Virtual reality vs. aerophobia

Farewell to fear of flying

By David J. Craig

Detailed accounts of what the last minutes of life were like for 88 people who perished on Alaska Air Flight 261 on January 31 were difficult to avoid in the days following the crash. The speed of the jet's descent, the resulting G-forces inside, and the exact time it took the plane to crash, upside down, in the ocean off the California coast all were fodder for nightly news programs.

Such gruesome images and extensive coverage of plane crashes have a profound effect on those millions of Americans who fear flying, according to one BU psychologist. "The idea that flying is unsafe is highlighted all the time in the news, on television programs, and in movies, and one of the major ways people develop a fear of flying is through the message that such disasters are more likely than they really are," says Donna Pincus, a College of Arts and Sciences research assistant professor of psychology, who treats patients suffering from a severe fear of flying, or aerophobia, at the BU Center for Anxiety and Related Disorders. "The image of a pilot struggling to bring a plane out of a nosedive and people plummeting to their deaths is very powerful."

Donna Pincus, a College of Arts and Sciences research assistant professor of psychology, guides Kamila White, a CAS research assistant professor of psychology, through a computer-simulated plane flight with virtual reality equipment used to treat patients with a fear of flying, at the Center for Anxiety and Related Disorders. Photo by Fred Sway

Despite the fact that flying in a commercial airplane in the United States is safer than driving in a car, and that more than 30,000 flights take off and land each day without incident, 25 million Americans, or one in six adults, avoid flying because of fear. Extensive media coverage of crashes seems to contribute to the fear. A Newsweek poll taken in the wake of the EgyptAir 990 disaster last November found that 50 percent of those who fly on commercial airliners are scared to do so at least some of the time -- up from 43 percent in a similar poll in 1996. The problem can become paralyzing.

"We treat people who have turned down high-paying jobs because travel was involved, and people who haven't visited family members in 20 years because of it," says Pincus, adding that the Center for Anxiety and Related Disorders sees an increase in patients complaining of a fear of flying following major plane crashes. "Some people are afraid that they'll literally crash and die. Others are frightened mainly by the bodily sensations they associate with flying, such as shallow breathing, a racing heartbeat, or feelings of unreality and disorientation."

Besides seeing news or fictional accounts of plane crashes, a fear of flying is also often sparked by a traumatic experience on a plane, such as a panic attack, or knowing someone who also is afraid of flying, a parent perhaps, or a friend. The effects of such associations can persist for years and overshadow even the most reassuring statistics.

"Once people have a fear of flying, they seek out information that confirms what they believe, because generally people like to be right," says Pincus. "Another feeling that can contribute to the fear is that of being out of control. In a car, people feel that they are more in control of their situation. That makes them feel secure."

Treatment for fear of flying, like that of other anxiety disorders, involves a process by which patients are exposed gradually to different elements of what they fear. For a plane flight, this includes driving to an airport, watching planes land on a runway, and eventually taking a real flight. The process can take months and can be very costly, including as it might the price of several flights for both the patient and the accompanying therapist. The Center for Anxiety and Related Disorders treated 400 patients last year, about 80 with specific phobias such as aerophobia.

A new virtual reality treatment available at the center, however, makes the process more efficient and affordable. The Virtually Better equipment allows a patient to experience a plane trip -- including flight instructions, a vibrating seat, varying weather conditions, and turbulence -- by wearing a headset that projects a computer-animated view of the inside of a plane.

"It's a very convenient form of exposure