- The Washington Times - Monday, May 7, 2007

One kind of air travel anxiety seems to breed another, but not always in the ways one might expect.

Psychotherapists such as Jerilyn Ross, director of the Ross Center for Anxiety & Related Disorders at 5225 Wisconsin Ave. NW (www.rosscenter.com), can even put a positive spin on the period following September 11, 2001, when a number of psychologists who treat anxious and phobic travelers somewhat surprisingly reported a drop in business.

Instead of people clamoring for professional help, Ms. Ross says, the event had the effect of being a kind of perverse reassurance.

“A lot of people were ashamed before and wouldn’t talk about their fears; after 9/11 it became almost socially acceptable and, in some cases, they were less likely to come in for treatment because they were understood,” she says. “Anecdotally, there is a sort of new normal. I think people probably are more comfortable saying even to a primary care doctor they want a prescription [to calm nerves] and not be embarrassed.”

The reality is that someone is more likely to be killed on their way to the airport, she says, referring to familiar statistics about highway versus airplane deaths: “The difference is when you get on a plane, you feel driven by someone you know nothing about. There is the whole sense of being trapped and out of control.”

While it is impossible not to be reminded of danger and discomfort, she suggests that the normally anxious traveler once on a plane — rather than the truly phobic who probably wouldn’t even buy a ticket — chat up airline personnel and find out about them as people; some security could come from knowing who is in charge.

R. Reid Wilson, associate clinical professor of psychiatry at the University of North Carolina, suggests reaching out to fellow passengers, to be aware others possibly are feeling the same way, especially during long delays on the tarmac: “You get support on the plane. Time goes by more easily and you are in a better mood. People who sit isolated and disconnected end up fuming and being more frustrated.”

There are no good statistics about an increase in number of people and their anxieties regarding air travel, but anecdotal evidence abounds, professionals in the field say.

“What is disturbing is how much more crowded every plane is; most major airlines are going to be sold out,” Mr. Wilson says. “There is no breathing room anymore. That makes people more irritable and closed in. Coupled with that we have a strain on the baggage system and carry-ons.”

He sees people using what he calls “more crutches,” such as pills and alcohol, to cope with lower-grade anxiety. His Web site (www.anxieties.com), he reports, gets 50,000 new people a month looking at, on average, 24 pages. Not all, of course, seek information specifically relating to air travel.

“We know all of us in general get more claustrophobic and uncomfortable. Then there are people who seriously have trouble,” he says.

Numbers of the latter have not increased in any major way, he notes.

He suggests that the seriously worried or afflicted try a therapy session by phone to help with the problem.

“The more you can step back and see issues in larger terms, to look at the bigger picture, the better you will be,” he says. Not tensing up is key: “People who fear the loss of control just need to know what to focus on.”

For decades, airlines denied such fears existed on grounds it was bad marketing. Then, for a period in the 1980s and 1990s, companies such as Delta, American and US Airways instituted service programs that included taking people up on special “graduation” flights to measure their progress. Mr. Wilson, who created such a program for American, says the decision to eliminate them on grounds they were not cost-effective was a foolish one; such programs could build loyalty to a particular airline among those helped, he says.

The Web site of the American Psychological Association reports on a study that showed “virtual reality therapy” worked equally well to decrease symptoms as “standard exposure therapy,” or actually going up in an airplane. Some 45 participants took part in the project intended to help the estimated 25 million adults the APA says are afraid of flying.

A move to have Congress pass an Airline Passenger Bill of Rights that would mandate better treatment by airlines in case of delays currently is being pushed by a California woman who was stuck for more than eight hours inside a plane on the tarmac last December. She is supported by therapists such as Jean Ratner, a clinical social worker who holds Fear of Flying classes out of the Center for Travel Anxiety in Bethesda where she is co-director (www.travelanxiety.com).

“I think more people are more claustrophobic,” Mrs. Ratner says. “People feel more stuck. Lines take longer. Claustrophobic people find that difficult — if they can’t move forward. Claustrophobia is the fear of being trapped — the feeling of being held and unable to get away.”

People who come in to her office, she says, a majority of them women, “get physical symptoms even thinking about making a reservation. A pounding heart. Lack of sleep. The normal is worrying over details. Not normal is feeling the same way at an airport. A lot who come to me say drink doesn’t help. Pills can be the best tranquilizer, coupled with working with a therapist.”

Treatment is reimbursable by most insurance plans, she points out.

Historically, more women than men are afflicted, agrees clinical psychologist David Carbonell, director of the Anxiety Treatment Center Ltd., in Rolling Meadows, Ill. (www.anxietycoach.com). This may be explained, in part, by men’s tendency to “self-medicate” with alcohol, he says, although they do it less now than in the past. What is new in his practice, he says, is “the fear of fear.”

Treatment in any case involves what he calls “working with the fear, rather than trying to prevent it. … The more someone can be open and take a permissive attitude, the less trouble they are going to have.”

Anxious times

Web sites available to people who suffer from anxiety — not only in connection with air travel — include:

• The Web site of the Anxiety Disorders Association of America (www.adaa.org) offers a generalized anxiety disorder self-test as well as facts and statistics about anxiety disorders.

• American University’s Counseling Center site (www.american.edu/ocl/counseling/) has an area on tips for travel by plane to help reduce stress.

• The Anxiety and Stress Disorders Institute of Maryland in Towson offers tips for traveling on its Web site (www.anxietyandstress.com/fearofflying.html).

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