Psychologists describe fear as “A rational reaction to an objectively identified external danger that may induce a person to flee or attack in self-defense.” Webster claims fear is a feeling of agitation and anxiety caused by the presence or imminence of danger. A state or condition marked by this feeling: living in fear. A feeling of disquiet or apprehension: a fear of looking foolish. A reason for dread or apprehension: fire, swimming, lightning, spiders etc.

Have you ever had a real fear of something?  I am not talking about superstitions, such as walking under ladders or black cats. I’m referring to a real fear, a perceived danger. A fear that can cause your heart to race, your hands cold, but still sweating, a fear so great it cause you to cry or be unable to move. No, you never had a fear that great, well then count your blessings, because I had that type of fear. I had a fear of flying and suffered all those symptoms I asked you about.

I first started flying while in the Navy in the mid 1960’s and had no problem with it. Somewhere along the way, I was trying to get some attention from my Father, I was trying to have him reach out and show me he cared about me and what I was doing. Something he never did all my childhood. So, I concocted a story about landing without wheels at Chicago’s O’Hare airport. This really happened, just as I told it back then, but it wasn’t my flight and I knew there was no way for him to know which flight I was on because I always flew military standby. The story didn’t change my relationship with him, it just slept in my mind and when ever I needed a good story, I would tell it. Eventually, I really believed it happened to me as the time went on.

In about 1972 or so, my wife and I had a very rough flight from my hometown to Norfolk VA. It was the kind of flight you see in the movies where the plates, glasses and anything not tied down flies up to the ceiling and all the passengers scream and hold on for dear life. Naturally, the pilot is able to save the day and leveled off and we landed safely. Now add that flight to my story I was telling and this made me very uncomfortable flying back to Cleveland. I told people that coupled with my lie about the Chicago incident and this real event, I was afraid to fly.

Years later, I went to work as a salesman and I was required to fly to Chicago for training and meetings, by then I had a real panic set in believing the plane would crash. I revolted and begged to drive at my own cost and my request was granted. I had stepped from a fantasy fear to real fear. I did not want to fly. Any time there were meetings, I would drive as long as they were close enough to do so. People would laugh about my fear and at times I enjoyed being the center of attention. I would never fly for vacations either. I chose locations that were within two days driving time. Unfortunately, there isn’t really any vacation time when you drive four of the available days on vacation.

The year now is 1991 and my wife was promoted with her job and we had to relocate to Florida. My wife left before I did as I was required to stay around until the movers had packed our belongings. I then drove to Florida to join my wife.  In the early part of 1993, my wife received another promotion and we had to move again. This time I had to fly to Detroit to help find a new home. As we were waiting for our flight to start boarding, I began to get a feeling of dizziness, cold sweats and a panic came over me like a large wave over a break wall. I knew I couldn’t get myself in the airplane, I knew this wasn’t going to be easy. My fear of flying, over the years had become so great, that when we were called to board, I couldn’t move. My wife was trying to be helpful, but nothing she said was helping me get moving.

Everyone was aboard the plane now, the booking desk attendant came over to us and said the plane is ready to leave and we needed to get on board. My wife described the problem and the attendant went and called the flight attendants to help me aboard. Yes, I was finally moving; I was getting on the plane with tears flowing down my face. Everyone was looking at me, me a 47 year old man crying and so afraid to be on this plane. The two hour flight was an eternity for me. I sat straight up, buckled in and never moved. I was clutching the armrests so hard, my fingers hurt, but I wasn’t going to let go. I didn’t eat the lunch offering or drink anything. I never left the seat until we were safely on the ground at the terminal. As soon as I was off the plane, I was just fine, back to my old self, but very tired from the emotional drain I had just went through.

It is the present day now; I’m 59 years old and just lost my best friend to cancer. His death opened my eyes to how short our lives are and how much my wife and I are missing due to me not flying. You see, my wife said “No more driving” she can’t take sitting days just to get somewhere, so if I wanted a vacation, I would need to fly to get there. Now what am I to do? I guess I have to fly if I want to go someplace other than my back yard.

I contacted my doctor, who told me to take a pill; just what I needed was another pill. The second doctor told me to take another pill, but also gave me the name of Stephen Pravel Ph.D, a psychotherapist. I made the call and set up an appointment. I imagined all sort of images of this doctor and his office, nervously I waited for the day to come and to start peeling away the many layers of fear I had built up over the years.

I had to do this; there was no turning back now, as I had already booked tickets for a vacation that would start in Miami. I was bound to give my wife a true vacation, but can I or should I say will I get on an airplane?

I met Dr. Pravel and I immediately knew he and I would get along. To me liking your doctor is very important and Dr. Pravel was very calming and professional, traits I liked. Over the months, I believe it was about two months, we found that I needed control. I needed to be the driver in a car and didn’t like having someone else controlling an airplane which I was a passenger in. I would have much rather piloted the plane myself.

I also have visual images popping through my mind, like explosions of the engine on take off, major turbulence causing the plane to plummet to earth, crashing during landing, Fireballs, having the plane implode due to extreme pressure. If something could go wrong with a flight, my overactive imagination would visualize it happening while I was on board.

Dr. Pravel first started with the visual images. A major question was asked, “If you can visualize the bad, why not visualize the positive?” Now that’s a great question, but the answer is not so easy to admit. I am a negative person and always look for the worst to happen. I now started talking with my wife about the positive visualization and each night at dinner we spoke positively about out trip and especially how easy and safe flying is today. We practiced “Positive Talk” which by the way we are still practicing every day and it does seem to be working and helping both of us face some trying times today with the health of an elder family member.

