thanks for your interest in some deep explanation of "boomerangs" and "rouge
pilots" (interesting lapsus Tony, :), not freudism neither sexism here ;).
Since there are so many interested in Belgrade paper, it's easier for me
mail the docuemnts to the forum. But first let me comment on Doug and Graham
posts:
Doug said: "The personality angle weakens the argument that roguism is
treatable, and strengthens the 'get rid of them' school of thought. However,
career-threatening testing/profiling will not be popular."
I maintainted and wrote this position 12 years ago in my first book
"Systemic Aeronatical Psiquiatry" (NASA Technical Memorandum 77816), but
also coincide with Graham (and Dan Mourino) "I think that the rogue
individuals fall in this category (system failure) so the true problem must
lie in recruitment and / or training."
That is the problem solving issue with rogue pilots: recruitment and/or
training.
In both cases you must have a theoretical framework to orient yourself to
make decisions.
Safety is not jeopardized by the 95% of pilots who buy CRM, but by the rogue
5% (and others), CRM reluctant or rafractary.
But why are they reluctant or refractary?, is it enough with acrostics and
self check lists?, how many seminars and loft sessions are needed to change
their dangerous behavior? CRM is the best context to self examine and
insight, but have these individuals enought insight capacity? Has peer
presure demonstrate efficiency to deal with them?
When you are in front of a characteropathic individual, you are dealing with
a person unable to make any insight. They believe that they are the "best
pilots they ever saw" (remember The Right Stuff and the Chuck Yeager
Syndrome?, also Maverik's Top Gun Syndrome)...
Hard data: In the periode 1970-1990 we had 24 accidents with pasangers more
than 6,000 pounds ACFTs, 18 of them with a conspicuous rogue pilot in
charge. The other 6 also human factors, but spanning from corporate presure
to insufficient training.
The 18 fall in the category or "aeronautical characteropathies" I explain in
the paper attached.
Hope this trigger more discussion in this very interesting and
multidisciplinary forum.
Greetings from Buenos Aires
Hugo
Hugo Oscar Leimann Patt, MD, PhD
Argentine Aviation Authority and Air Force CRM Developer
Tronador 1515
(1430) Buenos Aires
Argentina
Tel/Fax (541)552-4266
hleimann_at_houseware.com.ar
http://www.houseware.com.ar/users/hf_crm
PS: Have also a psychological categorization of stewardesses, inspired also
in mythological Wagner Walkirias, Greeg Amazones and so on, but I'm affraid
some one will charge me as "sexist" :)
2ºPS:
Incidence of The Right and Wrong Stuff in Civil Aviation Accidents.
HUGO OSCAR. LEIMANN PATT, M.D., PH.D.
ABSTRACT:
Aircrewmembers (ACMS) enter a mortally hostil environment when they take off
from Earth in their flying machines. Their physiological adaptation has
been augmented and supported through ergonomics, avionics, and engineering,
but no such technological aid helps them adapt their minds to that atypical
condition. They must rely upon their own psychic resources, i.e.
"aeronautical motivation" in the three levels of consciousness, and defense
mechanisms to counteract their "aeronautical anxiety." Various relationships
of motivation and defense give rise either to the flying adaptation syndrome
or the various forms of the secondary flying maladaptative syndrome when
ACMs must face the dangers of flight. These alterations of the ACMs'
psychic balance may cause temporory or permanent medical disqualification
due to the impairment of safety which they provoke. This paper propases an
analysis of the interplay between motivation, psychic defenses, and aviation
stress to expluin the manifestations of flight adaptation and maladaptative
seen in some aircrewmembers.
THE HUMAN BEING is neither genetically programmed nor psychophysiologically
conditioned for flying. Technological development has produced devices
which correct these human deficits, and make it possible for aircrewmembers
(ACMS) to reach the sky, the mythical home of gods and heroes, the image and
wish of the ancients that we all still keep in our unconscious. This
quantum environmental jump cannot be made without paying a
psychophysiological price.
FLYING ADAPTATION SYNDROME-"THE RIGHT STUFF"
Taking off from Earth in their flying machines. Submitting themselves to a
mortally hostile environment including hypoxia, dysbarisms (including sudden
and explosive decompressions), and spatial disorientation because of linear
and angular accelerations strange to the human semicircular canals and
otolithic organs; involves a physiological adaptation process which humans
would have never been able to carry out without the aid of technology,
avionics, and ergonomics. But as regards the human mind, no technologic aid
allows humans to adapt themselves to atypical conditions. Psychological
adaptation must come from within the ACMS; that is to say, they must create
it from their own "stuff."
