Flight phobia frequently begins late in pregnancy. According to research, as the expectant mother approaches delivery, the brain is flooded with hormones that cause her to become obsessed with safety. This, apparently, is nature's way of providing a safe environment for the infant upon its arrival.

The hormones subside in the weeks following delivery. But the patterns may persist. In addition, the additional responsibility of protecting an infant causes stress.

It is not unusual for flight anxiety to begin when becoming a parent. But, in my view, it begins at this time only if the person did not get, as a young child, the caregiver-child relationship necessary for secure attachment to the primary caregiver. In secure attachment, the child builds inside the mental processes that regulate arousal automatically and unconsciously. As the child learns there is a bigger world, the relatiionship with the caregiver - secure or insecure - extends to the world at large.

Automatic and unconscious regulation is important because, if a person did not develop this capacity, the person must regulate arousal consciously and deliberately. Conscious regulation is not only a lot of work, but, it cannot do as good a job automatic unconscious systems can.

Here's why. When the amygdala - the part of the brain that monitors what goes on around us and in our imagination - releases stress hormones whenever it senses something that is not part of our daily routine. When it releases stress hormones, our awareness gets hijacked. We are forced to look around and try to figure out what triggered the amygdala.

If we can figure out what triggered the stress hormone release, we determine whether it is (a.) an opportunity we may want to take advantage of, (b.) irrelevant, or (c.) a threat. If it is a threat, we look for a strategy to control the situation and neutralize the threat.

If we can't come up with a plan, stress hormones continue to be released, and we stay anxious. We may decide to try to escape. But, if we can come up with a suitable plan to deal with the threat, at the moment we start carrying out our plan, a signal is sent to the amygdala telling it to stop the release of stress hormones. Stress hormones - since they grab our attention - would get in the way of carrying out the plan.

When driving, conscious regulation works well. Each decision we make signals the amygdala to quiet down. But when flying, conscious regulation doesn't work. When stress hormones are triggered by a noise or movement of the plane (particularly in turbulence and during takeoff) we cannot be sure the noise is irrelevant. As a passenger, there is no action we can take. On the ground, this would call for escape. That, in the air, is no possible.

The A-B-C strategy that regulates stress hormone release on the ground - (A.) assessment, (B.) build a plan, (C.) commit the plan to action does not stop anxiety in the air. Nor can escape.

Courses on fear of flying, and therapists - even some who claim to be experts - recommend breathing/relaxation exercises. They simply do not work during takeoff or during turbulence. Nor does trying to focus on something other than the flight. Takeoff and turbulence are far too intrusive to keep out of mind. Both trigger stress hormones which override selective focus (distraction) and relaxation.

Panic is a major problem. Courses offered by airlines cannot prevent panic. CBT cannot prevent panic. Some therapists using it encourage clients get used to panic.

I worked with the original fear of flying program at Pan Am as a volunteer. Seeing how inadequate it was, I set up SOAR in 1982 to look for more effective methods. First, I tried - without much success - to get CBT to work. Finally, I simply stumbled on something that worked. Subsequently, brain scan research showed why it worked, which, in turn, made it possible to improve the method.

At this point, high anxiety, panic and claustrophobia can be controlled. We now know how to build inside the automatic and unconscious regulation that didn't get built inside early in life. If interested in learning how this is done, it is described in other blogs here at Psychology Today. It is explained in detail in "SOAR: The Breakthrough Treatment for Fear of Flying".

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