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Fear of Flying

 

 

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Page Contents: Introduction / The Facts...and the Problems / Vulnerability / Components / Symptoms / Medical Issues / Trapped? / Freedom / Cognitive Coping Strategies / Children and Fear of Flying / Other Issues to Consider / Treatment / Fear of Flying: In Pilots? / Related Fear of Flying Resources

 

Introduction

IE WAS A SUCCESSFUL MAN who through hard work and perseverance built up his own business. His wife, too, owned her business. They had two fine children.

He traveled frequently, and because of an odd premonition that he would someday die in an airplane crash, he refused to fly. For shorter trips he drove his car. For longer trips, he took trains, and even boats, to his destinations.

One spring night a pilot of a small plane experienced a complete engine failure. On top of that, he lost his electrical system, and with it, the use of his radio and navigation instruments. Mist filled the sky. The moon had not yet risen. The plane went down helplessly and blindly in the darkness.

Though injured, the pilot survived the crash. He still cannot remember anything that happened as the plane struck the ground and plowed into a motel just outside of a large town. There was only one casualty: a man sleeping safely in the bed of his motel room. On that sad night, that man’s life-long premonition that he would someday die in an airplane crash found its conclusion.

 


 

The
 
Facts . . .
 
and
 
the
 
Problems

Flying is generally considered to be one of the safest forms of public transportation currently available in the United States. Statistics compiled by the Department of Transportation have led to the conclusion that airline travel is 29 times safer than driving an automobile.

The problem with the above statistics is that they do not stop people
from being afraid of flying.

Statistics do not help because the fear of flying actually has little to do with risk as such. If the fear of flying were actually caused by the potential for an accident, then everyone who fears to fly would be even more afraid—29 times more afraid, to be statistically exact—to drive or ride in an automobile. But that is clearly not the case.

Anyone who flies—even someone not afraid of flying—understands that there is always some chance of an accident, just as with any life activity. Relatively few accidents happen in aviation because pilots are specifically trained to stay calm and to think clearly in an emergency—and they are trained to handle just about every emergency imaginable.

But, without their own specialized training, many passengers sit in the cabin worrying about the dangers of flight. Despite the safety statistics, they become disabled by fear and experience the psychological symptoms that make flying a misery.

 


 

Vulnerability
 

If you carefully read the information on this webpage, you will learn that, although the fear of flying isn’t really about the risks inherent in aviation, it is based in the uncomfortable awareness that life is fragile and vulnerable, and that none of us—much like the man in the fictitious opening story—has any real control over it, whether in the air or on the ground.

Because we were not designed to fly like birds, whenever we get into a “flying machine” we have to confront our deepest fears of human vulnerability. It’s not so much that flying is “unnatural,” but that in finding ourselves way up in the sky, sealed in a machine, we can hear our deepest whisperings of vulnerability more clearly than anywhere else.

Still, even though none of us is ever “in control” of anything, we can learn to be psychologically in command of our thoughts and feelings—and trust in something greater than ourselves—more than we think. We can learn to not be overwhelmed by fear itself.

Continue reading, therefore, to experience your own “specialized training” in flying without anxiety.

 


 

Components

Technically, the fear of flying is a Specific Phobia, one of several kinds of Anxiety Disorders. As an anxiety, the “fear” of flying is more concerned with what might happen than with what actually is happening.

  

If, for example, you were sitting in a plane with smoke coming out of the engines while the captain was trying to make an emergency landing, there would be a clear and present danger, and anyone would be afraid. But if you were sitting in a plane with all systems functioning normally and you felt afraid that something threatening could happen, that would be anxiety.

  

The fear of flying has many components, not all of which are specific to flight itself. Some of these components are anxieties about

Heights

Enclosed spaces

Crowded conditions

Sitting in hot, stale air

Being required to wait passively


  

Not understanding the reasons for all the strange actions, sounds, and sensations occurring around you

Worrying about the dangers of turbulence

Being dependent on unknown mechanical things to maintain your safety

Being dependent on an unknown pilots judgment

Not feeling in control

The possibility of terrorism

  

If your fear of flying derives from a past trauma or accident, you might consider a consultation with a psychologist specifically to resolve those “underlying” issues. You might also be interested in Wings of Light, an organization formed as a support and information network for persons whose lives have been touched by aircraft accidents.

  

 


 

Symptoms

No one can be in control of his or her future, and so anyone who worries unnecessarily about the future will cause physical and emotional reactions just as if something dangerous really were happening.

