The tragic imbroglio surrounding Boeing’s 737 Max 8 isn’t making Neil Rector’s job any easier.
As a psychologist and senior research scientist at Toronto’s Sunnybrook Research Institute, Rector treats the excessive and irrational fear of flying by helping patients perceive threats and risks realistically. Trouble is, “the threats around the 737 Max 8 seem legitimate,” he says. “It’s perfectly normal to be anxious about Boeing and the airline industry solving these problems.”
Because most people develop a fear of flying through exposure to information – as opposed to direct experience – media coverage tends to stoke anxiety. “What we now have to focus on in our regular cognitive behavioural therapy work is that the risks and problems with other planes have not changed as a result of what’s happening with the 737 Max 8,” Rector says.
Determining the extent and underlying causes of a fear of flying is the first step in overcoming it, he continues. “We have to distinguish between people who are uncomfortable flying – some estimates have it as high as 20 per cent – versus people who actually have a phobic fear. Being unable to fly, or experiencing significant distress when you do fly, are cues to seek help.”
Whether clinically or self-administered, help comes in many forms.
Cognitive behavioural therapy
CBT is a cornerstone of treating the fear of flying, as well as related generalized anxiety disorders such as claustrophobia, agoraphobia and acrophobia. That’s why Rector begins by assessing the components of a patient’s anxiety cycle. “I make sure the problem is a fear of flying and not an underlying problem that shows up with it.”
Once this fear has been singled out, specific triggers are pinned down. “People tend to fear flying for their own particular reasons: turbulence, the size of the plane, terrorism, weather conditions, the appearance of the pilots and so on,” Rector explains.
The next phase typically involves helping patients become experts in these aspects of flying, which in turn makes their triggers less threatening. There is a wealth of literature on these topics, Rector says, with many CBT clinicians recommending Patrick Smith’s 2013 bestseller, Cockpit Confidential.
“A lot of people are afraid of flying, but it’s not based on an understanding of flying or an intellectual grasp of what makes it safe,” says Smith, a veteran commercial airline pilot. “Air crashes have a way of haunting our consciousness and galvanizing our fears.”
Smith receives many messages from fearful flyers, he says, with the 737 Max 8 being “the hottest topic at the moment.”
Unless they’re suffering from an underlying phobia, which should be treated by a mental-health professional, Smith says these people “need to turn away from the media hype and look at commercial air travel from a wider perspective. Worldwide, it has never been safer than it is now.”
Statistics are emphatic on this point. According to the Aviation Safety Network, fatal accidents for every million flights decreased 16-fold between 1970 and 2018, from 6.35 to 0.39. Fatalities for every trillion revenue passenger kilometres, meanwhile, plummeted 54-fold, from 3,218 to 59.
“We have had two terrible accidents in the space of five months, and tragic as that is, it really wasn’t all that long ago that there would be 10, 20 or more large-scale aviation accidents globally each year. In 1985, for instance, there were 27 major air disasters, including two of the worst in history. Now, in North America, there hasn’t been a single large-scale crash involving a major airline since 2001.”
Smith credits improved cockpit technology, crew training and collaboration between safety agencies for this “astonishing” drop in accidents, and blames the media for inflating fears. “When there is an accident, even a minor one, it tends to get spun up in the media. There’s so much hype and coverage, albeit briefly, that people get this idea that accidents are happening more frequently than they really are. It’s the same as people thinking there’s more crime, or more people sneaking across the border from Mexico, even though both are at their lowest-ever recorded levels. It encourages people to feel more afraid exactly when they should be less afraid.”
Exposing patients to the sources of their anxieties – by watching videos of air travel and visiting airports, for instance – is a common aspect of CBT, Rector says. “We incrementally expose people to their triggers, up until the point where they schedule and actually take flights.”
While taking benzodiazepines and other anti-anxiety medications can help alleviate both underlying phobias and the fear of flying, CBT practitioners prefer to avoid prescription drugs. “Taking short-acting anxiety medication may reinforce the person’s belief that the only way they can cope with flying is by taking the medication,” Rector says. “It’s an understandable but subtle avoidance strategy.”
Meditation and mindfulness
Research has shown that these can be effective treatments, Rector says, with several digital apps now being promoted as ways to overcome a fear of flying. The Headspace app, for example, contains guided meditations designed to “intervene in the vicious cycle of panic before it gets going” and flying-specific programs can be accessed through the inflight entertainment systems of Air Canada, Air Transat, Air New Zealand and other airlines.
Canada’s largest airports have all introduced trained canine teams designed to soothe stressed travellers. While petting dogs may help relieve anxiety in the short term, Rector characterizes it as another avoidance strategy.
Smith, for his part, says it targets more than just airborne anxiety. “I wonder how much of this has to do with the general tedium and stress and hassle of flying, versus the fear of crashing. All the ancillary hassles can make it a terrible experience for anybody, and if you’re predisposed to being fearful of flying, it makes it that much worse.”