Systematic desensitization of a phobia for flying with the use of suggestion

This case study describes the successful treatment of a phobia for flying in an active-duty United States Marine helicopter crew chief by using systematic desensitization. Systematic desensitization is briefly described as a treatment technique which incorporates relaxation exercises paired with the visualization of anxiety-producing images--in this case, images associated with flying. The patient and the therapist constructed a hierarchy of 32 items which were then rank ordered from least to most anxiety producing with the first item being "Ordering parts to repair a helicopter" and the last item being "A routine helicopter landing". Treatment consisted of having the patient visualize the scenes from the list while achieving a state of deep relaxation. The patient was unique in that he possessed an extraordinary ability to experience olfactory, tactile, auditory, and kinesthetic cues as well as vivid visualizations when imagining the items. The patient moved to the next item on the list only after he could feel relaxed while visualizing the previously anxiety-arousing scene of the preceding item. After progressing through the entire list, the patient initiated an actual helicopter flight. The patient participated in a 6-month follow-up helicopter flight with the therapist and experienced an appropriate, manageable level of anxiety. The presentation concludes with a brief discussion concerning the protential usefulness of routinely incorporating relaxation exercises into flight training as a preventative approach to anxiety- and stress-related illness frequently found in aviators.