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Overcoming the fear of flying



ATLANTA, Georgia (CNN) -- Worried about the next time you have to fly? It's a perfectly normal reaction, according to Barbara Rothbaum, an associate professor of psychiatry and director of the Trauma and Anxiety Recovery Program at Emory University in Atlanta.

"We're all still in recovery from this," she said, adding that, with the passage of time, and no further incidents, people will gradually begin to feel the same way about flying as they did before the events of September 11. "My hope is the longer we go and nothing happens, we'll go back to base line."

But for some people, that base line means sweaty palms, shaky knees and a palpitating heart at the prospect of boarding another jet. For individuals with this type of severe anxiety, help is readily available. Rothbaum says therapy is extremely effective in helping nervous fliers overcome their anxieties.

Treatment usually consists of eight sessions -- half deal with problem identification and anxiety management, while half cover what is called "exposure therapy."

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During the first four sessions, patients uncover the source of their anxiety, whether it's fear of heights or claustrophobia, and then learn how to rein in their fear with coping mechanisms such as deep breathing and "cognitive restructuring," which teaches patients how to use logic to defeat their feelings of panic.

The last four classes deal with exposure therapy, where Rothbaum says, "we help them confront their fear in a therapeutic manner." This phase involves the use of virtual reality flight simulators or a trip to the airport to board a parked plane.

For many patients, virtual reality is extremely attractive because they don't have to take a trip to the airport, and "they know they're planted firmly on the ground," explained Rothbaum.

Atlanta-based Virtually Better (http://www.virtuallybetter.com) operates flight simulators that are used to help people overcome phobias and anxieties, including the fear of flying. Ken Graap, its president and CEO, says for the extremely anxious patient, virtual reality has an advantage because "it's in between what they can imagine and real life... you can practice over and over again successfully flying."

"We try to re-create as much of the flight experience as possible," said Graap. That includes immersing the patients in the sights, sounds and sensations that they would experience in flight.

"To overcome any fear, the best way to do it is face that fear in a controlled way," Graap explained, because over time, if a person is exposed to a stressful environment long enough, he or she will eventually get used to it.

Graap and Rothbaum recently published a study in the Journal of Consulting and Clinical Psychology, which found no perceptible difference in the outcome among patients who used virtual reality treatment and those who boarded real airplanes during therapy.

That's good news, because new, tighter security at airports will temporarily make it more difficult to conduct treatment on-site. So, for the time being, more patients likely will be using virtual reality.

At least one airport has a program of its own to help alleviate fears. Ted Bushelman, with Cincinnati/Northern Kentucky International, says they typically run two or three "Fear of Flying" classes a year. The typical student requires three or four hours of class time to help conquer fear.

The biggest problem he has seen is not fear of crashing, but claustrophobia, because many people who have never flown before "keep thinking of airplanes as being a small box," explained Bushelman.

Eventually, the students do board an actual jetliner -- it's permanently parked, does not fly, and performs double-duty, hosting thousands of youngsters who tour the airport each year. Participants stroll down the aisles, sit in the seats, and even visit the cockpit, which usually alleviates their fears, according to Bushelman.

However, "if we get a real hard-core person," says Bushelman, "we'll even get a pilot to speak with them." That conversation generally helps, because, "when they meet the pilot, that's reassuring."






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