Fear of Flying: An Interview with Rich Presta

by Jeff Wise, Psychology Today

A top practitioner’s insights into a common, and debilitating, phobia

Have you ever sat on an airplane and felt such a terrifying rush of anxiety and fear that you wondered how you’d make it through the flight?

If so, then you should probably know the name of Rich Presta, a psychologist who specializes in phobias, anxiety, and fear, especially as they relate to transportation.

Recently he’s also launched a new project that helps parents deal with their children’s anxieties. I asked him to share some of his insights into the fear of flying.

JW: Fear of flying seems like a no-brainer to a lot of people — planes crash, people die. So why shouldn’t someone be afraid of flying?

RP: What differentiates people with a true flying phobia is the extent to which they avoid flying in relation to the probability of an accident occurring.

Whenever we look at a fear or phobia, the first question we automatically ponder is the likelihood of something bad actually occurring.

If my neighbor tells me he refuses to drink milk that smells funny, that’s not a phobia, right?

Well why not? Because it makes good sense to not drink the funky milk because there’s a legitimate risk of getting sick from doing so.

So we have to ask if flying is an inherently risky activity and clearly the answer is no.

From 2002-2007 there was not a single fatality during large commercial air travel in the United States despite approximately 1.8 million people flying in the US every day.

From a statistical standpoint, you would need to fly every day for right about 22,000 years to ever be involved in a fatal airline accident.

JW: That’s logically true, but our fear centers don’t run on logic. Speaking for myself, as someone who loves airplanes and aviation, I still feel a twinge of anxiety when my plane hits turbulence.

RP: It’s a question of the intensity of the fear and the extent to which the situation is avoided.

If someone simply gets a little anxious before going on a flight in severe weather, but doesn’t let their feelings determine whether or not they board the plane on live their life, I think it’s fairly clear that’s not a true phobia and just normal apprehension.

On the other hand, many fearful fliers refuse to fly under any circumstances, or are unbelievably terrified while on board and even during the days and weeks before the flight!

These are typically the types of fearful fliers that seek and can benefit from treatment.

JW: What’s the basis of treatment, in a nutshell?

RP: With flying, there’s two distinct phases of treatment.

First is the intellectual understanding of how planes and aviation work. There’s so many myths and misinformation about flying that often what people fear happening while on board a plane is impossible or statistically improbably enough to be considered impossible.

Second, and the more difficult thing to accomplish, is to learn how to cope with the anxiety itself.

Other fears don’t have the first component, and the entire treatment is focused on first learning to understand and take the mystery out of anxiety and then later preventing the anxious feelings from occurring at all.

JW: Do you think some people are hesitant to seek treatment because it will feel like admitting that they’re cowards?

RP: Absolutely. That’s why it’s so difficult to know for certain the prevalence of anxiety disorders. You may often read that anxiety disorders effect more women than men, but I’m no sure about that.

I suspect that societies expectation that men be “strong and brave” may make men more reluctant to seek treatment or admit a problem exists, which presents an inaccurate representation of the true demographic breakdown of sufferers.

JW: If someone hasn’t had treatment, but feels themselves spiraling into panic on a plane, what one piece of advice would you give them?

RP: Obviously the best thing is to seek a form of effective treatment prior to being on the plane so the panic doesn’t surface to begin with, but if there was only one piece of advice for someone already in the midst of panic, it would be to breathe slow and take deep breathes following a four count.

So you would breathe in through your nose for a four count, pause for a four count, exhale for at least a four count, and then pause again for a four count.

With this type of relaxed and deep breathing exercise you can abort some of the more anxiety provoking symptoms such as dizziness, tingling, rapid heartbeat, and more.

JW: Thanks, Rich! Hopefully your insights will help some readers better deal with their anxieties and learn to take charge of their fears.

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Jeff Wise is a New York-based science writer and author of Extreme Fear: The Science of Your Mind in Danger.

Fear of Flying: An Interview with Rich Presta is from Jeff Wise’s blog Extreme Fear.

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Testimonial for Rich Presta’s program :

“I’m Jeffrey Skiles, and no one has more reason to be afraid to fly than me. I was one of the pilots of US Airways Flight 1549 which lost both engines and ditched in the Hudson River on January 15, 2009. Despite that life changing experience, I was back in the cockpit only 2 weeks later without even a twinge of fear because I understand what flying is all about.

The Takeoff Today program will help you better understand your experience of flying, cope with your anxiety or even panic on board the plane, and put your fears behind you. Use it to tackle your fears and discover how to fly in comfort and confidence.”

Co-Pilot Flight 1549 “The Miracle on the Hudson”
Contributor to the Takeoff Today Program

Takeoff Today program for fear of flying

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