avoiding the pitfalls of airline customer service
To get a taste of Patrick’s remarkable writing talent, see his blog at www.askthepilot.com where you can also order an autographed copy from him.
SOAR, The Breakthrough Treatment for Fear of Flying
My book presents the method of treating flight phobia I developed over the past thirty years. It is called, SOAR, The Breakthrough Treatment for Fear of Flying. It is precisely that, a breakthrough – and a needed one – because most of the phobic fliers who contact me say they have tried “everything” and nothing works.
Systematic desensitization exposes the client to the situation at a level of intensity or duration too low to cause distress. As treatment continues, exposure is increased in increments small to be noticed. Thus, over time, the client becomes able to face full exposure without reacting. Systematic desensitization cannot be used for flight phobia because exposure increases cannot be adjusted adequately.
Virtual Reality Exposure Therapy (VRET) uses computer-generated images of flight that can be adjusted. Though it sounds promising, clients remain aware that they in an office, not at 30,000 feet. No matter how realistic the images, VRET is artificial. It cannot provide desensitization for what the anxious flier struggles with: actual risk, separation from the ground, lack of control, and no means of escape.
VRET research at the University of Connecticut compared a treatment group with a group that sat on a parked airliner and pretended they were flying. Those who received VRET showed no permanent improvement versus those who pretended to fly. Rather than accept this failure, the sponsors of the research claimed it showed VRET was equal to a traditional fear of flying program. Not so: traditional fear of flying programs include – in addition to exposure to a parked airliner – hours of instruction on how flying works and real flights.
Research at the Stanford University School of Medicine involved two flights. On the first flight, half of the anxious fliers were given alprazolam and half were given a placebo. On the second flight, no medication was administered.
Placebo Group: 43% experienced panic on the first flight. Some desensitization took place, as only 29% experienced panic on the second flight.
Active Medication Group: only 7% panicked on the first flight. On the second flight – their first unmedicated flight – 71% experienced panic.
These results showed that alprazolam caused an increase in sensitivity to flying and blocked the ability to become acclimated to flying. See www.ncbi.nlm.nih.gov/pubmed/9299803
Cognitive Behavioral Therapy treatment for flight phobia involves four techniques: breathing exercises, psycho-education, cognitive restructuring, and exposure (continuing to fly)
Breathing exercises are generally recognized as ineffective.
Psycho-education can help a person accept feelings. But clients whose aim is be rid of the feelings may not able to benefit from acceptance.
Cognitive Restructuring assumes fear of flying is due to irrational thinking that needs to be corrected. Self-talk is used to counteract negative thoughts. This top-down approach ignores the fact that feelings can be caused bottom-up when stress hormones are released by exposure to the unfamiliar or to the unexpected.
Exposure (continuing to fly) – like flooding – is is not always helpful; some clients are increasingly traumatized.
CBT is only marginally effective for fear of flying, notably because it requires cognition which weakens – or indeed collapses – when stress levels rise.
Hypnosis, and self-hypnosis, can produce a calm state in a therapist’s office or at other places on the ground. Regardless of the level of relaxation a person can achieve, when the amygdala senses anything unfamiliar or unexpected, releases stress hormones. Relaxation ends, replaced with arousal.
SOAR, The Breakthrough Treatment for Fear of Flying teaches the reader how to train his or her mind to not release stress hormones when flying. Regular copies are available at Barnes&Noble.
Autographed copies are available at www.fearofflying.com/book.