Day after day, I'm contacted by fearful fliers who say they have tried everything and nothing works. They don't realize the things they tried are ineffective. When help is offered by "experts" it is natural to believe the advice they offer is valid.

Unfortunately, it may not be. An example is "Your 4-Step Guide to Overcoming Your Fear of Flying," published today by NBC. The first step "Know The Facts," asserts "the more you educate yourself on these facts, the less your anxiety will be able to creep in." The article says there is a one in eleven million chance of being in an airline crash. That statement is intended to be comforting. Instead, it alarms. A number like eleven million is too abstract to provide a positive emotional impact. But the other part of the statistic - the number "one" - hits home. When an anxious flier hears one plane in eleven million crashes, they imagine what people were feeling when on the one that crashed.

Few therapists know that stress hormones can disable a person's ability to separate reality from imagination. But, when an anxious flier imagines what it was like on the plane that crashed, stress hormones are released. If hormone levels rise high enough, they cause imagination to be mistaken for reality. Thus, statistics intended to reassure, have the opposite effect. They lead the anxious flier to "just know" their plane will crash.

The second step in NBC's four step program is "Release and Replace Your Thoughts." Anxious fliers are advised,“You take a thought like, ‘I’m afraid to fly because I think the plane will crash,’ and replace it with something like, ‘I am aware that flying frightens me, but I believe I will be fine and the plane will not crash.’ By doing this exercise repeatedly, you will feel less anxiety because your positive thought will override your negative thought.”

But when an anxious flier brings the statement to mind, they also bring to mind the reason they are using the statement: to feel less afraid of their plane crashing. Instead of calming, affirmations increase anxiety and reinforce the belief that flying is dangerous.

The third recommended step is "Distract Yourself." It suggests “Imagine yourself somewhere that is picturesque and beautiful." Distraction may work on the ground. But, in the air, distraction invites psychological disaster. This is because the amygdala, the part of the brain that releases stress hormones, is on guard for danger. When the plane drops, the amygdala reacts to the feeling of falling just as it would if you fell off a ladder when painting the ceiling. No matter how focused you might be on painting, when you fall, stress hormones are automatically released. They shove thoughts of painting out of your mind and replace them with fear of hitting the floor. The same thing happens in turbulence. No matter how focused you may be on being someplace else, such as on a beach, when turbulence begins, distraction ends. Stress hormones intrude. They shove the peaceful beach scene out of your imagination, and replace it with a terrifying scene: your plane falling out of the sky.

The fourth piece of bad advice is "Focus on Your Breathing." One study after another shows breathing exercises are either ineffective or counterproductive. Breathing exercises are nothing more that a distraction that lets anxious fliers down in turbulence, just when they need effective help most.

I understand therapists want to help. But the first rule is to do no harm. It's harmful to give fearful fliers cognitive tools that work on the ground, but not in the air. I, myself, tried for years to make cognitive tools work for flying. But Cognitve Behavioral Therapy (CBT) is  a "top-down" therapy. It is effective when feelings are caused by thoughts. It is ineffective when feelings caused "bottom-up," as they are when stress hormones are released non-cognitively by noises or by downward motions of the plane.

Emotions can be controlled in the air only by training "unconscious procedural memory" in the subcortex - a part of the brain that is not vulnerable to stress hormones - to provide automatic control.

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