[Editor’s note: the following is a guest submission from Joel Schmidt, a Navy Veteran and Licensed Mental Health Counselor who specializes in various forms of anxiety, including fear of flying.]
Scrolling social media reels, I often see well-intended, knowledgeable, and generally helpful and friendly commercial airline pilots speaking to the fearful flier. They talk about turbulence and provide reassurance as to how safe the phenomenon actually is. They demystify sounds and sensations. They speak to safety stats, quality control, training, redundant systems, and engineering feats that make the modern aircraft capable of handling just about any curveball Mother Nature might throw its way. They offer up ways of thinking about flying that might be helpful along with a classic coping skill or two. Take a few deep breaths, get comfortable, and enjoy the ride.
Before I explain why many of those truths can only go so far, I must first acknowledge that reassurance does carry particular weight when it comes from an expert in the cockpit. It helps instill trust and a sense of safety. And that’s worth a lot, especially for those who are newer to flying or who are more mildly nervous.
Although turbulence can indeed be anxiety inducing for many, and even though it might be the case that you’ll find an occasional anxious traveler truly worried about the unlikely in-air emergency, most truly anxious (or altogether avoidant) fliers are not at all caught up on the logic of it all.
They already know that flying is safer than many of the more common everyday risks we take, such as driving to work. As a therapist who frequently works with this type of anxiety, I know it’s more often much less about the airplane and more about the conditions flying on an airplane presents. And logic and facts in this case rarely help calm anyone down.
It’s not the Airplane: The Real Triggers of Flight Anxiety
A common inquiry into my practice for work on fear of flying sounds a little bit like the following. “I had a panic attack on a flight a few years ago. I flew for a long time with no problem before that, but I haven’t traveled by airplane since. Can you help?”
Most clients who show up to my office already have at least a little bit of insight as it relates to what it is that frightens them so much when it comes to flying. And what really terrifies them is the potential for panic. Not the flying. Not the airplane.
What you’ll find too, when interviewing the fearful flier at any depth, is that most of them are also avoidant of or afraid of other similar situations in which it is not easy to escape. That’s because the core of this problem is about the lack of control. It’s about being in a confined space that cannot be easily escaped. It’s about the fear of what might happen if the doors have closed and the anxiety kicks in.
The What Ifs
Contrary to what most people who do not suffer from disordered anxiety might believe, the person with a clinical level of anxiety about flying typically has a long list of “what if” scenarios that run through their mind that rarely involve the plane crashing. That’s not to say they don’t have scary intrusive thoughts that contribute, but theirs more often sound like: “What if the plane takes off and my panic sets in?” “What if my anxiety ramps up and I just can’t calm myself down?” “What if I lose control, cause a scene, embarrass myself, or get arrested?”
The catastrophic scenario, then, is more closely tied to their relationship with anxiety and their beliefs about whether or not they’ll be able to cope with it mid flight. This often causes anticipatory anxiety leading up to a scheduled trip, and causes many people to avoid it altogether or to ensure that they’re sufficiently medicated before they board.
A person in this phase of recovery from any kind of anxiety might not yet understand the physiological mechanisms of anxiety, what’s happening when triggered, and what the body will eventually naturally do to restore balance. They don’t understand that even the worst anxiety must peak and then fall. Even the most uncomfortable symptoms of panic are not actually dangerous and rarely ever lead to the outcomes the anxious imagination can come up with.
Why Facts Don’t Do Much to Calm
Those who haven’t experienced true anxiety or panic have a hard time understanding what can appear to be so irrational. A little science can help. The sufferer of anxiety, often genetically predisposed, in most cases has had some sort of past experience that has led to a sort of hijacking of the survival system.
The amygdala, the brain’s threat detection system, might associate threat where no true threat is present. The perceived threat in this case might simply be associations with past experiences of anxiety on a flight or in an enclosed environment. The amygdala sends signals to the nervous system that danger is present, adrenaline floods the system, and full-on survival mode commences.
It’s a false alarm, but the body does not know the difference. Without the ability to flee, the sensations can feel almost unbearable. It’s so convincingly dangerous that many people who suffer their first panic attack find themselves in the Emergency Room, only to be told after work-ups that they should probably find a therapist to work on their anxiety.
This built-in survival system that I reference only takes in visual cues, sounds, physical sensations, and other environmental stimuli. It’s primitive and does not always distinguish the difference between a safe situation and a threatening one, especially if the conditions in the environment limit space or control. It does not process thoughts, words, or logic, and that’s why it’s impossible to help a person reason their way out of panic.
So What Do We Do? Practical Insights
Gold-standard evidence-based approaches inform how we treat the anxious flier in a clinical setting. We teach the client about what anxiety is and what’s happening.
We teach them that avoiding things that make us anxious or engaging in compulsive attempts to control or manage the anxiety only reinforce it and make it worse. We encourage moving towards what’s important to them (like traveling to see family), even when uncomfortable. We prepare them for their next flight by teaching them new and nonreactive ways to deal with anxiety, even when the intensity might be off the charts.
We don’t rely on excessive coping mechanisms, distractions, or deep breathing exercises. We teach people to label their anxiety, to be with their anxiety, to “float with it” without resistance, and to remember that it will pass even if we do nothing with it. We teach them that doing what scares them, even when anxious, presents an opportunity to desensitize and to be less anxious over time, especially as they learn that some of those worst-case scenarios they might imagine never come true.
I realize that roles in aviation vary in terms of how intimate the interactions with passengers might be, and even if you are exposed to interactions having to do with passenger anxiety, you aren’t called upon or expected to serve as a mental health professional. So even if we do understand the experience of passenger anxiety on a deeper level, does that tell us in any kind of meaningful way what we do with that as an aviation professional?
Perhaps it broadens the understanding of what’s going on and informs not only how we communicate about flight anxiety but how we support or educate when the opportunity presents, whether that be with passengers or crew. Maybe it helps separate passenger anxiety from judgments about what it is that must be going on.
Or maybe, when the opportunity presents itself, we are able to share a few wise words and provide a simple grounded presence and an in-the-moment reminder that everything will be okay, that it’s just anxiety, and that this will pass.
Joel Schmidt is a Navy Veteran and Licensed Mental Health Counselor (LMHC) in the State of Florida and South Carolina. He is a group counseling practice owner based in Tampa who specializes in disordered anxiety, panic attacks, general anxiety, phobias and fear of flying using evidence based approaches. Schmidt is a frequent flier and his wife, who now helps run the practice, had a several year career in aviation, including becoming a pilot.
My brother in law suffered from anxiety about flying. A few times he used medication to control it. But only after he faced his fear and flew without medication, was he able to actually overcome the anxiety and is no longer afraid of flying.