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    How I Got The Fear Of Flying Scared Out Of Me

    Statistics be damned, a fear of careening through the air at 600 mph inside a long metal tube is as logical as it is debilitating. Exposure therapy — basically, scaring the shit out of you on purpose, repeatedly — is the cure for the common aviophobia.

    We get into trouble almost as soon as we take off. The captain's voice sounds distant and wary over the cabin speakers as he tells me and my fellow passengers that we are heading into a severe thunderstorm, and the quickest way through it is the center.

    It starts just seconds later, a rumbling beneath my feet that climbs up into my chair, and then my armrests, which I white-knuckle grip at the first sharp crack of lightning. The person sitting next to me and the person sitting next to him are both telling me that the plane we're on will crash, and I am going to die, and after that all there will be is blackness. While they speak to me I have to just sit here and be shaken. It's my only option. Maybe because it's the only thing I can stand to move, I close my eyes.

    But they won't stop talking. "Can you please open your eyes and face the window?" one of them asks me. I find this request very irritating, but I still do it. "Tell me how it looks outside the plane."

    "Scary, obviously," I tell him. I want to glare at him from my peripherals, but it's too hard with this contraption on my head, and anyway, he definitely knows I'm mad.

    These are my therapists. In a way they are my pilots too. They're the ones running the virtual reality program I'm watching via too-tight goggles strapped around my head, clicking what needs to be clicked to make me feel like I'm on a plane flying through a severe thunderstorm in a thick gray-brown haze, then a brief sunny respite, and then, unrealistically suddenly, another terrible storm. It must be nice, in a twisted way, to be them, playing God while I dig my toes into the floor and chew the inside of my mouth. They probably wouldn't admit as much. But I know.

    This is an agreement, at this moment, I feel I should never have made: to (allegedly) cure my debilitating, long-standing fear of flying — a goal that probably has some practical benefits, though I neither remember nor care for them now. Two months ago I promised my employer and these therapists that I'd take two trains, for a total of 36 hours, from my home in Minneapolis all the way out east to Hofstra University in New York, where Ph.D. students in clinical psychology administer phobia treatment using, in part, virtual reality technology.

    And for some reason, I also promised that at the end of just three-and-a-half days' worth of therapy, I'd fly back.

    I'm biased, but I think the fear of flying is one of the most rational fears a person can have. There is very little need for explanation: You're in a little room shaped like no other room you'd ever go in voluntarily, with wings, just floating along in the middle of the sky with no strings or stilts or anything. That is not normal behavior, historically, for a mammal, and because some of us are prone to thinking quite a lot about what does and does not seem normal, we get nervous. People who cite statistics at fearful fliers in order to prove to us that our fear is irrational — so condescendingly, too, as if we'll suddenly light up, like, "Wait. More people die in cars than in airplanes? You don't say!" — are only half-right: The evidence does prove that it is very, very unlikely that any given flight on a commercial airline is going to end in peril. But that doesn't mean the whole thing isn't still very weird.

    Statistics vary, but it's been estimated that as many as 40% of people have some level of anxiety about flying. These are people who might get a little nervous during turbulence, for example, or who try to block out the flight attendants when they're talking about water landings, or who might get a pre-flight drink to calm their nerves. But they still fly. Meanwhile, according to that same study, 6.5% of people experience that fear so acutely that it counts as a legitimate phobia (aviophobia, to be specific) — one that keeps them off airplanes altogether.

    I don't know whether I technically qualify as a phobic, and at some point it seems like splitting hairs. A little over five years ago, I flew to Spain and back for a semester of studying abroad in college. I cried for days and days before each of the flights — dramatically, too, covering my face and really wailing, imagining burning wreckage and terror and death — but I went because I knew I had to. The next year, I flew to Washington, D.C., for a conference with a friend, and I squeezed her hand so hard she asked me for breaks. On both trips, I was sedated with a Xanax tab from the small ration prescribed to me by my doctor. I considered those pills the single reason I was able to get on a plane at all — the medication helping only the tiniest amount, carrying me just over the line from hysteria to mere paralysis.

