Fear of Flying or Aviophobia, classified in the DSM 5 as a Specific Phobia, is characterized by “excessive and persistent fear of air travel” related to fear of mechanical failure and/or accident causing the plane to crash is the number one reason for fear of air travel. Fear of flying is also one of the most common specific phobias. Research have found that roughly one-quarter to one-third of adults experience significant anxiety about flying. However, in roughly 6–10% of the population fear is more severe , often interfering with travel, work, or family life

Individuals who struggle with severe fear of flying so embed themselves in the possibility of a fatal outcome that the flight becomes contaminated with idea of premature death. This perspective colors the person’s entire reaction to the idea of flying. Individuals in this group focus on every and anything related to the functioning of the aircraft and accident.

As a result, they have selective, biased memory of aviation accidents, reports of pilot error or irresponsible behavior. Aviation statistics mean nothing to them: 2.5 incidents per million aviation hours. 1 fatality per 5 million flight or 1 death per 850 passenger journeys, all discounted: “Someone has to go down, why not me”. “It is unnatural for this much metal to be in the air”. As with most phobias and obsessions, the perception of risk does not align with what is real or plausible, as they have a broken relationship with possibility. Some examples of fears in Fear of Flying include:

In fear of flying, as with other anxiety disorders, the go-to reaction is avoidance. Those who do fly rely heavily on a combination of sedative medications and Safety Behaviors, which are responses or actions that allow them to feel safer or 'protected'. Examples of common safety behaviors used by fearful fliers include:

This form of air travel anxiety is experienced by those who suffer from panic disorder. It is important to understand that, generally, this group of travelers is not afraid of the plane crashing, rather, they typically have Panic Disorder, usually with Agoraphobia, and, thus fear having a panic attack whilst on the aircraft, where escape is literally not possible. They experience typical panic symptoms, fears and generally rely on avoidance and classic safety behaviors. However, when flying they rely on additional safety behaviors relevant to the to the context and experience of air travel

CBT is the treatment of choice for both fear of panic and fear of accident during air travel. The core fears of each is different, and, consequently, the focus of cognitive methods varies accordingly. Nonetheless, the fundamentals of CBT are applicable to the treatment of both. Briefly, steps in the approach I use to treat of flying

Again CBT methods developed for the treatment of agoraphobia with panic are also the treatment of choice for fear of panic when flying. People with this type of anxiety during flight almost always experience agoraphobia with panic elsewhere. Thus, as in fear of transport, the airplane is an agoraphobic context instead of trains or buses or cars. Because this is panic with agoraphobia, Panic Control Therapy and Progressive Exposure again are the two pillars of intervention. Given the inconvenience and the expensive of flying, I also use video imaginal exposure in addition to the progressive immersive exposures the Ovrcome Virtual Reality (VR) platform provides.