As we know, every body heavier than the air will inexorably fall towards the
center of the Earth, unless it fulfills the terms of a formula which can be
simplified to Lift = [Speed x Wing Performance]/Weight.
By analogy, if ACMs want to "lift" themselves, and remain adjusted to flying
duties during all their active lives, meeting highly risky aviation
situations such as landing with marginal weather conditions, failures in the
machine's systems, hijacking, etc., they will also have to fulfill the terms
of an equation which could be stated as Flying Adaptation Syndrome (FAS) =
[M x DI/A, where M represents the "aeronautical motivation" which would have
its own characteristics and within which no inadequate, undesirable or
spurious elements should be present; D represents the "defense mechanisms"
which will have to be wielded by the ACM's ego to offset the third term of
the equation, A, the "aeronautical anxiety."
Aeronautical Motivation
Motivation is a mental force capable of directing drives and inducing
specific behaviors. Motivated behaviors are selective, active, and
persistent-they increase in intensity according to deprivation and they tend
to keel> internal balance and harmony with the environment.
At the conscious level, involving aspects known and accepted by the ACM
without hesitation as his/her own, motivation comes from the "pleasure," the
"joy of flying" with its deep unconscious roots (9), the feeling of being
free, the search for new sensations (some say, "Flying is like a drug"), and
the social usefulness of flight. Flying aiso represents a kind of challenge
to one's control of oneself; the expert psychophysiological performance of
an activit which does not allow many mistakes.
At the preconscious level, motivation involves aspects not overtly
professed but which can be recognized if the subject makes a real
introspective effort. Examples include the prestige linked to the
profession, the identification with heroic characters of aviation, the
supposed sexual success and secondary benefits of this profession, a need to
express aggressiveness extrapunitively, but inhibited by social standards
and the superego. The ACM may wish to be free of some social conventions:
aviation offers a freer atmosphere where supposedly everything is possible,
including the possibility of "escaping." Richard Bach says: "Would you like
to know a synonym for flying?: run away, escape" (2).
At the unconscious level, we can find the true motivational forces which
explain atypical behaviors, and aviation activity is atypical for human
beings. Jones and Perrien say that the prognosis of an ACM's
psycho-pathological maladjustment depends on the characteristics of
motivation, particularly the subconscious components (8).
Delineating this unknown "unconscious" can only be carried out through an
interpretive approach, taking into account not only the infantile
development of aeronautical motivation, but also every deep aspect of the
ACM's psychology and possible psychopathologic manifestations. Here we can
see the unconscious complex mechanisms ruled not by the "principle of
reality" (Aristotelian logic), but by the "principle of pleasure," which
resembles those magical relationships found in fairly tales and ancient
myths (mankind's fairy tales), which also help us to understand the ACM's
inner motivations. From ancient mythology, we can derive excellent
information about the human spirit. Oedipus is not the only archetype;
lcarus, Daedalus, Bellerophon, and Phaeton, as well as the Walkyries and
Amazons, give us analytical clues about the unconscious motivation of ACMs
(11, 12).
When the balance of the adapted ACM becomes unstable, "specific aeronautical
psychopathology" shows
the inner conflicting forces within the ACM's mind, which explain "normal"
behaviors as well as the
"abnormal" ones, the aviation behavioral maladjustments. Neurotic
"aeronautical motivational" components are also widely describes in the
literature. (3,5,6,8,15), from "counterphobic" components to latent suicidal
dynamics.
Defense Mechanisms
Healthy aeronautical motivation is as important to carrying out a successful
flying activity as adequate defense mechanisrns are to counteract
aeronautical anxiety.
Defense mechanisms are defined as operative resources, or coping skills,
used by the ego to maintain its bio-psychological integrity and psychosocial
integration. These operations are not always conscious; actually, the most
effective mechanisms are unconscious. These resources are generally used to
avoid endogenous anxiety but the ego also uses them throughout the
senso-perceptive process (16). The following mechanisms are:
Denial refers to the refusal to see a real potentially dangerous fact which
comes from the outer world; in aviation, the danger of death has to be denied.