Generally, people who experience a fear of flying report two basic kinds of symptoms.

 
Physiological reactions to fear and stress include

Muscle tension; tremors

Heavy, labored breathing

Heart palpitations; chest pain

Abdominal and intestinal discomfort


  

Sweating, weakness, dizziness, prickly sensations, dry mouth, flushed or pale face

 
Psychological symptoms include

Impaired memory

Narrowed perceptions

Poor or clouded judgment

Negative expectancies


  

Perseverative thinking

 


 

Medical
 
Issues

Anyone who flies should be aware that certain medical conditions—conditions not caused by psychological anxiety—can produce symptoms that mimic the physiological reactions to anxiety or cause additional anxiety.

Vestibular (inner ear) problems can cause disorientation, dizziness, and nausea.

Ear Pain

The middle ear is connected to the throat by a pathway known as the eustachian tube; this tube equalizes the pressure between ambient air pressure and air trapped within the middle ear. If the tube gets blocked, you can experience pain known as “middle ear block” or barotitis. (Remember that when an aircraft ascends, ambient air pressure drops, and when the aircraft descends the air pressure increases; this is why ear pain is encountered at either of these two times of flight.)
 
The safest and most common method of clearing an ear block is to move the jaw and swallow at the same time—which is what happens when chewing gum.
 
The next thing to try if gum doesn’t work is the Valsava maneuver: when you feel a block developing, hold your nose shut and then blow gently as in trying to exhale. The back pressure can force open the eustachian tube.
 
If this maneuver doesn’t help the pain, you can try using a decongestant nose spray or an oral decongestant (such as pseudoephedrine) about an hour before departure or an hour before arrival. (Avoid any medication that combines the pseudoephedrine with an antihistamine, because this can cause drowsiness that lingers for several hours. But then, maybe you want to sleep on the flight—just don’t try driving afterward.)

 

Sinus Pain or, when it is very serious, “Barotrauma of Sinuses.” This pain often appears around or above the eyes, as in a headache on one side of the head. The pain results from atmospheric pressure changes, just as with inner ear pain (described above), only the pain involves congested sinus cavities. It usually happens during descent, when the pressure of the air trapped in the sinuses cannot equalize with the pressure of air in the cabin. Just as with ear pain, relief can often be found by taking a decongestant (to open up the sinus cavities) approximately an hour before arrival, before descent begins.
 

Muscular pain, joint pain, and tingling, can be a symptom of decompression sickness (DCS). DCS can result from flying in an unpressurized aircraft at high altitudes, but in commercial aviation, with its pressurized planes, DCS isn’t likely to be seen except in scuba divers who have made recent dives. Nitrogen dissolved in body tissues from the dive may not cause problems at sea level, but at altitude the nitrogen can begin to emerge from tissues as bubbles. Such a condition requires immediate medical attention. Oxygen treatment on-board may help, but hyperbaric treatment on the ground may be required to recompress the nitrogen bubbles. (Just remember: waiting less than 24 hours after a dive before flying can increase the risk of DCS considerably.) [1]
 

Traveller’s Thrombosis or, in popular jargon, “economy-class syndrome.” 

“Deep vein (or venous) thrombosis is a condition in which a small blood clot (thrombus) or clots (thrombi) develop(s) in the deep veins, usually of the leg. The condition itself is not dangerous, but the complication of pulmonary embolism (venous thromboembolism — VTE), can, of course be life threatening.” [2]
 
It can be life-threatening because that little blood clot can be carried in the bloodstream to another part of the body where the clot can block the flow of blood to a critical organ, such as the heart—causing a heart attack—or brain—causing a stroke.

Actually, deep vein thrombosis (DVT) has occurred as much in first class and business class as in economy class, so calling it “economy-class syndrome” is a misnomer.

Common sense can explain why. All scientific evidence seems to point to the origin of the problem as restricted mobility for long stretches of time. So think about it. In cars and busses we stop for rest breaks every couple hours; in trains we are free to walk around from car to car; and cruise ships are like floating hotels. Only in airplanes are we literally strapped to our seats for hours on end; even food is brought to us, because there is no dining car. So it’s no wonder that DVT is associated with (not caused by) air travel.

And consider one other fact. If you make a long flight anywhere, you’re likely to make a long flight back home—and the risk of DVT seems to be associated with that second flight.

