Therapies commonly used for fear of flying are, for the most part, terribly inadequate. CBT is a good example. In an Associated Press article, Todd Farchione of Boston University's Center for Anxiety and Related Disorders said "fear of flying treatment consists of a fairly standard combination of cognitive and behavioral therapy. That includes identifying the patient's fear-provoking thoughts and challenging them, then getting the patient to gradually confront the fear, by imagining flying and then doing it."
The are two problems with CBT. First, some fear-producing thoughts can't be challenged. Flight means being up high, not in control, and without any means of escape. Since control and escape are basic ways to regulate fear and anxiety, it is rational to expect emotional trouble when these are taken away.
Second, takeoff and in turbulence cause a rapid series of noises and motions. Every instance triggers the release of stress hormones. Stress hormone levels rise rapidly. Too high a level can cause cognition to collapse. The client can be left unable to deploy their CBT-based techniques just when they need them most.
Systematic desensitization isn't practical because exposure to flight cannot be adequately titrated. As a substitute, Virtual Reality uses computer-generated images. Though controlled, exposure is unmistakably artificial. The treatment takes place on the ground and in an office, not at 30,000 feet in an airplane. There is no exposure - and thus no desensitization - to risk, nor to inability to escape.
In a research study, the anxious fliers who received hours of VRET were no better off than a control group that sat briefly on parked airliner. Rather than accept that VRET was ineffective, claims were made that the control group was a "traditional fear of flying program" and thus VRET was a convenient treatment alternative. Traditional fear of flying programs expose clients to both a parked airliner and an actual flight. In addition, there talks with pilots and mechanics, and hours of instruction that teach participants why flying is remarkably safe.
Pilots who run traditional courses are fond of saying "knowledge is power," in the belief that if a person just understands how safe flying is, fear will not be a problem. Knowledge, stored elsewhere in the brain, doesn't connect with the amygdala. Knowledge isn't powerful enough to stop the amygdala from releasing stress hormones when it senses anything it is not used to. Though pilots and therapists mean well, inadequate methods can do damage; when people try their best and fail, they blame themselves - not the method - as inadequate.
It is not knowledge that keeps pilots from being bombarded with stress hormones. Rather, they are comfortable when flying due to control and habituation. As to control, though there are many sounds and motions during takeoff, the pilots cause them. Due to habituation, these sounds and motions are routine to the pilot's amygdala.
But a passenger is neither in control nor is his amygdala habituated to flight stimuli. The engines speed up to a high pitch. The engine's exhaust roars like thunder. Acceleration pushes passengers back in their seats. The plane bumps down the runway. The nose rises, and the Earth - and all the control the passenger has ever known - is left behind.
Even if a passenger understood that none of these things mean danger, each noise and motion triggers a release of stress hormones. For many people, unless they are in control, or have the means to escape, when they feel the effect of stress hormones, they believe they are in danger.
The amygdala triggers the release of stress hormones when sensing anything to which it is not habituated. The amygdala alerts us whenever anything non-routine is taking place. That's the amygdala's job and it is going to do it. By the way, that's is why relaxation exercises don't work. It doesn't matter how relaxed a person is, when something non-routine, unfamiliar, or unexpected happens, the amygdala fires.
If a person's Executive Function can dismiss a stress hormone alert as a false alarm, the matter can be dismissed. But as a passenger, how sure can a person be? And, when these noises and motions happen in rapid fire succession, it is asking a lot of Executive Function to keep up. To keep anxiety at bay, Executive Function would have to identify the noise or motion, remember what it means, determine whether it is normal or abnormal in this particular situation, reassure itself that it is normal, and then dismiss the matter as irrelevant. If the noises and motions during takeoff were spaced out a minute or so apart, Executive Function might be able keep up. But spaced only seconds apart, Executive Function can get behind, and allow stress hormones to build up.
Buildup compounds the problem. When stress hormones get high, Executive Function gets slow. Robert Yerkes and John Dodson discovered that over a hundred hears ago. When Executive Function starts to slow down, stress hormones start building up faster. Once Executive Function gets, as we say in aviation, "behind the curve," the inevitable result is high anxiety, and perhaps panic.
If we can't depend on Executive Function, what can we depend on? Have you heard of the Social Engagement System? Probably not. But you have one, and you use it every time you are with other people. The Social Engagement System (SES) reads their signals, and if it likes what it sees, it calms you down. All this happens unconsciously, according to neuroscience researcher Stephen Porges.
The SES and calm a person by slowing the heart rate and activating the parasympathetic nervous system. In addition, it can prevent the release of stress hormones. In a romantic situation, when the chemistry is right between two people, when they look at each other as if they were the only two people in the world, the SES gets involved in the chemistry. It releases oxytocin and vasopressin, peptides that can inhibit the amygdala and make the release of stress hormones impossible. In this way, the SES temporarily shuts the fear system down, making fear of sexual engagement impossible. Thus, by releasing these hormones, the SES facilitates reproduction by promoting both mating and bonding.
Remember Pavlov's dogs? When he fed them, he rang a bell. After conditioning the dogs to associate the bell with eating, ringing the bell caused them to salivate even when no food was presented. To control fear when flying, we want things like the door closing or the plane taking off to produce oxytocin and vasopressin. The SES is a powerful anxiety control system. We can tap into it by associating - one by one - the things that happen on a typical flight with a memory that, if vividly recalled, produces oxytocin and vasopressin. For example, the memory of a partner's face in a romantically or sexually engaged moment.
Once links have been established between the oxytocin producing face of a lover and the various moments of flight (boarding door closing, takeoff, cruise, turbulence, landing, etc.) the SES provides powerful protection against fear, anxiety, panic, and claustrophobia. No stress hormones, no problems.