Quora Question: What Sort of Mental Health Demands Do Pilots Experience?

2015-04-02T181446Z_1139893139_GF10000047524_RTRMADP_3_FRANCE-CRASH-RECORDER
"Pilots famously have segmented crania. It's called 'compartmentalization,'" writes Tim Hibberts, a pilot. Wolfgang Rattay/Reuters

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Answer from Tim Hibbetts, Naval Aviator, Airline Pilot, Aerospace Eng Major.

The military and many airlines do specific testing to make sure pilot candidates are well balanced (whatever that means) and have healthy methods of dealing with stress. In the main, they look like anyone else's: exercise, hobbies, vacations, etc.

But how are pilots different, you ask? Pilots famously have segmented crania. It's called "compartmentalization." There's a little bin for everything from flying to anniversary dates (a smaller bin, easily closed evidently). It's going to sound questionable, but if you don't need that bin to fly, you close it. Argument with the missus? Shut that thing and push it aside. Got cut off in traffic? Daughter not feeling well? Lost your dog? Watched Game of Thrones? Shove all that frustration way back in the corner and shut it away in the dark. Once you're done defying gravity and cheating death, deal with it, but here and now isn't the place or time. You're saying you can't keep that lid shut tight? Don't fly. If your head isn't in the right place to wield a hundred tons of steel and fire, then you shouldn't be pulling a yoke.

The mental demands a pilot experiences cover the spectrum from intense boredom to sensory overload. Everything is handled in the same way: constant training that builds on years of study, practice, and deep revelations about which way is up and why it's important. Pilots have an instrument scan, checking each one just long enough to see where it is and what it's doing, then moving to another one. Likewise, a pilot has a mental scan, ensuring just the right amount of engagement. Too little or too much are both dangerous and can lead to tragedy. Complacency is an insidious threat, reduced by being trained to counter it. There are as many techniques as there are pilots; from humming to elaborate methods of recalling every aspect of the flight that could go wrong. If things are coming too fast, there's the aviator's axiom: aviate, navigate, communicate. Do them in that order and drop from the bottom if the top is suffering.

One of my buddies was a helo instructor. He had his student flying some normal pattern work, making low approaches to the field, then circling around away from the field to set up for the next approach. After a few passes, he noticed the student's air work got really sloppy around the same point in the pattern. He also noticed that he was starting to write stuff on his knee board. When queried, the student replied, "Well, my wife and I had a huge fight this morning and I'm writing down what she's taking out of the house. We live right there." He almost punched the dude, grabbing the stick, saying, "I HAVE THE CONTROLS!" The student was sent home to work on that bin he was understandably unable to close.

Another potential source of stress is between the crew members (which includes any aircraft formation, even if they are all single-seaters). Fortunately, Crew Resource Management is a mature subject and has been effective in wrangling the martinet captains and abusive instructors. Playing nice is still something that some have to work on, but the days of being told to shut the **** up or having the instructor throw his knee board at your helmet from the rear cockpit are rare. If you think that speaking up is going to get you chewed out, there might be a hesitation and that lapse may be all that's needed to court disaster. As a wise captain once instructed me in a pre-flight brief, "If I'm messing up, tell me. My skin is thicker than my wallet." On the obverse, if your fellow pilot is displaying erratic behavior, you now have grounds to question his fitness to fly that day.

It's not the mental strain that causes problems; it's how we react to it.

ADDENDUM: In light of discoveries in the Germanwings crash, expect heightened awareness and new procedures, especially for the countries that do not call for two-person integrity on the flight deck. There may also be tighter connections between health care providers (especially those who prescribe medications) and certain government agencies.

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Answer from John Chesire, 40 years of aviation experience, including 20 as a Naval Aviator and combat fighter pilot, and 20 as a commercial major airline pilot.

While pilots are only human and subject to "mental health demands" as anyone, they are a unique subset of the population. Both the military and the airlines subject their candidates to psychological testing before they are allowed to fly. Furthermore, given the stringent demands of the profession, any unusual behavior suggesting a mental health problem would immediately send alarms to their crew, co-workers, and supervisors and would be immediately investigated.

The demands of the flying profession may be more difficult and stressful than most. However pilots tend to love flying, and fit perfectly despite any additional stress.