So if you have the option, leave several days between long flights. Move around in your seat as much as possible. And if you have predisposing conditions—such as a blood disorder affecting clotting; cardiovascular disease; current or history of malignancy; recent surgery; use of oral contraceptives; recent lower limb trauma; pregnancy; age over 40 yr.; previous DVT; family history of DVT—see your physician before travelling.

Which is worse? Risking DVT by staying in your seat, or risking injury from sudden, unexpected turbulence when not secured in your seat? Only you can decide.
 

Mitral valve prolapse (MVP) can cause chest pain and may contribute to panic sensations. (There may not be a clear link between MVP and panic, so ask your physician for details.)
 

Hypoglycemia (low blood sugar) from not eating—commonly due to loss of appetite because of a “nervous stomach”—can cause faintness, irritability, muscle tension, and anxiety.
 

Allergic reactions to plastics, carpeting, perfumes, etc. can cause varying degrees of discomfort.
 

Side effects from prescribed or over-the-counter medications can cause a variety of uncomfortable and anxiety-like feelings.
 

A lack of oxygen at altitude may cause any number of symptoms of altitude sickness, such as headache, irritability, nausea, muscle weakness, fatigue, slightly blurred vision, and faster or shallower breathing.
 

That’s right—a lack of oxygen, technically known as hypoxia, can be noticed because even though the aircraft cabin is pressurized, it is usually pressurized only to about 8,000 feet. Unless you’re used to living in the mountains, the physiological effects of even this modest altitude can be significant. The effects of hypoxia may not be noticed on short flights, but many persons can experience symptoms on long flights; that is, after 5 hours at altitude.
 
Also, if you’re a smoker, the carbon monoxide in tobacco smoke diminishes your blood’s ability to carry oxygen, and so the hypoxic effects of altitude will be more intense for you than for a nonsmoker.

 

Dehydration from the very dry air in the aircraft cabin may cause headache, dizziness, and fatigue. Protect yourself by drinking plenty of plain water: about a cup (8 oz—or 250 ml) per hour. In general, unless you have kidney problems, this moderate water intake should be beneficial.[3] Avoid alcohol, colas, and caffeine.

If you believe that any of these conditions may apply to you, discuss them with your physician.

Never take any medication inflight which you have not first tested for adverse reactions while safely on the ground.

 


 

Trapped?

Clearly, the fear of flying can be associated with many different symptoms. You might even experience some of these symptoms in situations other than flying and not be nearly as incapacitated as when you are flying in an airplane.

In fact, this is the key to the whole problem. In other situations, you have much more freedom to change things. If it’s stuffy in a car, you can open a window. You can talk to the driver. You might be the driver. Even riding in a bus or train is usually less troubling than flying.

The reality is that flying can feel like being trapped—trapped in the airplane until it lands.

And so it might be said that your symptoms are your “out-of-control” reactions to feeling trapped and out of control.

 


 

Freedom

A person who has overcome the fear of flying still knows that anything could go wrong with the flight—just as someone driving a car surely knows that an accident could happen at any time. What this person has overcome, therefore, is the escalating spiral of ever-worsening symptoms triggered by one or more of the anxiety-provoking components of airplane flight.

 


 

Cognitive
 
Coping
 
Strategies

Research that has examined the cognitive coping strategies used by persons who are afraid to fly tells us that, in general, four specific coping strategies seem to be most associated with flight anxiety:[4]

1.

Rumination, which refers to thinking over and over again about the situation

2.

Self-blame, which refers to thinking a lot about mistakes you have made

3.

Acceptance (or resignation), which refers to thinking that you have no other option but to helplessly accept things as they are

4.

Catastrophizing, which refers to thinking about how awful the situation is or could become

This means that if you are afraid to fly, you are likely to spend a lot of time being preoccupied with worries about flying before the flight even happens, and you can get caught up in dwelling on all the physical and psychological symptoms you’re feeling once the flight begins. Plus, you will likely blame yourself for your failures and weaknesses, you will be telling yourself that you are helpless to do anything about those weaknesses, and you will be thinking of all the bad things that could happen.

Here, then, is some advice about how to change these anxiety-provoking ways of thinking.

Rumination—expand your awareness beyond the unpleasant situation:
 
I’m thinking about the flight again, and it’s still two days away. Let it go. Take a deep breath. Come on, get back to work.
 
Look. It’s a nice view. Sitting here paralyzed won’t make the plane any safer.

