Motivation and emotion/Book/2021/Fear of driving

Overview

 * Case Study

A 40 year old man who had a severe fear of driving which impacted on his life as well as his job. The individual started to develop the fear of driving due to being in a road traffic accident on a motorway. After 12 treatment sessions that consisted of systematic desensitisation of driving scenarios in imagination. This treatment assisted in the patient making a full recovery and able to drive without that fear. He was also prescribed Paroxetine and Clonazepam. The treatment and the prescribed medication was used together to help in the management of the individual fear of driving (Sharma, Vanjari, Shah, Bharati & De Sousa, 2015).



Driving is one of the most common ways of transport. Driving can be easy, quick, and reliable if done correctly. If a person has a fear of driving it may negatively impact many things in their lives, such as being late to work or important events just to name a few. Although with a negative side there is also a positive side of having a fear of driving. The positive side of having a fear of driving can be beneficial for many things, such as reduces everyday pollution for the environment. It is important for people to not have a fear of something that is used in everyday life, overcoming this fear will enhance the individual overall wellbeing.

Cognitive appraisal theory can help with the fear of driving as it helps the individual to overcome their fear and allows them to continue living without that fear of driving affecting them. Cognitive appraisal can be refers to how a person perceives a specific event to determine how stressful it is (Campbell., el at, 2013).

Another theory about the management of fear of driving is using technology for exposure therapy. This involves creating a positive virtual driving experience for the person with a driving fear, which directly reduces this fear (Costa et al., 2018).

Focus questions:
 * What does fear of driving mean?
 * what are the pros and cons?
 * How can it be managed?

The Fear of Driving
Fear of driving can occur due to many reasons, although the main factors found that contribute to fear of driving are having negative experiences in the past, influences of emotion on driving. As well as the influences of other variable seen as a distraction, this being other passenger in the car, other cars on the road as well as use of technology in a motor vehicle.



Having past negative experiences is one of the major factors that can contribute to being fearful of driving. It can also be the root of many anxieties related reasons of fear of driving. Negative experiences in driving can range from being or witnessing a major motor vehicle crash to being in a bad traffic jam or being in a verbal conflict while driving (Clapp el al., 2011). Major car crashes can cause post-traumatic stress disorder which can result in psychologically re-experiencing the trauma experienced (nightmares and intrusive thoughts), avoiding thoughts or situations to do with the trauma such as refusing to drive or get in a car, feelings of numbness and becoming or irritable (Beck & Coffey, 2007).

Influence of emotion on driving can also be a reason for fearing driving. Overall, there is a range of emotion that can influence driving, whether they are positive or negative emotions. Within the positive emotions that influence driving, they all seem to have a positive impact of driving and shows it decreases the fear of driving. Emotions such joy, calmness, and overall happiness all can lead to a better and more relaxing experiences while driving (Pêcher el at., 2011). Negative emotions in driving can include anger, aggression, anxiety, fear, sadness, and depression. These negative emotions that are felt by a driver can all contribute to having an increased fear of driving.

Anger and aggression are very prevalent on the road as there are many negative outside and personal influences that can induce these emotions. Some outside influences being busy traffic, other drivers’ behaviours off the road and sound stimuli such as horn honking. Whereas some personal influences can include age, education, and personal behaviour. These negative factors that are shown on the road are also more commonly known as “road rage”. Anger and aggression are negative emotions that can be felt when driving and this can lead to having increased fear of driving as the person who is experiencing the road rage may become a safety risk for themselves and others. Although, by having individuals on the road that have “road rage”, it may also increase the fear of driving in those drivers that have anxiety related disorders.

Several mental health related issues can affect the fear of driving. One particular mental health issues that is seen to impact the fear of driving is anxiety; this is due to the characteristics shown in anxiety. A few of these characteristics can include the fear of having a panic attack while driving, fear of not being able to react fast enough if stressful situation arises, as well as not wanting to be in a public social environment (Taylor et al., 2010). An example can include an individual who has a social anxiety related disorder, they may have an increase fear of driving as they may think other drivers are criticising their driving and/or thinking that they themselves are a bad driver. Anxiety and its characteristics are one of the major factors within the influence of emotion that contributes to someone having the fear of driving.

