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Comparative effectiveness of flight anxiety treatments and programs

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Generally Unreliable Methods Explained

• Aroma Therapy and Homeopathic Remedies
• Medication (various benzodiazepines)

Research published by the British medical journal Lancet asserts homeopathic cures to be placebo effect. See research

Research by the Stanford University School of Medicine has shown that anti-anxiety medication

  • makes the person more sensitive to flying (more likely to panic if not sufficiently medicated), and
  • blocks desensitization, making it impossible to become accustomed to flying.

The medical research involved two flights. On the first flight, half of the anxious fliers were given alprazolam and half were given a placebo. On the second flight, no medication was administered.


Placebo Group: though 43% of those given a placebo instead of active medication experienced panic on the first flight, some desensitization took place, and only 29% experienced panic on the second - also unmedicated -flight.

Active Medication Group: while only a few of those who received active medication panicked on the first flight, the medication both increased their sensitivity and blocked their desensitization. As a result, on the second flight – their first unmedicated flight – 71% experienced panic.

Since medication makes it increasingly more difficult to fly, the amount needed to control anxiety increases. When the medication loses its effectiveness, some passengers become desperate and in a state of panic, may take alcohol in addition even through they know the combination is dangerous. When taken together, benzodiazepine and alcohol reduce the breathing rate, possibly to unacceptably low levels, and can cause unconsciousness or death.

Anti-anxiety medication can cause confusion and make the person believe what their worst fear is actually taking place. In routine turbulence, the medicated passenger to believe the plane is plunging out of the sky. After the flight, instead of recognizing the problem was imagination, they believe the medication made it possible for them to endure a near-death experience. Further medicated flying causes additional experiences of terror, until the person can no longer fly.


If medication could provide effective long term control of flight anxiety and panic, it might be worth consideration. But long term effectiveness is doubtful. It exposes the user to risk of dependence and other serious risks. Even occasional use of alprazolam at recommended dosage has been known to cause seizure. Therefore, the use of anti-anxiety medication cannot be justified. Anti-anxiety medications are so problematic, some psychiatrists do not prescribe them for any reason.

. See research

The World Health Organization recommends against sedation when flying due to heightened risk of DVT (Deep Vein Thrombosis). See research

Somewhat Effective Methods Explained

• Reassurance Courses

Online Reassurances Courses. Pilots who are not - as SOAR founder Capt. Tom Bunn LCSW is – professionally trained licensed therapists, mistakenly believe phobia can be cured by learning how safe flying is. Though course participants are helped intellectually, they are not helped emotionally. Relaxation exercises offered are, according to research, completely ineffective. See research

Group Reassurance Courses. SOAR was the largest provider of group courses nationwide until research showed far better results were obtained when the person going through the course maintained control, learned information at their own pace, received individual counseling by phone, and took a flight only when ready. At times, airlines have offered group courses. When American Airlines hired a psychologist to conduct a group course, he consulted SOAR Founder Capt. Tom Bunn who advised him that group courses have major drawbacks that he would need to address:

1. Anxiety about the "graduation flight" makes it difficult to focus on course information.
2. Course length does not permit enough repetition to make learning permanent.
3. On the “graduation flight” participants depend on the group and the instructor for emotional support instead of learning to rely on themselves.
4. Relaxation exercises do not control anxiety or panic.
5. Attention to individual needs is limited.

After a short time, American Airlines discontinued the course. Group courses have claimed 90% success, based on the percentage taking the "graduation flight". Though able to fly with support from the group and the instructor, most who were unable to fly before the course are unable to fly solo after the course. Most participants show no improvement when tested six months later.

• VRET (virtual reality exposure therapy)

The psychologist who conducted the initial VRET research consulted Capt. Tom Bunn, before and after the research. VRET was unable to produce better results than comparison treatment consisting of sitting on a parked plane and pretending to fly. Yet, its promoters continue to claim it is effective. See info

• Hypnosis
• Exposure Therapy (in vitro)
• Psychoanalytic Psychotherapy
• EFT (Emotional Freedom Techniques)

Capt. Bunn trained in each these treatments in search for a solution. Each provided some, but not sufficient, benefit.

Effective in most cases

• SOAR CBT-based Program (1982 - 1999)

In 1982 SOAR introduced the first fear of flying program based on CBT (Cognitive Behavioral Therapy). The program was rated “highly effective” with most clients by independent university research. CBT techniques, however, did not work for everyone. Clients whose anxiety developed slowly found CBT effective, but clients whose anxiety or panic developed rapidly could not gain control through CBT.


Exceptionally Effective

• SOAR – Comprehensive Integrated Program (2000 - Present)

In 2000, SOAR introduced a method to automatically control high anxiety, claustrophobia, and panic. Recognizing that no single methodology is universally effective, SOAR employs a comprehensive and integrated approach consisting of automatic control, backup control, CBT, and aeronautic information (how flying works; how safety systems protect; what each sound and sensation is; what it means).

Though SOAR graduates learn CBT and other anxiety control techniques, most graduates use these as backups. They find automatic control established through six to eight guided training sessions stops anxiety, claustrophobia, and panic when flying. Occasionally, a client presents a special challenge that requires us to find new ways to provide help. That, of course, extends the knowledge base that makes it possible for us to help every client attain success.



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