Obsessive-compulsive disorder (OCD) can significantly impact your ability to feel confident on the road, as intrusive thoughts about accidents and potential hazards can distract you from focusing on driving. Exposure and response prevention (ERP) therapy can help, by teaching you to face these fears gradually, without resorting to compulsions.
While driving, you may have thoughts like: “What if I hit something or someone without realizing it?” or “Did I cause an accident, even though there’s no evidence?” These worries can make driving feel frightening, and may lead you to avoid the activity entirely in an attempt to prevent distress.
In some cases, fear of driving can be a result of obsessive-compulsive disorder (OCD), a complex, chronic mental health condition. OCD causes obsessions, which can include intense and unwanted anxieties about driving. In response, people with OCD engage in compulsions, or repetitive behaviors—such as retracing a driving route, or constantly checking a car’s safety features. These behaviors are often performed in an attempt to reduce anxiety, but they can end up making fears more intense.
Fortunately, with treatment, you can gradually learn to confront these fears and resist the urge to perform compulsions. Read on to learn more about driving-related anxieties, how to know if you’re dealing with OCD, and tips for regaining confidence behind the wheel.
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OCD and fears of driving
Also known as the “doubting disorder,” OCD can cause you to feel uncertain about even the most basic things you experience. The condition often seizes on concerns about driving, making it difficult to focus on the road. Hit-and-run OCD is a subtype of OCD, characterized by distressing, intrusive thoughts about unintentionally causing an accident or harming someone while driving—even when there’s no evidence to suggest this is the case. You may worry that you hit a pedestrian, another car, an animal, or property without realizing.
In response to these fears, you may engage in compulsions, like asking for reassurance that you haven’t hit anyone, or retracing your route. Or, you may avoid driving entirely, which can cause isolation, and impact daily life, social interactions, and work opportunities.
All of these behaviors may feel like the right response to your anxieties, but they only serve to reinforce your fears—making it hard to return to the road as a confident driver. “You’re unwittingly reinforcing the OCD cycle, virtually guaranteeing that in the future, any unexpected noise or sensation while driving will make you pull over to check that you haven’t hurt or killed a pedestrian, cyclist, cat, or dog,” says Dr. Patrick McGrath, Chief Clinical Officer at NOCD.
How do I know if it’s OCD?
Many people find driving to be stressful, but for some, fears become all-encompassing. In these situations, understanding the cause of your concerns can be helpful for figuring out the best treatment approach. In some cases, fear of driving (also called amaxophobia or hamaxophobia) stems from past traumas related to car accidents.
While these fears can look similar to OCD obsessions, they’re different in the sense that amaxophobia doesn’t typically appear out of the blue; it’s related to past trauma. OCD obsessions, on the other hand, don’t need to be attached to a specific past event. OCD is also distinct in that it results in both mental and physical compulsive behaviors meant to neutralize distressing intrusive thoughts.
Let’s examine driving-related OCD symptoms to get a better sense of what you might be dealing with.
Common triggers for driving OCD obsessions
While OCD obsessions can appear out of the blue, and don’t have to be connected to a clear situational trigger, there are some scenarios that commonly cause driving-related intrusive thoughts for people whose OCD centers on these themes. Let’s take a look:
- Driving on a street with a lot of pedestrians can lead to fears of accidentally hitting someone.
- Driving over potholes or bumps in the road can cause worries that something may have been damaged or hit.
- Having an animal run in front of your car can trigger fears of unintentionally harming it.
- Backing out of a parking space or driveway can lead to doubts about whether there’s something or someone in the way.
- Running over trash on the road can trigger concerns that you may have caused damage without realizing it.
- Driving in the rain or snow, with reduced visibility, can cause anxiety about not noticing important signs or signals.
- Making sharp turns or quick lane changes can lead to fears of losing control.
Driving OCD obsessions
In response to these situations, you may find yourself dwelling on unwanted concerns, thoughts, or feelings, known as “obsessions.” While many people experience intrusive thoughts from time to time, people with OCD struggle to move worries, like:
- “Did I hit something? Should I go back and check?”
- “How do I know if I didn’t kill someone?”
- “What if I caused an accident and didn’t notice?”
- “Did I stop at the red light long enough? What if I ran it?”
- “What if I left the car doors unlocked?”
- “What if I accidentally hurt someone and didn’t realize it?”
- “Should I retrace my route just to be sure I didn’t hit someone?”
- “What if I go to jail for hitting someone?”
These intrusive thoughts arise from the intense fear that you might hurt someone, not because you actually have the desire to cause harm.
Driving OCD compulsions
In response to the anxiety caused by obsessions, you might perform compulsions—repetitive behaviors or mental acts that are done to neutralize a thought, decrease distress, or prevent something bad from happening.
Compulsions may look like:
- Checking: You might drive around in circles to confirm you haven’t hit something or caused an accident.
- Avoiding: You might avoid driving on certain roads, such as busy streets or places with a lot of pedestrians, or you may avoid driving altogether because it triggers intrusive thoughts.
- Reassurance: You might ask someone driving with you to confirm that you haven’t hit anyone or anything.
- Mental rituals: You might mentally replay the drive over and over, trying to remember if you made any mistakes or missed any signs.
- Counting: You might count to a certain number to feel reassured that everything is okay.
These compulsions are done in an attempt to reduce the distress caused by the obsessions, but they only reinforce the cycle of OCD—making driving feel even more overwhelming.
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How to get over fears of driving
Exposure and response prevention (ERP) therapy is a specialized form of cognitive behavioral therapy (CBT) designed to treat OCD. ERP can help you regain your confidence as a driver, by helping you learn to resist compulsions and assign less meaning to your intrusive thoughts.
In ERP therapy, you’ll work with a therapist to gradually expose yourself to situations that trigger your intrusive thoughts, while resisting the urge to do compulsions. These plans will be structured and tailored to your specific needs, ensuring that any work you take on progresses at a pace that feels manageable. The goal here is to build tolerance to the anxiety these thoughts trigger, without needing to engage in ritualistic behaviors.
If your OCD centers on concerns about driving, you might start ERP therapy by visualizing yourself driving over potholes, and envisioning worst case scenarios. Once you feel comfortable tolerating this discomfort without engaging in compulsions, you’d be able to move on to driving over a real pothole, while resisting the urge to stop and check if you hit something, or pulling over to inspect your car. This can feel difficult at first, but the gradual nature of ERP means you’ll be up to the challenge once you and your therapist decide it’s time to take it on.
ERP therapy helps you learn that you can handle uncertainty, without resorting to compulsions. In time, this helps reduce the anxiety you feel when those doubts arise. With practice, you’ll be able to spend less time worrying about your driving fears, so you can focus on what’s actually happening on the road in front of you.
Key Takeaways
- People with driving-related OCD may constantly worry about accidentally hitting something or causing an accident, even when there’s no evidence to suggest this has happened.
- Amaxophobia is a fear of driving, related to past trauma; unlike OCD, it does not involve compulsive behaviors.
- ERP therapy is an effective treatment for driving-related OCD concerns, helping you learn to confront your fears gradually, while resisting the urge to perform compulsions.