Tag Archives: CBT

inability to regulate feelings at the root of fear of flying?

a guest post by captain tom, on the topic of fear of flying that we’ve discussed on and off here on this blog.

first, by way of introduction, i’m both an airline captain and a licensed therapist. working with people who have trouble with flying has been my specialty for twenty-eight years.

i am fully trained in hypnotherapy and in NLP (neurolinguistic programming). i studied both years ago in my search for things that would help me treat fear of flying clients. i found hypnotherapy to be very “hit or miss”, too unreliable. NLP works with mild cases of flight anxiety.

over the years, my work has been focused on work with people unable to find help any place else. thus, we give away ” free ” the help that some other sites charge for. for free help, see the SOAR library and other free help is available at the fear of flying web site

we also offer free group phone sessions every wednesday night.

there is a great deal of misunderstanding about the cause of fear of flying. it is not caused by a bad flight; most people on a bad flight don’t develop fear of flying. difficulty with flying is caused by insufficient ability to regulate feelings when facing uncertainty.

research since the advent of the functional MRI just eight years ago has helps us understand how the brain works. we now recognize that the ability to regulate feelings is learned and that the part of the brain that does this regulation requires stimulation of the right kind during the first two years of life. the right kind of stimulation requires a caregiver who is empathically attuned to the infant and responds to the infant’s signals, rather than simply providing for the infant according to an agenda set by the caregiver.

if the child is afraid, the caregiver needs to tune into the child’s fear in a way the child really knows the caregiver feels the same way. thus the child knows he or she is not alone.

then, the magic happens; the caregiver then lets the child know that ” though the child’s fear is 100% shared ” the adult has an additional point of view, which is that it is not the end of the world; it will work out alright.

many of us, obviously, didn’t get such optimal early development. thus, when facing uncertainty, we control our anxiety by being in control of the situation, or by having a way to out of it.

that works fairly well on the ground ” except for annoying those who regard us as control freaks. but when flying, there is uncertainty, of course. and, not being in control and not having a way out, there is no way to regulate the feelings.

therapists try to help with CBT (cognitive behavioral therapy), but anxiety can develop so rapidly that CBT techniques cannot keep up with the anxiety build-up.

hypnosis is pretty “hit or miss”. if it helps on one flight, it can fail to help on another flight.

medications are not to be recommended ” according to the world health organization ” because when sedated, the passenger doesn’t move around enough to protect against DVT, deep vein thrombosis. if a DVT clot forms, it is a serious and potentially life-threatening problem.

also, use of medications ” according to research ” is only helpful in very mild cases of fear of flying. in more severe cases, medications make the flight worse!

i have tried to give a good understanding of the cause and cure of fear of flying in a video here and here.

albert ellis: empirically, logically and self-helpingly

the other day i was listening to a little audio clip of an interview with albert ellis, the no-holds-barred founder of rational-emotive behavioural therapy (REBT, also known as RET and RBT). ellis was one of the grandfathers of cognitive therapy; he wasn’t too enamoured with the theories he said freud “made up” and jung’s “mystical nonsense”.

but just like jung and freud, ellis’s ideas made their way into mainstream and pop psychology, forever entrenched there – for he is not only one of the grandfathers of cognitive therapy but also one of the people who helped midwife the psychological “arm” of the self-help movement.

in the interview, ellis was asked how he helps people. his response (slightly paraphrased):

we dispute people’s irrational beliefs which lead them to become neurotic. individuals upset themselves, they tell themselves nonsense and then they blame it on their early childhood!

it works usually within the first 5-10 minutes.

they come in with anxiety, depression, rage. so i ask them, what happened? “well so and so did this and that and i got enraged”

and we say, “let’s assume you are right and they treated you unjustly. what did you tell yourself after that?”

“he was wrong and he shouldn’t be doing this!”

well, they may be wrong alright but that doesn’t matter. the problem is that people say this should not be, this must not be.

and here comes my favourite part

so we get them to think about this. and first they think about their thinking and then think about how they think about it – which human beings, being constructivists, can do, but rarely do.

and then we help them to realize, empirically, logically and especially self-helpingly, that it’s unrealistic to say someone should not or must not do XYZ. and that it doesn’t follow that they are no good as a person; just that they act no good.

finally, ellis tells us

then we say, “it’s too bad that he treated you this way – now what are you going to do to change that or to live with it?”

we show them that they’ve become anxious or depressed because of what they told themselves about this event.

then we use cognitive, behavioural and emotional techniques to act help them act otherwise.

i already mentioned some of those techniques in my eulogy to albert ellis back in june. another one is a shame-attacking exercise, and i’ve certainly used that in my practice.

example: a client, let’s call her marion, is always nervous of what people think of her. she doesn’t even want anyone to know that she’s in therapy, and that troubles her a lot. we decide to allocate a whole session to that. i ask her for a list of people who she thinks might think ill of her for being in therapy.

we then pick a person from that list – usually one who is not too “scary” – and i support marion as she calls that person and casually mentions that she’s just come from a therapy session.

after that we debrief. marion is surprised and delighted to shed a light on her thoughts, beliefs and feelings around the experienced – and she is relieved because she knows she’s starting to put down the burden of always looking over her shoulder to see that “they” think.

interested in experiencing how this works? email me at moritherapy at shaw dot ca, and i’ll give a free taste of it.

for a post i wrote on the occasion of albert ellis’ death at 93, go to don’t should on yourself: albert ellis dead at 93

(this post was mentioned in the carnival of quotes)