
Fear of flying and virtual reality therapy
I’ve suffered panic disorder since puberty. You likely wouldn’t know it if you met me. I’m told I’m relaxed, fun, and laid-back. I don’t worry about money or daily concerns. For those who’ve never suffered a panic attack, you do feel like you’re dying. I usually have severe chest pain, can’t breath. They’re classic heart attack symptoms so most people assume it’s a heart attack. I do have an extreme reaction to heights. I have high levels of norepinephrine — like many other people with anxiety disorders — but science hasn’t answered whether that causes our panic attacks or results from panic attacks.
My heights phobia began shortly after I moved to Colorado. Growing up in Florida, we didn’t have mountain roads. I refused to drive on them. I spent my first three years in Colorado snowboarding. The ski lifts were difficult, but tolerable with a small dose of Xanax. When I reached 25, I developed a true heights phobia. The panic on lifts was so severe I often had thoughts of jumping. Jumping off actually sounded more pleasant than enduring a three minute ride. If you haven’t suffered panic attacks, reflect on that for a moment so you might empathize with those who suffer. I’d been in and out of therapy many times for various reasons but I was never offered skills-based, evidenced-based treatment like cognitive behavioral therapy. Our mental healthcare system is broken. Many therapists continue offering talk therapy and the field often does not embrace evidence-based medicine. Primary care Dr’s would prescribe SSRIs — which increase panic attacks in most.
My last two airline flights were terrible. On a flight home from Vegas, we encountered turbulence and I grabbed the head of the man sleeping in front of me. I was so embarrassed. The panic was so intense, i couldn’t read a sentence in a book. The next flight was also terrifying. I spent $1,500 to rent a car and drive home. I decided I could no longer fly. I missed a dear friend’s wedding in Hawaii, and another asked me to be in her wedding in SF, which I declined. I declined free vacations to Prague & Sweden when I was showing dogs. I traveled the U.S. because I was self-employed and able to drive.
Yes, I knew flying was safe. I’ve been on planes since I was an infant. I loved flying. I even loved bungee jumping. My mother owned a plane when I was a teen, which we kept at the Boca Raton Municipal Airport. Her friends had planes. My grandfather was a pilot and my little cousin is a pilot, so I had access to free buddy passes. I didn’t visit him while he was flying in Dubai. I missed so many experiences in my life.
I began researching flying phobias. I read this person’s experience. The statistics for virtual reality therapy were astounding; 92% cure rate for most phobias.
https://www.wareable.com/vr/vr-therapy-cure-fear-of-flying-665
Fear of flying sounds much better than flying phobia — which is what it is. The word ‘phobia’ is stigmatized; I still have a difficult time using it. I know most people with an anxiety disorder reading this understand that we all feel “crazy” — please forgive the ableist word but I think it’s the word many of us identified with most of our lives because we realize our fears are irrational.
Let’s remove that label by understanding the cause of a panic attack. Fight/flight response was vital in the daily survival of our ancient ancestors — when faced with danger, an automatic response would take over that propelled them to take immediate action such as attack or run. It is useful when you must respond to a real threat quickly.
When the brain perceives danger, the sympathetic nervous system sends signals to prepare the body for action. Then the parasympathetic nervous system should step in and stabilize the body to a calmer state. If the parasympathetic nervous system fails, a person will experience a panic attack.
Through cognitive behavioral therapy — in only two days in NYC with an absolutely brilliant psychologist named Dr. Howard Gurr — I was given back my life. There are many physical conditions that contribute to this disorder including breathing problems, adrenal tumors like mine, vertigo, caffeine or alcohol sensitivities, and many others. Identifying ones triggers is the first step.
Virtual Reality participants are placed in a computer-generated three-dimensional virtual world and guided through different environments. Computer graphics and displays are integrated to give the patient a sense of immersion in the virtual environment — in this case airplanes. The therapist guides the patient through the environment and can interact with them through the entire event, providing relaxation techniques during times of panic. When I became overwhelmed, Dr. Gurr would send me to the bottom of a virtual ocean. The reefs were relaxing, beautiful, and alive — unlike our real reefs currently bleaching from climate change. I’ll save that for a different blog. Research indicates that 6 to 12 sessions of virtual reality are effective for most. Therapy provided is cognitive behavioral therapy skills and exposure therapy, and virtual reality is the tool. It allows the therapist to view the patient in a state of panic, and provide the patient the skills to reduce the panic. When we learn to stop focusing on the horrible sensation, it disposers quicker. The cost is $140-$200/session. It’s also highly effective for PTSD.
I completed only 4 sessions of virtual reality treatment in Dr. Gurr’s office in two days. I’d recommend a slower exposure, but I had to drive 24 hours each way and I’m a single parent. He pushed me far on day 1; it was a rough day. The virtual reality scenes don’t look any more real than a video game, but it’s enough to trigger the sympathetic nervous system and induce anxiety. I mostly used muscle relaxation techniques and breathing.
My first flight was one week after therapy. In the past, I didn’t experience pre-flight anxiety. This time I did, most likely because I’d taken a long break from the “friendly” skies. Each positive experience in a virtual world creates new neural pathways, and so does each real flight. I’ve taken nine flights in two months since VR. I struggle taking off and I now recognize the engine sound triggers my sympathetic nervous system. I spend most of that time with my expensive noise-cancellation headphones, listening to the Headspace fear of flying app, trying to increase my parasympathetic system. Usually by the end of the flight, I’m reading a book. I’ve even enjoyed a few flights. Much help has come from a friend who also suffered. She manages Hollywood actors and had to overcome her phobia for work, but years later she still considers herself in recovery because you never know when panic will strike. But now we have tools. We know the body can only release so much adrenaline before it stops. We take large doses of anxiety meds before boarding. We get through our flights, and enjoy the adventures that await us at the next airport.
One thing I learned is that each time you take a white-knuckle flight, you reinforce that reaction in your brain. If you’re a nervous flyer — seek help. Download Headspace if you can’t afford VRT. CBT can be self-taught with YouTube. The techniques are simple.
My next goal is to eliminate caffeine. If I ever succeed, I’ll let you know if it helps my panic disorder. Two days ago I had a flight. I followed my psychologists rule: no caffeine. I had a perfectly normal and happy flight. On the layover, I grabbed a latte. I had a miserable flight. I spent most of it watching the flight tracker and counting the minutes.
I’ve wanted to write about this for a while, so here it is. I hope it helps a few of you!
