I have suffered from panic attacks. Now I am planning a trip to Europe and I dread being on the plane for seven hours. I am not afraid of flying -- I have flown before -- but I am afraid of being miles over the ocean and nowhere to go. I can't make myself buy the tickets. Do you have any ideas as to how to deal with this? I do not want to create a commotion on the plane.

--Arthur

One possibility is to ask your physician for a prescription for a few doses of a medication used for anxiety and panic attacks. I understand that Inderal (generic name propranolol), for instance, is sometimes used by anxiety-prone individuals on an "as-needed" basis, such as before giving a speech. Using a prescription antianxiety drug only occasionally, such as when you fly to Europe, would lessen your chances of becoming addicted to it.

I also recommend that you make a list of all the relaxation techniques you know, and practice, practice, practice so they become second nature to you. (Obviously, this could benefit you even if you never leave the United States.) Examples of such techniques include deep breathing and visualizing yourself in a safe, relaxing place. Yoga, Tai Chi and Qi Gong can also alleviate panic and anxiety; if you don't know one of these Hindu or Oriental practices, consider taking a class and making one of them a part of your daily routine. (At a yoga workshop a few months ago I met a woman who said she cured herself of anxiety attacks through a daily yoga practice.)

And, of course, a counselor or therapist could also help you develop a plan for handling the trip.