    After all that, I pretty much decided I was done. There would be potential trips that came up in the next four years, but I rationalized my way out of all of them, citing "cost" or arguing for what I'd insist was a superior option, like the road trip my friends and I took from Minnesota to the Grand Canyon, which is 27 hours of driving. I'd swear up and down that I sincerely love road trips, and I think that taking the Amtrak is relaxing and thrilling all at once, and that is true, but at some point, at some length of time spent in a car or bus or train, nobody believes there isn't anything else going on.

    That length of time is about 36 hours.

    I'd done this train trip to New York before, last summer. I made it a verb: I'm training out and training back. Nobody could believe it. I went with my best friend and we ate in the dining car and didn't sleep. There were slow parts, but it was fun, and maybe (probably) out of defensiveness, I declared it a perfectly fine and normal way to travel to anyone who would listen. Cheap too. Flying was for snobs. ("It's like they need to be above everyone else, literally!" I said to my best friend, who isn't afraid of flying, but who knows that, with me, it is sometimes better just to nod and not say anything.)

    This time, though, I am making the trip alone. I still love this train, the dining car, the legroom, and the view out my window. But by hour 30 (or maybe even 28), something feels different. For the first time in a long time, I'm not able to pretend that the biggest reason I'm traveling halfway across the country by train isn't that I'm too afraid not to. And I hate that.

    When it comes to treating phobias, exposure therapy — a form of behavioral therapy that gained traction in the 1950s — is largely considered the most effective route available. The first recorded use in treating anxiety was at the University of Cape Town in South Africa, where psychologist James G. Taylor introduced situational exposure and response prevention to treat patients with phobias. It's a straightforward enough theory: Be exposed to the thing that frightens you and, with time, it will frighten you less. Therapists who utilize this technique attempt to identify a patient's various emotional and physiological responses to the triggering stimulus and subsequently help the patient break that response pattern through, basically, forcing that person to adapt.

    It is Mary Cover Jones, though, who is credited with developing the therapy's central technique: "desensitization," or the process by which the body's response to the triggering stimulus gradually diminishes by repeated exposure. Jones' most notable work is a 1924 study conducted on a 3-year-old boy named Peter with many phobias, including rats and rabbits. Jones posited that the introduction of a positive stimulus — food — in tandem with the triggering stimulus — a white rabbit — would desensitize Peter to his fear. Jones brought both the rabbit and the food closer and closer to Peter (a simultaneously bizarre and sweet image, if ever there was one) until he was able to touch the rabbit. There will, unfortunately, be no snacks to accompany my exposure therapy — today, it is the repeated exposure to the phobia itself that is considered important. That's what gets you used to it.

    That process is called habituation, which is a nicer, homier, more professional-sounding way to say that the goal here is to increasingly scare the shit out of you, until your body and brain get so tired of being so scared that you calm down. If it sounds overly simplistic and slightly cruel to you then, well, join the club. "Are you sure about this?" I'd ask my therapists, Steve Puliafico and Mike Lent — both third-year students in Hofstra's clinical psychology Ph.D. program, and, at 24 and 25 respectively, much too young for me to trust — and they'd try explaining it to me all over again. Then I'd say, "It doesn't sound right, though, does it?" They agreed that it's a somewhat counterintuitive theory, but promised me that it really does (or at least really can) work. I hoped they were right, so eventually I stopped arguing. For the most part.

    There are a number of other aviophobia clinics around the country, which I eliminated one by one as I researched — an $895 weekend group seminar called "MySky" in my own Twin Cities, Minnesota, was too nearby; I knew I'd need to be somewhat stranded in order to get back on a plane. A four-day $450 option in Washington is offered just twice a year, and same with a $1,000 six-meeting workshop called "Freedom to Fly" at the Westchester County Airport. All of the above, too, work largely with groups of patients, and I wanted to do this on my own. I knew that if I were with a group, I'd make a friend in it, and I'd end up asking her to sit by me on the graduation flight at the end of the program. And what I needed and wanted to do was to fly without anyone there to hold my hand. So for its flexibility in scheduling, its one-on-one therapy structure, its unwillingness to coddle, and its location just outside New York City, I chose Hofstra University as the facility that would scare me straight.

