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What is Driving Phobia?

Driving Phobia is an anxiety disorder that can emerge following exposure to a serious injury.

 

Injury experiences can lead to increased apprehension or worry that another accident or injury is likely to happen. When the anxiety or fear associated with driving causes a person to avoid driving, it is possible that the person has developed a Driving Phobia. Traffic accidents are the most common cause of Driving Phobia. It is estimated that approximately 1 in 10 individuals who have been in a serious motor vehicle crash might develop symptoms of Driving Phobia.

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The Diagnosis of Driving Phobia

A diagnosis of Driving Phobia is typically made on the basis of a clinical interview conducted by a trained health or mental health professional.

During the clinical interview, the health or mental health professional will enquire about the types of symptoms the individual might be experiencing, how these symptoms might be impacting on the individual’s life, and how long the symptoms have been present. The health or mental health professional will be particularly interested in how the individual’s symptoms of anxiety or fear might be interfering with participation in important activities of daily living.

The Symptoms of Driving Phobia

Fear of Driving

Fear is the dominant symptom of Driving Phobia. Several different types of fears might be experienced by the person with a Driving Phobia. The person might be fearful of having another accident, being injured, or injuring someone else. Frequently, driving phobia will also be associated with a fear of being negatively evaluated by others, particularly in relation to one’s driving ability. Even the anticipation of driving is sufficient to elicit high levels of fear in individuals with Driving Phobia. Some of the symptoms experienced in the anticipation of driving, or actual driving might include trembling, sweating, racing heartbeat, chest pain, nausea, dizziness, dry mouth or feeling faint.

Fear of Loss of Control

Individuals with Driving Phobia often report being fearful of ‘losing control’ while driving. They worry that in a driving situation, they might be distracted, make an error in judgment or lose control of the vehicle. They might also fear that they will not be able to control their emotional reactions to stressful driving situations.

Avoidance

Individuals attempt to deal with fear by avoiding the object of their fear.  An effective way of reducing one’s fear of flying is to avoid flying. Similarly, an effective way of reducing one’s fear of driving is to avoid driving. While avoidance can lead to short-term reduction in fear, it also contributes to the perpetuation of driving fears. Avoidance actually makes fear grow stronger.

Believing in the Dangers of Driving

By definition, a phobia is considered to be an irrational fear. For example, fears such as the fear of flying, fear of heights or fear of seeing blood are considered irrational fears because the probability of the occurrence of negative consequences is quite low. In all likelihood, the person with a fear of flying or a fear of heights has never been in a plane crash or fallen from the top of building. However, the person with Driving Phobia has experienced a motor vehicle accident. Since the person with a Driving Phobia has ‘proof’ of the dangers of driving, he or she might consider the fear and avoidance of driving to be quite rational. Thinking of one’s fear as a rational fear can make the problem more resistant to change.

Duration of Symptoms

Typically, the symptoms of Driving Phobia appear shortly following an accident or injury. After a serious motor vehicle crash, most individual will experience some degree of anxiety while driving or being a passenger in a motor vehicle. For the majority of individuals, driving-related fears will be temporary. For others, the symptoms of Driving Phobia might persist for a longer period of time. The symptoms of Driving Phobia rarely subside on their own. If symptoms of Driving Phobia have persisted for more than a few weeks, it is recommended that the person consult a primary care physician or mental health professional.

Disability associated with Driving Phobia

The avoidance of driving can lead to significant disability if the individual needs to drive (or ride in a motor vehicle) in order to participate in important activities of daily life. For example, if a person must drive to work, drive to the grocery store, or drive children to school, a Driving Phobia could have a very negative impact on the person’s life. In some cases, Driving Phobia can contribute to work disability. Prolonged work absence can complicate the recovery process as a result of stresses brought about by loss of independence and the loss of financial security.

Other problems associated with Driving Phobia

There are a number of additional health or mental health problems that can co-occur with Driving Phobia. Individuals who have been diagnosed with Driving Phobia often report experiencing other fears such as fear of open spaces or fears of being confined. Individuals who have been diagnosed with Driving Phobia often report symptoms of panic as well. They might also experience problems with alcohol or drug abuse. The presence of these additional problems can slow the pace of recovery of Driving Phobia.

