Feeling Better About Flying

Main Category: Anxiety / Stress
Also Included In: Psychology / Psychiatry;  Mental Health
Article Date: 18 Dec 2006 - 0:00 PDT

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"Shape without form, shade without colour, paralysed force, gesture without motion." In his 1925 poem "The Hollow Men," T.S. Eliot describes people made miserable by uncertainty and fear. At that time, Mr. Eliot was probably writing about citizens being alienated from the modern, industrialized world. But walk around Heathrow, JFK or Newark these days, and, sadly, Mr. Eliot seems to be talking about the present day air traveler. Nervous and overwrought, he or she can be found slumped over in waiting lounges or check-in lines, unsure and probably afraid of what might happen when their plane pulls away from the gate.

Ironically, statistics should point travelers in the other direction. Even with recent terror scares and a war against them, commercial jetliners still transport over a billion passengers a year while suffering only several handfuls of fatal accidents in the process. These are amazing odds for any mode of travel, especially considering that getting from point "A" to point "B" by bicycle or even walking runs a greater risk of getting oneself killed.

"Much of it comes down to perception," says Dr. Richard A. Friedman, a professor of clinical psychiatry at Weill Cornell Medical College and attending psychiatrist at NewYork-Presbyterian Hospital/Weill Cornell Medical Center. "Certainly, there is more danger in everyday life, because everyday life means getting in a car or crossing the street, where the chances of injury are much higher. But it is a quirk of human psychology that we don't always make decisions about risk based on rational data. On a purely statistical basis, people should be more afraid of driving than flying, of course, but that is rarely the case."

Part of this distortion stems from media coverage. Airplane accidents - and even suspected terrorist plots - are widely and graphically publicized, even though their occurrence is rare. And there is little air time or print space devoted to all the flights that take off and land without a hitch. Moreover, there is the mistaken assumption among many that everyday life is generally without significant risk, while getting on a plane opens up a plethora of potential pitfalls. These exaggerated perceptions can lead to anxiety and to developing a fear of flying.

To treat this, psychiatrists often use cognitive therapy, which involves getting a person to examine his or her thoughts while a therapist challenges them. When a person says, "I can't get on an airplane because something terrible is going to happen," the psychiatrist offers a reminder that the odds of an accident are very low and tries to get the patient to replace this thought with a more realistic one.

Cognitive therapy is not just saying that everything will be all right. Certainly, flying involves risk, and some places are riskier to travel to than others. "But you try to get the person to think what is realistic," says Dr. Friedman. "You get them to replace 'there's going to be an accident' with 'chances are I'm going to have a safe trip.'"

(Another treatment option is virtual-reality therapy, offered by Weill Cornell's Program for Anxiety and Trauma Stress Studies.)

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