San Francisco Airport’s Fear of Flying Clinic Welcomes Nervous Passengers Aboard

It’s twenty minutes before Alaska Airlines flight 626 takes off from San Francisco International Airport for Seattle.

Colette Vance closes her eyes and calms herself with a string of rosary beads, hoping that her claustrophobia doesn’t trigger a panic attack.

It happened the year prior, when she was flying back to North Carolina for her final semester as a college senior. She had such intense anxiety that she felt as if she was about to die. After graduation, she avoided flying altogether and drove all the way back to California instead. It was on that long road trip home that she realized she needed to confront her fear of flying.

The fear of flying is less a single phobia than a place where other fears converge. For many people, it’s rooted in one or more anxieties that flying brings into focus — the fear of turbulence, of heights, or of having a panic attack in front of strangers with no escape.

For Vance, being inside an aircraft activates her claustrophobia — a condition she developed at nine years old. A series of surgeries caused her to feel severe anxiety in closed spaces. Her panic attacks increased during her teenage years, especially on airplanes.

“If I’m in a car, I can pull over, open my door and get some relief,” she says. “But when I’m in a plane, there’s no out.”

A safe space to face the fear

Air travel isn’t something that most people can do often enough to ease their anxiety. Each trip can feel like starting all over again.

Luckily, Vance found somewhere to practice being uncomfortable: the Fear of Flying Clinic, a nonprofit support organization hosted at the San Francisco International Airport.

Fran Grant and Jeanne McElhatton, both licensed pilots, founded the clinic in 1976 in San Mateo, California. They created an educational program in order to help Grant’s husband overcome his turbulence anxiety so he could travel to Australia.

The curriculum demystified air travel and addressed the physical and psychological roots of fear. The first clinic welcomed a small group of anxious travelers and, by the end, Grant’s husband was calm enough to sleep through turbulence that had once overwhelmed him.

Today, clients from across California spend two consecutive weekends understanding the mechanics of flight and learning how to rewire their anxious thoughts. A four-day workshop culminates in a round-trip graduation flight to Seattle.

Vance arrives at the clinic on the first day with her mother, Louise, joining eight other participants, including one couple who drove in from Fresno. Volunteers run the workshop — many of whom are nervous flyers and have gone through the clinic themselves — and include instruction from working pilots, air traffic controllers, flight attendants and aircraft maintenance technicians.

Volunteer psychotherapist Paula Zimmerman begins the workshop by asking everyone to introduce themselves and their concerns about flying. Reasons for signing up range widely: panic attacks, childhood trauma from an earthquake, a decades-old rescue mission during the Vietnam War. One participant in their fifties had never even been inside an airplane.

Often, Zimmerman says, they sign up because of an important upcoming trip.

Retrain the brain

Zimmerman wants participants to understand the difference between adrenaline and real danger. Her goal is to help them to distinguish between the thing that’s happening to them and how they think about the thing that’s happening to them.

She writes the letter “A” on a large sheet of paper at the front of the room. A stands for an activating event — like, for example, turbulence.

Then she adds “B”, for belief — the idea you have about the turbulence. Someone might believe, for example, that turbulence means the pilot has lost control, and the plane is going to crash.

Finally, she writes “C” — the consequence of that belief. For most everyone in the room, the consequence is often panic.

In particular, she wants the group to analyze the tricky second step of belief. If you believe turbulence means disaster, it makes sense you’d be terrified. But what if that belief simply isn’t true?

To help make her point, she brings in reinforcements: retired pilot Keith Koch, who flew commercially for 40 years, fields questions about turbulence all the time. Turbulence, he explains, rarely moves a plane more than a few feet.

“As long as your seatbelt is on, you’re perfectly safe in turbulence,” he says.

His claim is backed by data: deaths from turbulence are very rare, and no modern commercial aircraft has been lost to turbulence alone.

Zimmerman offers a reframing tool to help shift people out of fear and into fact. Instead of saying “turbulence scares me,” she suggests: “I upset myself when there’s turbulence.”

It sounds subtle, but the shift matters.

“If I give the power to turbulence,” she says, “that means every time I’m in a turbulent flight, I scare myself!”

The goal is to recognize that the plane isn’t the source of the panic — it’s what you think about the plane that causes your adrenaline to rise.

In order to retrain their brains to respond differently, the group has to expose themselves to the very thing they think is dangerous: the inside of a plane.

“How are you going to be less afraid of dogs unless you meet a dog?” she asks. “How are you gonna be less afraid of flying unless you get on a plane?”

Exposure, the good kind

On the second day of the clinic, participants gather at United Airlines’ Technical Operations building just north of SFO. They wear bright orange safety vests, walk across the tarmac toward a maintenance hangar and gather beneath the tail of a 787 — also known as “the Dreamliner.”

Together, they observe the massive aircraft. Just seeing the outline of the emergency exit door triggers a familiar sense of dread and entrapment for Vance, who practices Zimmerman’s reframing.

“It’s just an airplane,” she tells herself. “Airplanes don’t harm anybody.”

A metal staircase is rolled up to the 787’s back entrance. One by one, participants climb inside. They wander down the aisles, absorbing from all senses. One person peers into the oven in the galley. Another taps the top of each seatback. Vance pauses at the emergency exit door window, her hands clasped behind her as if she’s walking through a museum.

Zimmerman gathers the group toward the rear of the aircraft. A volunteer flight attendant plays the familiar chimes and announcements they’d hear during a real commercial flight.

As the group closes their eyes and focuses on their break, Zimmerman recites what’s called an “imaginal script” — a first-person narrative meant to help them rehearse their coping strategies and guide them through every step of the air travel experience.

“You feel the speed and the strong acceleration,” she reads. “You hear the sounds as the plane lifts. Your plane has reached cruising altitude.”

Graduation in the sky

The group reunites at the airport one week later. This time, they’re on a real commercial flight to Seattle. As the plane accelerates down the runway, Vance gives herself a pep talk.

“I’m in charge. I’m the boss,” she whispers. “I have God on my side.”

Nearby, there are other nervous flyers from the clinic. Paul is seated just in front of her, and Sarah and Katherine are across the aisle.

Once the seat belt sign is off, volunteer instructor Koch is free to move about the cabin and check in with each participant. He’s wearing his pilot’s uniform: crisp white shirt and tie, navy blazer, and wings pinned near his lapel.

“The hardest thing you did was show up on day one,” he tells Vance. “If you show up on day one, there’s a really high chance you’ll end up here on day four — right where you are, on an airplane.”

The plane begins its descent into Seattle. It sinks in for Vance that she made it through the flight without a panic attack, and her excitement swells. She leans forward to Paul, seated in front of her.

“When the plane lands, do you wanna clap and cheer?” she asks. “Pass it down to everybody.” He does.

She looks out her window as the ground gets closer and closer. As the wheels hit the runway, the clinic group erupts with cheers and congratulations. Someone jokes that they wish this group could join them on every flight.

In the Seattle airport, they all eat lunch together at a Chinese restaurant and get fortune cookies. On the flight back to SFO later that day, Colette opens hers and shrieks with excitement.

Her fortune reads: “You will travel to many exotic places in the next few years.”

Reporter Evan Roberts was a 2025 Summer Fellow with KALW, where he first reported this piece.