Experts say fear of flying is treatable

screen-shot-2015-02-24-at-22.33_.40_.png

NBA rookie Royce White disclosed that he is afraid to fly and said he expects to travel by bus to play in at least some of the basketball games for his team, the Houston Rockets.

But psychologists who treat fear of flying and travelers who’ve overcome it hope he’ll ditch the bus and get help instead.

“The treatments we have for this are so effective for fear of flying that upwards of 80 percent and sometimes even more people who get the treatment can fly,” said psychologist Todd Farchione, of Boston University’s Center for Anxiety and Related Disorders, echoing statistics offered by other experts.

Farchione says fear of flying treatment consists of a “fairly standard” combination of cognitive and behavioral therapy. That includes identifying the patient’s “fear-provoking thoughts” and challenging them, then getting the patient to “gradually confront” the fear, by imagining flying and then doing it. Some programs use flight simulators or virtual reality programs; others put patients on airplanes on the ground and in the air, accompanied by counselors.

Either way, “the core of treatment is exposure” to the sensations of flying, said psychologist John Hart, who treats fear of flying at the Menninger Clinic in Houston, where patients can use a flight simulator that “has noise and shakes your chair.”

“It’s like the cockpit of a plane, with video screens that look like windows and show the ground and various airports,” Hart says. “It vibrates, bounces, takes off and lands and has different kinds of weather.”

Lisa Fabrega, a detox and lifestyle coach who lives in North Bergen, N.J., was cured by a Freedom to Fly workshop at White Plains Hospital’s Anxiety & Phobia Treatment Center in White Plains, N.Y. The program included sitting in a plane on the ground at a small airport and meeting a retired American Airlines captain.

“We got to bombard him with our most paranoid questions,” Fabrega said.

Before she took the class, she said, “even thinking about getting on a plane would make me break into a sweat.” She learned to visualize herself on a plane and deal with her feelings.

The White Plains program also encourages various types of exposure therapy, like riding a Ferris wheel, the Empire State Building’s SkyRide attraction or the aerial tramway over the East River from Manhattan to Roosevelt Island. The final session is a commercial flight to a nearby city and back. The program costs about $1,500 but is often covered by insurance for outpatient therapy.

Fabrega said half her family is from Panama and she was missing weddings and other events because she was afraid to fly. If she did fly, she said, “I had to be knocked out with Xanax.”

Now she routinely flies, drug-free, around the world.

Hart, of the Menninger Clinic, says medicating yourself with Xanax, used to treat anxiety and panic disorders, is a bad idea for phobic fliers because it “can actually interfere with the process” of coping with anxiety. The Menninger program consists of a one-day workshop followed by up to six months of exposure therapy and counseling that includes helping people with coping skills and changing their beliefs about air travel and using statistics and safety information with pilots going over how planes are built and flown.

Experts say many of those who fear flying have underlying fears of heights or claustrophobia. Some sufferers trace their fears to a stormy flight or other bad experience, but many don’t know why they’re afraid. Some experts say anxiety may run in families; others say some people are sensitive to turbulence, perhaps because of differences in the vestibular system, which controls balance.

While some patients worry about crashing, others fear nausea, vomiting or even heart attacks. They feel trapped on planes, fear “loss of control” and have “anxiety about their anxiety,” said Farchione, whose approach to treating flight phobia was featured on the PBS show “This Emotional Life.”

Hart says the sufferers don’t like it when the plane door closes and the cabin is pressurized.

“It’s not like a car: You can’t stop and get out,” Hart explained.

Challenging fearful thoughts is key.

“How likely is the plane going to crash? It’s much safer than driving or taking the bus,” said Farchione. And when symptoms of anxiety begin, patients are taught that it may feel frightening, “but you’re not going to die. The plane is not crashing.”

Farchione noted that White is not the only sports figure to go public with flight phobia. Retired NFL coach and sports commentator John Madden famously traveled by bus, his customized Madden Cruiser, to avoid planes.

At the Virtual Reality Medical Center, which has offices in Los Angeles and Brussels and has treated more than 1,000 people in 15 years, patients don headsets and sensors and are immersed in a 360-degree, three-dimensional visual and auditory computer simulation of air travel, from packing to security to boarding and taking flight. The software simulates night or day, various weather conditions and turbulence. The immersion is paired with sensors that measure breathing, heart and perspiration rates so patients can learn to recognize and handle symptoms of anxiety. The treatment costs about $2,000 and takes eight to 10 sessions.