Repression or suppression derive from denial and consist of a more
(repression) or less (suppression) unconscious obliteration of inner drives
and aspects of outer reality, which could be very painful or blameful.
Everything repressed keeps its psychic force and eventually, when defenses
are down, it may appear in the conscious mind, producing the subsequent
worry. What the ACMs repress are all those improper elements of their
subconscious aeronautical motivation, which are so infantile as to be
unacceptable for their moralistic superegos.
Psychophysiological habituation is an essential characteristic of fliers who
have to learn consciously and willingly (later on unintentionally) to block
some of the proprioceptive inputs that stimulate their vestibular nuclei, as
well as other visual and vestibular senso-perceptive inputs. They must do
this to avoid incongruency within a perceptual field with other non-habitual
linear and angular accelerations. When this mechanism fails, the secondary
flying maladaptative syndrome takes the form of motion sickness.
Rationalization is also a typical defense of ACMs. it refers to the
preference for believing those statistics which say it is safer to travel by
plane than by car, even though they tend to feel exactly the opposite during
each instrument landing.
Identification is with the instructor, who lets the would-be-pilot enter
that magical world of aviation, teaches him the necessary manual techniques
to control an airplane, and is the student's model as a future pilot. The
student thus acquires characteristic traits, operative manners, and
attitudes similar to those of the flight instructor. Those are the reasons
why, if we want to keep these characteristics within the frame of what we
call "right stuff," the selection and instruction of instructors should be
as important as the selection and instruction of pilots.
There are four defense mechanisms, among others, whose consequences are
usually tragic when they are accentuated within ACMs' personalities. The
first leads to substandard operational behaviors, and the other three to
severe psychopathologic downfalls. In our formula they will be written "D."
Reaction formation refers to an activity or habit opposite to a wish or
feeling which has been repressed because it is perceived as undesirable.
Although this mechanism, as well as sublimation, is essential for a healthy
superego, it is not the same in the aviation environment. Reaction formation
is seen in some civilian "hot pilots" who tend to show reckless operational
behavior in order to compensate for their unconscious fears or social
resentment; thus, they become "accident-prone" pilots.
Evasion is one of the most usual mechanisms among cabin crews who use
flying to avoid responsibilities as well as everyday boredom. In time,
evasion becomes inadequate or useless, and the subject may suffer a severe
breakdown (I have been aware of eight suicides).
Displacement and isolation redirect the feelings originally aimed at a
certain object or person toward another, who is perceived as less
threatening. Selection criteria should be based not only on the lack of
mental disease but, preventively, on the detection of the best psychological
conditions (motivation and defenses), in order to bear the subsequent
aeronautical anxiety which is sure to come in an active flying career.
Aeronautical Anxiety
As we already know, flying is dangerous. The danger is both real and
symbolic, generating fears and anxiety (9). Fear is an emotional
manifestation, generally related to neurovegetative manifestations as a
consequence of a real and outer danger. Fear is healthy and performs a kind
of adaptive function telling the subject where a physical or psychic danger
is (of course, seeing a situation as dangerous is mainly subjective).
On the contrary, anxiety has a mysterious, subconscious origin; thus, it may
alter the personality because the ego does not know who and where its
opponent is. Anxiety is provoked by the unconscious stimulation of early
normal fears inherent in the subject's childhood. Aeronautical anxiety is
the algebraic sum of fear, anxiety, and environmental stress.
SECONDARY FLYING MALADAPTATIVE SYNDROME: 'THE WRONG STUFF'
Modern manuals and books about aviation medicine usually use the DSM-III-R
(8) classification of mental disorders. But in the aviation milieu there
are mild psychopathologies which make one fit for flying, and there are
"normal" personalities not suitable for flying. Besides, medical-legal
difficulties arise because a specific aeronautical psychopathological
classification is lacking. These maladjustment syndromes are particular to
aviation because they are generally attributable to the service, or because
they represent potentially morbid conditions which may jeopardize flying
safety. These syndromes may be disqualifying for flying, but they are not
listed in the DSM-III-R.
>From a systemic point of view (10,11), humans in general, and ACMs in
particular, are bio-psycho-social entities. The following syndromes are
presents in the three areas mentioned above even though their main
manifestation is in just one of them.
