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John H. Greist, MD, Georgia L. Greist, PhD, and James W. Jefferson, MD

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Fearful Flyer's Guide

(below is the first excerpt from the guide)

Flying phobia

Flying phobia Flying phobia is a very real problem for the 25 million people in the United States who are so frightened they will not fly at all. For an additional 50 million who experience substantial anxiety whenever they do fly, it makes travel for pleasure or work unnecessarily uncomfortable. Phobias are fears or anxieties that a person recognizes as "irrational." Other synonyms sometimes used are "silly, ridiculous, stupid, dumb, crazy," etc., showing that phobic sufferers are aware their fears greatly exceed any realistic risk they face. Despite this awareness and embarrassment about their avoidance of everyday things, phobic individuals often find themselves unable to face the phobic object or situation. On the rare occasions when they force themselves into a phobic situation, they may function poorly and experience great distress.

While a phobia of snakes may not inconvenience a city dweller at all, flying phobia can constitute a terrible problem. Many flying phobics find it difficult to travel far from home because they are restricted to the use of surface transportation. The development of commercial jet aircraft has substantially reduced the availability of train and boat transportation. Some people with flying phobia cross oceans by boat or miss children's graduations and weddings and parents' funerals because surface travel is such a slow and onerous process.

"Anxiety" and "fear" are often used interchangeably. Strictly defined, fear refers to the set of thoughts, feelings, physiologic changes and behaviors that result from real danger. Anxiety produces similar thoughts, feelings, physiologic changes and behaviors but occurs in situations where risk of actual harm is small or even nonexistent. This technical distinction is unimportant to most patients, and clinicians are accustomed to hearing both terms used interchangeably.

When confronted with real danger, people experience thoughts of harm and how to avoid it, feelings of fear, physiologic changes (increased heart rate and blood pressure, rapid breathing, muscle tension, dilated pupils, etc.), and behaviors to avoid, control or overcome the danger. After the danger passes, these processes revert to a more neutral and comfortable state.

Fear helps us deal with danger safely. Anxious individuals recognize that they have "nothing to fear," but feel as though they face real danger.

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