I know, I've been threatening to write about this forever, even though fear of flying is probably even less common among my audience than paying with a debit card. I mention it a lot in my posts, but there's a reason for that: not a day goes by that I don't deal with my fear of flying. It's not just on days I have to fly. It's any day where it's cloudy (the clouds are probably turbulent), or when I see a plane in the sky (if I were on the plane, I'd be really anxious), or if I'm just anxious about nothing in particular, my asshole of a mind will focus that feeling on an upcoming flight just to be a jerk. As I've said before, I've never worked harder on anything than on taming my fear of flying (I hesitate to say "overcoming," since I'm not sure it will ever go away completely). This post is about where the fear came from, and what I've done to address it. Maybe it will be helpful to some people who deal with similar issues. If you don't have a fear of flying and don't really care about mine, go ahead and sit this one out and wait for my next gem to drop in a couple days.
My fear of flying has two main prongs. The first (which I know I have mentioned before) was a freak accident in which I almost died. See, most people have a little voice in their head that says, "you aren't about to die it this very moment." I used to have that voice, but I don't anymore. Irrationally or not, being high up in the air makes me feel vulnerable to death, and since my accident, it's very hard to talk myself out of that feeling.
The second prong was a flight from New Zealand to San Francisco that was really, really rough. Rough enough that the flight attendants told passengers it was the worst Pacific crossing they'd ever been through (and I'd assume Air New Zealand flight attendants have a few Pacific crossings under their belts). Passengers were screaming, some were barfing, and it went on for hours. I've never been so scared, since I was firmly convinced that I was going to die. Not knowing anything about turbulence, I was sure that the pilots were covered in flop sweat, white knuckling the stick up in the cockpit and praying to the gods of flight to spare them the catastrophe that I was sure was about to befall us.
Flying had been tough after the accident, but after the New Zealand flight, all hell broke loose. To be honest, I didn't realize how bad it was going to be until the next time I flew. As soon as the wheels left the ground, the panic hit me like a ton of bricks, and all the little coping mechanisms I had developed haphazardly over the years fell completely flat. I spent the flight (a short hop to Salt Lake City) hyperventilating, and I realized that this was going to be a thing from now on.
I got back home after an equally difficult return flight and started the process of figuring out how I would ever get back on a plane. I talked to a psychoanalyst who said, "Not only am I confident, I'm certain that you'll eventually be able to fly again without taking medication." He may as well have told he that he was also certain I'd grow wings out of my ass and fly around under my own power. Just the thought of having to fly would set off an anxiety attack; most nights I would dream that I was dying in a plane crash. I started researching Amtrak, figuring I may as well just give up on flying ever again.
Here's the thing, though: even then, I knew I'd have to fly again, and I wanted to be able to. If you've ever told a person any variation of, "You're more likely to die on the way to the airport; flying is safer than driving," you don't get how phobias work. Nobody wants to have a phobia. People who are nervous flyers aren't just ill-informed morons who just need to hear from you about how safe flying is before they can comfortably get on a plane again.
Having said that, it's true that lack of information plays a major part in flying anxiety. The catch is that you have to internalize the information, and someone condescendingly telling you that your fear is stupid has the opposite effect. A common element of flying anxiety is to not understand why everyone else on the plane isn't equally terrified (which creates a feedback loop and only ramps up the panic). Those unhelpful admonishments that usually start with "Well, you know..." or "You do realize that..." only reinforce the fear that I'm the only one who understands the gravity of the situation, and that just makes it worse for me.
Patrick Smith of AskThePilot.com is probably the best resource I can think of for nervous flyers. And while his website is good, his book is even better - particularly the chapter on turbulence. Before reading it, I legitimately didn't know that turbulence didn't pose a danger to planes. And you'd be surprised how many people I tell about the non-danger of turbulence who also had no idea. I mean, when your body is getting thrown around like you're on a roller-coaster, it's only natural to think that what's happening isn't normal.
What I needed to internalize went far beyond "flying is safe." It was that the specific things that I felt were unsafe - the wings visibly flapping in the jet stream, the steep drops, the loud noises a 777 makes when it's getting battered by wind - were in fact completely normal. I watched videos of wing flexibility tests, and I devoured as many articles as I could by pilots and other experts about why turbulence at altitude isn't going to crash a plane. I learned that pilots often engage autopilot during turbulence to limit any overcorrection and then sit back to ride it out just like the passengers (well, as much as a pilot ever "sits back" while flying a plane).
It took maybe 10 flights before I started to feel existentially at ease (in other words, that I wasn't about to die). Just being up in the air started to feel normal, rather than it feeling like a precarious, perilous position to maintain for hours on end. That was a big hurdle to get over, but it only solved part of the problem.
