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Ready for takeoff

Phobics conquer their fear step by step

Email|Print| Text size + By John Koch
Globe Correspondent / July 9, 2006

Only months ago, the entire globe was my no-fly zone. As in: no airplanes -- no how, nowhere , never.

The sky had been out of bounds for decades, 34 years to be precise, and like many people with phobias, I was stubbornly attached to mine. I adjusted to my condition and rationalized it. When obliged to talk about it, which I preferred not to, I hailed my provincialism as a charming eccentricity and recounted my scenic excursions to Florida, Texas, and California . . . by train.

I am writing this paragraph some 30,000 feet over Florida, jetting northward through milky clouds on a weather-compromised late winter day. I am proud and pleased.

This is my second plane ride since graduating from Dr. Albert Forgione's Fearless Flying Course, and I'm feeling surprisingly good. Sure, I'd rather be back on the beach, but I'm managing to work crossword puzzles and listen to some sweet Gerry Mulligan ballads on my iPod without fretting too much about where I am.

To anyone who has lived with a flying phobia, this may seem amazing. The last time I flew commercial ly I could only stare blankly at the open book on my knees, miserably attuned to the modulating sounds of the airplane and the relentless anxiety that had become my constant, unwelcome, and virtually paralyzing flight companion.

It took a long time and a special convergence of circumstances -- retirement (from the Globe) and my wife's hunger for travel -- to impel me to do something about my . . . my fear.

It's hard to take that first step, but once you name it openly and actively seek help , you're on your way to friendlier skies . Most phobics won't believe that statement, but it's demonstrably true.

``Once a person crosses the threshold in my office, there is a solid 90 percent chance that they're going to make it, they're going to fly," Forgione, 71, said in a recent interview, a month or so after I had completed his course and flown a few times.

He has not kept exact records, but Forgione estimates that he has worked directly with a minimum of 3,000 people and has seen firsthand the great majority of them fly on the trips that are the final act of his 10-session ground course.

It all began for him 30 years ago in an alliance forged with The Boeing Co. , which provided an airplane, a sympathetic flight captain, and other help for what was then a six-week program serving as many as 150 clients at a time. ``This had never been done before," said Forgione, who now leads an updated version of the course for three to nine scared but hopeful fliers.

My group was a fearful foursome that included a Rhode Island school teacher, a mother and professional from the South Shore, and a vitamin sales rep from Somerville. Our stories begin differently but end more or less the same: Together with Forgione, we all flew the Delta shuttle to New York's LaGuardia Airport and back on a pristine Sunday morning in January. Three of us have had occasion to fly in the meantime. Two of us, myself included, have enjoyed positive flying experiences and are planning long-flight pleasure trips.

So, how did we do it?

The short answer is, we did it ourselves, aided by Forgione's techniques, or what he likes to call his ``tool kit."

We came to class with stories about the origins of our fears, and Forgione listened to our brief narratives. The salesman, for example, lost a close friend in an airline crash. As a small boy, I flew on the edges of a big storm in a bucking DC-3, full of trembling passengers, that was struck by lightning.

Forgione's treatment largely ignores such histories. ``We treat what the psychoanalysts would say are the symptoms. As a behavior therapist, this is what we do, and we find that it works," he explained.

Another Boston-area psychologist, Dr. Alan Dodge Beck, describes the value of the treatment. ``Fear-of-flying programs, such as Dr. Forgione's well-respected course, are a reflection of a remarkable observation: That for some conditions, the only `cure' is of a psychological nature, requiring psychological intervention. "

Beck, a clinician and dean of the doctoral program at the Massachusetts School of Professional Psychology, also alludes to the sense of deep fulfillment that can be a by product of such a program. ``Anyone who overcomes phobias and anxiety feels a sense of personal control, mastery and empowerment -- and a general increase in self-esteem."

Requiring regular but not hugely time-consuming homework, Forgione's treatment is based on learning how to breathe freely and relax easily on cue. ``You're conditioning yourself," Forgione said, `` and you have to learn how to think in a certain way." Forgione is expert at helping the phobic gradually re engineer his or her self-defeating and fear-feeding mental habits.