The Treatment of Driving Phobia

A number of treatments have been developed to manage the symptoms of driving phobia.

Some of the more common treatments include:

  • Exposure-Based Treatments
  • Cognitive-Behaviour Therapy
  • Other Forms of Psychotherapy
  • Anxiolytic Medication

Psychological interventions are considered the treatment of choice for Driving Phobia. At times, psychological interventions might be complimented by pharmacological treatment designed to reduce the severity of anxiety. Driving Phobia is considered to be one of the most treatable of the anxiety disorders.

Psychological Interventions

Most psychological treatments for Driving Phobia share in common the use of some form of ‘exposure’ as a technique to reduce the severity of anxiety and encourage resumption of driving.

Exposure-Based Treatments

There is general consensus in the field of psychotherapy that interventions that include some form of exposure will yield the most positive outcomes for individuals with Driving Phobia. Exposure-based techniques might be incorporated in a behavior therapy program or a cognitive-behaviour therapy program for Driving Phobia.

As the term suggests, exposure-based treatments involve exposing the person to driving. Many exposure-based treatments for Driving Phobia will use a ‘gradual’ approach to exposure. In the initial sessions, the person might be exposed to photographs of motor vehicles, video films depicting motor vehicles, or might be asked to imagine being in a motor vehicle. As treatment progresses, the person is exposed to situations that resemble more and more of the actual feared situation, such as sitting in a stationary vehicle, riding as a passenger in a vehicle, and finally, actually driving a vehicle. At times, a driving instructor might be used to facilitate exposure to actual driving situations. In recent years, virtual reality technology has been used increasingly as a tool for exposure.

Cognitive-Behaviour Therapy

Cognitive-Behaviour Therapy, or CBT has also been used for the treatment of Driving Phobia. This type of treatment proceeds from the view that the symptoms of Driving Phobia might persist as a result of inaccurate beliefs or unrealistic negative expectations the person might have about the dangers of driving. The therapist might guide the client in developing more realistic or less alarmist beliefs about driving. These ‘cognitive’ techniques will typically be used in combination with exposure-based techniques.

Other Forms of Psychotherapy

Supportive psychotherapy and hypnotherapy are sometimes also used in the treatment of Driving Phobia. In supportive psychotherapy, a client might be guided in ways to manage his or her emotional reactions to the stresses of driving. In hypnotherapy, a hypnotic trance might be used as a means of ‘imagining’ exposure to driving-related situations. It appears that any treatment that uses some form of exposure can yield positive benefits for the client with Driving Phobia.  When the treatment does not include some form of exposure, while it might be possible to reduce the severity of anxiety, driving avoidance tends to persist.

Barriers to Treatment

Driving Phobia is one the few mental health conditions where an individual must actually face his or her fears in order to access treatment. In many cases, an individual will either need to drive or be driven to the clinic where treatment is being provided. If the driving phobia is severe, the individual’s avoidance of driving or being in a motor vehicle might actually become a barrier to accessing treatment. Any barrier to engaging fully in treatment will reduce the potential benefits of treatment.  A client should address potential barriers to treatment with his or her psychotherapist so that potential solutions can be discussed.

Pharmacological Interventions

There are no medications that have been designed specifically to treat the symptoms of Driving Phobia. However, there are occasions where a clinician might consider combining an exposure-based treatment with medication to reduce anxiety.

Anxiolytic Medication

Anxiolytic is the term that is used to describe medication designed to reduce the severity of symptoms of anxiety. A type of anxiolytic referred to as ‘benzodiapines’ are sometimes prescribed for individuals with Driving Phobia. These might include drugs such as alprazolam, clonazepam, diazepam, and lorazepam. Clinical research suggests that these medications should not be used for more than a few weeks. Although these drugs are effective in reducing anxiety, the danger of addiction is high. As well, these drugs can cause side effects such as dizziness, drowsiness or mental clouding that can compromise safety while driving. The research that as been conducted to date suggests that using anxiolytics in combination with exposure-based treatments does not yield superior outcomes to using exposure-based treatments on their own.

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