    The Phobia and Trauma Clinic is one of several clinics housed within Hofstra's Saltzman Center — they offer family therapy and speech therapy, among others, and it's also where Hofstra students go for counseling. The clinics themselves are separated out by theory more than physical space; the center looks more or less like a spartan two-story physician's office, with unmarked rooms and bare walls. I don't know why exactly I expected to see more in the way of inspirational posters, but I don't see even one when, on my first morning there, I follow Puliafico and Lent upstairs to the room I'll come to think of as mine — a cramped office with a desk, two rolling armchairs, and, in the corner on a slightly raised platform, a worn-down navy blue airplane seat, spacey-looking goggles, and headphones hanging on a hook just above it.

    The look of the room and the chair and the equipment do little to assuage my growing doubts about this clinic's capacity to fix me. This is, after all, a training program. Doing it this way cuts cost: A three-day intensive with Ph.D. students runs about $1,000–2,000, whereas an equivalent treatment with a licensed psychologist, like the one in charge at Hofstra, would cost $4,000–$6,000. And though it is a training program backed by substantial experience, education, and guidance — student therapists routinely meet with Program Director Mitchell Schare, who holds a doctorate in clinical psychology, to discuss technique, concerns, and patient progress — the most that can be said of the people responsible for my therapy is that they are almost doctors.

    Still, Puliafico and Lent do this a lot. They see all types of patients, of all ages, with varying degrees of fear, but in the end, of the people who complete their treatment, 96% of them get on a plane and fly, by Schare's estimation. When I meet him on the afternoon of my first day, all (or, fine, most) of my concerns about his much-younger students are calmed — Schare's personality is of the kind I find instantly soothing: He's funny and personable, a straight-shooter with a thick Long Island accent. When asked what makes his program different from the rest, he laughs and says, only partly joking, I think, "Me."

    "As a clinic, we are very adaptable to the patient's needs," Schare continues. "A lot of clinics follow a rigid, strict protocol, and I find that simplistic and not particularly helpful to individual people, even if they have similar problems." There are three major components to the exposure therapy offered in the program: imaginal therapy, or exposing patients to their fears within their own minds; in vivo exposure, or trips to the airport; and virtual reality. Treatment is individualized, with focus shifting from one form to the others if one isn't working. Most people come in for weekly or twice-weekly sessions over a few months, but there are others, like me, who take an intensive approach, coming in for multi-hour sessions over a shorter period of time. The people who do the best, Puliafico tells me, are simply the ones who keep showing up.

    I'm too manners-oriented to skip an appointment, even to do something I know I'll hate, so I'm somewhat surprised this is a common event until later, when Puliafico describes to me how they treat the claustrophobics. "We have them stand in, like, these huge wooden boxes, and we close them in." I gape. "Are there…breathing holes?" I ask. "I mean, enough air gets in. Sometimes, though, we wrap the boxes up in chains," he says. So I don't blame those patients for occasionally deciding, you know what, I think I'd rather not.

    These days, for aviophobes, exposure therapy is largely done a few degrees removed from the actual stimulus. Many fear of flight treatment and support programs used to make more use of in vivo exposure — bringing patients to airports around the country, taking them past security and, sometimes, onto airplanes, turning on the engines and the stale air conditioning, recreating the entire flying experience apart from the flying itself. But tightened security after 9/11 has made this level of exposure impossible, or at least very challenging, for most programs. Instead, therapists use imaginal work. In some places, like the Saltzman Center, therapy might also include virtual reality exposure.

    The program used in my therapy comes from a company called Virtually Better, and, in addition to the fear of flying model, they also offer virtual exposure therapy programs for job interviews, fear of heights (bridges or elevators), and combat-related post-traumatic stress disorder, among others. Libby Tannenbaum, a clinical psychologist with Virtually Better's own therapy program for over 10 years, told me the technology started taking hold in the mid-'90s, working first with fear of heights and then spreading as it proved effective in treating other phobias. On Virtually Better's site you can see a few stills from the fear-of-flying program, though I can't help but notice this seems to be a fancier model, possibly first-class, than the one I used, which still seems mid-'90s vintage, graphics-wise. Puliafico and Lent, sounding just a little like kids wanting a PlayStation upgrade, tell me they hope to someday be able to use Oculus Rift, a virtual reality headset (one with a very nerdy, Transformers-sounding name) that was designed for "immersive gaming," but which could, potentially, improve virtual reality therapy experiences like mine.

