A fear of driving may come about for many reasons.
Some people who have been in an accident fear that they will be in another one. Even if they have driven for 20 years without incident, it’s easy to wipe out the safe memories of driving and replace them all with one bad experience. When this happens, even thinking about getting in a car cues the accident memories, and it may lead to thoughts of driving becoming almost as frightening as driving itself.
Others fear that they will have a panic attack or other panic symptoms while driving. With that often comes the erroneous belief that a panic attack is dangerous and that it will cause you to either lose control, go “crazy,” or pass out. If this were to happen, the consequences could be severe, so the typical thought is that it is best not to drive so that this will not happen.
People may also fear harming others, and they will avoid driving so that they will not be the cause of someone being hurt. And some people may have a significant fear of getting lost, so they stop driving because they don’t want to get themselves or their passengers lost. Even if it is just in their neighborhood, over a route they’ve traveled hundreds of times while someone else was driving, they may fear that they might forget where to go.
When it comes to a specific phobia, like open spaces or heights, it doesn’t matter what you do not fear. You may be a mountain climber who fears driving in vast areas. You may be a pilot who fears driving over bridges. Reasons for having phobias often don’t make logical sense, even though they appear to make a great deal of emotional sense to the person experiencing the fear.
Good treatment is available for phobias, and it’s called exposure and response prevention (ERP) therapy. In ERP, a fear hierarchy is created – a list that ranks feared situations from least to most feared.
A therapist works with the patient on slowly doing the tasks (exposures) on the list, while also encouraging the patient to not engage in coping strategies (avoidance or seeking reassurance). Some of the tasks were easier than others.
A hierarchy that I have used with a patient who had been in a car accident looked like this:
Ultimately, it was important to accomplish the following:
You may learn your fear after just one experience, but it will usually take numerous experiences to replace your fear with adaptive coping behaviors.
Patrick B. McGrath, PhD, is Director, Center for Anxiety and Obsessive Compulsive Disorders, Alexian Brothers Behavioral Health Hospital,  Hoffman Estates, Illinois, and author of The OCD Answer Book (Sourcebooks, Inc.; December 1, 2007).