The Fear of Flying: A Deep Dive
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What is Aerophobia? Why do we Need to Talk About it?
Aerophobia (the fear of flying) is one of the most common anxiety disorders. The Cleveland Clinic estimates it affects more than 25 million Americans. People have a number of aversions to flying - some people are afraid of their plane crashing, some are afraid of turbulence, and some are just generally worried about the entire process.
For Mental Health Awareness Month, I thought it would be good to do a deep dive into aerophobia.
You may be asking, “why do we need to talk about this? Why should I care?” That’s a fair question. Statistically speaking, one in eleven people reading this suffer with some form of aerophobia. That number may be a little bit skewed based on the fact that this is an aviation forum, after all, but there are many, many aviation enthusiasts, even some who go on to become pilots, who are aerophobic. Even if you aren’t personally impacted by this, it’s a guarantee that someone in your life is. Knowing not only what it is but the treatments as well is critical in helping someone.
The Neuroscience of Anxiety (Very Simple Version)
To get a better grasp on the mechanics of aerophobia, I think it would be helpful to have a little crash course on anxiety. You could write books and get PHDs in the neuroscience of emotions and anxiety, so this is the very, very abbreviated bullet points. At its most basic level, anxiety is an activation of the body’s fight-or-flight response. Sometimes, this is a great thing that keeps us alive. If a bear is chasing you through the woods, your fight-or-flight response kicking is absolutely essential to your survival. However, sometimes that response activates unnecessarily to an irrational stimuli.
Sometimes, this activation can happen from no specific thing. This is called Generalized Anxiety Disorder. When there’s a trigger, however, that’s when you get a phobia. A phobia is an excessive and persistent fear of something that poses little or no actual danger. Take arachnophobia (fear of spiders) - rationally, a spider is unlikely to harm you. In fact, spiders are more afraid of you than you are of them. But, the part of our brain that controls anxiety, the amygdala, doesn’t think rationally. It just reacts to stimuli. You might have heard this referred to as the “hindbrain” or “reptilian brain.”
It’s very important to understand that while the cause of the fear is not real (in the sense that it poses no actual threat), the fear itself is very real and can be debilitating, causing symptoms from chest pain and nausea to sweating and shaking. It’s really a horrible feeling, one that’s hard to describe to someone who has been lucky enough never to experience it. I cannot emphasize enough how vital it is to acknowledge the anxiety when you’re helping someone going through this.
Why do People Have Aerophobia?
Looking at it from a purely primal standpoint - flying is weird. We were not made to be locked in a pressurized metal tube and shot at hundreds of miles an hour across the globe and land in a totally different time zone, climate, and culture just a few hours later. So it’s natural to have some skepticism or hesitancy towards flying, but it’s going to look different person to person.
Aerophobia can be categorized into two extremely broad sections:
Fear about the flying aspect or the aircraft itself:
There’s a lot of things that can be potentially scary onboard an aircraft or inflight. Things make loud, sudden, noises, the plane shakes and bounces during turbulence, and while it’s rare, things can go wrong mechanically. As we explored earlier, being afraid of these things is irrational (but again, I must restate, the fear itself is very real). The risk of being hurt or killed onboard a plane is astronomically low. The annual risk of dying in a plane crash in America is 1 in 13.5 million. The risk of dying in a car accident is 1 in 5,000, yet people are generally more afraid of plane crashes than they are of car crashes. This goes to illustrate the irrationality of it.
Not everyone in this category is worried about crashing. For some, the unfamiliar noises, sudden altitude changes (AKA turbulence), or even the feeling of takeoff can be deeply unsettling. Their bodies react with a heightened stress response.
In many cases, people will begin to anticipate these sensations long before the flight even begins. The thought of turbulence or being confined for several hours can lead to anticipatory anxiety, where the fear of fear itself becomes overwhelming. Unfortunately, having anticipatory anxiety can actually cause more anxiety about the thing you’re worried about; it’s a nasty cycle.
The second main category is fear related to the loss of control or being trapped.
Humans like to be in control of themselves - that’s a very natural thing. For some people, the idea that they’re handing over the reins to someone else, a total stranger, is nerve racking. Rationally, of course you’d want the trained professional piloting your plane, just like you’d want a trained surgeon operating on your heart. But again, the rational brain and the irrational brain don’t talk to each other very well.
