ABSTRACT
This chapter explores the complex issues involved in determining the flight status of those with cockpit duties who develop a fear of flying. It begins with an historical overview, including the predominant theoretical explanations of the motivation to fly (MTF) and fear of flying. The chapter provides a detailed examination of the concept of MTF, summarizes the different types of motivation, and discusses the importance of a ''healthy'' MTF as well as the adaptive defenses necessary to prevent fear of flying. The selection of an aviation career in response to parental pressures is another unhealthy MTF. Fear of Flying (FOF) defines as a reluctance to fly due to fear or anxiety, manifested by a variety of symptoms. Psychoanalytic formulations of aeroneuroses, flying phobia, and FOF dominated clinical thought for most of the past century. An understanding of the differences between adaptive and maladaptive coping defenses is fundamental to the psychodynamic formulation of FOF.
