Transactional Analysis Journal

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A Treatment for Flying Phobia

Ron Ohlson

To cite this article: Ron Ohlson (1980) A Treatment for Flying Phobia, Transactional Analysis
Journal, 10:4, 304-308, DOI: 10.1177/036215378001000406

To link to this article: https://doi.org/10.1177/036215378001000406

Published online: 28 Dec 2017.

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TA Treatment Strategies
A Treatment for Flying Phobia
Ron Ohlson
Abstract
A treatment metbodology for flying
pbobias, utilizing a combination of TA and
bebavioral principles and tecbniques is des-
cribed. Tbe etiology of tbe pbobia is dis-
cussed in terms of early cbildbood experience,
actual aircraft misbaps, early injunctions,
and learned bebaviors. Treatment involves
evaluation, relaxation training, decontami-
nation and redecision work, systematic de-
sensitization, and stroking for reinforce-
ment. A unique in vivo desensitization
procedure utilizing a f1oat-equipped air-
plane is discussed.
In the aftermath of recent air carrier
tragedies, many people experience appre-
hension about flying. This author, build-
ing on the work of the Gouldings (1977),
has developed a method to treat the most
intense flying avoidance behavior, the
phobia. This condition is characterized by
severe anxiety to the point of panic, some-
times even in response to the fantasy of
getting on an airplane. Some people deal
with their phobia by sedating themselves
with alcohol or drugs in order to fly. Others
simply decide not to fly in favor of some
other form of transportation. Still others
become counterphobic, behaving as if
they are not afraid when in actuality they
are quite frightened.
Flying phobias appear to develop in at
least four different ways. First of all, the
person may have had an early childhood
experience in which he was terrified by
"Similar thinking is also involved in the decision to become
counterphobic, thus avoiding the fear of death by pretending
that the fear does not exist at all."
©Copyright Ron Ohlson, 1980.
304
flying or falling. One man remembers his
father strapping him into a plane and doing
aerobatics, while another remembers
standing on a bridge railing and falling,
just being caught at the last moment. The
child's Little Professor then generalizes
thoughts and decisions from the early
experience to later, more complex situa-
tions that have the same cues. Similar
thinking is also involved in the decision
to become counterphobic, thus avoiding
the fear of death by pretending that the
fear does not exist at all.
A second cause of phobias is participa-
tion in an actual aircraft accident or mishap.
Survivors of aircraft accidents, including
seasoned pilots, are often quite phobic for
several weeks, months, or years following
the accident. These phobias are the result
of severe contamination in which primitive
and intuitive Little Professor thinking is
confused with adult facts which mayor
may not be accurate. The Adult then seem-
ingly agrees that the so-called "facts" are
true, which then legitimatizes the feeling.
The Gouldings have pointed out a third
source of phobic behavior in early childhood
injunctions (Goulding and Goulding, 1978).
Probably the most power injunction involved
in flying phobias is the Don't Exist injunc-
tion. This is often reflected in an intense
fear of heights, in which the person has
struggled with a past impulse to suicide by
jumping off a high place. The Don't Be
Close injunction often produces claustro-
phobia, which occurs as a person is strapped
into the tight confines of an aircraft cabin,
Transactional Analysis Journal

