Clinical judgment. Not all fearful fliers are alike. Some work faster, some are more deliberate. Some have mild co-occurring anxiety problems and some have a trauma history that must be addressed throughout the learning of the material. If a small push forward doesn’t get the job done, it is best to rework the lessons and accompanying problems until a “small push” delivers a sense of accomplishment from your patient. Read the material in the appendices. You will get a good sense of the variety of situations you will encounter. Some patients will remain your patients long after their fear of flying resolves and others will be happily on their way after their first post-program flight.
Active Relaxation.Don’t give up on the principle of “active relaxation.” As a general rule you will find that the more anxious your patient, the more difficult it is to achieve muscle relaxation. Sometimes a person will say their muscles are relaxed, but it is clear that there is a lot of residual muscle tension. Work with this until the muscles are truly relaxed, and then emphasize how important it is to be able to distinguish between a relaxed and tense muscle. Mastery of active relaxation is absolutely necessary for the fearful flier to achieve the freedom to fly and then the freedom from fear.
Muscle Relaxation. While muscle relaxation is necessary for success, it is not sufficient. The fearful flier’s capacity to learn and use this material is significantly facilitated by relaxed muscles.
Repetition and practice are critical to success. In the early stages of learning, regression to old habits and old ways of perceiving are common. Once success is experienced, the positive consequences are very powerful. It’s the “getting there” that is often painfully slow.