Mind Moves: This summer many people will have enjoyed holiday locations to which they travelled by plane.
Others will have chosen to holiday at home. But for an estimated one in eight people there is no choice if the desired destination requires a flight because they are terrified of flying. They suffer from aviaphobia.
The term phobia is usually reserved for any abnormally intense, exaggerated and irrational dread of any specific object or situation that leads to total avoidance. What distinguishes a phobic reaction from ordinary fearfulness, degrees of which many people experience during air travel, is the total incapacity to cope with even the thought, not to mention the actuality, of going anywhere by plane. Even imagining checking in, boarding a plane, waiting for takeoff, experiencing the flight, touchdown and disembarkation is enough to induce physical and emotional stress responses rising to panic reactions if there is coercion to confront the situation.
A distinction must also be drawn between adaptive, rational and irrational fears. While phobias are usually associated with irrationality - in that one may be afraid of the most innocent of objects, inoffensive insects, innocuous germs and unlikely ailments - fear of flying is not totally irrational. Risk may be low, but news coverage of air crashes, such as the most recent Helios Airways crash, heightens anxiety.
Additionally, the images of the attacks of September 11th, 2001 are inextricably and inescapably those of planes destined to destroy and be destroyed, memories exacerbated by the recent terrorist attacks in Britain, reminding travellers that any mode of transport is a possible target. Unease in the air is understandable at this time.
Understandable too is fear after any frightening flight. This might be a turbulent journey, illness on board, frantic travel home for a funeral, a difficult landing, being diverted to another airport, having to ascend suddenly during descent, a long holding pattern above a busy airport or the experience of an emergency exit. Explicable also is avoidance of flying by crash survivors in which others perished. The subsequent post-traumatic stress is hardly irrational, unfounded phobic fear.
Few go voluntarily and cheerfully into situations that once held significant threat. But the more effective avoidance is in allaying initial fear, the greater the anticipatory anxiety of flying again, as in that ancient advice to immediately get back on the horse from which you have fallen. This is because after any bad experience, the longer the reward of subsequent avoidance the greater the fear at the thought of return.
A further distinguishing feature of phobia is how it intrudes on normal life. Abnormal fear of elephants has little impact on ordinary living. Encountering elephants is unlikely and someone else can take the children to the circus and zoo. But fear of flying is more than an inconvenience. It may prohibit visiting friends abroad, attending a son or daughter's wedding, a grandchild's christening, returning in time to a dying parent or a family funeral, prevent job promotions that require travel, cause marital tension, induce fear in offspring and intrude on the sufferer's self-esteem.
Statistics suggest that women outnumber men two-to-one but some clinicians believe that more men conceal their fear of flying. Excessive consumption of alcohol before and during flights may be a symptom of secret self-administered treatment to take the edge off the fear.
Practical factors aggravate anxiety. Hardly conducive to reassurance are the safety demonstrations before flights, unusual engine noises, unexpected turbulence or even the knowledge that high profile families fly separately to protect their dynasties. It takes aerodynamic faith to concede that this massive object can remain in the sky, as it does to trust that aircraft safety checks have been meticulously executed, that air traffic controllers, pilots and crew bring no personal stresses on board to compromise critical takeoff and landing times.
Trust of one's fellow passengers is required, but with increased incidents of air rage and terrorism, travelling companions seem less reliable than reassurance requires. Finally, flying is one mode of transport on which a panic attack does not provide the opportunity to get off.
Ironically, while aviophobia may be specific, in the multiphobic person it may diffuse with agoraphobia, claustrophobia and social phobia, fears of crowds, confinement without means of egress, in addition to the embarrassment of a potential public panic attack.
So must one be grounded physically and psychologically forever? Absolutely not. Treatment for a flying monophobia (rather than multiphobia) is straightforward and extraordinarily effective in most instances. What is called in vivo desensitisation or learning to lose the fear in a live situation works. This is achieved by progressive desensitisation or graduated, simulated and real exposure, during which a person is taught to relax just going to the airport, then checking in, next boarding, then taking a short flight until finally all steps are accomplished. Simple, short, successful.
Marie Murrary is director of psychology, St Vincent's Hospital, Fairview, Dublin. See also Conquer Your Fear of Flying, by psychologist Dr Maeve Byrne-Crangle, Newleaf.