 
Self-blame—remind yourself that you are doing the best you can and that progress takes time:
 
Yes, I was very nervous the last flight. But since then I have learned some new techniques for coping with anxiety.
 
I did the best I could. I’ll get better with practice.

 
Resignation—give yourself credit for your own good sense:
 
I’m not really helpless. I can take slow, deep breaths. I can practice progressive muscle relaxation or autogenics.

 
Catastrophizing—acknowledge your fear, and then challenge it:
 
OK. I will be afraid as I’m boarding. But have I ever run away from other problems before? No.
 
OK. Maybe I will feel nervous. But I do have things I can do to relax. All things will pass.
 
Yes, I can imagine a lot of awful things that could happen. But the reality is that none of these things is likely to happen.

 


 

Children
 
And
 
Fear
 
Of
 
Flying

Sometimes children develop a fear of flying. But unless the fear can be traced directly to a trauma or accident, before seeking treatment specific to the child, it would be advisable to think of the child as just one part of a larger family system.

So consider whether the child’s anxiety relates in some way to family conflicts.

For example, children who have to fly from one divorced parent to another for visitation can develop anxiety about flying which relates primarily to feelings of helplessness and abandonment. In other words, the fear is not about flying so much as about what flying signifies: the despair of being shuttled from one parent to another like a sack of potatoes.

A child’s fears can also be an unconscious expression of a parent’s anxieties. It’s odd, but sometimes a child’s symptoms reflect things the parents are struggling with but are trying to keep hidden.

So always consider what the child’s symptoms mean psychologically within the greater family context. The child’s fear of flying may not be about flying at all.

 


 

Other
 
Issues
 
To
 
Consider

When someone flies across the country, it’s not usually for the benign reason the chicken crossed the street: to get to the other side. Human travel usually involves desires and expectations. And often those desires and expectations involve unpleasant emotions such as hurt, anger, and uncertainty about fulfilling obligations.

Now, because flying does have some risk to it, those unpleasant emotions can get psychologically transferred to the process of flying. That is, rather than acknowledge our “dangerous” emotions, we focus on something else that seems dangerous: flying itself.

So, as strange as it might sound, even an adult’s fear of flying may have nothing to do with flying per se. Consider the following case vignette.

  

A 32 year old woman calls the office, leaving a message in which she requests treatment for fear of flying. She says that the last time she had to fly she couldn’t board the plane, and she was such a nervous wreck that her husband had to drive her home. She now has recurring fantasies that she is on a plane which crashes.

When you call her back and request more information, she says that the last flight on which she flew encountered turbulence. One of the male flight attendants was injured by a beverage cart, and one of the female flight attendants who came to his aid started crying. The woman mentions that when she told this to her husband after the flight, he was not very sympathetic and they had an argument.

You ask if she can remember exactly what her husband said that was “not sympathetic.” She hesitates, then replies that he told her, “Oh, the flight attendant was just upset because the two of them were probably having an affair.”

You then ask for some general information about recent events in the woman’s life. She replies that she and her husband were married two years ago. For the last year they have been trying to have a baby. About six months ago the woman received a job promotion which required her to fly frequently across the country. She adds that she had no trouble making any of these flights until the problem with the turbulence.

  

 
Although this case is fictitious, there are several clinical possibilities that can be considered.

The woman is ambivalent about her job promotion and fears that it might affect her marriage, and so the fear of flying symptoms serve unconsciously to prevent her from fulfilling the duties of her new job and call into question the promotion itself.

The woman is afraid that her husband may be dissatisfied with the marriage and may be having an affair—or thinking of having one—and so the fear of flying symptoms keep the woman at home near her husband.

The woman is afraid of not being able to have a baby, and the thoughts of a plane crash may be an unconscious expression of her fear that she will die childless.

The woman may be feeling hurt by her husband’s behavior, for any of the reasons above, or for other reasons. But, because she cannot acknowledge the full extent of her angry response to feeling insulted, abandoned, and helpless, and because she may even feel guilty for having thoughts and feelings of revenge, she visualizes the plane crashing as an expression of an unconscious desire to punish her husband—or herself.

Any—or all—of these possibilities could be an explanation of the fear of flying symptoms. And none of them has anything to do with flying itself.

 
Therefore, if you have a fear of flying, before seeking treatment you might want to ask yourself several questions (along the lines of the vignette presented above):

1.