    It's exciting, the first afternoon, when I put the goggles on, or rather have them put on me, as if they might be too expensive for me to touch. I'm not sure what I expected, but "instant cure" probably sums it up pretty well. The idea that I would be wholly transported into an experience just like the worst I've ever had falls away quickly — when I notice that the lenses sit a few inches out from my face so that I can see around their edges, when the prerecorded "pilot" skips along in his speech, glitchily repeating the last sentence of his preflight announcement, and maybe especially when I'm told to move myself about the plane using a joystick.

    All the while, as they watch my virtual trip on their computer screens, Puliafico and Lent are narrating, saying things like, "You notice the plane is pretty empty, like maybe a bunch of people decided they shouldn't get on this flight," and "What was that bump?" I find myself distracted by the graphics, which leave something to be desired — walking through the virtual airport and onto the plane feels a little like playing an especially unnerving version of The Sims or watching a Taiwanese news animation reenacting my worst nightmare.

    It's hard to say, though, how much a more convincing picture would help; apparently it works for some people — Tannenbaum says, in fact, that they don't worry a great deal about improving the look of the virtual environments because most patients respond so well as is — but I can't get over the cognitive dissonance. The things I'm watching in my goggles, the thunder in my ears and the turbulence in my seat; all of these sensations do make me uneasy, but I am also inescapably aware of the fact that I'm not actually on an airplane. When Puliafico reads off a series of alarmist thoughts that might come to me under real-life circumstances like these — exposing me to my fears by speaking them aloud — but aren't occurring to me now, it mostly gets on my nerves: How stupid do they think I am? He says, "The lightning seems to be getting worse, and the plane could get struck at any moment," but out of the corners of my eyes I can see Lent lifting a flash bulb into the air to produce that "lightning." So the process makes me anxious, in a way, but probably not in the way they'd like. It's more agitation than terror.

    Some level of personal frustration is to be expected when you find yourself paying money to spend time with people who, if they do not actively wish you dead, are awfully good at sounding like it. It's part of the process, and one that's typically overcome as patient and therapist get to know each other better. "In the weekly sessions you can build a better natural rapport," says Schare. "[In intensive programs] it isn't so easy at first, because you're fearful, in the hot seat, and you don't really know these people." Getting along with each other would be nice, but Schare is quick to point out it isn't everything, either. "Rapport is a helpful element in therapy but it's not absolute. It's more important that you deal with your issues."

    I make it through the program on the first day (though, I'm realizing now, I don't think we actually landed so much as abandoned the plane, ostensibly in midair, after the second thunderstorm), but after a brief, impatient walk through the make-believe airport on day two of my three days of therapy, Puliafico and I decide this isn't working for me. (He'll tell me later that the virtual reality program works for more people than it doesn't — people who, sitting in the goggles, eventually report feeling the same level of fear they'd feel in a real flight. It's hard to say why my experience was different; my best guess is some combination of self-consciousness and inflexible pragmatism. Schare notes, too, that it often works best for older patients, possibly because their expectations for video graphics are lower than those of younger people who grew up gaming.) I feel almost proud, like I beat the system. Sorry, technology — my phobia and I are too old-fashioned for you. We go too far back.

    I was 19 years old, flying with my classmates and professor back from a monthlong trip to China in May of my freshman year in college. I had not yet become afraid of flying on the trip out; our 14-hour flight there had taken us over the North Pole and I'd stood at a little window in the back of the plane gaping at the endless, spectacular ice.

    But on the flight home we encountered severe turbulence early on, and it didn't let up for over an hour. It wasn't just rumbling, but side-to-side jerks, like someone slamming the side of the plane with a giant palm, waiting a second, and then doing the same thing from the other side. It went into little drops, too, ones that lifted my stomach into my chest, like we were about to fall and not recover. At some point a flight attendant came over the speaker and, sounding terrified, to me, she yelled, "Everyone, get in your seats! NOW!" I think she was just worried that someone would get hurt or thrown to the floor, but you don't think that through at the time. I became convinced that this was how I was going to die. I didn't think it, I knew. My life really did flash before my eyes. I had always thought that was a literary device or something, but it happens.

