Fear or Phobia?

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Blue Chips or Choco-Blue cookies?

My mind was occupied trying to decide which snack I wanted, a conclusion near, when the woman in the window seat grabbed my arm with a vice grip worthy of someone twice her size.

“Do you hear that?” she said. “That clicking noise? I’m sorry, I’m kind of a nervous flier, but this time … I just thought maybe there was something up with that engine.”

“I did hear it,” I said. “But, I don’t really pay too much attention anymore because I hear it every time I fly – it’s just a normal engine noise like when your car engine shifts from one gear to another.”

I let her arm rest right where it was – I am no stranger to white-knuckle flying, not only because of my clinical practice, but because I’ve been there, too.

My seat partner went on to relate her version of the “How I Became Scared to Fly” story, which involved a harrowing landing during which the pilot had to accelerate suddenly after touching down, executing an unexpected and rapid takeoff.

Later it was explained that a dangerous wind condition occurred during the final approach and the captain prevented the plane from landing while listing dangerously to one side.

Even though that flight ended safely, the idea of unpredictable airborne dangers inserted itself in this woman’s mind, and grew and morphed into patterns of thought that today inform every moment of flying for her – a torture she endures frequently, as she travels for her work.

We continued to engage in light conversation for the rest of the short flight down from San Francisco. Social anxiety trumps flying anxiety in most cases, so, not wishing to appear unfriendly, she was forced to use her resources to concentrate on responding to my light questions about her trip and her work, and couldn’t use quite as much brain power on her flying worries. Did she suffer from aviophobia (fear of flying)? Or just anxiety?

To distinguish a fear from a phobia, psychologists ask whether or not the fear causes impairment: the fact that the woman was able to board the airplane, take her seat and engage in a conversation meant that she didn’t suffer from a phobia, white-knuckle grip notwithstanding.

Worry is an emotion that is natural and accompanies a feeling of threat. An area of the brain called the limbic system becomes activated when we sense danger. The body “believes” the signals from the limbic system and goes into a state of alert, complete with rapid pulse and increased respiratory rate. Next, the slower part of our brain, the thinking brain, or cerebral cortex – which translates signals into words – goes to work explaining the nature of the fear (“The engines are making that noise because they’re breaking down and we’ll soon crash!”). Luckily that’s not where the story ends.

Turns out that the limbic system-cerebral cortex connection is a two-way street. The thinking part of the brain, though slower to react, is powerful and can effect permament changes on the body-mind with a little work. By asserting its talent for rationality, the thinking-cortex can “talk” to the body by challenging irrational fears. Even at 30,000 feet we can conquer fears by examining their irrationality.

Basic instruction in stress reduction and relaxation practice enables the cortex to issue instructions which calm the body. Controlling breathing, slowing it down, issuing a learned instruction to exhale as though “through a straw” – these actions lower the whole body’s panic response and give time for the “smart” cortex to assert facts against irrational fears (airplane safety is well documented, the lady eating the chips and cookies says the noises are normal, the pilots and crew are highly skilled).

Fears, phobias and panic take over so easily exactly because the limbic system-body connection is so quick—a bit quicker than the “thinking brain” and so it is our job to learn interventions to calm ourselves.

Our apparatus was really helpful when we had to run from tigers, but it sometimes gets in the way when we mistake an airplane noise, an angry e-mail from the boss, or another dip in the stock market as a “tiger.” The fight or flight response actually slows us down when we require a response informed by rational thought. Slow down the action, give the “thinking brain” time to assess whether the threat is indeed a tiger, and then decide whether to scream and run like hell. … or just call your stock broker and have a calm discussion.

Dr. Ruth Wimsatt can be reached at 949)-22-3285 or at [email protected]

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