Here's the major issue: I'm no longer scared that turbulence is going to crash the plane and kill me, but the physical sensation of rough air (let's say moderate or worse) makes me feel like I'm dying, which causes a panic attack. It's an input that operates on a physical level, and it's so disruptive to my nervous system that, no matter how hard I try, I can't regulate my thoughts until the ride has smoothed out and those inputs have passed.
There's a technique in cognitive behavioral therapy called "downward arrow," where you pick a situation that causes anxiety, and you drill down all the way to the very specific thing about that situation that makes you feel scared. (For example, "Movie theater" --> "Being in a crowd in the dark" --> "Not being able to get out of the crowd in the dark" --> "Being vulnerable to physical harm" --> "A shooter coming into the theater and killing me.") Once you have the specific thing you're scared of, the therapeutic process can zero in and more effectively address the main source of the anxiety.
For my issues with turbulence, the downward arrow exercise didn't point to any fear of external harm; at its core, my issues with turbulence are that it scares me out of my mind. Anyone who has suffered a panic attack knows how horrible it is. For someone who hasn't experienced it, I liken it to sticking your finger into an electrical socket, except instead of your finger, it's your lungs and brain. There's literally no worse feeling I have ever experienced, and yes that includes the accident during which I was buried alive and almost crushed to death.
So what do you do when you have fully internalized that flying is completely safe and that turbulence is completely benign, but the physical experience of turbulence sends you into a panic even as you remain aware that you aren't in any danger? I have spent the past seven years trying to answer this question. (One other way I try to explain this to people is to substitute the mental anguish of panic with physical pain. What if turbulence invariably caused your leg to feel like it was caught in a bear trap? Would you be nervous about turbulence then?)
First, let's get this out of the way: I take drugs to help me fly, and they work. Some fear of flying programs discourage this, since the most common drugs (benzodiazepines) dull your ability to react, which can limit their effectiveness. Brain chemistry is very personal, so what works for me may not work for you. That said, a lot of "drug-free" fear of flying approaches get almost masochistic in their resistance to any palliative avenues of self-care. Sure, drugs may be the junk food to exposure therapy's broccoli, but if the point is to convince yourself that you can get through a flight, then getting the fuck through the flight is a necessary first step.
Exposure therapy also has the risk of re-traumatization - especially in a theater like air travel, where progressive exposure is really difficult. Sure you can tiptoe through the first steps (start by driving to the airport and going home, then try going inside and leaving right away, then try clearing security and leaving, etc.), but once the plane is off the ground, you're locked in to whatever happens until it lands again. An unexpectedly rough flight may shake everything loose and make you realize you can handle it just fine, but it risks having the opposite effect. This is why most forms of exposure therapy are done under pretty close supervision by a therapist - yet another difficulty when trying to apply exposure therapy to commercial flying.
I take lorazepam (the generic form of Ativan), although klonopin, xanax, and valium can be equally effective for people, depending on an individual's particular brain chemistry. When I first started flying again, I took huge doses of lorazepam - big enough that if I took a dose that size on an average Saturday, I'd be nearly comatose for hours. However, the amount of anxiety produced by flying made me barely feel like I was on anything. At first, this created issues as I learned how to regulate my dosage... like the time I kept popping pills on the way from San Francisco to Boston because "I didn't feel anything," and then got lost in Logan airport looking for baggage claim until a cashier at Au Bon Pain made me sit down at an open table because I was all glassy-eyed and confused. Good times.
In recent years, I have made a lot of progress. I've done a bunch of flights in the last couple years without any meds at all (turns out that psych was right after all), but I usually take a small dose, just to put myself at ease a little more. I know I can get through a flight without taking anything, but it's a constant struggle to defuse the tension that builds up, and a minimal amount of lorazepam helps me slow my heart rate and relax without affecting my alertness or coordination. I have even been through some rough stuff and come out just fine - most notably a drug-free flight into Seattle during a storm complete with major roller-coaster drops on the descent. It wasn't fun, and I still found it terrifying, but I got through it.
Here are some ways that I have learned to cope over the years... First, the challenge is always to keep your thoughts from running away unchecked. Whether it's turbulence or something else, there is a definite line between physical discomfort and panic. One of the keys to being able to tame my overall anxiety around flying was to understand that feeling uncomfortable during turbulence is one sensation, a panic attack is another, and the two don't have to be linked. I can go through a rough patch and think "wow, this sucks and I feel awful," without thinking "I'm completely fucked and oh shit oh shit oh shit." One way to get to this point is to take medication designed specifically to prevent it from happening. We've been over this already.
Music is a big one too. I have two default playlists for turbulence - one is very slow, heavy, droning music by bands that coincidentally start with the letter H (Hum, Harvey Milk, Helmet), and the other is super up-tempo fist-pumping stuff like Andrew WK. Depending on my mood and the intensity of the bumps, I'll pick one of the playlists and make it the soundtrack, as if rocking and rolling through the air is a thing that I'm doing for fun. It's not that I use music just to calm down, or to take my mind off the turbulence. Instead, the music integrates with the experience of flying through rough air and gives me something to focus on, centering my thoughts and keeping them from spiraling quickly into fear and panic.
