En español | At some point in their lives, up to 12.5 percent of Americans suffer from a phobia — an irrational fear that interferes with their lifestyle — according to the National Institute of Mental Health. One kind of fear that can seriously limit mobility is a driving phobia, which experts say can come in the form of a fear of bridges, tunnels, freeways or intersections, or just from being behind the wheel in general.
Michael Valentine, a counselor in New Rochelle, N.Y., and the creator of the Anxiety Path blog, helps clients with phobias, anxiety and other mental health issues. He says his compassion for his patients comes from having a serious phobia himself: For years Valentine suffered from bridge phobia, a condition that kept him essentially landlocked — restricted in where he could attend college, find employment and travel. He suffered panic attacks, a sensation he describes as an overwhelming sense of fear coupled with a rapid heartbeat and the loss of sensation in his hands and feet, until he started working with a therapist who helped him overcome his phobia.
"People suffer so much and I know it, I experienced it,” Valentine says. “We have to reach those people and we have to let them know they're not alone [and] that there is help.”
Older Americans who have found ways around their fears — a partner who drives, staying close to home, an on-demand car service — can find their phobia resurfacing later in life when, say, grandchildren move farther away or a companion can no longer be the designated driver.
Some nervousness about driving can be legitimate, especially as our skills decline with age. That's why it's imperative to discuss your driving concerns with your physician, who can refer you to a driving evaluation, occupational therapy or additional resources.
But if your fear isn't based on any physical issues or cognitive impairment, you can likely overcome it — with work. “The wonderful thing about phobias is that patients really respond very well to treatment,” says Patricia Marino, a psychologist at the Institute of Geriatric Psychiatry at Weill Cornell Medicine and New York-Presbyterian. The most effective treatment is exposure: quite literally, facing your fear (see tips below).
Many therapists are happy to get in the car with patients, to help them on the spot; some communities will send a police escort to accompany fearful drivers through a challenging situation such as a bridge or tunnel.
Edmund J. Bourne, a psychologist in California and Florida and the author of The Anxiety & Phobia Workbook, has advice for anyone hoping to overcome a driving phobia:
Expect it to be hard
"I always tell my clients that exposure is like taking on a job — it's not a recreational activity,” Bourne says. “You need to be willing to tolerate some discomfort, which is likely to come up.” That said, you can minimize the stress of the process by taking it slow.
Take baby steps
It's a misconception to assume that diving right in, or “flooding,” as it's called in therapy, is the most effective way to overcome a phobia. Instead, experts recommend approaching your fear in hierarchical steps. “It's important to break the phobia down into a series of incremental steps of exposure, to minimize the initial anxiety a person feels when they're first taking on something they may have been avoiding for a long time,” Bourne says. Whatever your phobia, start by simply writing down your hierarchy — an exercise that he calls “the heart of the procedure for doing exposures.” Maybe your first step is sitting in a car without even turning it on, before progressing to turning the key, driving down the block and so on. For a fear of bridges, your first step could be as simple as looking at pictures of bridges online.
Allow yourself coping strategies — to start
Bourne advocates jump-starting your exposure with coping measures, like bringing along a therapist or trusted friend, writing coping statements like “This will pass” and “These are just thoughts — not reality” on an index card and taping it to your dashboard, practicing deep abdominal breathing, and taking a break as needed. These tools are not meant to be used forever, though — just to get your toe in the water.
The more you practice, the sooner you'll overcome your phobia. “If you're willing to go out for an hour every day for five days a week, of course you're going to move much faster through your hierarchy than if you just go out one or two days a week,” Bourne says. He advises patients to practice anywhere from an hour to 90 minutes at a time. “The client really determines the rate of recovery based on how much practice they put in."
Don't give up
You will experience setbacks. But it's essential to get back to driving after 15 to 20 minutes of taking a break. “If you just go home, it reinforces the idea that you can't do it,” Bourne says. Instead, if you hit a rough spot, use your coping strategies — breathing, breaking, coping mantras and so on — then try again.
Be patient with yourself
It may take time. Bourne has had patients take two months to overcome a driving phobia, and others take two years. Everyone is different.
Expect to feel anxiety
You're supposed to feel anxiety when you're exposing yourself to something that scares you, Bourne explains. “If you weren't feeling anxiety, you wouldn't be habituating to anything,” he says.
Therapists who are skilled in CBT (cognitive behavioral therapy) and treating OCD (obsessive compulsive disorder) are well-trained to help patients tackle phobias. And while it can be challenging to find therapists who accept insurance, Medicare does cover therapy. There are also countless self-help books, like Bourne's and others. And many communities have support groups for all kinds of phobias. With millions of Americans dealing with phobias, remember above all else that you are not alone — and you do not have to feel stuck any longer.