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The question

I have an unexplained fear of flying. I've never been on a plane - never want to - but now my daughter moved to the States, and I would love to go visit without driving for 10 hours. How can I get over it - or can I?

The answer

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A fear of flying is one of the most common phobias. By definition, a phobia is an irrational fear of a thing, place or situation that is out of proportion to the actual danger posed.

Although phobias sometimes begin following a fear-inducing situation (such as experiencing a very turbulent flight, for example), often people have no recollection of why or how their fear was created. And, not uncommonly, phobias can develop even when a person has never had an experience related to that which they are fearing, such as in your situation.

Anxiety disorders – and phobias in particular – are highly treatable.

The most effective treatment for phobias is cognitive behavioural therapy, which involves two key elements:

1) challenging the irrational, fear-inducing thoughts associated with the feared stimulus and

2) behavioural strategies involving an approach called "systematic desensitization".

Very simply, phobias persist if we continue to (without any persuasive evidence) think that a particular stimulus is fear-inducing.

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There are two common faulty patterns of thinking that individuals engage in that feed a phobia: probability overestimation and catastrophic thinking. Individuals consistently overestimate the probability of the worst negative outcome occurring. For example, you likely (without knowing it) are overestimating the likelihood that, for example, the worst imagined outcome of a plane crashing would occur.

Obtain accurate statistics on imagined worst case outcomes. Then, be aware of the automatic phobic thoughts you are having, and replace them with more accurate thoughts. So, if you have the thought "So many things could go wrong; the plane might crash and I could die", replace it with the more accurate and valid thought "Although plane crashes can occur, they are very rare. The likelihood of a plane crashing is extremely low, much lower than me dying driving my car, and I don't avoid that".

Individuals also tend to engage in catastrophic, exaggerated thoughts about outcomes. Instead of thinking things like "I could never, ever get on a plane – it would absolutely terrify me and I would lose it", trying replacing the thought with something more accurate like "Although it may feel extremely difficult I – like tens of thousands of people a day – could get on a plane. I may feel extremely anxious but I would be able to eventually get through it. With practice and time it will get easier".

There is an important behavioural component to overcoming phobias. Systematic desensitization involves two components: learning relaxation strategies and implementing them as one gradually exposes themselves to the source of their phobia.

So in your case: thinking about flying, then watching a plane on TV, talking about you on a plane, going to an airport, etc. You systematically expose yourself to situations that elicit more and more fear while using relaxation strategies throughout.

Working with a psychologist who specializes in cognitive-behavioural therapy for anxiety disorders/phobias can be tremendously helpful, and there is good evidence that significant benefit will be obtained following 8-16 sessions of treatment. So – yes, with some dedicated effort you will be able to get over your fear.

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Send psychologist Joti Samra your questions at psychologist@globeandmail.com. She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

Read more Q&As from Dr. Samra.

Click here to see Q&As from all of our health experts.

The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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