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How to Overcome Your Fear of Flying (Part 2)

In Part 1 of this series, the Savvy Psychologist covered 5 ways to get to your destination without leaving fingernail marks in the armrest.  Today, we’ll learn why you freak out at 30,000 feet and do a 10-second test to see if you’re prone to panic. Plus, the skinny on Xanax and what to do next.

By
Ellen Hendriksen, PhD
March 28, 2014
Episode #012

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Last week on the Savvy Psychologist show, we discussed tips and tricks to get you on a plane and to your destination without the aid of the airport bar or having a panic attack. Check out How to Overcome Your Fear of Flying (Part 1) for more.

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This week, we'll tackle the reasons behind your flying fears, plus some more tips on how to manage them.

In-Flight Panic

An in-flight panic attack can be triggered by thinking you’re in danger, fear of a panic attack itself, or even just out of the blue.  And if you’ve actually experienced a panic attack on a plane, memories of those excruciating minutes are often enough to keep you grounded, or at least heavily sedated on your next flight.  What you’re afraid of is no longer flying, but of panic.  Your fear really is of the fear itself.

How does it start?  Panic often flares from a spark in your own body—a racing heart, a tight throat, a feeling of lightheadedness.  If you’re leery of flying, you may be on the edge of your seat to begin with during a flight.  Then, a sensation such as popping ears due to increasing altitude, a stomach drop due to turbulence, or feeling smothered in the recycled air can all contribute to catastrophic thoughts of losing control, dying, or simply being trapped in a metal tube for hours with hundreds of strangers, a surefire way to jump-start a panic attack.

Some of us are more attuned to bodily sensations than others.  You probably know someone who can’t tell if she’s hungry or has no idea how he got that bruise.  On the flip side, you probably also know someone straight out of The Princess and the Pea.  This awareness of one’s own body (or lack thereof) is called interoceptive awareness.  Interoceptive awareness, unsurprisingly, is more sensitive in individuals prone to panic attacks. 

A classic and easy way of measuring your own interoceptive awareness is try to sense your own heartbeat.   To try this, sit straight up without letting your back touch your chair, put your hands in your lap, and breathe normally.  If you can’t detect it, don’t despair.  Either way is considered normal.  That said, a 2011 study found that individuals with a fear of flying have higher interoceptive awareness than those who fly without a second thought. 

The Skinny on Xanax

We don’t need a study to tell us that those who are prone to panic on a plane are more likely to take Xanax than those who get onboard easily.  Indeed, if you take Xanax, you are not alone.  With more than 49 million prescriptions a year, Xanax is the most prescribed psychiatric medication in history.  And if Xanax is what gets you on the plane to see your grandkids, you have my blessing.  Use every tool in your toolbox to get those sticky hugs—remember, the Savvy Psychologist is all about zero judgment

Now, some folks don’t like the feeling they get on Xanax or dislike relying on a pill.  Again, if it works for you, you’ve found a solution, but if it doesn’t, consider a small study where researchers asked a group of 28 women, all of whom had a fear of flying, to take two flights.  

Before the first flight, half of the women took a Xanax, while the other half got a placebo pill.  True to expectations, when the plane took off, those who had taken the real Xanax reported less anxiety than the placebo group.  But here’s the paradox: during the flight, the women who took Xanax, oddly, had faster heart rates and faster breathing than the placebo group.  The Xanax caused a dissociation between what their bodies actually did and how they felt.

A week later, when the women got on a second flight, none of them took any medication at all.  Two things happened.  First, 71% of the women from the original Xanax group had a panic attack on the second flight (now there’s a sight to imagine), but only 7% of the original placebo group did.  Furthermore, on the second flight, those who had originally gotten the placebo felt better than on the first flight.  Even though they were still frightened, their anxiety symptoms were fewer in number and intensity.  

So in sum, for the placebo group, going without medication at first was rough, but it got easier on the subsequent flight.  For the Xanax group, medication helped ease symptoms—sort of—in the moment, but when the medication was taken away, the fear remained as strong as ever.  The researchers concluded that the Xanax hindered a phenomenon called habituation.

What is habituation?  In simple terms, it is the body and mind getting used to something.  Consider putting your watch on your wrist.  At first, the nerves in your skin can sense the pressure and texture of the watchband, but after a few minutes, your nerves essentially get bored and stop sending the signal, so the sensation subsides.  The nerves habituate, or simply adjust, to the presence of the watch.  

Now, let’s translate this to fear of flying.  

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