Flying therapy for flying phobia.

INTRODUCTION: Optimum treatment for aircrew who have developed anxiety associated with flight includes a flying phase for desensitization. However, standardized flight profiles are not found in the literature. In this study, a method of desensitization flying, which may increase the probability of a return to productive flying, was devised and assessed.

METHOD: Seven aircrew were referred for flying desensitization. Behavioral therapy (relaxation training, imaginary flying, and thought switching) was usually continued by the Medical Officer (Pilot) (MOP). These aircrewmen flew 2-16 sorties in the RAF IAM Hawk or Hunter aircraft with the MOP. Each flight was structured with three purposes: to approach by increments the flight conditions in each victim's anxiety hierarchy, to regulate the amount of low workload, anxiety-vulnerable time during each sortie, and to practice relaxation techniques in the air.

RESULTS: In all referred aircrewmen, anxiety was controllable in flight at IAM. Somatic signs diminished and no sortie was terminated early. All returned to operational flying. Anxiety recurred in one fast jet pilot while flying solo, and in one navigator, both of whom requested a change to transports. A transport pilot had recurrent uncontrollable anxiety at high altitude and is grounded. At 9-24 months follow-up, 5/7 were flying comfortably with rare, controllable anxiety. We conclude that actual exposure to flying is usually necessary for aircrew to recover from anxiety associated with flight.