What exactly were the circumstances of the flight on which the fear of flying symptoms first appeared?

  

Why were you flying?
What happened just before the flight?
What happened during the flight?
What happened just after the flight?

(Try to recall the facts, as well as the exact words of anything that was said.)

2.

What was happening in your life before the fear of flying symptoms developed?
 
Did you experience any major life changes before the fear of flying symptoms developed?
 
Did anything happen that left you feeling uncertain or conflicted before the fear of flying symptoms developed?
 
Had anyone done anything to you that had left you feeling emotionally hurt and angry before the fear of flying symptoms developed?

 

3.

What exactly might a fear of flying prevent you from doing?

  

How do you really feel about not doing it?
Maybe you don’t really want to do it.
Or maybe you feel guilty about doing it.

 
Who knows? You might end up in treatment for something other than fear of flying, or you might be able to solve the problem yourself without professional help.

Testimonials from readers

 


 

Treatment

Considering all that has been said on this page, treatment for the fear of flying can take several forms.

You might simply need factual information about principles of flight and flight safety, such as turbulence. You can begin by reading my page Principles of Aircraft Flight. You can also get similar information for free from other websites, or you could buy any number of online courses, or you could participate in a group fear of flying program offered through airlines. For more information about these alternatives, see my page Fear of Flying Treatment, and its Additional Resources section.

If information alone is not sufficient, then you might want to treat the symptoms of your fear of flying by changing your negative thinking or by learning a relaxation technique. I offer two free self-help training courses on this website, one in Progressive Muscle Relaxation and the other in Autogenics.

If a basic symptomatic treatment is not sufficient, then you might want to try exploring the psychodynamic aspects of your anxiety, as outlined in the section above called Other Issues to Consider.

If a basic symptomatic treatment is not sufficient, and if your own psychodynamic exploration does not help you, then you might want to add a more clinical approach. You can follow the free self-help treatment guidelines I offer for Systematic Desensitization, or you can consult with a psychologist or other mental health professional for treatment of a phobia, or you can seek treatment to help you better understand your emotional life.

Finally, if your anxiety is based in an existential fear of death more than an anxiety about flying, you might want to consider the idea of spiritual healing.

 


 

Fear
 
Of
 
Flying:
 
In
 
Pilots?

As I have described above, in my clinical experience I have found three basic causes for a fear of flying: (a) a lack of information about basic aviation procedures, (b) some sort of psychological trauma resulting from an aircraft incident or accident, and (c) a symbolic transference of an interpersonal conflict to the experience of flying. There can also be a fourth reason for a fear of flying, a reason found only in pilots: flight training issues regarding a lack of confidence.

Now, when wondering why a trained pilot would become fearful, we can rule out the first possibility.  

 
Psychological Trauma

This second possibility is self-evident,[5] but still it can be obscure. In one case,[6] a military pilot in training exhibited severe insomnia the night before his training sessions; after a thorough medical investigation, it was determined that he had a tendency to gray-out under high +Gz and was afraid to tell his instructor, fearing that it would be a sign of weakness. Anyway, once this all came to light, he was given some special assessment and all worked out well. 

 
Symbolic Transference

This third possibility is the most complex and, often, remarkably fascinating.[7,8,9] Consider, for example, the following case.

  

A pilot suddenly develops a disabling fear of flying when thunderstorms are forecast and becomes obsessive about gathering minute bits of weather information.
 
Further history reveals that this airline captain also likes to fly aerobatics on his own time. In fact, the adventure and thrill-seeking aspect of flying drew him into aviation in the first place. Because of this independent, adventurous aspect of his personality he has never felt completely comfortable with all the mundane responsibilities of family life. But then, four years ago, his daughter was born, and this immediately threw him into conflict. The part of him that wanted to be a good father started struggling with the independent thrill-seeker part of his personality. All kinds of questions came up. “Am I really capable of looking after a child?” “Do I have the ability to be there for her as she will need me to be there for her?” “What if something happens to me while flying? What will become of her?”
 
So he ends up obsessing over the weather (as if outsmarting the weather will prevent the accident that could take him away from his child) in order to obscure and hide the real issue: Is he willing and able to make the changes and sacrifices in his life to accommodate this new child?
 
Thus the thunderstorms symbolize the “gathering storm” in his marriage, and his fear of being near them symbolize his own risky attitude to life that could destroy his own life if he doesn’t “change course” very quickly. 

