fear of flying

Julia Dobmeier is currently completing her master's degree in clinical psychology. Since the beginning of her studies, she has been particularly interested in the treatment and research of mental illnesses. In doing so, they are particularly motivated by the idea of ​​enabling those affected to enjoy a higher quality of life by conveying knowledge in a way that is easy to understand.

More about the experts All content is checked by medical journalists.

In people with a fear of flying (aviophobia), the very thought of getting on a plane triggers anxiety. This can be extremely stressful for those affected, especially if they have to fly for professional reasons. In many cases, however, the fear of flying can be overcome quickly with the help of therapy. Read everything you need to know about the fear of flying here.

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. F40

Fear of flying: description

Fear of flying (aviophobia) is one of the specific phobias. Experts speak of this when a person is afraid of certain objects or situations - in this case, of flying.

Many people have a queasy feeling when boarding an airplane. Although the plane is statistically the safest mode of transport, the fear of falling remains. Especially after major aircraft accidents, many air travelers find it difficult to give up control and trust the pilot and the machine.

However, people with aviophobia are so afraid of flying that they cannot bear this situation at all or only with agony. The very thought of a plane trip makes them nervous and sweaty. A survey by the Allensbach Institute for Demoscopy came to the result that around 16 percent of the German population are afraid of flying. Compared to men, women are about twice as likely to suffer from fear of flying.

Not all people with a fear of flying are necessarily afraid of falling. There are several reasons why people fear flying:

• Some suffer from a fear of space or heights.
• Others are afraid of the technology and complexity of an aircraft.
• For some, the "passenger syndrome" triggers fears. You have problems entrusting your own well-being to someone else, in this case the pilot.
• Still others have had bad experiences while flying because they got caught in turbulence or a machine had to restart on its approach. In such cases, the fear of flying arises from the expectation that similarly frightening events will occur again on the next flight.

Often other fears are added to the fear of flying. Various mental disorders can also occur together with aviophobia, for example depression.

Fear of flying: symptoms

When people with aviophobia are faced with an airplane, certain thoughts, behaviors, and physical symptoms occur. As a rule, the fear increases quickly and only slowly disappears. If the fear is very strong, panic attacks can also occur.

Physical symptoms

Flying is very uncomfortable for people with a fear of flying, especially due to the pronounced physical symptoms. The heart beats faster, the muscles tense. People breathe quickly and shallowly, which causes them to emit excessive amounts of carbon dioxide. As a result, dizziness and feelings of suffocation can occur. Typical symptoms of a fear of flying are diarrhea or a strong urge to urinate, abdominal pain, tremors and weak knees.

The closer the plane gets, the worse the physical symptoms become.

Negative thoughts and selective perception

Negative thoughts start the vicious circle of fear. Even before the flight, those affected imagine what could go wrong. Just because of these thoughts your pulse rises. The person concerned interprets such changes in the body as a threat. The fear increases as a result.

If a plane crash happens somewhere, people with a fear of flying take this as confirmation of their fears. They fail to realize that most flights go well as the focus is on the negative exceptions. Experts call this phenomenon selective perception.

Symptoms of a panic attack

Fear of flying can build up so strongly that those affected suffer a panic attack. If you have a panic attack, the fear is even more intense. Often those affected even fear dying from the physical symptoms. Difficulty breathing, palpitations, choking, dizziness and fainting can all be signs of a panic attack. These seizures usually peak after ten minutes and then subside. They cause great discomfort in those affected and fear of another attack.

Fear of flying: causes and risk factors

Fear is a psychological and physical reaction to danger and therefore something completely natural. The body releases stress hormones and reacts with either a fight or a flight reaction. If there is a real threat, these reactions are vital. Fear prevents people from exposing themselves to life-threatening situations. It becomes problematic when this fear is excessive and occurs even when there is no real threat. This is exactly the case with a phobia.

Fear of flying: learning on the model

The fear of flying often begins with an experience in childhood or adolescence. When children see that their parents fear flying, they too can develop a fear of flying. Even if the adults do not express this fear, the children notice the tension and nervousness and take over the behavior. So you can develop a fear of flying even though you have never boarded a plane yourself.

