At one point or another, as many as 12.5% of Americans will struggle with a phobia — “an intense, irrational fear of something that poses little or no actual danger” — according to the National Institute of Mental Health. Of these, a fear of flying, or aviophobia, is one of the most common, with estimated prevalence ranging from 2.5% to 6.5% of the population.
Far more people have a fear of flying that doesn’t reach phobia levels, despite the fact that people are flying more than ever before and plenty of data shows it’s a reliably safe way to travel. So what is it about flying that stirs such widespread anxiety?
“A lot of it is the lack of control they have in the situation,” explains Todd Farchione, the director of Boston University’s Intensive Treatment Program for Panic Disorder and Specific Phobias. “When the doors close, they’re in it. They’re stuck. They can’t get out of the situation. I think that’s often what’s most frightening for most people.”
Fear of heights or crashes, or not understanding how flight works, may also play a part, Farchione says. And flying is a uniquely terrifying activity for many people because they know that if fear or anxiety strikes during the trip, there’s little they can do, he says.
“They’re afraid that they might have fear in the situation and be unable to get away from it,” Farchione says. “It’s this image of being stuck sweating and being totally afraid for two hours, four hours, six hours. They’re at the mercy of the pilot.”
Sound familiar? Here’s what you can do if you’re afraid of flying.
Change your response
It’s okay to be afraid of flying, Farchione says. What’s more important is reacting to the situation in a healthy way.
Many anxious fliers manage their fear by gripping the seats, studying the flight attendants or analyzing every last bit of turbulence, Farchione says. But in doing so, “they’re actually contributing to the fear. Their actions are inadvertently telling them that the situation is dangerous, when in fact it’s not.”
Instead, do whatever it takes to distract yourself. Read a magazine, watch television, listen to music or talk to a travel companion. It may also help to practice deep breathing techniques and consciously release muscle tension. “Even just putting a smile on your face can change the emotional reaction,” Farchione says.
Don’t self-medicate
If you don’t fly very often, using a pre-flight Chardonnay to calm your nerves may not be terribly harmful, Farchione says. But if you travel regularly and consistently rely on sleeping pills, alcohol or other substances to get through the experience, you’re just reinforcing bad behavior. “It creates a temporary Band-Aid, but the fear starts to build over time,” Farchione says. “Every time they drink or take medication to get through that situation, they’re saying to themselves, ‘I can’t feel what I feel. I can’t cope with this.’ Because of that, they’re going to be more frightened the next time.”
Prepare for the flight right
Many people with aviophobia experience significant anxiety leading up to a flight. In some cases, Farchione says, this can be worse than flying itself.
“In that scenario, I do think it’s useful for the person to ask themselves questions regarding what it is they’re afraid of, and what they think is going to happen on the flight,” Farchione says. Doing so may help you realize there’s nothing to be afraid of, or at least to identify and address sources of fear.
See a professional
The above strategies may work for someone with a non-clinical fear of flying or mild aviophobia, but severe phobias often require professional treatment. Exposure therapy — a process of growing acclimated to and eventually accepting the source of fear — is often used to treat phobias, but that’s difficult to arrange for most people with aviophobia. Farchione says treatment for the condition is increasingly moving toward helping patients reframe their fear response, and adds that virtual reality flight simulators may help as well.
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Write to Jamie Ducharme at jamie.ducharme@time.com