Physician Mark Wiederhold, who runs Virtual Reality with his wife, Brenda, says for most people the anxiety will never completely vanish, “but you can learn to cope with it.”

John E. DiScala, better known as the travel writer and blogger Johnny Jet, flies constantly, but as a 17-year-old, he had an anxiety attack before boarding a plane for a trip to Australia with his mom and didn’t fly for three years. As an asthma sufferer, he says, “my fear was not being in control. What will happen if I have an asthma attack in the air?”

A few years later, someone gave him a ticket to visit a friend in Tucson, Ariz. Emboldened by a positive horoscope, he decided to “give it a shot” and got through that flight and a second one to Los Angeles for a family funeral.

“I got over my fear of flying, but I’m always aware of that anxiety, even though I fly more than 150,000 miles a year,” he said. “If I can do it, anybody can do it.”

For Caitlin Condon, who works in tech communications in Cambridge, Mass., information was key in coping with flight phobia.

“Planes are this crazy magical thing,” she said. “You’re flying 500 mph in a pressurized tube, seven miles above the earth.”

She did a lot of research online, using sites like Flyingwithoutfear.com and threads about air travel on the knowledge-sharing site Quora. Now she can get on a plane whenever she wants.

“Flying,” she said, “is the safest way to travel except for elevators.”

This article originally was published in foxnews.

Advances in Virtual Reality and Anxiety Disorders – Press Release

Brenda K Wiederhold, President of Virtual Reality Medical Institute (Belgium) and Interactive Media Institute (California) together with Stéphane Bouchard, Professor, Université du Québec en Outaouais are pleased to announce the publication of their most recent book by Springer:  Advances in Virtual Reality and Anxiety Disorders.  The book is part of a series on Anxiety and Related Disorders, edited by Martin M. Antony, Professor and Chair, Department of Psychology, Ryerson University in Toronto, Canada. The interactive computer-generated world of virtual reality has been successful in treating phobias and other anxiety-related conditions, in part because of its distinct advantages over traditional in vivo exposure. Yet many clinicians still think of VR technology as it was in the 1990s–bulky, costly, and technically difficult–with little knowledge of its evolution toward more modern, evidence-based, practice-friendly treatment.

These updates, and their clinical usefulness, are the subject of Advances in Virtual Reality and Anxiety Disorders, a timely guidebook geared toward integrating up-to-date VR methods into everyday practice. Introductory material covers key virtual reality concepts, provides a brief history of VR as used in therapy for anxiety disorders, ad­dresses the concept of presence, and explains the side effects, known as cybersickness, that affect a small percentage of clients. Chapters in the book’s main section detail current techniques and review study findings for using VR in the treatment of:

 

·                     Claustrophobia.

·                     Panic disorder, agoraphobia, and driving phobia.

·                     Acrophobia and aviophobia.

·                     Arachnophobia.

·                     Social phobia.

·                     Generalized anxiety disorder and OCD.

·                     PTSD.

·                     Plus clinical guidelines for establishing a VR clinic.

 

An in-depth framework for effective (and cost-effective) therapeutic innovations for entrenched problems, Advances in Virtual Reality and Anxiety Disorders will find an engaged audience among psychologists, psychiatrists, social workers, and mental health counselors.

Please visit http://www.springer.com/psychology/book/978-1-4899-8022-9 to find out more about this new publication or to order your paper copy or eBook.

Clinical Psychologist Discusses Pioneering Innovation in Virtual Reality Therapy for New Museum Exhibition

May 16, 2012, Silver Spring, Md.: Brenda K. Wiederhold, Ph.D., MBA, BCIA, executive vice president of the Virtual Reality Medical Center, recently shared stories of using virtual reality technology to treat soldiers suffering from posttraumatic stress disorder, for a new multimedia exhibit installation at the National Museum of Health and Medicine.

In a video interview, Wiederhold explained that her organization was originally using virtual reality computer simulation technology to treat patients with phobias, panic disorders and post-traumatic stress disorder from being involved in motor vehicle accidents. However when soldiers began being deployed to Iraq and Afghanistan, the technology was adapted to not only treat soldiers coming back from the battlefields, but also to prepare troops getting ready to go into battle.

