How do you work with flying phobia in psychotherapy?

Let's take a look at the techniques and procedures used when working with cases of flying phobia in therapy.

Flight phobia is one of the most common specific phobias, but fortunately, it responds very well to psychological treatment.

In this article we will see what the process of work in psychotherapy with patients with phobia to fly consists of in broad outlinesThe treatment is always personalized and varies depending on the needs of each person.

What is the phobia to fly?

The phobia to fly is a type of specific phobia, category of psychopathologies that in turn is included in the disorders of anxiety.. Therefore, it will be defined with the same criteria as these psychological disorders and similar treatments adapted to the specific type of phobia will be used.

The characteristic feature or criterion of any specific phobia is the disproportionate fear or anxiety that appears before a stimulus, generating great discomfort and the need to avoid it. Thus, a phobia of flying will result in a very intense fear of flying, which will affect the patient's functionality, i.e., it will have a negative impact on different areas of his or her life too often.

How are cases of people suffering from this phobia detected?

The diagnosis of specific phobia can only be carried out by mental health professionals.Thus, before the work carried out in therapy, there is a phase of symptom recognition and identification of the underlying psychopathology.

The fifth edition of the Diagnostic Manual of the American Psychological Association (DSM 5) indicates that in order to diagnose a specific phobia, a series of criteria must be met. The first defining criterion indicates that the phobia is related to an intense fear or anxiety about a specific object or situation, such as being inside an airplane; the second criterion that must be met is that the phobic object or situation almost always provokes immediate fear or anxiety, i.e. it occurs at the very moment the stimulus appears.

Likewise, another criterion that all phobias also meet is that that the anxiety is disproportionate to the real danger. that generates the specific object or situation (in the case of the phobia of flying, the aircrafts used today are very safe); the fourth point is the tendency to avoid the phobic object or situation, or the fact that if it is endured it is with great discomfort.

The next criterion is that fear, anxiety or avoidance causes discomfort and dysfunction of the quality of life in important areas of daily life, such as social and work life.

Finally, it is necessary that the pattern of occurrence of fear, anxiety and avoidance lasts for a minimum of 6 months.

It is also necessary to to make a differential diagnosis and to verify that the anxiety is not better explained by another psychological disorder such as panic disorder, panic disorder, panic disorder, panic disorder, panic disorder, panic disorder, panic disorder such as panic disorder, agoraphobia, obsessive-compulsive disorder, post-traumatic stress disorder, separation anxiety or social anxiety, among others.

Thus, knowing the main characteristics that specific phobias must meet, it can be said that the phobia of flying meets the defining criteria of phobia of specific stimuli caused by the experience or expectation of flying in airplanes, helicopters, etc.

Within the types of specific phobia, the one that makes its symptoms emerge in the situation of flying in an aircraft is classified within the category of situational phobia; that is to say, anxiety and fear appear in specific situations, being this type of phobia the one that normally appears later in the age range from 13 to 22 years old.

What is done with flying phobia in psychotherapy?

Different treatments of varying effectiveness have been used to treat specific phobias, and specific and concrete interventions have also been designed to cope with and manage the symptoms of flying phobia.

The techniques that have been shown to be most useful and effective for any phobia are behavioral and cognitive techniquesIn particular, it will be essential to carry out exposure exercises to the phobic stimulus in order to overcome and cope with the anxiety it causes.

This implies, among other things, making the person "expose" himself/herself to the phobic stimulus gradually and going from the easiest to the most difficult, resisting the urge to withdraw and avoid this kind of experience. This can be done with imagination exercises (prior training in the ability to imagine vividly), with virtual reality resources that offer simulations of the interior of an airplane, or using real airplanes.

Similarly, components and forms of treatment adapted to the specific phobia of flying will be used. Thus, for the phobia of flying, a type of treatment programs have been used that include the following elements.

Psychoeducation

First of all, a psychoeducation phase is carried out, which aims to informing the patient about the nature of the disorder he/she has developed, helping him/her to detach himself/herself from the disorder.This phase is aimed at helping the patient to get rid of preconceived ideas and erroneous beliefs that could make it difficult for him/her to improve his/her quality of life.

The patient is explained what phobias and anxiety consist of and how they affect him, so that he can better understand what is happening to him, and he is also given information about airplanes and how they work, making reference to their safety and the probability of an accident occurring compared to other means of transportation.

2. Intervention on cognitive processes

Another component used focuses on treating the possible cognitive alterations that may occur in the patient, i.e, irrational or untrue beliefs that the subject may present..

To this end, we will use the cognitive restructuring technique, which consists of identifying those irrational or negative beliefs related to airplanes and the act of getting on an airplane that arise in the patient, and that generate great emotional discomfort and frustration.

This process consists of raising questions and presenting issues to confront and change these harmful ideas, leaving it to the patient himself to question his beliefs once he has been presented with a certain information or made to combine two or more concepts.This process consists of posing questions and presenting topics to confront and change these harmful ideas, leaving the patient himself to question his beliefs once he has been presented with a certain piece of information or has been made to combine two or more concepts. It is an intervention inspired by the Socratic method.

3. Training in relaxation techniques

This is followed by the teaching of controlled breathing and/or relaxation techniques. This helps the subject to achieve breathing control by relaxing the abdominal muscles, contracting the diaphragm and relaxing the intercostal muscles.

Through the conscious control of certain processes linked to the physiological aspect of the individual, the individual is helped to let the state of anxiety fade away.This is associated with a state of nervous and muscular hyper-activation.

4. Exercises of exposure

As we have seen, in the psychotherapy applied to the cases of phobia to fly it is necessary that the person learns to confront his fear without yielding constantly "to what the body asks him" before the appearance of the phobic stimulus, reason why it will have to resign to avoid or to flee before these experiences. In order to facilitate this process, exposure techniques used in psychotherapy have been developed, which are intended so that the patient does not become frustrated and does not increase his fear by failing again and again to overcome the anxiety..

To this end, psychologists give a series of indications on how to manage anxiety (related to provisionally accepting a certain level of discomfort without trying to eliminate it completely and keep it "out of mind") and with an ascending difficulty curve adapted to the degree to which the person is able to resist the phobic stimulus in each phase of therapy.

For example, one can start with an imaginary exposure, i.e. without the real phobic stimulus (we can use either a computer program or virtual reality, or imagination exercises) and then move on to real stimuli.