In my 40 years of both military and commercial aviation, I know personally of only one pilot who had some mental health issues and had to be precluded from further flying duties. I have read or heard of only a few others. It may happen, but it is extremely rare.

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Answer from Tom Farrier, retired U.S. Air Force command pilot; current aviation safety contractor for the government.

Headline: Everyone has pressure in their lives, but hardly anybody handles it by driving across a double yellow line. Pilots are no different.

(Want an excruciating level of philosophizing and amplification on this theme? Read on.)

There are a few other responses on this thread as I write mine, and I'd suggest anyone really interested in this subject check them out. However, from the variety of directions they've taken toward answering, it's easy to see that the very notion of demands on a pilot's "mental health" can be interpreted differently by different people. So, I'm going to take a stab at this issue (from an aviation safety professional's perspective) that might look a little different than the other takes to date.

About 15 years ago, Dr. Tracy Dillinger, formerly of the U.S. Air Force Safety Center, wrote a pretty accessible overview article on "pilot personality" that's worth a look, both for the way she synthesizes a lot of the literature and for its list of references: see Page on dlielc.edu. If you look at both this article and the original question as elaborated upon, you can see three distinct aspects of the issue: training, job-related stressors, and coping. However, the contribution of what might be broadly referred to as "mental health" to each of these areas is a lot tougher to pin down. In my opinion, this is partly because pilots are human beings subject to the same ups and downs as anyone else, and partly because there is a small wedge of society who consider pilots a little weird for doing what they do in the first place.

The training piece is relatively easy to address and then move on from. Pilot training is stressful for some more than others because it requires an individual to go beyond the terrestrial, 3 miles-per-hour hard-wiring of evolution to work MUCH faster and in three dimensions. Some people can make the jump; others can't, and still others select themselves out of flying simply because they find it scary hard work that intellectually is within their grasp, but emotionally is just too difficult to deal with on a recurring basis. So, simply becoming a pilot involves being successful at what comes down to intellect-based risk-taking, using knowledge to minimize risks associated with the activity and deal with the natural apprehension that sometimes accompanies what can be a somewhat unnatural activity.

Job-related stressors on commercial pilots fall into several categories. Some have analogues to those in any work environment, while others are unique to flying. Lots of pilot jobs these days tend to be quite low-paying at the entry level, especially when the physical demands of long hours and constant exposure to on-board aircraft environment (dry, lower-pressure air, etc.) are taken into consideration. They also often require pilots to go out-of-pocket to get adequate rest; they don't necessarily provide opportunities for rest or meal breaks during the day; and, they frequently drive newer pilots to travel significant distances to start and end their work cycles simply because the cost of living of major airline markets often is out of newer pilots' reach.

These factors are part of the lifestyle and the career; how well individuals handle them and are affected by them is a function of the "coping" dimension of the overall "mental health" equation. By and large, I've found people who fly tend to love life--whether naturally an introvert or an extrovert, flying is a pleasurable activity that offers the opportunity for self-expression, stress relief, or just the chance to be really good at something many people can't do. Some pilots have outsized egos; others are outwardly humble, but really feel pretty good about themselves. (Tom Wolfe makes a funny and painfully accurate observation about this type, wearing a big watch and standing quietly off to the side, in his book The Right Stuff.)

So, what happens to a control freak who starts to leak around the edges? Dr. Frank Dully, a former Naval flight surgeon who Tracy Dillinger cites in her article and whose work I greatly respect, coined the term "failing aviator" many years ago to describe somebody with what might be considered a typical "pilot personality" who for various reasons starts to become at-risk. (Tracy suggests an intermediate stage she calls a "distressed aviator" as a precursor to full-blown "failing.") In any event, if "mental health" is considered a function of one's ability to appropriately manage various aspects of one's life, a failing or distressed aviator is just somebody in a particular occupation who might--or might not--follow a somewhat predictable path when it becomes difficult to handle otherwise normal life events.

The way I've internalized this concept is to look at it as applying to somebody who's high-functioning, but by virtue of the demands of a pilot's normal workload and stressors finds himself or herself under pressure not normally experienced by others. This can be in part because they are working from a routine baseline of greater than average stress simply by having adapted to the mental rigors associated with regular flight. In my experience, "coping" becomes a problem for pilots, air traffic controllers and similarly highly skilled professionals with challenging, task-driven jobs when the various compartments into which they like to keep the different parts of their lives (daily personal routine, family life, work performance) start to leak into each other.

