Fear of driving

from Wikipedia, the free encyclopedia
Classification according to ICD-10
F40.2 Specific (isolated) phobias
ICD-10 online (WHO version 2019)

Driving fear , as Amaxophobie called, is the fear of the car or in front of the car driving in traffic. Drivers in particular suffer from this, and sometimes passengers too. The fear relates to threatening situations in traffic, for example on the motorway or when driving on unknown routes. Thoughts revolve around disaster, fear of causing an accident, injuring or killing others. When attempting to approach such situations despite their fear, those affected will react with severe physical symptoms. Therefore, they avoid the threatening situations. Finally, even very harmless situations, such as residential streets, are viewed with fear and driving is completely stopped.

Total avoidance leads to a loss of mobility, quality of life and self-confidence. These severe forms of fear of driving are also known as driving phobia and are to be regarded as illnesses with a corresponding need for therapy. From a scientific point of view, fear of driving is one of the specific fears (phobias), such as B. Spider fear. “The fears are primarily based on the dangers and threats emanating from the situations and objects, e.g. B. Fear of plane crashes, fear of injuries from dogs, fear of accidents in the case of car driving phobias. "

Afraid of the car, afraid of driving

Driving fear can relate to both the car itself and driving it, so appear as:

  • Fear of the car as an unpredictable machine that is difficult to see through and to control and does what it wants - suddenly stalls, brakes sharply, races away or skids. Those affected fear that it is not they who drive the car, but the car that drives them. According to her nightmare, accidents could occur in the wake of the uncontrollable driving maneuvers.
  • Fear of driving a car in threatening situations, for example in dense, fast city traffic, on urban motorways, federal highways outside of towns with a lot of traffic, driving on unknown routes, in bad weather or at night. Those affected feel pressured in the flow of traffic and overwhelmed by a lot of information. You feel rushed and depressed, feel the compulsion to make a decision and at the same time feel helpless. In the hustle and bustle, they fear losing the overview, making more or less random and then perhaps wrong decisions, getting into an accident situation.

This creates severe stress, followed by severe physical symptoms. Subsequently, such places are fearfully avoided more and more often. The Würzburg psychologist G. Alpers and colleagues in the USA examined female car driving phobics and control subjects while driving on the autobahn. The cortisol level was determined before and during the journeys. Together with adrenaline, cortisol is a classic stress hormone. Result: The cortisol level of the phobic women initially behaved as in the control group. About an hour before the trip, it rose, stayed high, but then sagged as the highway journey progressed. Alpers speaks of a "anticipatory fear".

Anyone who is afraid of driving is limiting their driving more and more, to the point of complete avoidance. Avoidance increases fear - a vicious circle develops. Those affected are not only afraid of the real situation (driving a car in heavy traffic or even only in residential streets), but also of the tormenting effects of their own fear (“fear of fear”). Since those affected are often not understood by those around them, they withdraw and keep silent about their condition.

Driving fear as unspecific fear

In addition to the specific fear of driving, there are also general, unspecific fears that are less related to objects or situations when driving a car. The car or driving in traffic exists as a background or stage for general fears. Such general, unspecific fears affect not only driving and its safety, but life as a whole (family, work, leisure). These fears have a serious impact on the well-being of those affected and their quality of life. Therefore, they usually have to be treated therapeutically.

Driving a car is particularly suitable as a stage or as a trigger for such fears and it really intensifies them. Factors triggering fears when driving a car can be: the tightness in the car, the density of traffic, high speed, the pressure of having to make quick, error-free decisions with potentially serious consequences under the supervision of others, jostling, dangerous routing or weather and that in general Risk of accident.

The unspecific driving fears include:

  • Social fear of driving or social anxiety , including fear of exams , fear of passengers or drivers or other road users. It is the fear of socially stressful situations in traffic, e.g. B. through critical remarks by others, angry looks, disparaging gestures, horns. People with social fear or social fear of driving react to such events exaggerated, they flinch, are guilty and despair when someone honks their horn. They try to avoid such situations or react with great fear when they find themselves in such a situation again.
  • Fear of accidents or post-traumatic stress disorder . It arises due to the excessive exposure to accidents. Those affected suffer from distressing, recurring memories of the accident, difficulty concentrating , lack of sleep and frightfulness . They lose themselves in fruitless brooding and guilt and fear new, serious accidents everywhere. Such situations are now avoided. Clemens, Hack et al. a. distinguish post-traumatic stress disorder from anxiety disorders that can also develop after an accident. They call these fears “travel fears”, a term that fits well with the concept of driving fears: “It is a group of phobic fears that manifest themselves, for example, in the inappropriate fear of having another accident or even taking part in traffic can. Certain accident-related situations then trigger physical and psychological fear reactions. If the accident z. B. happened at an intersection, the person affected can later react with violent tremors, sweats, cramps and panic-like fears when he approaches an intersection. "
  • Fear of panic attacks in spatial situations from which it would be difficult to escape, e.g. B. in the supermarket, in queues, when traveling in the bus or in the car. When driving a car, situations are feared from which one could not escape quickly enough if panic attacks occur, such as expressways, tunnels, bridges, wide streets with dense, fast traffic, where one drives in the middle or on the left, the way to the next one Exit is very far, highway and high speed. Such situations are avoided or only approached with great fear. This fear is called agoraphobia .

Spread of driving fears

There is no scientific study of the prevalence of driving fears in the population. Until such an investigation is available, the number of people afraid of driving can only be assumed or roughly estimated. It is clear, however, that far more women than men suffer from driving anxiety.

We know little about the spread of the specific fear of driving. Angenendt u. a. In their summary of the specific phobias, the phobic fears of driving are also among the fears that are “most widespread”. Scientists at the University Hospital Münster and the University of Würzburg speak of the "three most common phobias", which include fear of driving.

As far as general driving fears are concerned, one can calculate backwards from the spread of the unspecific fears on which they are based or make more detailed assumptions. This can best be shown using the example of agoraphobic fear or fear of accidents. We don't know anything about the spread of social fears among drivers.

The lifetime frequency of the anxiety disorders panic disorder or agoraphobia, which usually occur together, is estimated at approx. 5%. This number says what percentage of the population will develop this anxiety disorder briefly or chronically in the course of their life. The average age at which the anxiety disorders panic disorder or agoraphobia begin is over 25 years. This means that most of those affected still experience their driving license and their first driving days without fear. The population of the Federal Republic of Germany is around 82 million. Based on this number, there are roughly 4 million people who temporarily suffer from panic attacks or agoraphobia.

There is a connection between anxiety disorders and driving anxiety. This connection is evident in fears such as agoraphobia. Most agoraphobics, it is assumed, will also have fears when driving. The connection has not yet been researched in more detail, especially not in numbers.

As for the frequency of driving fear as a consequence of an accident, Clemens, Hack et al. a. came to the result that “a third of the victims of road accidents with severe personal injury develop a clinically relevant mental disorder.” According to official information, there were around 414,500 road accidents with injured people in Germany in 2008. Of these, around 4,500 were killed, 71,000 seriously injured and 338,000 slightly injured. A third of the seriously injured, around 24,000, continue to suffer from post-traumatic stress disorder (stressful memories, insomnia, frightfulness, feelings of guilt). According to the authors, this is accompanied by the development of fears and the avoidance of situations that are stressful due to the accident (e.g. certain intersections or driving a car). The so-called "travel fears" by the authors occur in "around 30% of accident victims". Based on the aforementioned accident figures, around 100,000 people would be affected by further driving fears, as drivers around 80,000.

Development of fear of driving

The origin of fear of driving is - like that of fears in general - difficult to determine. A “fearful” inherited disposition probably plays a role, a particularly sensitive attitude. In addition, there are influences of the social environment: For example, many fearful people report that their families have already spoken fearfully about cars, obtaining a driving license and road traffic. In the mood of fear, some shocking events for these people may happen. During the driver's license training, the driving instructor made a rough remark, the partner mockingly commented on the first driving attempts, or there was a small sheet metal accident. These rather harmless incidents are experienced almost traumatically by those who are afraid of driving and reinforce the fearful attitude.

Legal evaluation in Germany

Section 2 (4) of the Road Traffic Act (StVG) states that the condition for suitability to drive motor vehicles is that “the necessary physical and mental requirements are met”. Appendix 4 of the Driving License Ordinance (FeV) containsa list of “more frequent illnesses and deficiencies that may impair or impair the ability to drive vehicles”. Annex 4 refers in point 7 to the "mental (mental) disorders" related to the subject of driving fear.

