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Situations that are hard to escape from are fertile ground for anxiety and panic to develop. Not surprisingly, driving is one of the most common situations that trigger panic. Bridges and tunnels, in particular, can be challenging since they present the possibility of getting stuck with no easy or safe escape route.
Many people with high anxiety about driving end up avoiding certain driving situations or will stop driving altogether. One of the most effective ways to treat driving-related panic and avoidance is cognitive-behavioral therapy (CBT), which includes facing the situations where the person is afraid of panicking.
I’ve treated many people for driving-related panic, which usually involves riding with them as a passenger while as they face their fears. The following six principles have emerged from that work.
1. Focus on the road ahead.
Driving-related anxiety often leads you to think ahead to the whole trip. You might map out the route in advance, checking for bridges along the way. As you drive, you might keep imagining the scariest parts ahead. It ends up being a lot to manage—not just the road right in front of you, but your entire drive.
None of us can manage a whole trip in our heads—we have to take the road as it comes. It’s true in life, and it’s true when we’re driving. But we can manage the piece of road we’re actually on, which is all we ever have to do. You don’t even have to drive across an entire bridge—you just have to cover the small stretch of bridge you’re on at that moment, and then the one after that, until the bridge becomes a regular road again.
It takes practice, of course, since the mind wants to jump ahead and make sure things will be okay. Focusing on sensory experiences can help to ground your attention in the present, like seeing the road in front of you and feeling your hands on the steering wheel.
2. Question catastrophic assumptions.
Panic can lead to believing that a disaster awaits you on the road, even if it’s never happened on all your previous drives. Our fear is good at threatening us that “next time it’s going to be really bad”—that you’ll panic and “go crazy” or “lose control.” And yet in every instance so far, your worst fears haven’t happened.
This is not to say that nothing you fear will happen. If you ride enough elevators, one could get stuck between floors. If you drive over bridges, one day there will be a traffic jam on the bridge. Traffic may come to a standstill when you’re in the middle of a long tunnel.
But none of these events is the true fear behind panic—it’s about what happens next. Our fear tells us that if we’re in these kinds of situation, the panic will cause something undeniably awful to happen. In reality, the most likely thing you’ll experience if panic gets really intense is, fear and panic.
By seeing through the “fake news” our minds tell us, we can stop letting it control our behavior. See this previous post for more on this topic: "The Secret Behind Panic (and How to Escape It)."
3. Dismiss emotional reasoning.
Sometimes our fears give us valuable information that helps us avoid danger. However, our fears can also be unfounded. A common thinking error when our anxiety is high is that feeling like I’m in danger is evidence that I’m in danger. The problem with this belief is that our minds and bodies are well-equipped to give us a false feeling of danger.
For example, I was once boarding a plane when I heard a violin piece by J. S. Bach that I had asked my wife to have played at my funeral. What are the odds that this piece happened to be playing as I boarded? I thought anxiously. It’s a bad omen—I shouldn’t get on this plane. I got on the plane anyway, and we landed without incident (as you may have guessed). My fear was just that—unfounded fear.
For many people, “feeling is believing,” says psychotherapist and former airline pilot Captain Tom Bunn, a recent guest on the Think Act Be podcast. “If I feel it, it has to be true.” He noted that people prone to panic tend to interpret physiological symptoms of anxiety as danger, whereas “some people enjoy the physiological arousal, like getting on a roller coaster.”
If you recognize emotional reasoning in yourself, start to question your assumptions about what fear means. It might simply mean that you’re afraid.
4. Beware of psychic equivalence
Most of the time we can tell the difference between what’s real and things we imagine. But when we’re intensely anxious, this distinction can dissolve—a process known as “psychic equivalence.”
“Under stress, you might default to believing that your mental experience represents perception,” said Bunn. “When people worry about having a panic attack, that can cause enough stress that they’re sure they’re going to have a panic attack. They forget that what’s in their mind is imagination.”
Intense fear can lead to a powerful form of emotional reasoning, in which the driving-related disasters you're afraid of feel like reality instead of fears. When you're relaxed you may know perfectly well that panic doesn't make you faint, for example, but might think you're on the verge of fainting when panic hits. In his treatment program, Bunn offers ways to calm the nervous system (based on Stephen Porges’s Polyvagal Theory) so it’s less likely to trigger psychic equivalence.
5. Eliminate avoidance
Every time we avoid what we’re afraid of, our brains learn that what we’re avoiding must be dangerous—otherwise, why would we avoid it? You can try to talk yourself down and reason with your fears, but nothing retrains the brain like direct experience. Confronting the situations that trigger anxiety is the most powerful way to teach your nervous system that it doesn’t have to sound the panic alarm. In CBT we call this approach “exposure.”
Sometimes avoidance can look like exposure, like always taking the “safer” bridge. But for many people, taking a safer route actually reinforces their fear, because they know they’re not facing a perceived danger. As the next section describes, it’s helpful to address these subtler forms of avoidance.
6. Drop safety behaviors as you are ready
The final step for most people in dealing with panic is to drop behaviors that are intended to prevent panic, or avoid a disaster if panic strikes. Common examples when driving include things like:
- Asking for reassurance about the possible consequences of panic on a bridge, even though they’ve been assured countless times that what they're afraid of almost certainly won’t happen
- Doing repetitive Internet searches on the possible consequences of panic while driving
- Checking traffic before getting on a bridge to make sure it’s not backed up
- Avoiding driving during rush hour so there’s less chance of getting stuck in traffic
- Previewing a new route to see if it includes bridges or tunnels
- Researching the bridges they’ll have to drive over on a new route
- Avoiding certain lanes on a bridge
- Driving too fast on a bridge to “get it over with” (ironically an un-safety behavior)
- Driving unnecessarily slowly because it feels safer
The problem with safety behaviors is that they give your brain the false impression that you would be unsafe without them. "Good thing you checked traffic," your brain tells you, "or that might have gone badly." As a result, you continue to feel that driving is extremely dangerous and must be closely managed so nothing terrible happens.
Beware of subtle safety behaviors like taking the long way around to avoid roads you find uncomfortable, while telling yourself you just prefer that alternate route. Our fear often likes to stay hidden while it directs our behavior.
When given the choice between avoiding a drive altogether and doing the drive with safety behaviors, I generally recommend the latter. Exposure therapy proceeds gradually from easier to more difficult situations, and tackling challenging roads with safety behaviors can be a necessary step toward greater driving freedom.
CBT for panic disorder includes additional techniques such as focusing on the breath and challenging one’s thoughts. If you’ve dealt with intense anxiety or panic attacks when driving, talk to your doctor or a mental health professional about effective ways to reduce your fear.
For additional ways to manage anxiety, see my free e-guide, “10 Ways to Manage Stress and Anxiety Every Day.”
References
Bunn, T. (2019). Panic free: The 10-day program to end panic, anxiety, and claustrophobia. Novato, CA: New World Library.