``The plane is not dangerous, it's the thoughts that phobics have in their head that are dangerous," is a typical Forgione construction. When I heard statements like that early in the course, I thought they were aphoristic cheerleading. As I mastered the relaxation response and began to appreciate my own irrationality, they made sense.

They also made sense to recent Fearless Flying graduate Mike DiPietro, who said that so-called ``thought-stopping" -- learning how to banish defeatist, self-deprecatory thinking -- was the key to beating back his anxiety. For DiPietro, an engineer from Weymouth, the course has been a ``life-changing experience taking you from believing you'll never get on a plane again to traveling" at will.

The two-hour classes meet on Saturdays in a high-ceilinged old office on Boylston Street with big windows looking directly onto Trinity Church and the Hancock Tower rising above it. Forgione is a graying, stocky man at ease with himself, and in that regard, along with his casual sweaters and slacks, he evokes Columbo, the deceptively logical detective played on TV by Peter Falk. Like him, Forgione, wraps his intelligence in plain talk, entertaining digressions, and affable, sometimes mildly profane, humor.

While the classes are informal, they are also information-rich and efficient in following Forgione's agenda. Constantly emphasizing relaxation and how to achieve it, the course branches out to consider the effect of diet on stress reduction, positive mental imaging, how to alter attitude and harness anger, and basic aerodynamics. Forgione also says class members can try low doses of anti anxiety medication as part of the overall recipe.

Classes can occasionally be emotionally challenging or draining, or both. To get a sense of another, larger, group, I visited the class succeeding mine. Here were nine people -- a young actor, an operating-room nurse, a middle-aged engineer among them -- packed around Forgione's desk for their sixth session.

The centerpiece this week was Side A of one of Forgione's four Fearless Flying tapes, titled `` Guided Flight to Portland. " Never mind the vintage of the tape -- it goes back to Forgione's Boeing days -- or the destination of the graduation flight then. It's the content -- and the ambient sound -- that matter to us phobics. As the airplane prepares for takeoff, lifts off the runway, angles up , and settles into its flight path, we hear commentary from the captain.

And we also hear the noises -- the accelerating turbines, rushing air, retracting landing gear -- that can drive phobics crazy with anxiety.

After one playing of the tape, conversation flows. The subject of Sept. 11, 2001, arises, prompting Forgione to distinguish between rational and irrational fears (it's not unreasonable to be frightened of terrorism). There is talk of updated security measures, sky marshals, even airplane crashes (carefully researching wreckage has led to safety refinements, Forgione points out).

The tape is played twice more, louder and louder, to approximate the experience of flying. During the ``takeoff," Forgione coached the class through a short relaxation exercise called ``jamming." When the recording is turned off, class members are asked to report their ``SUDS levels" during the simulated flight; they vary between about 25 and 50. (SUDS stands for subjective units of discomfort. The numbers range from zero, which is relaxation bordering on sleep, to 100, which is sheer panic. ) It's a shorthand way of assessing one's anxiety level, and during the program, Forgione will often ask ``What's your number?"

No one even flirted with 100, although during the loudest playing of the tape, one woman cried briefly. ``You can entertain thoughts of flying and not panic. You're different now than when the course began," Forgione told the group. ``The relaxation is inside you. In my mind, you've passed the ground course. Congratulations."

Class member Lynne Hagopian, who hadn't flown since her honeymoon 27 years ago, went on to her graduation flight last month. Not only does she consider the course helpful in making flying possible again, she also said she now uses the breathing and relaxation techniques she learned to reduce other, more ``everyday," anxieties. A realtor and interior decorator from Framingham, Hagopian added that the discipline helped her deal with physical pain when she was ill recently.

It's difficult, if not impossible, to persuade someone with a deep-seated fear of flying that techniques such as these really work. In some mysterious sense, our fear becomes a friend we hesitate to lose. But you can break away. I did.

Does that mean that my graduation flight was an unalloyed joy, a sky-high celebration? No. Even with a half a milligram of Klonopin as insurance, I was mildly nervous -- maybe a 20 at times, perhaps a 30 for a moment or two. (These are good numbers, and I gave up the Klonopin the last time I flew.)

Flying is not yet routine, but my vistas are broader. It's a new life.

Contact John Koch, a freelance writer in Cambridge, at jlivekoch@comcast.net.

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