In the following equations, remember that M = aeronautical motivation, D =
defense mechanisms, and A = aeronautical anxiety; quotation marks = neurotic
rather than healthy drives (i.e., "M", "D"). Up and down arrows denote,
respectively, increases and decreases in these factors.
Fear of Flying - M x D
A ^ (meaning ^up and ! down)
This is the most frequent syndrome. Usually it is not incapacitating for
flying activities, unless it becomes unusually severe.
In this syndrome, there is increased anxiety or uneasiness plus a sensation
of insecurity under some flying undetected preexisting disorders, or recent
life changes with libidinal readaptation. Strongin (18) published an
excellent review of the uses and misuses of the expression and the
administrative problems caused when bureaucrats don't consider it an
aviation maladaptative syndrome, or a symptom without underlying illness (8).
Cabin crews are usually more affected by this syndrome than flight crews.
This happens partly because their selection does not always fulfill strictly
medical aeronautical criteria, and thus their motivation and the quality of
their defense mechanisms are not generally the best; their instruction about
emergencies (e.g., sudden decompression, hijacking) also is not enough; and,
finally, because they must frequently remain passive during aviation
emergencies. When a subject confesses a fear of flying to his examiner, he
or she is asking to be grounded for a short period of time. I think that,
whenever this happens, we have to accept his or her decision. lf not, the
subject may acquire a more severe and irreversible pathology.
Flight Phobia -- M x "D" !
A !
When the frightened ACM keeps on flying for a while, his/her defense system
may suffer some kind of damage needing to use latent second-line defense
mechanisms, and thus fear may change into phobia, particularly when those
not very adequate defense mechanisms-reaction formation, displacement, and
isolation-are included. Flight phobia occurs when flying or environmental
stresses debilitate denial and rationalization and when the unsuitable
defense mechanisms are strongly present. There is no flying phobia if these
elements are not present. That's why Davis (4) said of fear of flying:
"Early recognition and active therapy in preventing phobias would eliminate
the tremendous waste of time . . . because the nature of the condition was
not recognized. "
Sometimes, the phobia is partial and flight per se is not the phobic element
but only some types of aircraft or flights.
Chronic Flight Fatigue M! x D
A
Chronic flight fatigue is linked to aeronautical motivation by an inversely
proportional relation. Motivation deterioration may be dramatically shown
in the so called "get-home-itis," which is an important complication of
acute operational fatigue that, for example, may induce the pilot to land
with marginal weather or under minimums. "Get-home-itis," however, may have
other causal factors.
The causes for motivation loss range from the weakness of its own
components, especially the subconscious ones, to real problems with the
company, which I call "labor microtraumata": low wages, lack of professional
esteem, pilot's social and professional demotion, etc. All of these factors
gradually undermine the aeronautical motivation, and thus the subject becomes
Aeronautical Climacteric = M !! x D
A
When motivation is damaged to a great extent, the ACM does not want to fly
any more and seeks a medical or administrative way to be grounded. The
causes are similar to those mentioned above. Motivation loss is a medical
condition as incapacitating for flying duties as progressive deafness,
notwithstanding that it is difficult for general practitioners to assess.
Traumatic Aeroneurosis = M x D
A^^^
When an ACM suddenly faces a great increase of stress which cannot be
"metabolized," a suddenly traumatic aeroneurosis breaks out. Generally,
this is an accident, a serious incident, a hijacking, or some other major
trauma. Symptoms are not always immediate; generally, there is a latency
period (rumination) of up to 1 year, and sometimes there has to be another
event, even an insignificant one, to precipitate the latent neurosis.
The concept "psychic trauma" is completely relative, and depends on the
ACM's susceptibility. lts symptomatology is also variable and polymorphous.
A very important defense element is the active role of the subject during
the event. That is why captains are usually less affected by such events as
the rest of the crew. In hijackings, the opposite may occur (14).
Aeronautical Characteropathies = "M" x "D"
A
Character disturbances (personality disorders) may go unnoticed during the
selection examination and periodic exams, but they may become manifest when
flying. "Macho pilots" (paranoid characteropathy) are masters at freezing
other flight deck members into silence by their prepotent, overbearing
personalities, although most of them are excellent "stick and rudder" pilots.