Writing is a major component of my anxiety management as well. Maybe the most important component, actually - even moreso than drugs. I realized on my first flight after the phobia started how powerful a tool writing can be when it comes to keeping my mind from racing. I took my seat after boarding and immediately started veering into pre-panic anxiety, so I pulled out a notebook and wrote down some of the motivational stuff I had drilled into my mind in the months leading up to the flight. I quickly realized that it didn't even really matter what I was writing - the physical act of writing slowed my thoughts down to the speed of my pencil on the paper, which prevented my thought process from going off a cliff. Going back and reading my old notebooks, there are times when I would fill up entire pages with stuff like, "Okay WOW IT'S BUMPY but I'm fine, just gotta keep writing, BIG BUMPS WHOA, it sucks but I'm fine, writing writing, that's what I'm doing, feeling okay even in bumps, writing is good..." It seems ridiculous in retrospect, but it worked, so that's really all that matters.
Finally, it's impossible to overstate the benefit of meditative breathing. I have read that it's impossible to have a panic attack while practicing meditative breathing - I've never tested this, but I do know that focusing on breathing can stop a rising panic attack in its tracks. Panic attacks have a certain velocity, where everything seems to speed up - fast heart rate, racing thoughts, hyperventilation, sweating, and so on. Breathing is the one thing you can always control, though, and by slowing it way down and focusing intently on the in/out rhythm, everything else starts to settle back down too.
Realizing that you can arrest a panic attack's momentum is hugely valuable, since so much of the fear around panic anxiety is that when an attack strikes, there's nothing you can do. It's very comforting to know that the knife's edge between panicking and not panicking isn't so much a knife's edge as a plateau that you can control with techniques as simple as breathing or writing.
The lack of control is a big issue for many people who have a fear of flying. This could either be the lack of control over the plane itself, or simply the lack of control over one's situation (insofar as you're stuck on a plane and can't get off no matter what). However, what meditative breathing taught me is that I'm at least in control of my reaction to my surroundings. While I may not enjoy it, I can focus on dealing with the anxiety and pushing it away, or I can succumb to it and let myself roll headfirst into a panic attack. And that choice starts with my ability to regulate my breathing.
EDIT: After I published this post, I realized that I left out one additional technique that has been very helpful. Again, this may just be something that works for me, but I figured it was still worth mentioning. I call it "rebound thoughts," and it's basically a catalog of the thoughts that accompany rising anxiety paired with the exact opposite thought that instantly refutes it. By studying these in advance, I can beat back the fearful thoughts as they start, rather than letting them build until I'm having panic attack. Here's an example: probably one of the most reliable signals that I'm about to have a panic attack is that I start thinking, "get me off this plane." The rebound thought there is: "Keep me on this plane!" To expand on that: "Keep me on this plane so I can keep challenging myself to encounter turbulence and prove to myself that I can manage this." Another one is, "that last bump was fine, but if it keeps going or gets worse, I'm gonna lose it." Rebounding: "that last bump was fine, and if I can do one, I can do a hundred - so bring it on and let me see how big of a bump I can handle!" I agree that this sometimes veers into motivational speaking territory, but in the moment, psyching yourself up is one of the most important things you can do to keep fear and anxiety at bay. After all, panic is just your fight or flight response misfiring, which creates a surge of adrenaline. If you can repurpose that adrenaline surge into making you feel like you're having an exhilarating experience as opposed to a terrifying one, you're much less likely to panic.
In the end, I don't know if I'll ever get all the way to the point where I can say I've beaten my fear of flying. It's more like back pain. Some flights are great, and I fly through turbulence as calm as if I were at home on the couch, and other ones are tense and shitty. The point, though, is that I always do it, even if it stresses me out. That's why I say I have tamed my fear - I don't let it dictate my choices or prevent me from seeing the world, but I do still wrestle with it constantly. I'm pretty sure that if I suddenly found myself in a job where I was flying a couple times a week routinely, the repeated and consistent exposure would finally get me to the point where I could fly without nervousness. That's all hypothetical, though, since I don't travel that much for work, and I don't have the time or money to fly somewhere every weekend just for practice.
Still, without getting too didactic, have hope if this is something you also struggle with. It's definitely possible to get to a place where flying is doable, and sometimes I even find it enjoyable. And let's be clear that I love a lot of things about flying - in fact, I love pretty much everything about flying except for the physical feeling of flying. There's nothing I'd like more than to be like the 75% of flyers for whom the worst thing about flying is the legroom... the people don't care what the weather is doing, and who don't bat an eyelid when the plane flies into a thunderstorm or over a mountain range. But even if I never get there, the fact that I can do it at all is still a pretty huge accomplishment, and the fact that I figured out how to do it in maximum comfort thanks to churning is the cherry on top.