    Eventually, though, it stopped. I heard an American woman sitting in the row behind me telling her neighbor that part of the reason we made it out alive was that in China she'd met a monk she'd supposedly recognized from a previous life, and she'd prayed to him on her Buddha beads during the turbulence, and that's why we were going to be fine. I was too exhausted to roll my eyes.

    This is the experience I cite when anyone — including Puliafico and Lent — ask me if I had a traumatic experience that I think contributed to my phobia, but it isn't really the whole story. It's just the easier one to explain. On the morning of my second day in therapy, when they ask, "Is there anything else?" I figure I might as well dig deep.

    The next time I get on an airplane after China is five months later, in November, when I come out of class to five or six missed calls and voicemails from my dad. When I call him back, he tells me that my mother has had an accident, and when I ask if she'll be OK, he says he doesn't know. She fell down some stairs, onto a cement landing, and she's in a coma in the hospital. He calls what happened a "traumatic brain injury." I ask him, "What do I do?" He says that I need to fly home — about an hour's flight from Illinois, where I'm in school — and this part isn't said, but it's with the understanding that I need to hurry if I want to make it back before she dies.

    I don't remember that flight at all.

    My mom, miraculously, is OK. Not at first — brain injuries require a great deal of wait-and-see, which is impossible until the days keep going by — but eventually, now, she is healthy. But back then, I was living in the hospital with her and my dad for three weeks, sleeping on a couch in a waiting room or else on a cot in a little hotel that sits across the parking lot from the hospital, there for families in situations like ours. Thanksgiving and my 20th birthday both come and go with my mother still in a coma.

    It's decided that I'll go back to school just for four days, to take my winter finals and then return home. By then my mom is awake, if not altogether present — sometimes she is very much her, asking a nurse for "good coffee," but other times she is frustrated and confused and thinks that I am her sister, or her sister is me — but still I feel unable to leave her side. I think that if I do, she will die while I am gone.

    Someone takes me to the airport anyway, and it's there, for the first time, that I become acutely aware of this new terror. My plane is going to crash, and when my mom gets better she'll have to deal not only with what happened to her, but with what happened to me too. I call my dad crying and he tells me I have to go, I have to finish my semester. So I get on the plane. But as soon as they shut the cabin door, I decide I have to get off.

    I ask a flight attendant if I can get out, trying to explain as quietly and quickly as possible about my mom. She is kind, but she tells me it's not possible. I am as anxious as it is possible to be, but I am also someone who typically defers to authority and wishes to avoid making a scene, so I don't fight her on it. The woman seated next to me — in her fifties, with short gray hair, glasses on a chain — notices that I'm agitated, and when the flight attendant moves further down the aisle, she offers to buy me a drink: "I'll pretend like it's for me, but you can have it when nobody's looking." Somehow, in spite of this encompassing fear, I find it in myself to consider another: I'm too afraid of getting in trouble with the flight attendants or maybe the captain, so I decline. But now I know she's on my side.

    The woman tells me her name is Mary, and she talks to me, trying to distract me throughout the whole flight, piping up even more when there is turbulence and I close my eyes and grip my armrests. When we finally land, she wishes me well, and I thank her. I don't see her after we get off the plane. And I — who months earlier thought a woman silly for thinking she and her beads had anything to do with protecting our plane — decide Mary must have been a saint. I figure I only got through it because of her.

    It surprises me to realize, when I'm done telling Puliafico and Lent these stories on day two, that maybe I was wrong about which of the two flights affected me most. They tell me it sounds like my anxiety is connected much more to a fear of death than it is to flying itself. It sounds obvious, like something I thought I already knew. But I guess I only sort of did.

    I tell them it's true, that whatever plans I've made for later this summer feel almost hypothetical, because they fall on days that come after my flight home. I'll agree to anything in August — I might not even be around at that point. Booking flights, in that way, feels like I'm suggesting a possible day for my own death: Does this one work for you? It feels like I'm reminding whoever and whatever is or could be responsible for my end that I am here. I have often otherwise been trying to escape notice, living as close to riskless as I possibly can, hiding from mortality at my desk in my room.

    Maybe this is why it's so easy to get angry with anyone who suggests I just get over it: Asking me to overcome my fear of flying feels synonymous, to me, with asking me to accept that I will one day die. Of course I will never agree to that. I'm going to assume that that is not necessarily true until the day it happens.