Only those deficiencies "which represent a danger to road traffic" and cannot be compensated for in any other way mean that the vehicle is unsuitable for road traffic and lead to a denial of the driver's license. And a danger to road traffic can arise from the occurrence of a driving phobia or a non-specific driving fear such as agoraphobia: for example, when severe physical symptoms occur that make it practically impossible to operate the vehicle in traffic (muscle spasms, dizziness, concentration disorders up to blackout), or with Panic attacks in the middle of the fast flowing traffic on the motorway, followed by brakes on fear and creeping at the crotch to the rescue stop on the hard shoulder.

If such an incident were detected by the police, it would probably be reported to the driving license authority. This would require the person concerned to dispel the authorities' doubts about fitness to drive by means of an opinion from a specialist (neurologist with additional qualifications in traffic medicine) or an opinion from a medical-psychological assessment agency ( Section 11 FeV). The opinion could end up suggesting a course or therapy. If the conditions imposed by the authority following the report were met, the authority’s doubts that the driver’s license would not have to be withdrawn would be dispelled.

But this description is rather abstract. The overwhelming majority of fearful people avoid driving after a few anxiety attacks - for fear of no longer driving safely, of losing control, of harming others. And at some point they seek the direct route to therapeutic treatment or to another organization in order to overcome their fear of driving. In this respect, those affected behave very sensibly in advance, also in accordance with the legislature.

Coping with fear of driving

In the German-speaking countries, several organizations have been set up since the 1990s to deal with the problems of fearful drivers. There are also psychotherapists whose tasks include treating phobic disorders and thus the pathological fear of driving.

According to experts, specific fears do not have as severe an impact as general, unspecific fears. This also applies to fear of driving. Those affected can to some extent limit the driving fear to the driving situation and continue their normal life - albeit with restrictions. Since the intensity of the driving fear can also fluctuate (from only mild driving fear in a partial area, e.g. on the motorway, to severe, phobic driving fear with complete avoidance of driving), it is understandable that the newly developed initiatives outside the therapeutic Environment are specifically dedicated to overcoming the specific fear of driving.

Discussion groups

The name “scared women” for women with driving fears was used for the first time by a committed association in Magdeburg. It has set itself the goal of offering women with a driver's license who could no longer drive because of their fears a perspective again. The women were offered theoretical training, joint discussions (“Stammtisch”), if necessary psychological support and practical exercise drives in a large parking lot. The “car club for fearful women” is now part of the “Advice Center for Women and Families, Association for Equal Opportunities and Social Protection Saxony-Anhalt e. V. “risen. Based on this model, a large number of discussion groups for fearful people, led by psychologists, developed. For refresher drives and the confrontation with fearful situations, those affected are referred to normal driving schools. The advantage of this approach is the loose shape. The disadvantage is that a main part of the fear management, the practical driving confrontation, remains non-binding.

Special driving schools

There are now several driving schools that specialize in looking after people with driving fears. Overcoming fear of driving in driving school takes place in several steps. The first steps consist of a behavior-oriented part (group seminars, group discussions or individual discussions in the driving school), the further steps consist of a practical driving part, which is about confronting fear-inducing situations.

Important parts of coping with driving fear are dealing with the tormenting thoughts (e.g. "every little mistake means a terrible accident"), dealing with physical symptoms and confrontation exercises in the car, in which the feared situations are visited with the help of a psychologically trained driving instructor . At the beginning of the journey, a cautious, almost overcautious "fear of driving style" is maintained. This allows fearful people to process the wealth of information flowing in calmly and with less fear and to make sensible decisions. During the practical coping exercises, it usually turns out that the fear can be endured well.

For safety reasons, the first attempts should only take place in the driving school vehicle. If those affected drive correctly and are trained in coping with fear, we recommend switching to driving their own car. There are still many fears lurking here that do not come to light in the protected phase in the driving school vehicle. The driving instructor should also provide support during this phase. However, he can only guess, he is now denied intervention, the driver bears full responsibility.

At the end of the supervision, self-performed "homework" and debriefing of the coping experiences improve the stability of the learning effects. The aim is for those affected to be able to drive away from their fears independently, safely and carefree.