and then sometimes is confused with fear
of flying when in reality it is a fear of
closeness.
The third injunction is Don't Trust. This
is especially crucial in flying because under
few other circumstances must a person
more clearly entrust one's life to another
person and machine than when the cabin
door closes on an aircraft and the pilot
takes command. For most people with
severe fears of flying, all three of the above
injunctions are operating and redecision
work will necessarily be done with each
one in order to effect a cure of the flying
phobia itself.
Fourth, fear of flying or almost any
other phobic behavior may be a learned
behavior. A parent who is frightened to the
point of phobia about almost anything can
serve as a very potent model of avoidance
behavior for the observing child. The
child's Little Professor therefore will
decide that since parents are perfect and
are frightened about something, then he
also must be frightened to the same degree
that the parent-model is frightened. These
learned responses tend to persist, often even
in face of adult information. to the con-
trary, especially if the avoidance behavior
is stroked by the model. Thus, a flying-
phobic parent may model phobic behavior
to the child and then reinforce the avoid-
ance behavior by appreciating the child for
staying home and being a good companion
while the rest of the family goes on a
flying vacation.
The following are the procedural steps
involved in treatment of a flying phobia:
Step 1, Life Script Interview
Each phobic patient is given a detailed
Life Script Interview (Holloway) in order
to establish script information, especially
with respect to injunctions that are operat-
ing. The Fear Survey (Wolpe, 1968, p, 172)
is also administered in order to assess the
degree to which a person is target-specific
in phobic behavior or to which he is pan-
phobic, demonstrating avoidance be-
"These learned responses tend to persist, often even in face of
adult information to the contrary ... "
Vol. /0, No.4, October 1980
A TREATMENT FOR FLYING PHOBIA
havior in a number of areas. In the case
of panphobics, it might be wise to success-
fully treat a phobia of more limited inten-
sity before attempting to treat the flying
phobia. This would result in significant
decontamination which can aid in later
treatment of the more difficult phobia.
Step ~, Relaxation Training
Wolpe (Wolpe, 1968) has significantly
demonstrated that the relaxation response
is incompatible with anxiety and therefore
can be substituted as an incompatible
response in the phobic situation. Thus,
each patient is taught a progressive,
gradual relaxation technique. The pro-
cedure is taped and the patient is encouraged
to practice the relaxation exercises on a
daily basis until he is able to voluntarily
move from a tense to a relaxed state imme-
diately.
Step 3, Covert Systematic Desensitization
Once the relaxation response has been
developed, the patient cooperates in de-
veloping an approach hierarchy (Kanfer
and Phillips, 1970, p, lSI) of frightening
stimuli associated with flying. Thus he is
first asked to put himself in the relaxed
condition and then progressively move
closer and closer to the feared stimulus.
The hierarchy may begin with the patient
imagining being at home packing luggage
in preparation for a flying trip. The hierarchy
may continue with driving to the airport,
parking the car, going to the ticket counter,
waiting in the waiting room, entering
the aircraft, fastening the seat belt, and
hearing the aircraft door close. This is the
most frightening moment for most flying
phobics because at that point they are
trapped in the aircraft and unable to get
off until the plane has landed. By a process
of reciprocal inhibition (Wolpe, 1968, p. 12),
the patient is encouraged to relax com-
pletely in the face of frightening stimuli
until the fear disappears, at which time the
patient moves to the next most feared
stimulus. The patient is also exposed to
305
RON OHLSON
" ... the patient may be asked to restate this redecision several
times throughout the flight by visualizing her parent in the
back seat of the aircraft, saying the same words again."
an audio tape in which instructions are
given concerning the entire flight. The
patient is instructed to relax at various
intervals throughout the imaginary flight
until he has landed and is inside the terminal
where he is told to give himself positive
strokes for having made the imaginary
flight successfully.
Step 4, Decontamination Process
Since most phobias involve a contamina-
tion of the Adult by the Child (Woollams
and Brown, 1978), decontamination in-
volves obtaining adult information about
flying. In order to strengthen Adult ego
state boundaries, the patient is given specific
instructions about the nature of flight, air
traffic control, air traffic safety, and
emergency procedures. In addition, the
patient may visit several types of aircraft,
from light planes to large commercial air-
liners, and may also visit the local air
traffic control center in order to witness
firsthand how radar separation is main-
tained with all types of aircraft.
Step 5, Redecision Work
The patient is next encouraged to work
the second degree impasse in order to
establish redecisions around the original
injunctions of Don't Be Close, Don't Trust,
and Don't Exist. This may be effectively
accomplished in an office setting, but it has
been demonstrated to be more potent when
actually carried out in an aircraft. For
example, while sitting in the passenger's
seat of the aircraft prior to starting the
engine, the patient tightens the seat belt very
tightly, closes the door, latches it, and
then is asked to visualize his injunctive
parent standing outside the aircraft. He
is then asked to say in a loud voice the
following words. "I am going to trust this
"Since an aircraft only involves two phases of operation-
taxiing and flying-successive approximation is extremely
difficult."
306
pilot to keep me safe, and I am not going
to jump out or fall out of this airplane."
In addition, the patient may be asked to
restate this redecision several times through-
out the flight by visualizing the parent in
the back seat of the aircraft, saying the
same words again. Redecision about
closeness can be accomplished in group
prior to getting aboard the airplane.
Step 6, In Vivo Desensitization
This step involves actual desensitization
in the aircraft. One of the reasons why
flying phobias are sometimes difficult to
modify compared with other behaviors is
that there is no way of successive approxi-
mation of small steps toward the desired
goal. For example, in desensitizing a snake
phobia it is possible for the phobic person
to take one step toward the snake and relax
or take a step backward, only approaching
the snake under relaxed conditions. Since
the aircraft only involves two phases of
operation-taxiing and flying-successive
approximation is extremely difficult.
However, this author has devised a tech-
nique using a float plane which allows for
successive approximation, gradually
calming and deconfusing the frightened
Child. With the aircraft on floats it can be
taxied on the water and is actually a boat
until it is airborne. Thus, on a large lake
it is possible to taxi the plane at varying
speeds until the patient becomes relaxed
at that particular operation and is ready
to proceed to the next operation. If the lake
is large enough, it is possible to actually
take off, fly a few feet, and land again,
allowing the patient to become relaxed with
the idea of flying a little bit at a time. In
this procedure the passenger's controls are
removed from the aircraft in order to avoid
disastrous consequences from a panic reac-
Transactional Analysis Journal

