Fear Of Flying: Diagnosis & Therapy

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Fear Of Flying: Diagnosis & Therapy
Fear Of Flying: Diagnosis & Therapy
Video: Fear Of Flying: Diagnosis & Therapy

Fear of flying: diagnosis & therapy

Fear of flying is one of the "specific phobias". Particularly good treatment results are achieved with so-called cognitive behavior therapy. Cognitive behavioral therapy has proven particularly useful for treating fear of flying. In order to combat the fear of flying, entrenched lines of thought and assessments of the situation must be changed - with regard to the dreaded object, the aircraft.


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  • Behavior Therapy & Medication
  • What can I do myself?
  • Whom can I ask?
  • How are the costs going to be covered?

Fear of flying is usually diagnosed using the ICD-10 (International Classification of Diseases Version 10) diagnostic tool. It lists the fear of flying as a "specific phobia", which is characterized by the following features:

  • Obvious fear of the thought of flying, or especially of flying itself.
  • Strong avoidance of any situations that lead to the dreaded situation.
  • Fear symptoms (such as those listed in the “Fear of Flying Reactions Scale”) occur in the dreaded situations at least once since the disorder occurred.
  • Serious emotional stress from the symptoms or avoidance behavior while realizing that they are disproportionate and unreasonable.
  • Symptoms are limited to flying or thinking about it.

According to the criteria of the DSM-V (Diagnostic and Statistical Manual of Diseases - Version 5), which is now mainly used in the USA, the fear of flying can be classified as a “specific phobia”. As an additional criterion, it is stated that this phobia must have existed for at least six months.

Behavior Therapy & Medication

A method of psychotherapy, cognitive behavioral therapy, has proven particularly useful for treating fear of flying. Neurologically, people with various fears, such as fear of flying, show a particularly strong overactivation of certain brain areas as a reaction to supposed threats. With the help of cognitive behavioral therapy, this overreaction can be reduced to a level adapted to the respective situation. In some cases, medical support (e.g. benzodiazepines, selective serotonin uptake inhibitors (SSRI)) can be helpful initially.

Cognitive behavioral therapy works on the knowledge and the emotional level. Both levels have had an unfavorable learning process in people with a fear of flying. This is often supported by an inherited ability to react more strongly than other people to threatening stimuli. In order to combat the fear of flying, entrenched thoughts and assessments of the situation must be corrected or "restructured" - with regard to the feared object, the aircraft, and everything that is thought in connection with flying.

Information component

On the “knowledge level”, behavior therapy deals with the following topics…

Information about flying, e.g

  • Aerodynamic principles (why does an airplane fly at all?)
  • Safety of flying and actual accident frequency,
  • Safety nets in air traffic,
  • Turbulence and normal movements of the aircraft,
  • Role of weather,
  • technical aspects such as fresh air supply and cabin pressure, maintenance.

Information about the body and stress / fear reactions, e.g

In fear of flying, certain automatic body reactions (e.g. racing heart, sweating, dry mouth, nausea) take place, which can be very threatening for those affected. However, they are fundamentally designed as protective mechanisms in evolution and can never endanger the body or health

Emotional component

On the emotional level, information about fear, panic and helpful counter-strategies are treated, e.g.

  • Fear and panic reactions happen automatically, and trying to stop or suppress them only makes them worse.
  • Fear and panic reactions are not dangerous for the body or mind.
  • If the “false alarm” is recognized as such, the willingness to trigger fear reactions is reduced.
  • Appropriate breathing and muscle relaxation can reduce anxiety.
  • Every fear is learned and can be unlearned again.
  • Reducing the trigger and accepting fear responses are essential keys to success.
  • Don't think about what might come, but what is right now.

What can I do myself?

  • Prepare for the flight in good time and leave for departure in good time.
  • Before the flight, do moderate physical exercise and eat a light, low-sugar diet.
  • Wear loose, non-restrictive clothing.
  • As soon as fear arises on the plane, inform the flight attendant about it.
  • Do not defend yourself against movements of the aircraft.
  • Even when stress reactions occur, concentrate on exhaling rather than inhaling.
  • Accept any fear reaction that arises.
  • Always keep in mind that flying is based on physical laws (e.g. dynamic lift).
  • Do not think about what could come, but what is just now.
  • Drink enough (no alcohol).

Whom can I ask?

If you suffer from fear of flying, you can contact the following:

  • Individual therapies, which usually last several weeks to months, are mainly offered by clinical psychologists and psychotherapists.
  • Two to three day group seminars are organized by various airlines, mostly directly at an airport.

How are the costs going to be covered?

A full assumption of costs for psychotherapy is possible in own or contractually bound institutions of the health insurance carriers as well as in institutions that are subsidized by the public purse. In these cases, there is the option of paying a deductible. Otherwise, you have the option of applying for a subsidy from the health insurance company if you are undergoing psychotherapy with a resident psychotherapist. If this is approved, the health insurance provider will reimburse you for part of the fee paid to the psychotherapist. However, the health insurance carriers only provide a subsidy if there is an illness-related disorder.

Clinical-psychological diagnosis is a service provided by the health system, the costs of which are borne by the health insurance carriers. With a medical or psychotherapeutic referral, patients can take advantage of a psychological examination by a contract psychologist for clinical-psychological diagnostics. You have to bear the costs for treatment or advice from resident clinical psychologists, as this is not a benefit from health insurance.

Note Seminars against fear of flying must be paid for by those affected.

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