How to Get Over Your Fear of Flying -- Without Leaving the Ground!

North, M.M, North, S. M., & Coble, J.R. (1997). Virtual reality therapy for fear of flying. American Journal of Psychiatry, 154, 130.

Overview:

Phobias and Behavior Therapy

Your heart is pounding so hard you think it might jump right out of your chest. Your chest is so tight you can't breathe. Sweat breaks out all over your body. You want to run, you want to scream but you can't because you are absolutely frozen in fear.

Are you about to be attacked by a vicious monster? No, it is just a tiny spider crawling in the bathtub. Or an elevator ride. Maybe you have to make a presentation in class. You are suffering from a phobia, a type of anxiety disorder. People with phobias have an intense, irrational fear of some specific object or event. They know their fear is irrational but they can do nothing about it.

Phobias seem to have evolutionary significance, such as fear of spiders or snakes or high places, although people may develop a phobia to evolutionarily innocuous objects such as computers. Phobias may also have a learned component, such as people who have been bitten by dogs as young children, although many phobics can't remember any specific experience with the feared object or event. Whatever the underlying cause of a phobia, it can be a debilitating disorder.

Behavior therapy is the most commonly used approach to helping people overcome phobia. Exposure treatment consists of providing the person with increasingly intense exposures to the phobic stimulus. Often the person is taught a conflicting response as well. For example, a spider phobic might be treated by first learning relaxation techniques. Next the person is instructed to think about spiders while using relaxation. Eventually a physical spider is produced while relaxation continues, until the person can even touch a spider without developing the phobic reaction.

Some phobias are difficult to treat with exposure therapy. Taking a person with a fear of flying on an airplane can be a very disruptive experience for fellow passengers. North, North, and Coble (1997) have devised a unique approach to exposure therapy to treat fear of flying -- virtual reality. In this case study, they report using a virtual reality flight simulator to treat aerophobia, a fear of flying.

Article Summary

People who develop phobias cannot lead normal lives. Imagine having to quit your job or drop out of school because of a phobia. Behavior therapies have been quite successful in the treatment of phobias but providing the phobic person with increasingly intense experiences with the phobic object or situation can be dangerous, time consuming, and expensive. Computer scientists and therapists have begun to team up to develop virtual reality therapy for phobias. North, North, and Coble (1997) report on a case study of treating a man with aerophobia with virtual reality exposure therapy.

Mr. A was afraid of flying. His aerophobia interfered with his normal activities to the extent that he could not attend professional conferences.

North et al. created a computer based flight simulator to provide virtual reality exposure therapy for aerophobia. Their apparatus consisted of a virtual reality head set for simulating the visual aspects of flight, audiotapes of a helicopter, and a vibration device placed under the chair to simulate engine vibration.

Mr. A participated in five virtual reality therapy sessions that increased in intensity, from sitting in the virtual cockpit to flying over cities, rivers, and lakes. At frequent time intervals during each session, Mr. A completed an anxiety scale to measure his degree of anxiety.

Mr. A reported that he felt he was actually flying, indicating that the virtual reality successfully simulated real flight. Mr A's anxiety increased with each increasingly intense flying situation, then decreased as he experienced the new situation. This finding is consistent with other studies of anxiety experienced by people undergoing exposure therapy for phobia. Following therapy, Mr. A successfully completed real flights to professional conferences.

North et al. concluded that their virtual reality exposure therapy was successful in reducing anxiety and allowing the phobic person to engage in more normal activities. The therapy certainly was quicker, cheaper, and less disturbing to real passengers.

For Instructors

Links to the Lecture

There are almost as many fears as there are objects and situations. Have students complete the fear scale developed by Geer. Collect and quickly collate results so that students can compare their fears relative to their classmates.

Geer, J.H. (1965). The development of a scale to measure fear. Behaviour Research and Therapy, 3, 45-53.

Virtual reality is a growing medium for exposure therapy in treating phobias. The following article is a very careful case study of treatment of a spider phobic woman. There is also a link to this research in For Students (virtual reality therapy for spider phobia).

Carlin, A. S., Hoffman, H. G., and Weghorst, S. (1997). Virtual reality and tactile augmentation in the treatment of spider phobia: A case report. Behaviour Research and Therapy, 35, 153-158.

Students often experience test anxiety that borders on phobia. Have students list their reactions to testing situations and relate these to phobic responses. Work out an anxiety hierarchy for overcoming test anxiety as described in:

Eison, J. (1987). Using systematic desensitization and rational emotive therapy to treat test anxiety. In V.P. Makosky, L.G. Whittemore, and A.M. Rogers (eds.), Activities handbook for the teaching of psychology, Vol. 2 (pp. 159-163). Washington, DC: American Psychological Association.

For Students

About the Authors

Max North, Sarah North, and Joseph Coble are at Clark Atlanta University. They also have formed the Virtual Reality Therapy Center to research, develop, and distribute virtual reality therapy devices.

About the Journal

The American Journal of Psychiatry publishes a wide range of articles reporting experimental research, case studies, and reviews dealing with psychiatric medicine and clinical research. Abstracts for articles from the past two volumes are online.

Links to Life

Here is a description of virtual reality therapy research at Graphics, Visualization and Usability Center of Georgia Tech, where this case study was conducted.

Somewhat less dramatic but equally fascinating is the work on virtual reality therapy for spider phobia at the Human Interface Technology Laboratory of the University of Washington. In "Spider World," spider phobics are encouraged to interact with, pick up, and squash spiders.

Resources on social phobia can be found at the Social Phobia/Social Anxiety Association Home Page. In addition, the Internet Mental Health offers an online phobia diagnosis and a lot of interesting information about phobias and other mental health disorders.