"In addition, a patient may be encouraged to roar occasionally
throughout the procedure as an alternative to the relaxation
response. "
tion on the part of the patient, who may
suddenly grab the nearest object in sight
to hang on to when frightened. That ob-
ject is usually a control wheel in a small
aircraft. (This probably accounts for a
number of major aircraft fatalities in light
planes: The accident is attributed to pilot
error when in fact the phobic passenger
may have grabbed the controls at a critical
moment.)
After redecision work outlined in Step
5, the aircraft engine is started and the
plane taxies out on the water. Through the
aircraft intercom the patient gets a calm,
detailed explanation of everything that is
happening so that there are no surprises
and questions are quickly answered. The
passenger is encouraged to relax. When
sufficient power is applied to cause the
aircraft to plane on top of the water like a
highspeed boat, the noise of the engine
often is quite frightening to phobic patients.
This author has discovered that encouraging
the patient to scream or shout as loud as
possible at this moment will diminish the
fear. It is important that the noise emitted
at that point be an aggressive roar rather
than a frightened scream. In addition, a
patient may be encouraged to roar
occasionally throughout the procedure as
an alternative to the relaxation res-
ponse. Both the roar and the relaxation
response are incompatible with anxiety,
through the process of reciprocal inhibition.
As the plane attains flying speed while
planing on the water, it can be lifted off
the surface of the lake briefly and the
patient is asked to notice this. If the patient
indicates that he is still frightened, the
plane can once again be lowered to the
surface of the lake and the power reduced
until the relaxation response returns. The
process can be repeated until the patient is
relaxed or assertive enough to begin actual
flight. At that point the principle of suc-
cessive approximation can be achieved if
there is unlimited airspace.
Vol. to. No.4, October 1980
A TREATMENT FOR FLYING PHOBIA
It is possible in a light plane to overcome
related height phobias by increasing altitude
in l00-foot increments until the patient be-
comes frightened. At the time it is possible
to reduce altitude until the patient is more
relaxed. Obviously, this is not possible in
commercial airliners and is one of the ad-
vantages of utilizing light aircraft to
desensitize phobias. At each point the
patient is stroked for both relaxing and
setting limits. In addition, the length of the
flight may be varied beginning with a very
short flight on the first day and gradually
lengthening the time that the patient is
actually in the air. It is always best to
stop before the patient is actually ready to
stop, thus giving the patient the clear idea
that it is not absolutely necessary for him to
push his limits. This creates a maximum
experienceof safety for his Child.
Step 7, Generalization to Larger Aircraft
Once the avoidance behavior has been
inhibited in the light aircraft, it is then
possible to generalize it to larger aircraft.
For the most part these behaviors generalize
easily. Once a patient has become secure
in a light plane, he usually is much more
secure in a much larger aircraft. In these
cases the phobic point is most likely going
to be reached at two points-first of all
when the door of the aircraft is closed and
escape is no longer possible, and secondly
as the plane departs the runway for a climb-
out. In the first instance the patient is asked
to reassure his Child and once again make
a redecision stating to himself and if
possible to another person that he is going
to trust the pilot and the aircraft. At the
point of liftoff the patient is encouraged to
utilize either the relaxation or roar techni-
que as a reciprocal response to fear. The
latter can be accomplished by putting an
article of clothing over his mouth, keeping
the mouth open and making possible a
muffled scream. It is best to have him
inform fellow passengers that he is going to
307
RON OHLSON

