Thursday, June 23, 2011

Flying With the Greatest of Ease

For some, fear of flying is a serious phobia that becomes so debilitating it keeps people from taking jobs that involve travel, attending family weddings or funerals and choosing vacations that are accessible by car. For others, airplanes invoke other anxieties, such as a fear of enclosed spaces or a fear of heights.

Ron Nielsen, a retired US Airways captain, demonstrates safety equipment with two students in his fear-of- flying class at the Phoenix airport.

Dr. Robert Reiner demonstrates virtual-reality goggles on his executive assistant, Maria Gianoli, at their New York office.

Fear-of-flying classes enroll a steady stream of customers. Countless websites, books and DVDs are devoted to overcoming flying fears. Virtual-reality therapy has emerged over the past 10 years to offer exposure to flying without leaving the ground. Many airports sponsor classes run by therapists or pilots. Several airlines offer classes as well, including Virgin Atlantic, British Airways and Air France.

Psychologists say a fear of flying is best resolved by a combination of psychology and exposure. No matter the severity, a person needs to understand the triggers and symptoms of flying phobia, and have ways to cope, such as breathing and muscle-relaxation techniques. Tensing muscles adds fuel to anxiety, so relaxation can get the mind out of a panic state and let people realign their emotional response.

In addition, fearful fliers need to better understand the physics and mechanics of flying and gradually increase their exposure. Classes show that flying is not some magical miracle. Air travel is grounded in science, so it's important to understand how it works. Becoming familiar with how wings produce lift, plus the sounds and sensations of an airplane and the jobs of pilots, mechanics, air-traffic controllers and flight attendants helps calm anxious travelers and shows that their anxiety is emotional, not rational.

"It's faulty wiring in the brain" that activates the fight-or-flight response to the routine of airline travel, said Robert Reiner, who teaches at the New York University Medical Center and is executive director of a private Manhattan psychological practice called Behavioral Associates.

Dr. Reiner, who sees four times as many people with fear of flying than with fear of public speaking, uses virtual-reality training to treat patients. Computer-driven goggles simulate the flying experience, conditioning patients to the sights, sounds and motions that occur on a flight.

Jill Greenberg grew up flying often, but like many, her phobia kicked in during her late 20s. Her anxiety grew after a flight she was on was hit by lightning-something planes are built to withstand without any trouble. On her next flight, she clutched a family photo and convinced herself she'd never see her relatives again.

Virtual-reality therapy and controlled-breathing techniques have her back in the air. "I don't love it when it's bumpy, but I'm no worse than the guy next to me," she said.

The goggles simulate the flying experience, conditioning patients to stay calm while in the air.

Researchers at Emory University studied virtual-reality therapy for fear of flying and found it to be just as effective as traditional treatments, with about 93% success at getting people back to flying. With phobia, doctors don't talk about "cures," only effective treatments.

"We want their thoughts and fears to change and we want their body's physical reaction to change," said Barbara Rothbaum, a professor of psychiatry at the Emory University School of Medicine who led the research and also treats flying phobias.

Katherine Carroll tried Xanax and either chardonnay or vodka to mute her flying fears, with little success. Her family lives in Europe and she had to fly back and forth, but turbulence shook her and aircraft noises rattled her. "It was really a hindrance to life," she said.

Ms. Carroll, an interior designer in Redwood City, Calif., took a course at the non-profit Fear of Flying Clinic in nearby San Mateo. The course, run by pilots with a behavioral therapist, offers tools to make flying more manageable. After classroom sessions, students go to the United Airlines maintenance base in San Francisco and go over an airplane with a mechanic. Some classes tour the airport's control tower as well.

Seeing air-traffic controllers at work was enlightening, Ms. Carroll said. One was wearing a Hawaiian shirt. "They looked calm and relaxed and in control of their jobs," she said.

Now she takes non-stop flights with little trouble-but no small commuter jets or connecting itineraries. She listens to motivational recordings, tightens arm muscles and relaxes them, works on slow-breathing techniques and studies index cards she made with key teachings of the course.

"It's just all about keeping your fear in check," she said.