A common thread among many who fly for a living seems to be an ability to focus on the task at hand while setting aside other aspects of their lives (e.g., relationship issues, money concerns, etc.). Flying tends to be an immersive activity demanding a great deal of attention to do properly and safely. At the same time, pilots are not always good at introspection, so they don't always catch themselves losing focus. Their supervisors also tend to be pilots, and may find it difficult to approach another about performance or behavioral problems they might observe that don't have a direct bearing on how well an aircraft is guided from Point A to Point B on a daily basis.

Sometimes when pilots find themselves starting to fail they may turn to the same kinds of compensatory behaviors as anyone else--substance abuse, running up debt, etc. Airlines and pilot unions have long known of such possibilities and have created safety nets that allow individuals in such positions to self-identify and seek help without the fear of losing their jobs for doing so. While few would be likely to refer to these as "mental health" related programs in so many words, that's their effect.

To me, the bottom line is that stress is stress, and human are humans. Different jobs bring different stressors; the aviation industry as a whole has a lot of experience with theirs, and has institutionalized a number of protocols for trying to relieve them. Can more be done? Sure. Is the monitoring of individual pilots optimum in every company? Probably not, but there's little agreement on precisely what symptoms or markers should be considered warning signs of a need for intervention.

It'd probably be impractical to even consider much beyond what's already been recognized as necessary and appropriate at an industry level. Pilots represent a major investment on the part of every aviation-related concern; they're generally recognized and protected as valuable resources (even though they're sometimes pushed awfully hard by the pursuit of profit).

You'll notice I haven't referred to current events in my answer. I'm not going to, either. At their core, pilots are people, and individual motivations simply can't always be understood no matter how much others might try to "explain" them. Rational people like to assume that even irrational acts can be dissected and understood; for my part, even a written manifesto purporting to justify a given course of action is self-serving and therefore not to be trusted, if it isn't obviously a product of self-delusion as well.

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Answer from Paul Mulwitz, eight years in the regular USAF.

Pilots need to be mentally stable. This is most important when something goes wrong and the pilot needs to stay cool and deal with the problem. The worst thing a pilot can do when faced with a problem is panic. Panic kills.

I don't know how to answer the question of how much mental capacity a pilot needs. There are many things which must be learned and skills demonstrated to get any pilot's license. Even the licenses with the lowest privilege levels are a challenge to obtain. There are a lot of different areas which must be mastered or at least learned well enough to pass all the tests. These include such diverse subjects as weather, engine design, weight and balance, navigation, regulations (well at least a portion of the thousands of FAA regulations). Those are just the "ground school" issues. Then the potential pilot must learn how to actually fly airplanes or some other kind of aircraft. This takes a lot of skill in terms of hand-eye coordination and practice along with some basic knowledge of how the whole aircraft works. All of this is a lot like learning to drive a car or truck but with everything amplified by the three dimensional nature of flight and the fact you can't just pull over and stop if something goes wrong.

In the case of airline pilots or most commercial pilots they must also master all the incredible complications of instrument flight. Private pilots can also obtain an instrument rating. This is the hardest activity for any pilot. It includes the issues of flying a fast moving aircraft without being able to see anything beyond the instrument panel. The pilot must also be able to find his destination without being able to see outside the aircraft. On top of all that there is an endless list of regulations and procedures required to get along with the government using the National Airspace System under Instrument Flight Rules.

There are no obvious requirements for civilian pilots to pass any mental health screenings. It is different for military pilots, but they sometimes are in control of the world's deadliest weapon systems along with the aircraft they fly.

I am at a complete loss to answer the final part of this question--how pilots cope with the mental requirements. I suppose this is really more of a personality question than anything else. Pilots are people who like to be in control of everything around them and accept the responsibility of that control--even when it includes the lives of other people or a whole lot of other people. I guess each pilot must learn to deal with this responsibility in his own way.

I suspect this question arises now when we have an example of a qualified pilot who decided to hijack his own airliner and kill himself and all aboard by flying into a very solid object. I will say that this is a very rare event. Beyond that I have no clue how such an event happens or how it could be prevented if that is even possible.

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