    But for the rest of that day, for nearly two hours, Puliafico and Lent are going to make me imagine it happening, because that is what one does in exposure therapy: Whip up your fear and then sit with it. I keep expecting them to offer some sort of comfort, some statistical support or information about the way turbulence works, or at least some reassurance that I will not die this week — not because I think that's a part of the therapy, but because they're two human beings sitting near a third one in distress. But it never comes. It's their job not to do that. They'd classify all of the above as "avoidance," or things I could repeat to myself to distract myself from my anxiety. I just have to feel it. I lean back into the battered old airplane seat and close my eyes because they tell me to, and then I walk them through three separate flights and the crashes they end in. It's strange — they ask me for tiny, seemingly irrelevant details, like, "Who's in front of you in line to get your boarding pass? What is she wearing?" But what's stranger still is that I have answers. She's a young mother wearing a gray sweater and her hair in a ponytail, holding the hand of her son. I don't know where it all comes from, but I've got a full narrative filling out in my brain, and then another.

    I know what the people around me will sound like when they start getting nervous that this time, something might actually be wrong. I know that on the final imagined flight of the day, which Puliafico helpfully suggests I make fail by way of faulty landing gear, we'll hit the ground nose first. I know the floor will peel up in a metal curl like unwinding a soup can, and that anyone sitting in the middle seats will be dragged out, skidding along through the few inches between plane and tarmac. I know the fire will start at the front and move back, and I know how it will smell. I know what I'll miss out on for the rest of the life I would have had.

    When I am done, because after a certain point, there is nothing left to say, my therapists tell me I did a good job today. (Do I say "thank you"?) They are impressed by my details, I guess because it shows I put in effort. I made my mind work hard at this. But I am horrified by how gruesome I made it, embarrassed for being so dramatic and sounding so weak.

    The most unexpected thing is that after all that desperation and doom, I also feel, on the whole, calm.

    This is the pattern my emotional roller coaster took on each of the first two days of therapy: eager hopefulness in the morning followed, quickly, by irritability and mild aggression toward the two jerks who kept telling me my plane could crash. After that — usually, appropriately, while describing my death — I'd feel anxious and sad, followed by an unfamiliar kind of neutralized acceptance. Throughout the therapy sessions, Puliafico and Lent repeatedly asked me to rate my fear level on a subjective scale from 0 (no anxiety) to 100 (the most anxiety possible). It's hard to assign a number to something like that, but I guessed that at my most anxious in the clinic I felt about a 50.

    When I first met them, I told my therapists that even just being in an airport would put me at around 65-70 on the fear scale, so it's surprising when on my third and final full day, which we spend walking around John F. Kennedy International Airport, I don't ever feel more anxious than, say, a 30. It's not for Puliafico and Lent's lack of trying — they needle me, asking, "Does looking at the security line make you anxious? That guy looks antsy, does that make you feel anxious? What about the delays on the departure board? What about the rain?" I clench my jaw, not out of fear, but because I want to tell these people to leave me alone, but I know that I can't. Or, at least, shouldn't.

    In the third terminal we visit (we can't go past security, so we wander around different entryways instead), no more than an hour into the day, I feel ready to snap. (Is this the goal? I'm still not sure.) We sit three in a row in some black leather chairs to the side of the Delta check-in line. Puliafico, apparently aware of my flagging motivation, tries a new tactic and makes a joke about my plane crashing, and I'm so relieved I could cry. Despite my best efforts to get them to make fun of me with me — because it helps — they've been holding out until now, Puliafico explains, because at first they thought I was doing it as an avoidance tactic. They thought that when I joked about flight numbers with two of the same number in them (your 773s, your 442s) being a bad omen, it meant I wasn't talking about what really scared me. But those stupid little things do scare me. I believe them, and I think the fact I believe them is kind of funny.

    So the joking — though it is dark — is welcome. It would be funny, in a way. Not to me, but cosmically. Three full days of intensive therapy for fear of flying followed by a plane crash at the end? "Think how we'd feel," Puliafico says.

    "I hope that if my plane crashes, it ruins the rest of your lives," I say. "I will come back, and I will haunt you forever."