Two other variables that can affect the fear of driving is interaction and distraction, which intertwin within each other. Interaction and distraction in the context of driving can refer to having the presence of passenger/s and/or items such as mobile phones, in the motor vehicle with the driver while driving. This can affect fear of driving as it can have a negative affect on the driver as they are interacting and distracting themselves from driving which can lead to safety risks such as crashing the vehicle. On the other hand, it may also influence the driver for the better, if they already have a fear of driving. Having a passenger may calm the driver down as they aren’t alone and playing music or listening to a podcast could also reduce anxiety related disorders. Overall, interaction and distraction can have good and bad qualities to them when it comes to the fear of driving.

Case Study

As Cathy sat at the traffic light thinking about the errands she was running; she could hear her two year-old singing in the backseat. Suddenly, a violent blow from behind launched her car forward approximately 15 feet. Immediately, she felt a sharp pain in her neck. With her ears ringing from the noise of the collision, she at once thought, “my baby is dead”. Whipping her head around despite the intense pain, she saw her baby wide-eyed and surprised, but completely uninjured as he sat buckled in his car seat. For months following the collision she asked herself, “It was just a wreck - like people have every day … Why am I having bad dreams about it, a hard time driving, and I can’t seem to relax anymore”.

Pros and Cons
Everything in life has pros and cons, advantages, and disadvantages. Some issues have more cons than pros. The fear of driving has both, pros and cons, but research shows that this particular issue has a lot more negative characteristics associated with it. But in saying that it does have its advantages.

Pros
One pro of fearing driving can include being more awareness. This advantage if for the people who still drive but has that fear attached to it. Having awareness is crucial when driving as the driver needs to be aware of what is going on in the environment, they are in. By having a more heightened awareness it may also reduce anxiety for the driver; this is due to the driver feeling positive emotions and feeling a little more in control and is focused on the task. Awareness is also good for those who are still too fearful to drive as it may bring calmness as a passenger.

Another advantage of having a fear of driving is that if the individual is too fearful to drive, it will reduce pollution for the environment as it is one less car on the road. Current research that shows that using a car less will reduce pollution and increase the use of more eco-friendly transports such as public transport as well as active transports such as cycling, walking, running etc. By having these eco-friendlier transports, it may also reduce their fear of driving as they have alternative options if it is readily available to them (Xia el at., 2013).



Cons
The disadvantages of the fear of driving are overwhelming a lot more than the advantages. This could be because fear is quite often associated with anxiety; this mental health disorder can affect a persons’ daily routine and their overall quality of life. Fear of driving can affect an individual’s independence as they may need to rely on others to drive them places, it affects mobilities as people may be too afraid to get in a motor vehicle (Taylor et al., 2010).

Having a heighten awareness is a pro but it can also be a con of fear of driving. This is due to the fact the driver may be overly cautious which has been seen to cause more car accidents and conflicts (Joanisse, el al., 2018) and in turn create more anxiety and more fear towards driving.

Another con seen in the fearing driving can include having restricted time to get places due to not having a convenient motor vehicle. This can lead to being late to important places such as work, school, and events. Alongside this, it can also limit the individual to be able to go on holidays, see friends and family and restrict them in travel (Gentile & Morrison, 2004).

Table 1.

Brief Summary of Pros and Cons of Fearing Driving.

Quiz
{Awareness is both a pro and a con of fear of driving: + True - False
 * type=""}

{Reduced pollution is a pro of fear of driving: + True - False
 * type=""}

Both, the pros and cons of having a fear of driving can affect a individual positively or negatively. It is depended on the situation of the person.
 * Take home message

How best to manage the fear of driving
The fear of driving can affect a persons’ life in many ways. In a personal aspect it can affect their mental health and in a professional setting it can increase the chance of running late etc. Managing the fear of driving is essential to enhance these individuals’ overall quality of life. The most prevalent management techniques include therapy and medication; to achieve the best management of this fear these two techniques should be used together.

Therapy
Seeking management for the fear of driving can involve the person going to therapy. This involves going to a professional psychologist who may specialise in the techniques and theories that will help reduce your fear of driving. One theory that is found to be very helpful and is used most commonly throughout the management of this fear is cognitive appraisal theory. Another technique that is used to reduce and best manage the fear of driving is exposure therapy.



In 1966 a Psychologist named Richard Lazarus developed a theory in the book Psychological Stress and Coping Process called cognitive appraisal theory. (Smith & Kirby 2001). This theory refers to how a individual’s interpretation of a event can influences how stressful or traumatic the event is perceived by the person. How a person interprets the situation depends on many variables, some important variables can include whether the situation affected the persons wellbeing negatively, whether there are formal and/or informal resources and support available to them after the event occurred, these resources can include access to professionals such as psychologist and also having the informal/personal support such as helpful friends and family. Another variable that is found to influence how a person perceives a situation is whether their strategies for dealing with stressful situations is healthy or unhealthy. An example of this in terms of fear of driving is if a person was in a car crash and their response to this situation and perceives it as negative it may bring emotions of fear and anxiety of driving and in turn, they have appraised this event as having negative effects (Campbell., el at, 2013).