Managing Aerophobia
People with aerophobia are in luck - because of how prevalent this anxiety is, it’s thoroughly researched and documented.
When it comes to treating anxiety, there’s only so much you can do by trying to “think your way out of it.” Roughly 80% of the signals in the nervous system travel from the body to the brain, while only about 20% go the other way. This means our brain receives far more input from the body than it sends back as instructions. It’s important to remember that the brain’s anxiety center is very primal — it relies heavily on information from the body to make decisions. Holding tension in your body directly impacts how anxious your brain feels, because the signals it receives suggest that something is wrong. Even if you’re not consciously aware of danger, your brain interprets that physical tension as a threat.
Because of that, the solution is mostly (but not entirely) going to come from a physical standpoint. You’ve certainly heard it before, but the single best trick for managing anxiety is breathing. Your breathing directly impacts your heart rate and thus your nervous system, using the parasympathetic nervous system to counteract the fight-or-flight response. There’s lots of ways to breathe for anxiety relief, but the important part is slow, deep breaths. Some popular methods are Box Breathing and the 4-7-8 Rule. The minutiae of how you go about it doesn’t really matter.
Another way of managing aerophobia is talking to a mental health professional. Cognitive Behavioral Therapy (CBT) is one of the most effective ways of addressing really any kind of anxiety. A therapist can also guide you through exposure therapy. Essentially, exposure therapy is confronting the thing you’re afraid of in a measured, spaced out way. For example, for someone afraid of flying, exposure therapy could look like this:
Step One: Talking about flying
Step Two: Watching videos about flying
Step Three: Driving to the airport
Step Four: Walking around in the airport
Step Five: Going through security
Step Six: Boarding a plane
Step Seven: Fly
It might seem extremely slow and tedious, but doing it in a very dosed out manner is the key to this type of therapy.
Prescription medications, like Xanax and Valium, can be used in acute aerophobia situations. However, like with most medicated mental health conditions, it’s best used in tandem with other forms of care, and these drugs don’t come without side effects.
Someone who is anxious about flying can also deal with it (to some extent) on their own. Simply talking to the pilots of flight attendants can be very helpful in putting your mind at ease. If you have concerns about, say, the wings breaking in turbulence, you can go onto YouTube and watch wing flex tests being performed by Airbus and Boeing - it’s very reassuring to see just how much they’re able to bend without breaking. Sometimes, this alone can be enough to make someone comfortable in flight - however, it’s important to not avoid seeking treatment from a professional when you really need it.
There’s an interesting, relatively new treatment for aerophobia - the use of virtual reality to expose patients to the sensations and sounds of flight. While its widespread efficacy has yet to be proven, a small scale study at Cambridge University proved it more helpful than traditional CBT.
Rather unique to this type of anxiety, key players in the aviation industry actively work to help. Major airlines, like EasyJet, Virgin Atlantic, and most famously, British Airways offer classes for fearful flyers. BA’s “Flying With Confidence” program boasts a 98% success rate, and is taught by both BA crews and clinical psychologists, who use a combination of exposure therapy (on a real plane) and classroom teaching to combat aerophobia.
I touched on this in my topic about airport design, but the very design of aviation infrastructure actively works against aerophobia and anxiety in general. Airports use signage, color coding, and iconography to reduce cognitive overload; less confusion = less stress. Soft, neutral tones, calming architecture, and biophilic design elements (like plants and water features) can also help nervous passengers. Some airports have sensory rooms. While they’re normally designed for people with autism, the lack of stimulation can be incredibly helpful or anxiety
Additionally, onboard the plane there’s a number of features that can help anxious travelers. The right boarding music can have a significant impact on the mental state of passengers, as can subdued lighting (soft blues and purples are the most calming). Some airlines have guided meditations and breathing exercises on their IFE screens which are designed to calm passengers. The planes themselves actually combat anxiety. Newer aircraft, like the 787 and A350 have significantly lower cabin altitudes than their predecessors. While there’s no directly proven correlation between a lower cabin altitude and decreased anxiety (yet - it’s not a well studied topic), a lower cabin altitude is known to reduce fatigue and stress, which do contribute to anxiety.
Sources
This was an incredibly detailed topic to research, and I wanted to do it correctly. Rather then paste like 25 links here, I made it into a nice Google Doc, all in MLA format (my English teacher would be proud).
This topic was created with direct moderator approval from @Asher
