Captain Dave Fielding
Stress has been described as ‘The Curse of the Strong’, which on the face of it is a really bizarre concept. If you are a strong, tough professional trained in dealing with extreme time-critical operational situations then surely everything else in life is just a walk in the park? Well, not quite. It turns out that the techniques we use in the cockpit don’t work quite as effectively in life outside the aircraft. We cope with the extreme stresses in the sim, and occasionally on the line, through a mixture of training and a subconscious recognition that those stresses are time-limited. We know that either the sim session will end or gravity will exert its inevitable influence, so the stressful situation will cease in a relatively short period of time.

The problem with the stresses of everyday life, however, is that they aren’t always time limited. Particularly the big ones that we all know about. Whilst these naturally affect all sections of the population, the issue with pilots, I believe, is that we try to apply our cockpit skills to these long term stresses. When they don’t work we rarely have a plan B. In the grand scheme of things, we are high-achievers and not used to failure. I wonder if this is a major reason why pilots under-report stress and generally don’t seek help for mental health problems. In addition, there is the perception that doing so will mean permanent removal of our licence, particularly since the Germanwings tragedy of 2015. We can’t choose whether to go into the sim – we deal with it when we do – but we can choose whether to assess ourselves for mental fitness. Given that one in four of the general population have or will suffer from some form of mental health issue, the figures would suggest that a lot of pilots are ducking the issue.

Stress is a complex subject. The body has evolved an amazing array of reactions and defences to what life throws at us, both mental and physical. An example of this would be the autonomic nervous system which kicks in immediately a threat is perceived, significantly heightening the body’s normal responses. The effect of this was memorably described in Pink Floyd’s ‘The Final Cut’: “Like the moment when the brakes lock / And you slide towards the big truck / You stretch the frozen moments with your fear.” Hormones such as adrenaline and cortisol come into play as well to assist physical reactions; chemicals such as serotonin in the brain help regulate moods and anxiety. And so on.

The point is that these reactions are basically temporary responses to temporary situations. 
Continued stress can easily turn into a pressure cooker situation and unless those stresses are either removed or coped with they will find a weak point and something will give. In my role as a disciplinary rep, over the years I’ve noticed a particular type of case which can be very varied in character, such as alcohol abuse, sleep walking (which is often mistaken for drunkenness), and odd behaviour downroute. Yet they all share a similar root cause - stress. With good management and good union support, such cases can be dealt with without long-term detriment to the individual and help secured for them. Nevertheless, some cases are so bad that the manager has no choice but to dismiss, no matter how mitigating the circumstances. This is tragic beyond words, when an individual realises too late that they have unaddressed issues in their lives which are causing them huge amounts of stress, and it has cost them their job.

There are two saving graces to this apparently doom-ridden scenario. The first is the fact that as pilots we are generally far more self-aware than the general population. We are trained in, and frequently discuss, human factors and how we as people react to situations and also to each other. The fact that we are aware of our reactions to stress and talk about them regularly means that our ‘denial layer’ of the stresses of the outside world is generally thinner. By that I mean it takes less than the average individual to be persuaded that we have a problem if indeed we have one.

It’s a tricky area though. You might remember the Life of Brian Messiah scene, where Brian tries to deny the crowd’s insistence that he is the Chosen One but is hit with the killer line “only the true Messiah denies his divinity.” Post Germanwings, mental health issues are very much in the spotlight - which is good - but there is a danger of a syndrome developing which states that ‘only someone with a mental health problem denies that they have a mental health problem’. It’s all about getting the balance right between knowledge and education about stress and the problems it causes versus an over-reaction to someone who admits that they might be struggling. The big positive that has come out of Germanwings is that general awareness of mental health issues is now much higher, their importance is recognised, and the stigma is reducing. All this means that there is a greater chance of that mental injury being spotted, either by the pilot themselves or someone close to them, and that injury being treated. 

The second saving grace is that the vast majority of mental health injuries heal completely with no licence implications, especially if they are caught early. The body has developed remarkable healing mechanisms, and they apply to both physical and mental injuries. Modern medical thinking is moving more towards providing appropriate protection and support for a physical injury and then allowing the body to heal itself rather than intervening with surgery. The same is true for mental injuries, where the move is away from traditional anti-depressant drugs such as Prozac and more towards talking therapies such as Cognitive Behavioral Therapy (CBT) which teaches the brain strategies for dealing with the stressors in order to adjust the way it responds to them. Reduced reliance on those drugs which prohibit flying is clearly beneficial, as is a widening by the authorities of the list of medications which do not impair the ability to fly. Yes, your medical is likely to be temporarily suspended if you do declare a mental health issue, but that applies equally if you break your leg. The point is that the modern approach to the subject means a much more rapid return to flying than perhaps used to be the case.

So what is the message? Be aware of yourself and be honest with yourself. If you are struggling to cope, as most of us will at some stage in our lives, then talk to someone. Peer Support Programmes will be mandated for all European airlines later this year, so within three years every pilot in the UK and Europe should have access to a safe zone to talk about issues they might be facing and to seek help if needed. Please use these programmes. They are different from the current HR employee assistance offerings in that they are based around ordinary line pilots trained in listening and assistance techniques. These volunteers understand the job and everything that goes with it because they do it and they can help. 

My experiences of disciplinaries and welfare over the years has convinced me that being strong and turning a blind eye to stress in a very British way does nobody any favours. The link between mental health issues and flight safety could not be any clearer. They no longer have the stigma that they did - it’s OK to talk about them.

Posted on 13 May 2017

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