Negative emotions have increased negative effects on driving and the implications of driving such as safety. By having negative emotions such as fear, feeling scared, anxious it increases the negative effects on driving such as being overly cautious which can lead to accidents. If a car accident is about to occur and the person driving is feeling negative emotions such as panic, it could make the situation worse as the driver may go into a panic and not know what to do. By using cognitive appraisal therapy techniques, it will reduce these negative emotions felt and in turn, reduce the chances of having negative effects on driving (Pêcher el at., 2011). Within the positive emotions side, by increasing positive emotions while driving it can reduce the fear the driver has. It has been shown that certainty and control are two major positive emotions that are seen to decrease the fear of driving and keep the driver feeling more relax (Lu el at., 2013)

Exposure therapy refers to being exposed to something that has caused some sort of trauma in the past and it often linked to the management of fear-related problems. It has many techniques within reducing fear; one interesting technique that is being used in the reduction of fear of driving is a virtual reality exposure therapy. This refers to as real-time virtual graphics, sounds and other specific sensory to generate a real-time virtual world (Costa el at., 2018). It used for those individuals who have the fear of driving from a motor vehicle accident, big or small. It is also used for those people that have a fear due to anxiety related issues such as fear of not being in control and others criticising how well the driver is driving. By having this it not only stimulates a virtual world for patients to be fully immersed to be able to help reduce their fear, but it also allows psychologist and specialist to study and observe real-time reactions of fear that the person has. It is used to induce emotions while being in a controlled and safe environment while also being done in a standardised way. Virtual reality exposure therapy is very useful in the management of fear of driving; although alone it is not effective in the full treatment (Kaussner el at., 2020) but is still a great therapy technique to help manage and reduce the fear while driving.

Medication
Medication alongside therapy and treatment can help individuals to reduce their fear in a short-term and a long-term way. Due to people being afraid and anxious while driving; anxiety medications may help in the reduces of fear while driving. A few types of anxiety are seen to help the most in reduce the fear of driving. Some including being benzodiazepines, cortisol, d-cycloserine, Paroxetine and Clonazepam. Although all anti-anxiety medication has been tested and they do work; they can have different side-effects on different people. Many of the well-known side effects and symptoms of anti-anxiety medication is weight fluctuation, increased anxiety, nausea, dry mouth etc. There are different types of anxiety medication and are needed for different reasons and for different circumstances. Specific anti-anxiety medications such as benzodiazepines are fast acting whereas some are slow release. There is also an increased chance of addiction with fast release as typically, they will lose it effectiveness less than 4 weeks and stop working as well and the person needs more to feel the effectiveness of it again. Reducing food and drink that have high amounts of caffeine or stimulations may be needed as it has been found they can increase anxiety. Overall, medication can be helpful in the management of fear of driving as it can help reduce the fear.





Charlie has started to develop a fear of driving due to anxiety related reasons. Although they were recently in non-serious car accident only a few months ago. What should Charlie do to manage this fear? Select the correct answer.}


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- Go on only medication for their anxiety + A combination of therapy and medication - Not do anything about it, they will get over it!

Conclusion
The fear of driving can start from many things in a persons’ life, such as a traumatic event such as a car accident or being fearful of what others think of how they are driving. There are many emotions that can affect how a person drives a car. Some emotions that came up frequently throughout the research was aggression and anger, anxiety and fear, sadness, and depression. These are all emotions that can negatively influence a person driving a car. Overall, there seems to be more negative connections and disadvantages in the research over the positives. The negative cons included too much awareness (eg. being overly cautious), being late, and having increased anxiety due to having that fear. The pros of fear of driving included having a heighted awareness (feeling more in control), reduced pollution due to less car gases, and reduced anxiety as you may experience positive emotions such as control. Managing the fear of driving has two main treatments which are therapy with a professional psychologist as well as medication treatment. Cognitive appraisal theory as well as exposure therapy can both help reduce fear of driving by reducing negative emotions felt and being exposure in a safe and controlled area, respectively. Medication such as anxiety medication can reduce anxiety and fear and will help with the management of fear of driving.

Overall, it is important to understand what fear of driving is and to seek help with the management of this fear as it can negatively impact the quality of life someone might have.