Health: Fly in the face of fear

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EDINBURGH to London, London to Seattle, Seattle to Anchorage, Anchorage to Barrow and on to Atqasuk, Alaska. Then back again, making a total of 10 flights in a week. With that schedule you'd never know Martin Ayres was terrified of flying, but he refuses to let his fears clip his wings.

The 48-year-old artist from North Queensferry is just one of the quarter passengers on any flight suffering varying degrees of fear of flying, with 20 per cent of the population admitting that the thought of getting on a plane fills them with dread, and as many as five per cent never flying as a direct result of their fear.

"I really hate it. I can only describe it as absolute white-knuckle clenching fear and terror," Ayres says. "In the 1990s, I was on a flight from London and there was a lot of turbulence. Although I rationalised it and knew that planes don't really crash because of turbulence, that flight was the catalyst for my fear."

Since then, Ayres has managed by taking Valium before each flight, clocking up thousands of air miles and 26 flights in the last year alone as he refuses to let his phobia hamper his career or curb his desire for travel.

"The last time I flew was to the Arctic Circle where I was working with Inuit children and teachers as part of an exchange project with kids in Aberdeenshire. That required all those flights and I found myself getting less frightened with each one. The last leg was in an eight-person plane and the pilot told us after we arrived that two planes on that route had gone down in the last two years, but it didn't upset me. That could be down to the build-up of Valium!" he says.

Fear of flying is a heightened state of emotional and physical arousal while on a plane, or even just thinking about it. It typically ranges from low-grade apprehension to nausea, sweating, trembling, fear of losing control and, in the worst cases, having a full-blown panic attack, either before or during a flight.

According to Ayres: "Valium stops the symptoms. It takes more than the edge off it – 20mg of Valium and a stiff gin and you end up enjoying the flight."

He is not alone in turning to Valium but a new approach is suggested in Overcome Your Fear of Flying, a self-help book written by two psychologists and a pilot with over 20 years' experience treating aerophobics. Rather than blanking out the fear with medication, co-author Professor Robert Bor and his colleagues advocate cognitive behaviour therapy, emphasising techniques and skills that can be used to deal with it.

"Every person's story is different and you need to understand how their unique fear is developed and maintained, what kicked it off, not assume it's just a fear of flying," says Bor.

"We know that underlying psychological issues – depression, relationships, empty nests, redundancy, various life events – all make us feel vulnerable generally and these can express themselves as a fear of flying," says Bor, Lead Consultant Clinical Psychologist in Medical Specialities at the Royal Free Hospital, London, and with 25 books to his name.

"What happens is people fear losing control and jump to the worst possible conclusion, that the plane will crash and burn, as we've all seen on the news. We over-read into situations and believe that these incredibly rare and unfortunate circumstances are likely to happen to us because that buys into the fear we already have," he says. "We all saw 9/11 and turn from possibility into probability and overestimate the risk despite the evidence."

Ah yes, the evidence. Overcome Your Fear of Flying doesn't attempt to argue with phobics' fears or bamboozle them with statistics about how safe planes are.

"We know there is more chance of being killed going to and from the airport and driving is much more risky than flying, but the fear comes from the lack of control we have," says Bor. "We have a greater chance of being kicked to death by a donkey than being killed in an air crash but we don't worry about donkeys, we worry about a plane crash."

Appealing to commonsense may work with a few phobics, but for the most part cognitive behaviour therapists prefer alternative methods.

"People know that it's statistically safe, yet they're still afraid. Large numbers have given it a lot of thought and are very knowledgeable about planes but are still scared. Simply saying 'the wings won't fall off' isn't getting to the heart of the matter."

Indeed, it doesn't help when we read news stories as we did this week, about the Thai plane that skidded while landing on the tourist island of Koh Samui, and the jet forced to make an emergency landing in Miami following extreme turbulence.

Instead Bor and his psychotherapist colleagues teach relaxation techniques that change how phobics think (the 'cognitive' part) and what they do (the 'behaviour' element). The idea is to focus on here and now problems and solve each part, step by step, changing how a sufferer thinks by reducing negativity and flaws in the thinking process and replacing it with rational and positive thoughts and reactions.

Bor and co-authors Carina Eriksen and Margaret Oakes also argue that Valium or other medication might mask the phobia, but won't cure it. "GPs will prescribe Valium or more modern medications to help you sleep and lower anxiety but medication might not be necessary. With a little work you can overcome the fear. We help people realise that their problems are driven by co-factors, that they may have loss issues rather than a fear of flying," he says.

For 69-year-old grandmother of five, Lesley Walker, a fear of flying began in her twenties on a flight from London to Edinburgh. "They announced there were problems with the plane and then we circled and circled for ages," she says. Terrified, she was overwhelmed by feelings of dread and panic and felt sick. "I've been afraid of flying since then."

Forty years later, she is still terrified yet gamely battles on any time she has to fly, with the help of Valium and an understanding husband.

"I'm terrified. Even thinking about it makes me nervous and afraid. The fear is the plane won't make it. I sweat, my heart pounds, I can't breathe. I take Valium before the flight and possibly even one during and it helps a bit, but it's difficult to get it right if you are delayed. We avoid having to fly although I love places like Majorca so I do it when I have to," says the retired hairdresser.

However, Walker has found a solution, without resorting to medication or therapy.

"Next time we're going on a cruise, so I won't have to worry," she says. "Well, apart from the flight to Amsterdam to catch the boat, but I'm just not going to think about that yet…"

Overcome Your Fear of Flying, by Robert Bor, Carina Eriksen and Margaret Oakes is published by Sheldon Press, priced 7.99.

Just sit back and enjoy the flight

• Avoid tea, coffee and eat well to make sure you are well nourished before you fly because a blood sugar crash makes you feel vulnerable.

lMental distraction can help you avoid catastrophic thoughts. So take plenty of things to do with you – iPods, books, puzzles, magazines, DVDs.

• Take charge of yourself, especially if you are with children. If mummy or daddy are tearful, kids pick up on it and can be affected, too.

• Don't leave it all till the last minute. This applies to packing and organising travel documents, as well as your fear avoidance techniques which take time and persistence.

• Try and sleep well before so you are relaxed.

• Get to the airport early so you can find your way round and make the experience as enjoyable as you can. Treat yourself to a snack in a caf and browse the duty-free shops.

• Take a copy of Overcoming Fear of Flying with you. It's a good psychological aid, full of tips and information.

• Take a computer with you and, if you're feeling really out of sorts, you can distract yourself and feel a connection with other people which allays anxiety.

• Travel with others and distract yourself by chatting to them.

• If you're on your own, tell a flight attendant you're scared and they will help you by giving you attention and being aware.

• Visit airports and expose yourself to the environment. Look at pictures of planes, read books about them, desensitise yourself.


• Go to your GP and ask them to recommend a psychologist. Ask for an expert in cognitive behaviour therapy.

• See the British Psychological Society website ( for your nearest options.

• Not all psychologists offer a free service and prices vary from around 150 for a 50-minute session. Some people require one meeting, others up to six