Treatment Approaches to Phobias
Most of what Dr. Robert T. London discusses about phobias, and especially fear of flying and their treatments, seems practical and often works ("Treating Fearful Flyers," The Psychiatrist's Toolbox, March 2005, p. 27). But I would like to add a few points. First, medications such as benzodiazepines and propranolol might actually be helpful for successful treatment of phobias. These medications give the patients the capacity to approach their fears and develop ways of mitigating or mastering those that might continue even after medications are discontinued. I have frequently seen this with medications when treating social phobia.
Second, intrapsychic personality dynamics are a central part of every phobic disorder and are not specific or relevant to just certain patients. Third, it is difficult, if not impossible, to uncover the origin of learned phobic behavior in "one visit." The origins are often forgotten, repressed, or unconscious, and are not easily accessible. Fourth, the apparent reason or reasons might also not be the whole story, i.e., fear of flying might be a cover-up for other fears.
Nader Oskooilar, M. …