 

To see the full article, click here.

Brenda Wiederhold Featured in Smithsonian Magazine

From a psychologist’s perspective, a fear of  clowns often starts in childhood; there’s even an entry in the psychologists’ bible, the Diagnostic and Statistical Manual of Mental Disorders or DSM, for a fear of clowns, although it’s under the umbrella category of a pediatric phobia of costumed characters (sports mascots, Mickey Mouse). “It starts normally in children about the age of two, when they get anxiety about being around strangers, too. At that age, children’s minds are still developing, there’s a little bit of a blend and they’re not always able to separate fantasy from reality,” explains Dr. Brenda Wiederhold, a veteran psychologist who runs a phobia and anxiety treatment center in San Diego that uses virtual reality to treat clients.

Read more: http://www.smithsonianmag.com/arts-culture/the-history-and-psychology-of-clowns-being-scary-20394516/#ixzz2uzFqVHEu

Brenda Wiederhold Featured in Smithsonian Magazine

From a psychologist’s perspective, a fear of  clowns often starts in childhood; there’s even an entry in the psychologists’ bible, the Diagnostic and Statistical Manual of Mental Disorders or DSM, for a fear of clowns, although it’s under the umbrella category of a pediatric phobia of costumed characters (sports mascots, Mickey Mouse). “It starts normally in children about the age of two, when they get anxiety about being around strangers, too. At that age, children’s minds are still developing, there’s a little bit of a blend and they’re not always able to separate fantasy from reality,” explains Dr. Brenda Wiederhold, a veteran psychologist who runs a phobia and anxiety treatment center in San Diego that uses virtual reality to treat clients.

 

For the full article, click here.

2008 Spring Editorial

Journal of Cybertherapy & Rehabilitation

Spring 2008, Volume 1, Issue 1

    

                                                                 EDITORIAL

Welcome to the inaugural issue of the Journal of CyberTherapy and Rehabilitation (JCR), a new peer-reviewed academ- ic journal that explores the uses of advanced technologies for therapy, training, education, prevention, and rehabilita- tion. Published quarterly, JCR is unique among academic journals in that it focuses on the rapidly expanding world- wide trend of moving toward technological applications in healthcare. At JCR, our main areas of interest include, but are not limited to, psychiatry, psychology, physical medicine and rehabilitation, neurology, occupational therapy, physical therapy, cognitive rehabilitation, neurorehabilitation, oncology, obesity, eating disorders, and autism, among many others.

An exciting body of research regarding the utilization of advanced technologies in healthcare has emerged over the past decade, revealing the continuous advances and discoveries made by over 450 investigators to help patients with both mental and physical disorders. Advanced technologies—such as virtual reality (VR), robotics, non-invasive phys- iological monitoring, E-health, and adaptive displays—are now being applied to several areas of healthcare.

This premiere issue of JCR features comprehensive review articles by preeminent scholars in the field. These reviews cover some of the most promising applications for technology in therapy, and rehabilitation, surveying the concepts and studies that laid the groundwork for the field up to this point. It is my hope that this collection of papers will not only act as an introduction for those new to the field, but will also expand the knowledge of those well-established in their careers with newer applications for technology in healthcare. This set of articles is a repository for many of the most vital findings in CyberTherapy and Rehabilitation to date.

The first paper, by Professor Giuseppe Riva from Italy, focuses on using virtual reality (VR) as an embodied technol- ogy for managing body image. Many eating disorders (e.g. Anorexia Nervosa, Bulimia, Binge Eating Disorder) are associated with a distorted body image. Because of its immersive tendencies, VR is an effective tool for altering and adjusting body image in individuals with these disorders. In addition, VR can be used for nutrition education and train- ing for those with obesity.

The second paper, “Virtual Reality for Posttraumatic Stress Disorder and Stress Inoculation Training,” features ways in which VR and other advanced technologies can be used to help prevent and treat stress-related reactions in sol- diers and the civilian population. Traumatic events such as motor vehicle accidents, assault, combat, or other threats to life can sometimes cause symptoms that interfere with daily life. VR exposure therapy has shown promise in alle- viating these symptoms, restoring healthy function to those affected. It has also been shown to help train individuals to deal with stressors prior to exposure.

