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Kathleen Caggiano says she loved to travel, and she had flown dozens of times without a worry. But in 2008, something happened. She flew into Reagan National Airport from Dayton, Ohio. The flight was full, and about 30 minutes before the landing, something in her cracked. At first, it felt like an allergic reaction, she says.
"My throat started closing in," Caggiano says. "And I just had this sensation of, 'I have to get off the plane now.' Of course, I realized, I couldn't - I'm thousands of feet up in the air. But I've never had that feeling of 'get me out, now.'"
There's little reliable data on how many people suffer from a fear of flying. A USA Today/CNN/Gallup Poll from 2006 found that 9 percent of American adults count themselves as "very afraid" of flying, but the number of people for whom the fears are serious enough to count as a phobia may be much lower.
Jean Ratner, a clinical social worker who specializes in patients with travel anxieties, says for about half of the fearful flyers she's seen, the problem has little to do with worrying about a crash or a terrorist attack. The issue is more often claustrophobia, or a fear of being trapped in a small space, she says. Ratner remembers one client who made her realize that not all flying fears are the same.
"This one woman said to me, 'you know what, if that plane exploded or had a crash, at least that would be a way to get out of that plane,'" says Ratner. "And that really drove it home to me."
Life with claustrophobia
Caggiano -- who fell into the claustrophobic group -- avoided airplanes for about two years after her 2008 episode.
"My dad and stepmom retired to Naples Fla., and that was hard for me because I ended up driving," she says. "And it was 16-18 hours. It was ridiculous."
And the fear spread. Riding the Metro became too much for her, and even driving became a problem when it came to the Fort McHenry Tunnel on Interstate-95 in Baltimore. Caggiano says she knew she needed to get help after calling off a trip to visit family in Pennsylvania.
"I had my car packed, I was at the tunnel, and I couldn't do it," she says. "I got off a the last exit and went home. I told my family I was sick and not feeling well. That was really hard for me. I really wanted to go and see everyone, and I couldn't do it."
Increasing isolation from family and friends is common for travel claustrophobics who aren't getting help, according to Ratner. She says many of her clients in the D.C. area are successful professionals who are fearful of getting promoted at work if it means they'll have to travel more.
But, she adds, there is plenty of reason for hope, even if it feels as if the fear is insurmountable. For many people, stopping a panic attack before it starts is all about breathing. Many people start holding their breath as they start to panic, she says.
"With each person, I try to find what will help them get into a natural, effortless kind of breathing," Ratner says. "It doesn't have to be anything fancy."
She also makes her clients practice sitting facing a wall for extended periods of time, with just a book and glass of water to simulate an in-flight experience. When they're ready, Ratner even accompanies clients on short flights. Caggiano, who counts herself as a success story, has now flown with Ratner twice.
"I have found typically, they don't need me on those flights, but they know I'm there," Ratner says. "It gives them that feeling of just in case they panic."
"It's kind of crazy, my family thought I was nuts," Caggiano remembers. "They didn't understand. They're like, 'You flew to Chicago, and just came back.' You fly there and come back the same day."
Whether it's nuts or not, Caggiano has slowly been conquering her fears. Ratner says it's important for those with fears like Caggiano's to practice their coping skills, whether it's breathing or visualization exercises, as they go about their daily lives. And she says even if a fearful flier feels he or she has conquered the fear of being trapped in an airplane cabin, the battle isn't likely to go away forever.
"Most people really need to take three to four flights -- even short ones -- that year," she says. "The repetition -- locking it in -- is really important. If they let even six months go by before they take that second flight, they start to relapse."
Caggiano says she's still working up the nerve to ride the Metro again, but she does have a vacation planned for February with some friends. They don't know exactly where they're going to go, but it'll be someplace warm, and yes, they will be flying.
"For the first time I'm actually excited to fly again, so I'm excited about that," Caggiano says, "And that's been a long time coming."
[Music: "A to B" by The Futureheads from The Futureheads / "Learning to Fly (As Made Famous By Tom Petty)" by The Karaoke Crew from Drew's Famous #1 Karaoke Hits: Sing Like Bob Seger, Tom Petty and John Mellencamp]