To improve cockpit resource management and non-technical skills may become
both a cultural (17), and a psychotherapeutic problem (12). I agree with
Helmreich about the impossibility of teaching "old dogs new tricks," and we
may have to wait for time to eliminate the untrainable (7). "Bellerophon"
(aggressive-paranoid) and "Phaeton" (counter-phobic) characteropathies must
be eliminated during the selection process (12).
Substandard Operational Behavior = "M" x "D"!
A^
In confirmed, efficient, and trained pilots, SOB may be provoked by the
following psychological breakdowns: paroxismal emotional manifestations;
decompensated diffuse anxiety, fear, or panic; thymic disturbances; the
emergence of personal, psycho-affective, or working problems; temporary
disturbances in awareness, memory, or judgement leading to wrong decisions,
SOBs may also be caused by saturation due to overwork; personality problems,
psychopathic personalities, ego hypertrophy, excesive self-confidence;
emerging unconscious processes; self-punitive drives; death anguish; and, in
extremis, suicidal and pseudo-suicidal behaviors.
Alkov et al. (1), describe "pilot error" as inadequate stress coping. My
description is analogous, incorporating inner psychic dynamics into the
analysis, thus allowing experts in the civilian milieu, where there are no
flight surgeons in close relation with pilots and cabin crews, to act
earlier and preventively.
Neurotic motivation and defense mechanisms should be detected early by means
of informational feed-back between instructors and flight surgeons or
psychophysiological boards, in the frame of a systemic preventiva philosophy
applied to the aviation environment (10, 1 l). Later on, it is very
diffícult and painful to ground a pilot because he/she was wrongly accepted
into the aviation system.
Compulsive ACM = " M" ^ x "D"
A ^
Among those who confess that flying is a drug, and especially among those
who feel it but say nothing, there are those who just cannot stop flying.
Flying becomes a symptom; it is a means through which such ACMs keep their
personalities more or less adjusted. Obviously, this balance is very
unstable and depends on the satisfaction of the main defense mechanism,
evasion. This may also depend on the existence of conscious or unconscious
spurious motivation components, driving these people to fly even when they
are ill, thus jeopardizing safety and their own health.
Hyperdefensive Syndromes = M x D ^^^
A ^
These syndromes are characterized by an increased efficiency of defenses,
such as denial and suppression, so that the anxiety doesn't reach the
conscious, but is resolved at subcortical levels through somatization.
Thus, severa] psychosomatic disturbances appear, especially gastroduodenal,
muscular, cardiovascular and, particularly, motion sickness disturbances.
Psycho-pathologically, motion sickness disturbances are organoneurotic
symptoms, and are more likely to appear in obsessive and alexithymic
personalities in stressful environments (13).
Substance Abuse = M x D !!
A^
In Yeager's (20) and Wolfe's (19) books, one can easily see how lax
regulations were in regard to this matter. This has been reflected in the
nice but dangerous aphorism "8 hours between bottle and throttle," which is
insufficient, among other things, because it ignores hangover effects.
Gamma-Glutamyl-Transpeptidase (GGTP) dosage should be included in
psychophysioiogical examinations in order to confirm possible cases of
alcohol abuse. From a preventiva point of view, peer pressure must replace
the so-called "conspiracy of silence." Alcoholics'self complacency should
inspire our compassionate understanding during therapy but our firmness
during the psychopchysiological examinations.
Such self-complacency is clearly shown in laboratory investigations and
surveys, when pilots state that they have no subjective sensation of
deteriorated performance after alcohol ingestion, and also extends to other
drugs like marijuana (21,22).
I agree with Jones and Perrien: "Nothing excuses alcohol abuse. lt is
maladaptive behavior that may quickly become an addicting disease" (8).
Psychodynamically, it is a disbalance due to the increase of anxiety plus
the deterioration of a weak defense system.
CONCLUSION
The adapted ACM enjoys flying. Any change in that enjoyment, and the
subsequent consequences, is the product of a secondary flying disadaptation
syndrome imputable to flying service.
This may occur either because aeronautical psychic micro- or macro-traumata
eroded motivation or defensa and increased anxiety, or because the subject
enterad the aeronautical system by mistake under selection criteria not
based on aeronautical medicine and psychology scientific standards.
We must improve these standards, expanding the interpretative paradigm of
our aeromedical discipline:
"The criterion of authority is science's main foe," Virchow.
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