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What we call aerophobia can actually be a manifestation of completely different conditions and disorders. The examples described by psychologists Martin Seif and Sally Winston help to take a closer look at the fear we experience on board an airplane.
Aerophobia, or the fear of flying, is a term that includes many mental states that require very different approaches to treatment. A person with white-knuckled fingers in a nearby chair may experience fears radically different from our own.
Depression and anxiety researchers, psychotherapist Martin Seif and psychologist Sally Winston, have done a great job of studying the fears behind aerophobia. According to them, details are the most important for diagnostics.
Using the example of a flight from New York to Los Angeles, they describe six different cases of six frightened passengers occupying seats A through F in row 17. All of these passengers would answer “yes” to each of the following questions:
1. Are you afraid of flying?
2. Are you looking forward to flying?
3. Would you rather avoid flying if possible?
4. Are you currently experiencing anxiety?
Below are descriptions of each individual disorder.
Passenger 17A
Condition
“I don’t know if I can bear it when the doors close. I will feel trapped because I won’t be able to get out. This unbearable, oppressive feeling, rapid heartbeat will begin again. I don’t know if I can control my reaction. I guess I could just go crazy or even give myself a heart attack. What if I go crazy and open the door during the flight? I wonder if there is a defibrillator on board? .. “
Diagnostics
This person has panic disorder. He is terrified by the thought of having a seizure on an airplane. His fear of flying is the fear of having a panic attack.
Passenger 17B
Condition
Rapid heartbeat, difficulty breathing – the passenger’s sensations are similar to those described in the first case, but his attention is not focused on his own internal state, but on the social context. He thinks, “That anxiety again. I might vomit and look pale and restless. Then the neighbor will turn to me and ask if I’m all right. And everyone in the salon will understand that I’m crazy. I don’t know if I can hide my condition. What if the flight attendant comes to help me? Then, for sure, all the passengers will pay attention to me and begin to be interested in what is happening. What if I start to look strange and crazy in their eyes? What if someone decides I’m a terrorist?
Diagnostics
This person is afraid of social condemnation, humiliation and shame in connection with manifestations of anxiety. His fear of flying is one aspect of social anxiety disorder.
Passenger 17C
Condition
“I know that they treat the cabin of the aircraft with an antibacterial solution only once every two weeks and that the air in flight is not cleaned, and between flights they just collect garbage. I have to keep my hands away from the seat all the time – you never know who was sitting here and what germs they could have, maybe even AIDS. As for AIDS, experts are only 99% sure that it is not transmitted in this way. How do I know that the passenger who sat here before me did not have an open wound on his arm? The main thing is not to breathe too deeply, because the salon is a big incubator of germs, and I don’t want them to end up inside me … “
Diagnostics
In the old days, this woman would have been misdiagnosed as germophobia. In fact, she suffers from OCD, obsessive-compulsive disorder. The obsession to avoid contact with germs is just a futile attempt to reduce your anxiety. Of course, the thought of a plane crash might scare her too, but for now, she’s focused on how the flight could harm her and her children.
Passenger 17D
Condition
Nearby sits a woman whose older brother crashed in Vietnam. Each time during the flight, an image of a burning falling plane appears in front of her mind’s eye – what she imagined when she received the news of the death of her brother. She hyperventilates and is overwhelmed with fear and grief. She is half here on the plane, half in the traumatic past. The flight brings back very painful memories for her and knocks her out of the present moment.
Diagnostics
This woman suffers from post-traumatic stress disorder (PTSD).
Passenger 17E
Condition
The man in this chair is worried about a possible plane crash. He worries if the pilot is hungover and if it’s normal for a rattling sound to come from under the seat. Then disturbing thoughts appear that the throat seems to be tickling, which means that the vacation will be hopelessly ruined. The airline may lose baggage, and the greeter will get stuck in traffic or forget to come. To top it all off, after six hours of sitting on a plane, your muscles will definitely hurt.
Diagnostics
This person is in a state of constant toxic anxiety known as generalized anxiety disorder. In fact, it is a confusing and incoherent set of “what if …” worries, which is also characterized by muscle tension, autonomic arousal, anxious mood and episodes of panic attacks.
Passenger 17F
And finally, here he is – a passenger with aerophobia. Fear of flying is a particular phobia in which a person is fixated primarily on the safety of the aircraft and dangerous weather conditions. He is horrified by the images of the crash in his head and tries to imagine how the children will be able to survive his death.
As you can see from the examples given by Seif and Winston, our “aerophobia” can be very different from that of a frightened neighbor. The most effective treatment will be one that addresses the specific fears that plague the person. Therefore, it is important not to rush to generalize the experience, but to find out the details – perhaps something completely different lies behind our fear.
About the Authors: Martin Seif, Psychotherapist and PhD, Sally Winston, PhD, Depression and Anxiety Research Specialists.