In just one week, we’ve seen three major airline disasters. For Tom Bunn, a retired airline captain and licensed therapist who works with people who are afraid to fly, this has resulted in a frantic last few days hustling to soothe his increasingly frantic client base — both in real life, and on his website’s popular message boards.
Here’s one from commenter Ant020 (whose message is titled, “Really? Again?”):
So there’s another confirmation of a plane crash? I’m flying toChicagotomorrow fromAtlanta. Not sure if I can make it. I’ve done all my “exercises” but this is putting me over the top…..help!
Bunn opts for straight talk:
What do crashes some place in the world you may have never heard of have anything to do with you personally, or your flight in the U.S?
Science of Us enjoyed his no-nonsense approach, and so we reached out to Bunn to answer some more questions about working with people who are afraid of flying, and how his job changes at a time when it seems, especially to jittery fliers, like planes are dropping out of the sky every day. (We should note here that Bunn’s views on treatment don’t always exactly jive with mainstream research; cognitive behavioral therapy in particular has been shown to work in adults with anxiety.)
You work with people who are afraid of flying, How did you become interested in that?
A pilot at Pan Am, Truman Cummings, started a course and asked me to work on it with him. I got hooked. I found all these anxious fliers were highly intelligent: They could think of hundreds of things that could go wrong. And they were highly imaginative — they could put each of those things so vividly in mind that it caused a strong emotional reaction.
What sorts of things?
First, they imagine the sudden realization that the plane is in trouble — plane crash, terrorist attack, etc. Whatever it is — the person knows are going to die. They imagine that they will live through an extended period of knowing they are doomed, and then they will be killed. They imagine what that terror will feel like — that they’ll have a heart attack, or go crazy. Some worry that they’ll get out of control, and do something such as try to open the door, and get arrested — or killed —a by an air marshal.
Do you get an uptick in clients after there’s a plane crash or other airline disaster in the news? I certainly get an uptick in calls and emails from clients I’m already working with. The news has an interesting effect on others. Those who don’t have to fly don’t want to deal with flying in any shape or form. The news helps them feel right to be afraid, and to avoid flying. But people who must fly call. They are up against it. They already had difficulty flying. Now, the news is making them feel like they can’t fly, and yet they must. So they reach out for help. Fortunately, we can help them, even if their flight is in a day or so.
How have their imagined scenarios changed since this recent string of airline disasters?
These events give anxious fliers two new categories of things to worry about. As if they didn’t have enough already! And, yes, these new ones have pushed the old crashes into the background. No doubt this will make flying even more difficult.
What have you found to be the best ways to help people deal with their fear of flying?
Counseling, in most cases, means Cognitive Behavioral Therapy. Though CBT is good for anxiety on the ground, it is sorely inadequate as a treatment for flight anxiety. CBT approaches anxiety as something caused by thoughts. But most of the anxiety that arises in the air is not caused by thoughts; it is caused by unconscious processes: When the plane drops, a part of the brain (the amygdala) releases stress hormones. One drop wouldn’t be so bad. But in turbulence, there is one drop after another after another. The person is literally bombarded with stress hormones.
Exposure therapy is a way to train the amygdala to get used to something. It doesn’t react to what it is accustomed to. Exposure therapy is a solid treatment on the ground. But, to get used to something, it helps to start with mild exposure and increase the intensity or duration of exposure slowly over time. It just isn’t practical to do that with flying. It would be far too expensive, for one thing, and it may not even be possible to regulate exposure to the most difficult parts of the flight, takeoff, and turbulence.
Virtual Reality Exposure Therapy (FRET) tries to get around this by using computer imagery. The problem is artificiality. There is no exposure to actual risk; you are in a psychologist’s office. There is no exposure to not being in control of the situation; you are the client and you run the show. There is no exposure — and thus no desensitization — to being unable to escape; you can leave it you want to. VRET misses because it does not address the main three problems: risk, control, and escape. [Editor’s note: Some recent research suggests that virtual reality exposure therapy can be helpful.]
Okay, so what does tend to work for your clients?
A few years ago, I stumbled on a way to do what desensitization does — stop the amygdala from releasing stress hormones in response to a stimulus — in a roundabout way. That was fortunate because we couldn’t apply desensitization adequately to airline flying.
What we ask them to do is to make a list of all the things that happen on a routine flight — plus, the things the person is afraid will happen. These are usually pretty long lists; it may be 50 or more items.
We then look for a moment in the client’s life when, because of our genetically programmed psychological wiring, the fear system shuts down. Frankly, it is a bit X-rated! Our fear system shuts down in order to reproduce. So we look for a romantic moment in which the chemistry was just right. We ask the person to vividly recall the other person’s face, voice, body language, etc. And then we ask them to add one thing: pretend the person is holding by their face a black-and-white snapshot depicting one of those things on the list.
We go through the entire list. Once each definable moment of flight (and each worried-about moment of flight) is linked to a lover’s face, when that moment comes about during the flight, the brain produces oxytocin, the hormone that shuts the fear system down. When oxytocin is produced, stress hormones can’t be produced. No stress hormones; no fear.