Behavior therapy

For people with unspecific fear of driving, therapy, ideally in the form of behavioral therapy , is the classic way of overcoming fears. In the confrontational part of therapy, e.g. For example, if someone fears panic attacks on the autobahn and has to go to these situations by car, there are now tentative attempts to call in a driving school specializing in coping with driving anxiety. However, the collaboration between therapists and driving schools is still in the testing phase. In the "Deutsche Angst-Zeitschrift" it is easy to follow individual articles, how many possibilities with respective advantages and disadvantages there are to shape the confrontational part of coping with fear:

  • The therapist does the therapy and the confrontation exercises himself: He drives to the exercises in the patient's private vehicle. Advantage: The therapist knows the patient and the status of her coping with fear. Disadvantage: The therapist does not have a driving school car and is not able or trained to intervene in an emergency. Any kind of interference could also have legal and insurance-related consequences.
  • The therapist only does the therapy: he sends the patient off to do the confrontation exercises alone. Advantage: The patient practices independently coping with her fears in reality. Disadvantage: Fears can flare up again - even with the best intellectual restructuring - in the face of reality. In this situation she needs help. Without help, the confrontational part of therapy may be broken off.
  • The therapist is also a driving instructor: He treats and drives in the driving school car and in the private vehicle to confrontation exercises. This is a rare ideal.
  • The therapist sends the patient to face-to-face exercises with a well-known fear driving school: There, the patient is trained to cope with fear in the driving school car and at the end of the care in the private car. Driving instructor and therapist work together. In order to work together, the patient must release the therapist from his duty of confidentiality. Advantage: Both complement each other with their respective professional skills. Disadvantage: Both may work side by side.

Since neither driving instructors nor therapists are specially trained in the care of fearful people, the development and long-term organization of training for these professional groups are urgent tasks.

University research

Scientists at the Münster University Hospital, the Dresden University Hospital and the Psychological Institute of the Julius Maximilians University of Würzburg are pursuing a different approach to overcoming fear of driving - therapy “in virtual reality ”. The patients sit in a darkened room with 3D glasses in front of a screen with special software. The software displays images and situations that occur when people are afraid of driving. The patients can control the approach or the distance from the objects or situations themselves. They are wired so that the attending doctor or psychologist can determine the intensity of the nervousness at any time. The scientists suspect that this therapy "may be as successful as conventional methods". Advantage: The tests are standardized and can therefore be easily evaluated. Disadvantage: Reality is always good for surprises. Hamm points to “the frequently observed phenomenon of the resurgence of fear”, which is particularly evident “when the dreaded object appears in a new or different context (the so-called renewal effect ).” And, as is well known, nothing is as varied as reality .

A comparison and an effectiveness study for these different approaches are still pending. Hamm speaks of “experiencing self-efficacy” and a higher degree of “control beliefs”, although just getting used to fear is not enough. A variation of the environmental conditions is particularly important. The desire of those affected and the linchpin in overcoming driving fears is, of course, independent, safe and carefree driving.

literature

  • Anxiety disorders. In: Federal health reporting. Robert Koch Institute in cooperation with the Federal Statistical Office. H. 21 May 2004.
  • J. Angenendt, U. Frommberger, W. Trabert, C. Stiglmayr, M. Berger: Anxiety disorders. In: M. Berger (Ed.): Psychiatry and Psychotherapy. Urban & Fischer, Munich / Jena 2000, p. 567ff.
  • B. Bandelow: The fear book. Rowohlt, Hamburg 2004.
  • Beck Road Traffic Law. Loose-leaf text collection with references, subject index and samples. As of 01/2010.
  • daz German fear newspaper. Focus on driving phobia - the fear of driving. H. 35, 2006.
  • A. Hamm: Specific phobias. Hogrefe, Göttingen 2006.
  • G. Kaluza: Calm and safe in stress. Springer, Heidelberg 2007.
  • F. Müller, HJ Ruhr: No more fear behind the wheel. Springer, Heidelberg 2009.
  • R. Peurifoy: Fear, Panic and Phobias. Huber, Bern 2007.
  • S. Schmidt-Traub: Panic Disorder and Agoraphobia. Hogrefe, Göttingen 2000.
  • M. Schué, P. Glowalla, J. Brauckmann: Handbook of driving license law. Kirschbaum, Bonn 2008.
  • Statistical yearbook 2009 for the Federal Republic of Germany. Publisher: Federal Statistical Office. Wiesbaden 2009.