Next is an article on using video games for therapy and rehabilitation of the elderly by Professor Luciano Gamberini of Italy. This paper offers an overview of recent game-based applications used to improve elderly people’s cognitive abilities and to treat psychological problems accompanying illnesses and social isolation. The authors present several examples of videogames adopted within training programs for elderly people, which have been tested through scien- tific procedures.

Pioggia and colleagues discuss the possible uses of robot-human interactions for the treatment and training of people with Autistic Spectrum Disorders (ASDs) in their article. Since individuals with ASDs have impairments in process- ing of social and emotional information, it has been suggested that robotic dolls, mobile robots and humanoids can act as social mediators to teach those with ASDs social interaction skills. It is proposed that ASD patients are better able to focus on and imitate human behavior with training from a biomimetic android.

Later in the issue Cameirão and colleagues present a review of the use of VR for cognitive neurorehabilitation following stroke. VR has revealed itself to be a beneficial tool in the diagnosis, monitoring, and recovery of motor and cognitive skills. This paper reviews cutting-edge VR applications for restoring function to the upper extremities after stroke.

Our colleagues from Canada, Côté and Bouchard, cover the history of VR use for treatment of specific phobias in their paper. They examine 39 studies on the treatment of specific phobias including acrophobia, aviophobia, claus- trophobia, arachnophobia and fear of driving. In their paper these experts provide a critical analysis of research up to this point, and propose future directions for this original application of VR.

Professor Cristina Botella’s team from Spain examines VR applications for both the treatment of chronic pain and dis- traction from acute pain generated by medical procedures or other stimuli. Many medical procedures produce acute pain, and often medication is not sufficient to counteract the distress patients experience. However, in many cases VR has been found to be an effective distracter from pain during medical treatment. The authors also address the new concept of using these advanced techniques for treating chronic pain.

And finally, Professor Sun I. Kim and fellow researchers from Hanyang University in Seoul, Korea evaluate the use of VR for patients with schizophrenia, a brain disorder that is characterized by disturbances in general cognition, such as abnormal expressions of emotion and ways of thinking, mental derangement, regression from reality, strange lan- guage or behavior, and delusion or illusion. Because VR is a medium that can present social and emotional situations via realistic human-computer interactions, it can be used for traditional forms of therapy, with the added advantage of being able to provide objective measurements.

The second issue of JCR will continue to explore the ways in which technology influences and enhances the health- care of citizens in Europe and throughout the world. We are interested in receiving original research and ideas for future theme issues from our readership. Current topics being considered include technology for the elderly, for those with disabilities, and other specialized populations. Please contact us with your interesting manuscripts and ideas for additional topics for the Journal. Thank you for your support of this promising new publication.

 

 

Brenda K. Wiederhold, Ph.D., MBA, BCIA

Editor-in-Chief, Journal of CyberTherapy & Rehabilitation

Virtual Reality Medical Institute

Brussels, Belgium

Driving Along a Virtual Road to Recovery

By Abby Ellin

STEPHANIE WALL is from California, so driving is practically part of her DNA. It was a given that one day she would slide behind the wheel and zoom off; that’s what everybody did.

But in August 1999, just two days before she started college, a teenager plowed into her sport utility vehicle on a freeway in Denver. Ms. Wall ended up in intensive care. Her father, a passenger, was killed.

She wanted no more to do with driving, but she knew she would have to get back on the road. ”I didn’t want to freak out and get into another accident,” said Ms. Wall, now 21. A psychologist referred her to Brenda K. Wiederhold, a clinical psychologist and the executive director of the Virtual Reality Medical Center in San Diego, where Ms. Wall lives.

With virtual reality, ”you can have an accident and not get hurt,” Dr. Wiederhold said. ”People who are afraid of the freeway say, ‘Oh my God, this is dangerous.’ I get them to stop the thought and think instead, ‘Oh, I’m sweating and in control.”’

Over the last decade, psychologists have been using virtual-reality therapy — computerized simulation of the feared situation — to treat such phobias and anxieties as fear of heights, public speaking, spiders, flying, even combat. But Dr. Wiederhold is one of the first to use it for people who are afraid of driving.

For full article, click here.