Desensitization Training and Exposure Therapy are two such techniques.
Watered down versions of these two treatment methods are often used in some form or fashion when treating more diffuse or generalized forms of anxiety disorders, such as social anxiety. The essential mechanisms are the same: learn relaxation skills and then pair with the feared event or object.
I am going to play lazy today and give you a link to Michael Murrell, Psy.D.'s blog post (click here) where he describes Desensitization for Anxiety. So please check our Dr. Murrell's post if you are looking for help with a specific phobia. It's important to be guided through the correct procedures by a trained professional in order to find treatment success. Reviewing these techniques and then asking the psychologist you are interviewing whether she or he uses them to treat phobias is a great way to insure you find the proper treatment for your fears.
The core of desensitization involves first pairing, and then replacing, feelings of anxiety with feelings of calm. Learning to relax is a necessary first step toward applying desensitization. Deep breathing is one type of relaxation exercise often recommended. You can check out my previous post which describes a particularly effective form of deep breathing that I most frequently suggest, here.
Additional resources:
Some good advice here that applies to driving phobia.
Anyone who has seen me for any length of time
will agree I should hang this cartoon on my wall
(thank you, Natalie Dee).
As an airline captain and licensed therapist, I've specialized in the treatment of flight anxiety for over thirty years.
ReplyDeleteSystematic desensitization is impractical if not impossible to use due to problems adjusting exposure. VRET (I was involved in the original research) does not work for fear of flying though those invested in VRET claim it does.
Relaxed or not, the amygdala releases stress hormones any time it notes something non-routine. Since everything going on when you fly is non-routine, the amygdala will release stress hormones. That's its job and it is going to do it whether you are relaxed or not.
Stress hormones trigger the Mobilization System (fight or flight) and Executive Function, which - being far more sophisticated - takes priority. It trys to find a way to deal with the situation. On the ground, it usually does, but as a passenger, information is limited. It may be impossible to dismiss the stress hormone alert; control revers to the primitive Mobilization System. But it is blocked; you can't flee at 30,000 feet.
There is another regulation system than can be employed. See http://www.fearofflying.com/free-video/
Thank you, Anonymous, for your comment and insights. When you say systematic desensitization is "impractical if not impossible to use due to problems adjusting exposure" I believe you are referring to in-vivo (using the technique "in real life", in an actual setting such as on an airplane flight and by this I think you mean the inability to exert control over the graduated exposure once the passenger boards a commercial airline flight. This lack of control is certainly true.
ReplyDeleteI do have a question about your statement that "everything going on when you fly is non-routine." Do you mean non-routine compared to being at home in one's living room? Or that what goes on during flight is non-routine from one flight to the next? Or maybe you mean unfamiliar as opposed to unvarying.
From the video link you posted to the CNN coverage of the woman's success using the SOAR program, it appears the program recommends the participant refocus their mind on their immediate present (focusing on her hands, in the CNN clip), remaining focused on the present, and understanding the mechanics of an airplane flight. I wonder if there is any use of relaxation exercises or systematic desensitization in this program pre-flight? Focusing on the present is similar to what is referred to by some as a "mindfulness" exercise?
I took the time to do a brief search of summaries (abstracts( from published studies looking at virtual reality as a treatment of fears/phobias. While by no means comprehensive, here are a few examples of what I found:
Studies by Rothbaum et al (Emory University School of Medicine) have shown treatment gains using both virtual reality exposure therapy, standard exposure therapy(J Consult Clin Psychol. 2000 Dec;68(6):1020-6).
Six sessions of VRET in a single case study was shown to lead to comfortable flight (Behav Res Ther. 1996 May-Jun;34(5-6):477-81).
A 2008 review of 40 studies using virtual reality exposure therapy for the treatment of fear of flying published in the Aviator, Space and Environmental Medicine concluded (taken from abstract)
"All studies that used cognitive and relaxation techniques in addition to VRE treatment were effective. More randomized clinical trials are required in which VRE therapy could be compared with standard exposure therapy. Thus, we suggest that CBT, psychoeducation, and VRE could be combined to treat [fear of flying]."
(de Costa RT, Sardinha A, Nardi AE Aviat Space Environ Med. 2008 Sep;79(9):899-903).
However an earlier 2007 review of virtual reality studies looked at 50 studies, only 4 of which involved fear of flying. Advantages and disadvangages were found across all fear types (fear of heights, public speaking, spiders, agoraphobia, etc). Summarized, "Although virtual reality based therapy appears to be superior to no treatment the effectiveness of VR therapy over traditional therapeutic approaches is not supported by the research currently available."
(Gregg L, Tarrier N. Soc Psychiatry Psychiatr Epidemiol. 2007 May;42(5):343-54. Epub 2007 Mar 12).
Nice stuff and informative blog!
ReplyDeleteNice article.Keep it up..Thanks!!
ReplyDeleteCognitive behavioral therapy can be very effective for curing various kinds of treatments. My cousin is presently going through this particular therapy for his alcohol addiction. We all have been able to notice a major positive change in him.
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