Web links

Discussion groups:

  • “Fear of driving” is an offer from ADAC Berlin-Brandenburg
  • Car club for fearful women in the advice center for women and families, Association for Equal Opportunities and Social Protection Saxony-Anhalt e. V. Theoretical training, get-together, psychological support
  • Club of AUTO-Stressed Women Lectures, discussions, advice
  • Hello Ms. Information portal for women (series of seminars to reduce driving fears in cooperation with TÜV Rheinland)

Research institutions and advanced training institutes that deal with coping with driving anxiety:

Footnotes

  1. ↑ Description of driving phobia G. Alpers: Car driving phobia. Horror on Wheels. In: Psychology Today. H. 2006, p. 52f.
  2. ^ Description of the symptoms in W. Goede: Panik behind the wheel. How to get a grip on driving fears. In: daz German fear newspaper. P. 4ff.
  3. ^ W. Goede: Panic behind the wheel. How to get a grip on driving fears. In: daz German fear newspaper. P. 4ff.
  4. ↑ J. Angenendt et al.: Anxiety disorders. In: M. Berger (Ed.): Psychiatry and Psychotherapy. Urban & Fischer, Munich / Jena 2000, p. 579.
  5. ^ G. Alpers, J. Abelson, F. Wilhelm, W. Roth: Salivary Cortisol Response During Exposure Treatment in Driving Phobics. In: Psychosomatic Medicine. 65, July / August 2003, p. 679ff.
  6. ↑ Anxiety disorders. P. 13.
  7. ↑ K. Clemens, E. Hack, J. Schottmann, HJ Schwab: Mental disorders after traffic accidents - implications for personal injury management. In: DAR, legal journal of the ADAC. Issue 1/2008, page 9 ff.
  8. ^ Description in S. Schmidt-Traub: Panic disorder and agoraphobia. Hogrefe, Göttingen 2000, p. 20 ff.
  9. ↑ W. Goede estimates the ratio of women to men about 6 to 1. W. Goede: Panik behind the wheel. How to get a grip on driving fears. In: daz German fear newspaper. P. 4.
  10. ↑ J. Angenendt et al.: Anxiety disorders. In: M. Berger (Ed.): Psychiatry and Psychotherapy. Urban & Fischer, Munich / Jena 2000, p. 578f.
  11. ↑ This includes the fear of spiders, of heights and of driving a car. Innovative therapy: UKM doctors research the treatment of phobias in "virtual reality". In: Information Service Science. Press release from the Münster University Hospital. 4th December 2009.
  12. ↑ J. Angenendt et al.: Anxiety disorders. In: M. Berger (Ed.): Psychiatry and Psychotherapy. Urban & Fischer, Munich / Jena 2000, p. 571.
  13. ↑ Anxiety disorder. Issue 35 2004, p. 13.
  14. ↑ Statistical Yearbook 2009. 2 Population, p. 28ff.
  15. ↑ B. Bandelow: The fear book. Rowohlt, Hamburg 2004, p. 61: "Many agoraphobics are afraid of driving."
  16. ↑ K. Clemens et al.: Mental disorders after traffic accidents - implications for personal injury management. In: DAR, legal journal of the ADAC. Issue 1/2008, p. 11.
  17. ↑ Statistical Yearbook 2009. 16 Verkehr, p. 439ff.
  18. ↑ B. Bandelow: The fear book. Rowohlt, Hamburg 2004, p. 119 ff.
  19. ↑ Scaredy Rabbits Reports
  20. ↑ Such reports must, however, be questioned critically. They represent the path into fear as a kind of slide with no possibility of alternative. In this respect they are themselves an expression of the original fearful hopelessness.
  21. ↑ M. Schué et al.: Handbook of driving license law. Kirschbaum, Bonn 2008, p. 209 (emphasis added by the authors)
  22. ↑ Anxiety disorders. In: Federal health reporting. Robert Koch Institute in cooperation with the Federal Statistical Office. H. 21, May 2004, page 13.
  23. ↑ F. Müller, HJ Ruhr: No more fear behind the wheel. Springer, Heidelberg 2009, p. 12 ff.
  24. ↑ daz thematic focus on driving phobia. The fear of driving a car. H. 35, 2006.
  25. ↑ Also A. Hamm: Specific phobias. Hogrefe, Göttingen 2006, p. 52.
  26. ↑ Innovative therapy: UKM doctors research the treatment of phobias in "virtual reality"
  27. ↑ A. Hamm: Specific phobias. Hogrefe, Göttingen 2006, p. 4.
  28. ↑ A. Hamm: Specific phobias. Hogrefe, Göttingen 2006, p. 50.