Fear of driving?: “Behind amaxophobia there is anxiety and an obsessive profile that can be treated”

Getting behind the wheel is not equally easy for everyone.

Oliver Thansan
Oliver Thansan
14 May 2024 Tuesday 10:21
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Fear of driving?: “Behind amaxophobia there is anxiety and an obsessive profile that can be treated”

Getting behind the wheel is not equally easy for everyone. Nervousness, catastrophic thoughts, tachycardia, dizziness or blurred vision are some of the symptoms presented by people with amaxophobia, that is, the excessive, persistent and irrational fear of driving. “They need to stop and get out of the car,” says psychologist Montse Costa, an expert in phobias and founder of the Psicoavanza clinic in Barcelona.

The causes that can cause its appearance are very varied and, far from what one might think, post-traumatic stress after an accident is the least common and most “simple” to manage. The real problem comes when the origin of the fear is found in a psychological aspect of the person who suffers from it. When drawing up the patient's profile, Costa points out that “behind amaxophobia, there is anxiety and an obsessive profile.”

In his words, “any phobia limits life.” Aspects of daily life become clouded by the presence of an idea, a constant and highly disabling “belief”: an obsession. Driving to work can become an odyssey, while some don't even get their license. This is a fear that affects one in four drivers and to which women are more prone. Of course, what many do not know is that the majority of people who start treatment, overcome it. We spoke with psychologist Montse Costa to find out what is hidden behind amaxophobia.

How does someone start to feel amaxophobia?

There are many causes, very varied, and each case must be looked at separately. However, what usually happens is that there are people who carry very high levels of anxiety with them every day. It is the case that, although driving on the highway is relaxing, precisely by being relaxed, your body thinks “this is not normal.” Then, anxiety is activated again. They feel that their heart is going faster, that they tremble and are scared. When they get scared, they tell their brain “danger” and anxiety grows. So, with these sensations and at 100 km/h on the highway, they think they are going to kill themselves. At that moment, they manage to stop, but they become afraid that it will happen to them again.

What aspects of driving scare you the most?

Above all, they are afraid of driving on the highway because they associate it with speed. Actually, it is the safest thing, but they think they have to run; when the truth is that they can go 60 km/h. Then, there are also those who are afraid of going through tunnels, because they feel there is no escape, or of bridges, since they believe they are going to fall.

What are the symptoms that patients present?

Those typical of anxiety: they feel that their heart is beating quickly, pressure in their chest, tremors, dizziness, a feeling of suffocation or blurred vision... They feel that they do not have control of the car and they panic.

Do you think it is a taboo topic in our society?

Yes, my patients tell me that people laugh when they talk about their fear of driving. “What are you afraid of? "If you've been doing it your whole life!" they tell them. The problem is not that amaxophobia itself is taboo, but that phobias in general are not understood. They don't understand that you are afraid of things that, in reality, are not dangerous. That's why it is called a phobia.

I had a girl as a patient who was a police officer and didn't dare tell her colleagues. “You're not going to believe it,” she told me. She did everything and more, she was a cop, but she always asked them to drive.

From what he says, many of his patients have a driver's license. What about those who fail to pass the practical exam?

There are patients who are afraid even before starting and become very nervous doing the practices. They are already more perfectionist profiles, who put a lot of pressure on themselves to do well and, if they have a bad experience, it feeds back the idea that they cannot do it. They are becoming more and more nervous and it is getting worse, so that there are many who do not manage to get their license.

In the event that amaxophobia is triggered by a traumatic situation, what steps should that person take to drive again?

The first thing is to work on the trauma. “Trauma” means that, when the patient remembers it, he feels the same discomfort as then. It doesn't matter if the accident was six months ago. He revives it.

To do this, a therapy called EMDR is done, through which the patient tries to process it. Furthermore, in therapy we do visualizations in imagination in a relaxing way so that the patient sees himself driving in a natural and calm way; Then, we get into virtual reality and the next thing is the real exhibition. You have to keep in mind that the phobia requires you to make it easy for yourself. When you enter the stimulus that scares you, do it little by little, without pressure and with continuity.

And when the origin is anxiety, is the process the same?

No. If it is due to trauma, it is easier for that person to drive again. When it comes to an obsession, it's much harder.

In this case, the first thing is to focus on the basic idea. The one that tells you things like, for example, that while driving on the highway something is going to happen to you. Then, you have to work on the obsessive idea when it comes. The problem is that, at that moment, the patient is driving and it is difficult to manage. What we do then is a prior training based on the fact that it is a false idea. Your mind tricks you and makes you feel anxious, in response to a danger that does not exist. Therefore, through acceptance exercises and knowledge of bodily sensations, we try to stop the patient from fearing the symptoms. He has to know that this situation is going to generate anxiety, but that the anxiety is going to go away.

In your office you perform exercises with virtual reality. How does it help in these cases?

It is very favorable that they see themselves driving. With virtual reality, if they are afraid of going through a tunnel, you can leave them there as long as you want. Furthermore, if the patient connects with the discomfort while in virtual reality, we can work on anxiety in situ, in the office.

How can family members, friends or partners of people with amaxophobia help?

It's difficult because just talking is not going to do anything. The best way to help is when driving. For example, if my partner is afraid of going on the highway, then I should drive on the highway; but little by little, so that you see the ease of going to the right and slowly. If we can get him to see it as something easy, it will be a great help.

Are there cases of people who have overcome it?

Yes, of course, most overcome it. But, like everything in life, you have to work for it. Think that fears live there, in the unconscious, and the human being is made in such a way that if we could rationally remove them all, we would die from real danger.

Sometimes, when there is a trauma involved, in three or four sessions they are back to driving. In the case of obsessive profiles, it is more complex and depends on the patient's determination, but yes, it can also be overcome.