do this. Prior to flight on a commercial
airliner or larger aircraft, the client is asked
to review the relaxation, desensitization
procedures, and, using earphones on his
tape recorder, to play his densensitization
and relaxation tapes during the flight.
Step 8, Stroking
It is advisable to have a stroke session
following successful completion of any
stage of this program. The procedure is
best conducted in groups so that as a
patient returns from a flight he is warmly
stroked by members of the group, whether
he has demonstrated phobic behavior or
not, creating a climate of warm acceptance
and eliminating performance anxiety.
The above procedure is effective and can
be modified to meet the situation demands
of each individual therapist. By being
creative, the therapist may modify the pro-
cedure to fit the availability of pilots,
instructors, and aircraft, which can be
chartered for the purpose of the program.
The airlines are usually quite cooperative
in allowing people to visit the cockpit of the
aircraft between flights and sometimes
may offer reduced rates for group desensi-
tization flights. The Federal Aviation
Agency will assist in flying safety informa-
tion lectures. By utilizing this procedure
within the availability of other resources,
the TA therapist may experience success
in modifying a difficult phobia.
Ronald W. Ohlson, PhD, ABPP, RM,
is Director, Ohlson Psychological Services,
in Anchorage, Alaska.
REFERENCES
Goulding, M. Phobias. Transactional Analysis
Journal, 1977, 7(1),44.
Goulding, R., & Goulding, M. The power is in the
patient. San Francisco: TA Press, 1978, 227-247.
Holloway, W. Clinical transactional analysis with
the use of the life script questionnaire. Aptos,
California: Holloway Books.
Kanfer, F., & Phillips, J. Learning foundations of
behavior therapy. John Wiley and Sons, 1970,
147-172.
Wolpe, J., & Lazarus, A. Behaviortherapy techniques:
A guide to the treatment of neuroses. Pergamon
Press, 19687, 54 rr., 172 f.
Woollams, S., & Brown, M. Transactional analysis.
Dexter, Missouri: Huron Valley Institute, 178, 36f.

Thanks to Ronald Ohlson for a superb explanation of treatment of flying phobias!

This article is clear, both theoretically and practically. I'm especially appreciative of
his use of actual flying in desensitization. Non-pilot therapists could use his techniques
by employing an interested pilot.
I do not use Wolpe's relaxation techniques because I find excitement a better anti-
dote to fear. Parents tell their children to "calm down" and "relax" when something
fearful is about to be done to the children, such as just before innoculations or even
preparation for surgery. Therefore, the command to "relax" may induce fear. Fun
and excitement, instead, can be used as Ron uses them when he has clients yell and
growl over the sounds of the plane motor. We also have clients make their fears
funny; for example, they may say, "If I watch the wing, it won't falloff," or "As
long as I'm scared, Pilot, I am safe, but if i stop being scared, God knows what you'll
do with this plane!" Such spoofing of Child-magic counter-acts the injunction,
"Don't feel too good or something bad will happen." Also, when the client is
experiencing the take-off or the flying, either in fantasy or actuality, the client will
have much more fun being excited by the view than by repeating to self that it is
important to relax.
-Mary McClure Goulding

308 TransactionalAnalysis Journal