  

Professional pilots in general, however, especially those with a military background, tend to be very much focused on a goal-directed, rational approach to life [10] and so can suffer a considerable lack of emotional intelligence—so this concept of psychological awareness may take some effort for them to grasp.

 
Training Issues

The fourth reason for a pilot’s flight-related anxiety can derive from any aspect of flight training. It’s often seen in regard to landing procedures when many decisions have to be made quickly in a short time in often changing conditions (i.e., crosswinds). An especially good example, though, can be found when a pilot, newly trained in Instrument Flight Rules (IFR), must fly in Instrument Meteorological Conditions (IMC)—that is, in weather conditions with such limited visibility that the pilot must rely exclusively on the instruments to fly the airplane. A pilot might confess that he feels afraid of the weather conditions and will wonder why this is so, because it would seem that with his IFR training he should feel more comfortable with worse weather than before.

These concerns are very understandable, and, in fact, they show really good, common sense to be “afraid” of bad weather. Weather is a powerful force and only a profound respect for it will allow a pilot to fly in difficult conditions and stay alive.

Unlike the case presented above, involving a symbolic transference, the psychological principle underlying anxiety about a training issue is this: We cannot feel comfortable and confident doing anything until we have acquired some experience in performing the task under our own authority. Flight instruction teaches us, but personal experience on our own solidifies our confidence.

So, in this sense, the only way to get comfortable flying in IMC is to get experience flying in IMC. But remember good common sense about weather. There’s no point in risking your life trying to get experience. The solution, then is to get some experience flying in IMC along with another IFR pilot who has more experience than you currently have. This isn’t a matter of training—it’s a matter of mentoring.

You could do this in any of three ways.

1.

You could ask an experienced IFR pilot to allow you to fly with him when he makes flights in IMC. You can volunteer to serve as an informal co-pilot. Then buy him lunch in gratitude. Or pay him for his time.

2.

You could ask an experienced IFR pilot to act as a sort of informal advisor and to accompany you on IFR flights that you must make in IMC. Again, buy him lunch in gratitude, or pay him for his time.

3.

Pay an instructor to accompany you on IFR flights in IMC, but as a mentor, not as an instructor.

In doing this, learn to set aside any “pride” in yourself that having your IFR rating makes you “qualified” to fly in IMC. Keep in mind that any license is only an acknowledgment of minimum qualifications, and that real competence comes through wise and safe experience. So there’s nothing “wrong” with you for needing some extra guidance in IMC. Your seeking out extra guidance, in fact, shows that you respect the weather—and that you respect your own life.

 


 

Related
 
Fear
 
of
 
Flying
 
Resources

Here is a list of related Fear of Flying self-help resources available on this website, all offered in freewill, with no advertising and no sign-up gimmicks.

 

WEB PAGE

CONTENTS

Rx

Basic Principles of Aircraft Flight

Explains in simple, easily understood language how airplanes fly, what movements and sounds to expect in flight, and what turbulence really is and how to stop the panic it causes.

Autogenics Training

Complete training program for physiological and mental relaxation with guidance for changing unwanted behaviors.

Progressive Muscle Relaxation

Complete training program for physiological relaxation using a simple muscle tensing/relaxation procedure.

Systematic Desensitization

Explains the Systematic Desensitization procedure, using Fear of Flying examples, so that you can desensitize yourself to flight anxiety.

Hypnosis and Cognitive Psychology
 

Explains how to change negative, self-defeating thought patterns.
 

 


 

Gratitude
 

Has this web page been helpful? Then please help support this website in gratitude, as a “down-payment” on the success of your hopes and dreams!

 

No advertising—no sponsor—just the simple truth . . .


 


 

 
Notes:

1. Freiberger JJ, Denoble PJ, Pieper CF, Uguccioni DM, Pollock NW, Vann RD. The relative risk of decompression sickness during and after air travel following diving. Aviation, Space, and Environmental Medicine 2002; 73:980–984.
 
2. Bagshaw M., Air Transport Medicine Committee, Aerospace Medical Association. Special Committe Report: Traveller’s thrombosis: A review of deep vein thrombosis associated with travel. Aviation, Space, and Environmental Medicine 2001; 72:848–851.
 