Fear of flying: conditioning of fear

A specific phobia - such as the fear of flying - can also arise from a traumatic experience. An emergency landing, for example, can trigger fear of death. The person concerned connects the negative feelings during the emergency landing with the flight. All smells and perceptions that the person concerned registers at this moment are stored in the brain and linked to the fear. The next time that person sees a plane, the feeling of fear comes up again. One speaks here of a negative conditioning: The aircraft is no longer neutral for the person concerned, but rather has negative associations.

A life-threatening event is not always the trigger: Turbulence during the flight can also result in fear of flying. The decisive factor is the evaluation of the event. Fearful people are more likely to classify turbulence as dangerous than people who go through life more carefree.

Nowadays experts assume that films or information about the dangers of flying can also contribute to a phobia. The fear can even arise after the flight. For example, many people find flying through a thunderstorm uncomfortable, but not necessarily threatening. However, if you watch a film about a plane crash caused by a thunderstorm, you can suddenly become very afraid.

Fear of Flying: Biological Roots of Fear

As we know today, genes not only determine the blueprint of our body. Hundreds of them are also involved in increasing your risk for anxiety disorders. The genes then become active in interaction with certain environmental factors. This makes some people more prone to phobias than others. This susceptibility (vulnerability) is influenced by various biological factors. Family and twin research suggests that part of the risk for phobias is passed on genetically. Experts also assume that an imbalance of messenger substances in the brain can promote the disorders. In addition, upbringing and the environment have a major impact on how anxious a person is.

The messenger substances serotonin, norepinephrine and dopamine could also play a role in the negative interpretation of experiences. Medicines that influence the transmission of messenger substances in the brain can therefore also influence the strength of the fear.

Fear of flying: examinations and diagnosis

If you suffer from severe fear of flying, your first point of contact should be your family doctor. The doctor will talk to you about your thoughts, feelings and physical reactions while flying. He will also examine you to rule out physical causes for the symptoms you are experiencing. For example, he will check your heart and thyroid function using blood tests and an EKG (electrocardiography).

If everything is organically in order and the suspicion of a specific phobia is confirmed, the family doctor can refer you to a psychotherapist or psychiatrist. Some airlines are now also offering seminars against fear of flying.

The psychotherapist can use the Diagnostic and Statistical Guide to Mental Disorders (DSM-IV) to diagnose a specific phobia such as the fear of flying. The following criteria must apply for this:

1. The person concerned has pronounced and persistent fear that is exaggerated and unfounded. The actual presence or expectation of a specific object (airplane) or a specific situation (flying or sitting on an airplane) triggers this fear.
2. The confrontation with the phobic stimulus (airplane) almost always causes an immediate fear reaction or panic attack.
3. The sufferer realizes that the fear is exaggerated or unfounded.
4. The person concerned avoids the corresponding situation or endures it with great fear.
5. The symptoms (fear of flying) significantly impair the normal functionality of the person or the phobia causes the person considerable suffering.
6. The phobia has lasted for at least six months.

Fear of flying: treatment

There are various methods available to help those affected overcome their fear of flying. Cognitive behavioral therapy (CBT) is particularly effective against fear of flying. The German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN) therefore recommends this form of therapy as the first choice.

Cognitive behavioral therapy can be done on an outpatient basis. If the fear is not very pronounced, a few therapy sessions can be enough. Central elements for treating fear of flying are confrontation, restructuring of thoughts and relaxation techniques. Medicines are rarely used.

Confronting Fear

The fear of flying is so uncomfortable for people with aviophobia that many prefer to forego it altogether. Avoiding what is feared, however, maintains the fear and can even intensify it. Because people who avoid flying out of fear do not experience that nothing bad will happen to them on the plane. Many know that their fears are exaggerated, but that doesn't change the phobia. Only by confronting the dreaded situation can one overcome the fear of flying.

There are different ways of confrontation.

The graduated confrontation leads the client step by step to the dreaded situation. The therapist often begins with what is known as “confrontation in sensu”. With this method, the client first imagines the flight situation in his or her mind and can get used to the idea. After a while, it will become easier and easier for the person to imagine flying and the fear will decrease. The therapist increases the challenges in each session. In the end, the client dealt with the real aircraft, which therapists call "confrontation in vivo". The disadvantage of staggered exposure is that the process can take several weeks to months.

