My family and I were looking forward to our flight home. Shortly after take off, there was an announcement: “Are there any doctors on the plane?” I worried that someone was having a heart attack or seizure. A few minutes later, another announcement: “Is there a nurse on the plane?” Then, a paramedic. I was concerned but what could I do? I’m not a physician.
Then, a request for a dentist. A dentist? Helplessness gave way to confusion. Maybe they thought a dentist had some medical training and something was better than nothing? Then: “Does anyone have any anxiety medication?” My wife asked if the problem was anxiety. It was.
My wife and I are psychologists. I treat and study anxiety so I offered to help. A flight attendant told me that someone was having a “panic attack” and demanding that the plane land. The crew’s solution was to give her medication to calm her down. A nurse on the plane was offering anti-anxiety medication donated by a passenger, but the panicking person refused it. The crew wanted me to convince her to take it.
I kneeled down next to her seat so we could communicate face to face. I introduced myself and asked her what the issue was. She told me that she would be fine if the plane just landed. She had refused the medication because she was not putting anything in her body that she knew nothing about. I told her that she would not have to take anything unless she wanted to. That comforted her a bit. At this point, a flight attendant came by with an oxygen tank and then a blood pressure cuff. I had them taken away. Oxygen was worse than useless. One reason panic is more likely on an airplane is that the air is relatively rich in oxygen and poor in carbon dioxide. This leads some people to breathe rapidly, to hyperventilate, which increases anxiety. The blood pressure cuff was almost as bad. What would be accomplished? We already knew she was panicking.
We started to talk. (I am leaving out details out of respect for her privacy.) She was able to sustain a sensible conversation with me. Her breathing was not labored or quick. The only aspect of our discussion that was not rational was her belief/insistence that the plane could land so she could get off. I told her that this was not going to happen and that our job was to help her deal with her anxiety until we reached our destination. I explained what anxiety was, the functions it served and how, in this case, it was misplaced. We also talked about her life, the reason for her journey, and her plans upon landing.
After a bit of time, she calmed and I returned to my seat. I told her that I would come back if she wanted to talk some more. I did visit with her one more time. After that, the flight attendants told me that she was well behaved and no longer demanding that the plane be diverted. We landed without further incident. I did not see her again, although I gave her my email in case she wanted to contact me. I promised that, if she wished, I would help her find a therapist who could help her deal with anxiety. I also told her that, after we landed, she might experience some embarrassment over the incident and that this was normal. The obvious take-home message is that simply talking and connecting is effective treatment.
It ended well. But I remain struck by the crew’s helplessness and their lack of training in dealing with something as common as anxiety. They did not know, for example, that oxygen is contraindicated for panic on an airplane. Breathing in and out of a paper bag would have been a better idea because it raises carbon dioxide levels and slows respiration, which is calming. They did not even know who could help. They called for a dentist, but never considered asking if a psychologist or other mental health professional was on board.
Had my wife not asked if this was anxiety, had I not identified myself as a psychologist and offered help, this might not have had such a benign outcome. What would have happened if I did not intervene, if I was not there? Would the passenger have become more agitated? Would the crew have put her in restraints? Would they have tried to force medication on her? Would the plane have had to land and law enforcement called in? Would we now be watching viral videos and television news stories about another “incident” between an airline and a passenger? Instead, the passenger was empowered to deal with her issues and the flight proceeded as planned.
Why aren’t crew members trained to deal with anxiety? Why did they offer oxygen? Why didn’t they think of a mental health professional? Because it is not part of the mindset of the airlines, any more than it is part of the mindset of our culture. Heart attacks, although extremely rare on flights, are real. Mechanical difficulties, although extremely rare, are real. Terrorism, although extremely rare, is real. But anxiety, which is common, is somehow not real. Tell that to the sufferer. Tell that to the crew. Tell that to the other passengers who could have suffered through a traumatic flight.
Recently, we have heard of incidents on airplanes wherein passengers and/or crew members have been threatened and even assaulted. I have to wonder whether some basic mental health training in how to talk to anxious, even agitated, people might have helped. A relatively short tutorial could do the trick.
That would be a win-win. The passenger could be calmed, the crew members would have an idea of what to do in these situations, and the other passengers would not be traumatized.
Until this happens, such incidents are likely to continue. And it’s not only the airlines. If you suffer from an emotional or mental health condition, or have an anxiety attack, don’t expect understanding and don’t expect help. Until such time as this changes, it might be wise to keep in mind that one should not recommend a psychologist for a toothache nor a dentist for a panic attack.