3. Well, actually, if you really work at it, you can put yourself into a state of water intoxication (hyposmolality/hyponatremia). But if you drink only a glass (8 oz—or 250 ml) of water per hour you would be well below the maximum recommended ½ qt/hr (500 ml/hr) in moderate temperatures and easy work load. See:
    Kolka MA, Latzka WA, Montain SJ, Corr WP, O’Brien KK, Sawka MN. Effectiveness of revised fluid replacement guidelines for military training in hot weather. Aviation, Space, and Environmental Medicine 2003; 74:242–246.
 
4. Kraaij V, Garnefski N, van Gerwen, L. Cognitive coping and anxiety symptoms among people who seek help for fear of flying. Aviation, Space, and Environmental Medicine 2003; 74:273–277.
 
5. Dyregrov A, Skogstad A, Hellesøy O, Haugli L. Fear of flying in civil aviation personnel. Aviation, Space, and Environmental Medicine 1992; 63:831–838.
 
6. Rouse DM. Cases from the aerospace medicine resident’s teaching file. Aviation, Space, and Environmental Medicine 2002; 73:713–714.
 
7. Jones DR. Flying and danger, joy and fear. Aviation, Space, and Environmental Medicine 1986; 57:131–136.
 
8. Strongin TS. A historical review of the fear of flying among aircrewmen. Aviation, Space, and Environmental Medicine 1987; 58:263–267.
 
9. Voge VM. Failing aviator syndrome: A case history. Aviation, Space, and Environmental Medicine 1989; 60(7, Suppl.):A89–91.
 
10. Picano JJ. An empirical assessment of stress-coping styles in military pilots. Aviation, Space, and Environmental Medicine 1990; 61:356–360.
 

Additional Resources
 
Government/Safety:
AGC — Quarterly Enforcement Report  provides information from the Federal Aviation Administration (FAA) about which airlines have been fined or disciplined by the FAA in the last few years.
Aviation Accident Statistics  are compiled by the FAA.
NTSB Aviation Accident/Incident Database  provides searchable database information from The National Transportation Safety Board (NTSB).
Passenger Injuries and Injury Rates,  by year, are compiled by the NTSB.
 
Medical Issues:
Altitude Illness  from THE MERCK MANUAL, Sec. 20, Ch. 281.
Decompression Sickness  from THE MERCK MANUAL, Sec. 20, Ch. 285.
Mitral Valve Prolapse  from THE MERCK MANUAL, Sec. 16, Ch. 207
Mitral Valve Prolapse  from MitralValveProlapse.com
Motion Sickness  from THE MERCK MANUAL, Sec. 20, Ch. 282.
 
Other Fear of Flying Websites:
Fear of Flying Treatment  from this website, explains the various treatment options for fear of flying and provides links to other Fear of Flying websites.
 
Track Current Flights:
Flight Tracking  from TRIP.com.
TrackStats  from fboweb.com.
 
Travel Help:
AirSafe.com  provides safety information for the airline passenger.
Air Traffic Control System Command Center  provides real-time FAA updates about airport delays around the US.
British Air-ways Health  is a comprehensive source of advice about health matters related to air travel.
eHow to Overcome Your Fear of Flying  provides links to many helpful tips related to commercial flying.
Relief Band  — sells a product for drug-free relief of motion sickness.
Useful Tips for Airline Travel  — from the Aerospace Medical Association (AsMA). PDF format.
Virtual Hospital: Psychiatry: Fear of Flying  — helpful information from the University of Iowa Hospitals and Clinics.
Virtual Naval Hospital: Patients HomePage  provides a broad range of medical information for the consumer specifically relating to Wellness issues.
 
Within A Guide to Psychology and its Practice:
Autogenics Training  explains a self-taught relaxation technique. Why pay for something somewhere else when you can get it here for free?
Aviation Links  of special interest to pilots and the General Aviation community.
Basic Principles of Aircraft Flight  explains basic aerodynamics, including turbulence, in relation to commercial flight.
Fear of Flying Treatment  explains the various treatment options for fear of flying.
Progressive Muscle Relaxation  explains a self-taught relaxation technique. Why pay for something somewhere else when you can get it here for free?
Stress  explains the psychological and physiological aspects of “stress.”
Systematic Desensitization  explains a simple, self-taught treatment for fear of flying. Why pay for something somewhere else when you can get it here for free?
Terrorism  explains the psychology of terrorism.
 
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A Guide to Psychology and its Practice

www.GuideToPsychology.com

 

Copyright © 1997-2013 Raymond Lloyd Richmond, Ph.D. All rights reserved.
San Francisco

 

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