Now I have to face the biggest factor of my fear, “Control”.  Dr. Pravel suggested I try to reverse some of my actions I do when flying. I listened to what he had to say and broke out in laughter at his suggestions. Again, it was imagery work, but this time it was not mental imagery, this was actual activity that I should do during flight. I would sit in my seat and if I would feel the plane losing altitude, I would be pulling up on the armrests, as if I could really pull the plane up out of the descent. The Doctor gave me the reason not to pull up, but to actually to push down and try to crash the plane. Now that is absurd, I wouldn’t want to crash the plane. But think about this a minute, I waste my energy pulling up to save us from a crash and I know I wouldn’t really be able to save the plane, so give it up, relax and let the trained pilots do their job.

Just as pulling up armrests can’t do anything, the same goes for any action I take while sitting in my seat. I can not fly the plane from my seat nor would I be able to fly the plane in the pilot’s seat. I’m not John Travolta the pilot you know. So with this out in the open, why not just sit back and enjoy the flight, everyone knows it’s much faster and hundreds of times safer than having me behind an automobile steering wheel.

I just had to release control to the pilot and crew, not easy to do, but very possible to accomplish. We worked on pulling the reasons for my fear out from the back of my mind and out in the open. The doctor recommended a book which, although I do not like reading books, did give me more tools to ease my mind. The key to success in my case was the real desire to overcome my fear. I was prepared to do whatever it would take to fly with my wife on a real vacation. With the help I received from Dr. Pravel, I was able to be the first one down the walk way to the plane, not a bit of perspiration, a bit of nervousness, but nowhere near what I had encountered in the past.

I was relaxed, ate lunch and even had a cola with it. To make matters even better, I was able to get out of my seat and use the washroom. The view was marvelous and the sun was bright once we were out of Michigan airspace, but the sun never came close to the bright eyes of my wife who was really going on a true vacation. Upon exiting the plane in Miami, the first task at hand was a phone call to Dr. Pravel which went something like this: “Dr. Pravel this is Sam, Thank You, Thank You, Thank You, We did it, I’m in Miami!”

The flight back to Detroit was pretty much the same, except for some unexpected problem with the plane, which caused us to land in Memphis TN instead of straight through to Detroit. Even with this minor inconvenience I remained calm and enjoyed our trip. By the way, my wife had a fear of sailing, once in Miami we boarded a ship and took the first cruise of our life. We both are looking forward to the next trip.

Thank you Doctor Pravel, without your help and concern I know I could not have done it alone.

To close, I recommend you face that fear of yours, but take Dr. Pravel with you when you do, he will open the right doors for you to step into a new world. That is a world where you no longer need to be afraid of something which may be preventing you from enjoying your life to the fullest.

Respectfully,

Sam

STORY UPDATE FROM SAM: 

I just wanted to tell you that I am still flying with no problems. I have even stopped the preflight Xanax. Since our sessions, my wife and I have visited about 90% of all islands in the Caribbean and even Columbia SA. I still credit you with getting me off the ground. I now live in Ohio, actually we moved back home after Lorena retired. Her parents are 90 and we knew it was time to go and take care of them. This move also puts us less than 15 minutes from my daughter and two grandsons. I hope all is going well in your life and your practice is keeping you busy. Best to you and yours,

Sam

CLINICAL SUMMARY

As Sam explains, his fear of flying developed many years ago. But in avoiding what he feared – flying – he turned his fear into a phobia. A significant issue that is often involved in the fear of flying is the fear of loss of control – of the plane and of oneself. Sam’s personality involves a tendency to need to feel in control of many situations, and flying in a plane is clearly a situation well beyond the control of all but the pilots. Interestingly, it is usually more the loss of control that underlies fear of flying rather than the sense of enclosure. But the anxiety it generates leads to the usual fight or flight response, and it is obviously difficult to take flight i.e. escape – from a jet cruising at 10,000 feet – therefore anxiety intensifies. By Sam coming to understand his control issues, he was empowered to begin to accept situations beyond his control. This was a significant portion of the cognitive component of CBT and part of the insight portion of therapy.

 But the turning point in Sam’s therapy came from the use of imagery exercises done in the sessions – the behavioral part of CBT. I had Sam imagine himself in a plane, imagining all the details of the plane’s takeoff. He had a history of clutching on the seat arms, lifting up on them, and straining his entire body upward to help the plane liftoff. This revealed the degree of control he needed, even in this type of a situation. But in these imagery exercises, instead of lifting up, I had him imagine pushing down on the arms of his seat and pushing down with his feet – to attempt to keep the plane from lifting off. This is called a paradoxical intervention in that the exact opposite results from the experience: instead of feeling he can actually keep the plane from lifting off, it helped him see that he cannot and that his efforts are all in vain. This therefore helped him connect on a deep and powerful emotional level with the fact that all his best efforts to help the plane liftoff are equally meaningless and therefore unnecessary. It put the lie to the irrational belief that he must try to control outcomes, freeing him up from vain attempts to control the plane and paradoxically giving him immediate relief and joy. By relinquishing control, he was able to allow someone else – the pilots – to be in control. He was now free to sit back, enjoy his flight, and not have to work hard to keep the plane in the air. He not only was anxiety free on both legs of his recent Bahamian vacation, but was able to reconnect with the thrill and sense of awe in flying that he used to feel as a young man. He now feels in control of himself – the only control he really ever needed.

 It is important to note that Sam accomplished all of this in only 9 sessions. Though he has decided to continue in treatment, it is to deal with other life issues, no longer a fear of flying. Sam brought to treatment some important ingredients that contributed to quick success: commitment, cooperation and trust. He was committed to resolving his fear, was cooperative with the treatment process, and had trust in me as his therapist.

Excellent work Sam, and a great story to be told.