Fear of flying with a flight already booked
A wedding abroad, a work trip, a holiday you could not refuse. A deadline concentrates the mind, and it usually helps treatment rather than hindering it. Here is what can be done in the time.
Most of the time the fear is manageable, because you have quietly built your life so you do not fly. Then something makes it unavoidable. A wedding abroad. A job that involves travel. A holiday your family has waited years for. And suddenly the thing you had arranged never to meet is the biggest thing in your calendar, and the date is fixed.
People often assume a deadline makes treatment harder. In my experience it usually helps. Knowing the date focuses the work, and it gives us something concrete to build the ladder towards. Tell me at the first session, and we shape the course around it.
What you are actually afraid of
Fear of flying is rarely one fear. When we map it, it usually turns out to be several, and they need slightly different work. There is the fear of the plane itself: crashing, turbulence, something going wrong. There is the fear of being trapped: no exit, no control, hours in a sealed tube. There is the fear of panic: having an attack at thirty thousand feet with nowhere to go. And there is the fear of the fear: being seen to be terrified, making a scene, not coping.
For many people, the second, third and fourth are bigger than the first. They are afraid of what they will do inside the plane, more than of the plane falling. That matters, because the treatment for fear of panic in an enclosed space is different from the treatment for fear of mechanical failure, and we aim at the one that is actually yours.
Sometimes there is a specific bad flight behind it, and where that memory is still driving the fear, EMDR can take the charge out of it. Often there is no origin to find, and that is fine, because the treatment works on how the fear is maintained now.
What the deadline changes
With time to spare, phobia treatment moves at whatever pace suits you. With a date, we plan backwards from it. Usually that means starting the cognitive work immediately: the specific prediction you are making about the flight, the images that come with it, and the safety behaviours you have planned, the drink, the medication, the aisle seat, the not eating beforehand, each of which brings relief and keeps the fear intact.
Then the ladder, compressed but not skipped. Words, images, video of take-off and turbulence, airport environments, and, where it can be arranged, time in and around aircraft. Each step stayed with until the anxiety comes down on its own, rather than escaped at the peak, because staying is what teaches the alarm something new.
The flight itself
If the flight arrives before the work is complete, we prepare for it as an exposure rather than an ordeal. That means going into it with a plan: what to do when the anxiety rises, what not to do, what the sensations mean and what they do not. It means treating turbulence as the thing we have practised rather than the thing we feared. And it means the flight becoming part of the treatment, a step on the ladder, rather than a thing to be survived and then filed as more evidence.
Many people find that a flight approached this way, even a hard one, does more for the phobia than any number of sessions, because it is the top of the ladder and they climbed it.
Panic on the plane
If your fear is really about panic, the work borrows from panic disorder treatment. Panic runs on sensations misread as catastrophe, and an aircraft is full of sensations: pressure changes, engine noise, the lurch of turbulence. We work on what the sensations mean, bring some of them on deliberately beforehand, and find out what they actually do, which is peak and pass. A panic attack on a plane is deeply unpleasant. It is not dangerous, and it always comes down.
Time
Specific phobias are among the quickest things to treat. After an assessment session, most people need 6 to 10 weekly sessions, sometimes fewer, and much of the progress happens between sessions in your own week. If the flight is closer than that, we work with the time there is, and I will be honest about what is achievable in it.
If the date is in the diary and the dread has started, there is more on how I treat phobias, and the deadline is a good place to start the first conversation.