How Thererapy Can Help Fear of Flying


by David Lanzas

When to comes to therapy for fear of flying, you might imagine it to include learning relaxation techniques and getting on a plane to face and overcome the phobia. But in fact these are just isolated strategies which without the previous work of the bases of aerophobia, on their own remaining fairly limited in their effectiveness.

That’s why today I’d like to explain to you what really happens during therapy to effectively overcome the fear of flying. When the intervention is aimed at rooting out aerophobia and not just mitigating its symptoms, the first objective is to detect the origin of the person’s phobia. It involves three main stages:

The Exploration Stage


Some initial sessions are dedicated to identifying and understanding the varying aspects and symptoms of the patient’s difficulties with flying, as well as the way in which anxiety manifests itself, what resources are available to regulate it, and what problems present themselves when faced with the need to get on an airplane. We also explore the strategies the patient has used in the past to feel more secure on flights, which have worked and which haven’t. This is actually a crucial step – in fact, in my estimation the most important – since it provides the basis on which to build a process which is both personalised and effective.

The Conceptualisation Stage


When therapists have collected and analysed all this information, they’re then prepared to explain to their patients how the rest of the sessions will play out. In addition to uncovering the causes of the aerophobia, it also provides explanations for what aspects of the patient’s past and present are preventing the natural resoltion of the problem. Another important aspect at this stage is the explain concepts that need to be clear in order to understand how phobias function, and so to learn what and what not to do upon boarding a plane. For example, it’s useful to be aware of how anxiety manifests itself in the body and of how traumatic past experiences affect the patient when faced with flying.

The Intervention Stage


Here the goal is to repair the difficult experiences which form the basis of the patient’s phobia with a therapy modality called EMDR (Eye Movement Desensitisation and Reprocessing), which aims to help patients’ brains understand and process the emotional experiences which it couldn’t at the time, making them tense every time they get on a plane. Many of these experiences are related to unpleasant situations that have happened to them on a plane or that they’ve heard happened to others, and which had a very high emotional impact on their nervous systems. When this occurs, the brain may not process the information properly, and stores it in a dysfunctional way. Meaning that they’re remembered and experienced again as very dangerous, making patients feel that every time they fly they’re in danger, even though they rationally know that according to statistic, flying is the safest means of transport and with fewer accidents than any other means of transportation.

Essentially, then, this type of therapy gives patients’ brains a second chance to process the information and see the experiences they lived as they really were:  something much less threatening and also part of the past, a precedent for the future. Then after having analysed these situations in session, it’s advisable to carry out a progressive and staggered exposure to flying. It’s common to start with contexts related to travelling by plane without necessarily getting on it, such as gradual exposures to airports, then graduating to actual flying, for which emotional regulation strategies will have to be addressed to gradually decondition the emotion of fear of travelling by plane.

Although it’s normal for psychologists to discharge patients when they have finally reached the goal of flying more serenely, there’s always the option of having review sessions from time to time depending on patients’ needs.


David Lanzas is a psycholgist specialising in anxiety and trauma, and founder of the Instituto Lanzas.


Photo | SDI Productions