The so-called "massaged confrontation" immediately exposes the client to his greatest fear. In the case of fear of flying, that means getting on a plane. This approach seems brutal at first, but it is very effective. In this way, the person concerned experiences that nothing happens to him in the dreaded situation. Another important experience is that physical symptoms such as palpitations or shortness of breath are not life-threatening. If the client is exposed to the situation for a long time, the symptoms subside until they have completely disappeared. First of all, the therapist accompanies the person concerned. At the end of therapy, the patient should have learned to cope with the situation on their own.

Restructuring of thoughts

Thoughts play an important role in creating and coping with fear. Negative thoughts can trigger and intensify fears. An important step in therapy is therefore to recognize and change such thoughts.

With the support of the therapist, the client learns to question exaggerated or unreal thoughts. A common thought when people are afraid of flying is: "The plane is sure to crash". The therapist checks this assumption with the client. Is a crash realistic? Can you be sure that it will crash? How likely is a crash? With questions like this, the therapist breaks down the client's disastrous thoughts. Over time, the person concerned replaces the wrong assumptions with realistic thoughts.

Relaxation techniques

Many therapists also work with relaxation techniques. The client can learn this under supervision and practice it independently at home.

A good and easy way to manage anxiety is with breathing exercises. Here's an example:

First, try to control your breathing. Abdominal breathing is the basis of all relaxing breathing techniques. To do this, place your hand flat on your stomach about two centimeters below the navel and breathe in slowly and deeply. Imagine how the air you breathe flows through your nose into your chest and from there into your stomach to your hand, and your hand is "breathed up" in the process. Then breathe out again and imagine how the air rushes through your stomach, over your back, through your nose.

Then take a break of 6 to 10 seconds. A little tip: Count "21, 22, 23, ..." in your mind. A number is roughly equal to one second. You can also stop breathing after inhaling. The only important thing is that you do it. Otherwise you will breathe too quickly and exhale too much carbon dioxide (CO2). Through the controlled conscious breathing you will notice that the muscles relax and you feel more comfortable. You should do the exercise 2 to 3 minutes a day until you can achieve significant relaxation.

An easy relaxation technique to learn is progressive relaxation (progressive muscle relaxation). In doing so, you gradually relax all the important muscle groups in the body after tensing them beforehand. The perceived physical relaxation causes the mind to relax as well. Exercise this progressive muscle relaxation for a few minutes every day while breathing calmly. Since the exercises can be performed lying down as well as sitting, you can also use this relaxation technique in a stressful situation (e.g. on a plane).

Another effective relaxation technique is autogenic training. It can be used in a wide variety of situations - for example for anxiety, to reduce stress and for sleep disorders. It is best to learn autogenic training under professional guidance. Audio instructions can also be a good help to get started.

Medicines against the fear of flying

So-called benzodiazepines can be used to reduce the fear of flying. These sleeping pills and tranquilizers take effect quickly. They ensure that people who are afraid of flying are much less afraid on the plane.

The problem, however, is that the fear is not coped with, but only suppressed. Those affected who use medication (or alcohol) to calm down increase their fear of flying in the long term.

Another disadvantage of benzodiazepines: They are highly addictive!

What helps against fear of flying? Fear of flying tips

What can you do about the fear of flying if it suddenly overwhelms you on the plane? In such a case, it is important to control your breathing and thoughts. Relaxation techniques are of great help here. The better they are internalized, the easier they are to use in acute cases.

It is also crucial not to let the negative thoughts escalate. One possibility is to block this with a thought stop. This is a conscious interruption of the fearful idea by a loud or internally shouted "Stop!"

It also helps many of those affected to acquire knowledge about flying and airplanes. This helps them to counterbalance their fears in a rational way. In seminars against fear of flying as well as in guides, those looking for help can find a lot of information about the technical details and other tips against fear of flying.

Fear of flying: disease course and prognosis

A phobia about flying or planes usually begins in childhood. After a frightening experience, those affected avoid getting on a plane. This increases the fear. Without treatment, the fear of flying often lasts for a lifetime.

People with a fear of flying rarely seek treatment because it is possible for many to simply avoid flying. Anyone who is not professionally dependent on flying can live with a fear of flying without major restrictions. But the step into the treatment is worthwhile, because the aviophobia can be treated very successfully with the help of a therapy. So if you face your fear, you can get rid of your fear of flying.

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