    Personal motivation is so great a determining factor in the success of exposure therapy that it's hard not to wonder how much the therapy itself really accomplishes. Are people who decide to come to the clinic — and to keep coming — already nine-tenths of the way there? I wasn't sure whether I ultimately got on the two planes I took home because the therapy worked, or because I'd already decided beforehand that I would — that this was the time, that 26 was the age I'd stop being so afraid of things.

    But deciding something like that is rather grand, and possibly a little unrealistic, and maybe that's where the therapy comes in — to remind you that it's work.

    "Motivation is the first step. It's helpful. But just because someone wants to change doesn't mean they're ready to change," Schare tells me over the phone, after I'm home. "Motivation is big, but are you willing to experience some of the pain that goes along with it?" I am sure he must be right. It's more than just wanting. Throughout the therapy I kept telling Puliafico and Lent that no, really, I could get over this completely, and they kept telling me they doubted it would ever be totally gone.

    And they were right, at least so far: I am nervous heading to LaGuardia Airport for my flights — there is, cruelly, a two-hour layover in Chicago — back home to Minneapolis, and a little more so when I meet Puliafico and Lent after checking my bag. We stand around by a floor-to-ceiling window in the lower-level food court, watching planes take off, going over things a few more times — since I'm flying within a few hours, they'll spare me the most frightening imagery, instead reminding me, simply, that it's not going to be easy. There's an air of cautious anticipation between all of us, like we know I'm about to make it. "You're smiling more than you have all week," Lent says.

    When it gets closer to boarding time, we head back upstairs, standing near the top of the escalator, just outside the security line, maybe putting off the inevitable just a little. Below us I watch a little girl, maybe 5 years old, standing nervously in front of the escalator, refusing to get on it. Her dad sets her on the bottom stair and she wobbles upward for a few seconds before tumbling back down, painlessly, the way little kids do. She stands with her dad again and he counts, "One… Two… Three!" and she jumps back on. At first she stands still, holding the rubber bar, but about halfway up she starts running, stretching her legs to leap up the stairs. She's ready to be done. Me too.

    I say good-bye to Puliafico and Lent and shake their hands. Both are careful not to tell me "good luck," because earlier I told them not to, since it might make it sound like I needed it. Instead they just say, "OK, let us know when you get there." Then the therapy is over, and I am on my own.

    It is crowded at the airport — it is the Friday of Memorial Day weekend — and outside it's windy and cloudy, a pre-thunderstorm sky. There are delays spread across every departure board I see. My own flight is pushed back 20 minutes. Before the program (or before this year, all of it together, whatever it is that got me here), these things would have added up like checkmarks off a list in my head and together they would have just about killed me. I would have been looking all around me for more proof that I was meant to run away, to decide it was acceptable and maybe even smart to stay afraid, to keep being the same, to stay safe.

    But this time, somehow, my pet omens don't bother me so much. When it starts to rain I take it in like a fact — one I don't love, but still an objective, impersonal event — rather than a threat on my life. Something about hearing the worst of my flying-related fears all week — the worst pictures in my mind, the worst refrains about my plane getting lost in the storm — makes the real thing seem less dramatic now. Even though I was pretty sure it wasn't helping, even though I didn't want to trust these two young guys, barely out of college, and even though I was a smart-ass of a patient, somewhere along the line — and truly, I am really not sure how — the therapy that didn't feel like therapy started making a difference. I got to a place where I could sit in an airport experiencing some of my least favorite triggers and accept them all. I can just think: This is just how it's going to be. I don't take any of the Xanax sitting in my purse like a safety blanket. I don't cry, and I don't call my parents before the flight in hopes they'll tell me it's OK if I just take the train back instead. Once we're in flight, above the clouds in bright sun that shifts over us from left to right, I even look out the window a few times, and it isn't so scary after all.

    On the ground afterward, I feel tired and strong. I did it, but if I want it to stick, I'll have to do it again. I think it will be fine. I can't know that it will, but that is something that you and I all have to live with if we ever want to get up and go.

    Just before takeoff on that first flight, from New York to Chicago, the lead flight attendant, whom I knew I loved right away, says over the intercom, "Sit back and relax, or lean forward and panic. It's up to you." It's funny, but it's also true.