Fear of Flying: Differentiating Between Specific Phobia and OCD

It’s officially almost summer here in Arizona which means nearly everyone is setting off for cooler weather and ocean breeze. For some, this is the most exciting time of the year. Family reunions, international travel, and cruising! For others, one fear can halt people in their steps and prevent them from participating in these memorable experiences with others. Fear of flying is a common phenomenon affecting a significant portion of the population. For some, it's a manageable discomfort, while for others, it can be debilitating, triggering panic attacks and avoidance behaviors. When examining such fears, it's crucial to differentiate between specific phobias and Obsessive-Compulsive Disorder (OCD). While both can manifest as intense anxieties, understanding their nuances is essential for accurate diagnosis and effective treatment.

Understanding Specific Phobias:

Specific phobias are characterized by excessive and irrational fears of specific objects, situations, or activities. These fears often lead to avoidance behaviors aimed at reducing anxiety. In the simplest form, flying terrifies me, so I’m not flying! How the heck do all those people stay up in the air inside a big metal bird?! When it comes to fear of flying, individuals with a specific phobia may experience intense anxiety or panic attacks at the mere thought of flying or being in an airplane. They may go to great lengths to avoid air travel altogether, even if it means missing out on important events or opportunities.

The key feature of specific phobias is the immediacy of the fear response. It's triggered by the presence or anticipation of the feared object or situation, such as boarding a plane or seeing images of airplanes. This means it happens when the practical next step involves stepping onto the plane. Planning the trip can be a combination of fun, enjoyable, and exciting. Someone can still have anxiety about the flight as a part of the trip, but they are able to view the trip as a whole and experience excitement about the time spent at a new location. The triggered response begins once we require putting our body into the airplane seat. Additionally, individuals with specific phobias usually recognize that their fear is excessive or unreasonable, but they may feel powerless to control it. For example, someone might think, “I know people fly every day and everyone says air travel is safer than driving, but something is still so terrifying about being a person up in the sky.”

Examining Obsessive-Compulsive Disorder (OCD):

OCD is a mental health condition characterized by the presence of obsessions and compulsions. Obsessions are intrusive, unwanted thoughts, images, or urges that cause significant distress. They are our fears, worries, or doubts surrounding anything our OCD picks; in this case, we are using flying. Obsessions are rarely limited to only one area of life and are often seen surrounding many things that are important to us. Compulsions are repetitive behaviors or mental acts performed in response to obsessions aimed at reducing anxiety or preventing perceived harm.

In the context of fear of flying, OCD may present differently from specific phobias. Individuals with OCD might experience obsessions related to catastrophic events happening during the flight, such as the plane crashing or being hijacked. These obsessions can trigger intense anxiety, leading to compulsive behaviors aimed at neutralizing the perceived threat. Other examples might include fear of being separated from belongings and losing them, fear of running out of air, fear of sitting next to a stranger and having no idea what to say, fear of someone having a medical emergency, or anything else our OCD picks to fear about being on the plane. Other fears on planes may have to do with contamination fears of being stuck next to others that are sick, touching common surfaces, magical thinking that something bad will happen, fear of going crazy on the plane or having a panic attack, or fear that the windows or doors might open.  

Compulsions in OCD related to fear of flying may include:

1. Excessive Checking: Constantly checking flight schedules, weather conditions, or safety records of airlines.
2. Mental Rituals: Engaging in mental rituals such as repeating prayers or counting to a certain number to ward off perceived dangers.
3. Avoidance Behaviors: Avoiding not only flying but also any stimuli associated with air travel, such as airports or discussions about flights. Bathrooms are also commonly avoided.
4. Superstitious Actions: Bringing specific items believed to provide protection or comfort during the flight, such as lucky charms or emergency kits.
5. Cleaning Rituals: Sanitizing of seats, armrests, beverages, or other surfaces.
6. Reassurance: Seeking reassurance from others or giving reassurance to yourself before going onto the plane as well as on the plane.
7. Distraction: Distracting from the fear might include watching a movie to avoid thinking, excessively talking to those around you, or other behaviors.

Unlike specific phobias, individuals with OCD feel they HAVE TO do these compulsions in order to alleviate the distress caused by the obsessions. Someone with specific phobias might feel terrified to fly, but they don’t feel driven to engage in compulsions in order to engage in flying. 

Differentiating Between the Two:

While fear of flying can manifest in both specific phobia and OCD, several factors can help differentiate between the two:

1. Presence of Other Fears: Individuals with specific phobias typically only experience fear about one specific topic such as flying, whereas those with OCD have fears present throughout their lives on varying things.
2. Response to Exposure: Exposure therapy, which involves gradually confronting the feared object or situation, is a common treatment for specific phobias. However, in OCD, exposure alone may not suffice, as it often requires addressing underlying obsessions and compulsions through techniques like cognitive-behavioral therapy (CBT). Someone with OCD must learn how to “talk to OCD” in order to move through the exposure.
3. Presence of Obsessions and Compulsions: While both conditions involve anxiety, OCD is characterized by the presence of obsessions and compulsions, whereas specific phobias primarily involve fear and avoidance.

Fear of flying can be distressing, whether it stems from a specific phobia or OCD. Flying fears can prevent someone from experiencing the things they love or fully participating with family, missing out on family reunions or trips. Understanding the differences between the two is crucial for accurate diagnosis and effective treatment. While specific phobias involve intense fear and avoidance of the feared object or situation, OCD adds an additional layer of obsessions and compulsions aimed at neutralizing perceived threats and is seen in more than one area of life. By recognizing these distinctions, mental health professionals can tailor interventions to address the unique needs of individuals struggling with fear of flying, helping them overcome their anxieties and regain control of their lives.