When Terror Comes Along for the Ride

For most of us, the act of merging onto the freeway or taking surface streets for the daily commute is an unconscious exercise, much like getting dressed or downing a bowl of cornflakes in the morning.

But for some, the experience can be downright terrifying. It can cause life-altering changes to a daily routine: depending on others for rides, extending commutes by hours to avoid certain roads or freeways and turning down jobs or homes that require longer drives.

Therapist Olive Morton knows the feeling. She not only treats driving phobias in her Laguna Hills practice, she also suffered through the condition while working on her master’s degree in the early 1970s.

Morton recalls suddenly being gripped by panic during the two-mile drive she made to classes at USC.

“I was breathing deeply, my hands were sweaty and my insides were shaking,” she said. “I would get totally disoriented and pull over to the side of the road. I would cry and cry.”

Morton, who had never before driven regularly in Los Angeles, feared that her psychology instructors would react badly if she divulged her phobia.

Her therapist made matters worse by curtly telling the then 53-year-old: “When are you going to grow up?”

While it is not known precisely how many people suffer from driving-related phobias, about 11.5 million Americans have had some kind of phobia during their lifetimes, according to figures from the Anxiety Disorders Assn. of America.

Dr. Dennis Munjack, associate professor of psychiatry and director of the Anxiety Disorders Clinic at USC Medical Center, has estimated that as many as 100,000 Americans suffer from some kind of driving phobia.

Driving fears generally fit into one of two categories: “specific phobias” related to the act of driving or the freeway conditions and “panic disorder with avoidance,” which, like Morton’s, is the fear of a person’s own anxiety reaction, experts said. Research shows that about 75% of panic disorder patients are women. Specific phobias are split evenly between men and women.

Driving phobias often grow out of specific experiences, said Joel L. Becker, a clinical psychologist and a director of the Center for Cognitive Therapy in Beverly Hills.

They also can be triggered by events that are only imagined or observed, including witnessing a car crash on the highway or watching the aftermath of an accident on television news, Becker said.

Phobias are highly idiosyncratic and can be triggered by anything from road construction to the hour of the day, the presence of a passenger or the sight of trucks or buses.

One of Becker’s patients obsessed over remaining in the right-hand lane, fearing she would somehow be forced to stop in mid-freeway and cause a major traffic jam if she ventured farther into traffic. If a new lane merged to her right, she panicked, Becker said.

Experts say treatment can range from simple meditation, yoga or consulting self-help books to intensive behavioral therapy and drugs.

With specific phobias, Becker said, he focuses on getting patients to use relaxation and visualization techniques. They rank their commuting fears from merely irritating to outright terrifying.

On each visit, they visualize a more problematic driving situation, getting closer and closer to their worst fear.

Once the problem is conquered in the comfort of the doctor’s office, they go out and repeat those steps while driving on the open road with an instructor.

Panic disorder, in contrast, requires desensitizing patients to their physiological reactions, Becker said.

Those with panic disorder typically are struggling through difficult times in their lives, like the death of a relative or divorce.

Many also lack interpersonal and assertiveness skills and struggle with dependence, he said.

“I sometimes call it ‘hardiness training,’ ” Becker said, noting that he doesn’t intend the term as an insult. “These patients have become kind of like wimps with regard to the symptoms that anxiety turns on in their bodies. What they need to learn is to become less of a wimp.”

Using a series of exercises, Becker determines their physical reactions to anxiety. He then teaches patients to breathe deeply and consciously cope with their symptoms as they visualize a nerve-racking driving scenario.

“The panic disorder patient says, ‘I’ll be so overwhelmed I won’t be able to see straight and [will] crash into the wall,’ ” Becker said. “But notice it’s the feeling of not seeing straight as opposed to [driving] skills.”

Even with the range of anxiety, driving disorders usually can be successfully treated in weeks, with success rates of 80% to 95%, Becker said.

Diminishing driver anxiety does not necessarily relieve more deep-seated psychological disorders, which may require longer-term therapy or medication.

Treating the problem, however, starts with recognizing that you have it, said Dr. John Murphy, medical director of Beverly Hills-based Southwestern Research Inc. and a USC clinical assistant professor.

Panic disorder, in particular, is defined by a specific and intense fear that peaks within 10 minutes and occurs at least once a month, as well as by persistent fear of additional attacks, Murphy said.

Those who have it report at least four of the following symptoms: a racing or pounding heart, trembling or shaking, shortness of breath, chest pain, sweating, nausea, dizziness or lightheadedness, feelings of unreality, fear of dying, and fear of going insane.

Often, Murphy said, victims hyperventilate, leading to the feeling of dizziness or disorientation.

The best way to combat road anxiety is to recognize symptoms at the onset.

Then remember to breathe calmly through the nose and try to remain relaxed, he said.

Some people are so overcome by fear they can’t even make it into a car, Murphy said.

He recalls one patient who had a scholarship to the University of Arizona, but couldn’t drive there because of freeway panic attacks. Driving within a 10-mile radius of his home, with a family member, was no problem. So the student stayed in Los Angeles, attended USC and sought treatment, Murphy said.

For Olive Morton, now in her 80s, those long-ago anxieties always seemed to pass.

Eventually, she addressed her phobia with therapy and a more mundane coping mechanism. Before hitting the road, she made sure she was armed with a map and a detailed set of directions.

If you have questions, comments or story ideas regarding driving or traffic in Southern California, send an e-mail to behindthewheel@la times.com.