You are offered a job forty kilometres away and the first thing you think about is the motorway. You have had your licence for years, but you drive less and less: only on roads you know, never at night and, if possible, with someone else at the wheel. When there is no way round it, your hands are sweating before you even start the engine and the journey feels endless.

If this sounds familiar, it may be driving anxiety, sometimes called amaxophobia when the fear of driving becomes intense and starts to limit your life. It is not clumsiness or a weak character: it is an anxiety problem, and it can be treated. If you are thinking about seeing a psychologist and looking for therapy for driving anxiety, this guide explains when to seek help, where the fear usually comes from, what therapy involves, how long it takes, whether it works online and how to choose a professional.

When to see a psychologist for driving anxiety

The NHS describes phobias as an anxiety condition usually caused by a particular object or situation. The symptoms it lists include:

  • Severe anxiety and worry.
  • Feeling dizzy and lightheaded.
  • A more noticeable or unusual heartbeat (palpitations).
  • Tightness in your chest.
  • Feeling or being sick, or diarrhoea.
  • Trembling or shaking.
  • A strong or intense fear that you may faint, lose control or die.

The NHS advises seeing a GP if you think you have a phobia and the symptoms are affecting your life. Amaxophobia is not a separate diagnosis: depending on the case, fear of driving is treated as a specific phobia, as part of agoraphobia or, after a crash, as part of post-traumatic stress disorder. That is why it is worth having it assessed by a professional.

It is worth getting help if you have stopped driving or only drive in very specific conditions, if you have turned down jobs or plans, if you depend on other people to get around or if you feel bad for days before a journey. A Brazilian study of women with driving phobia sums it up: it restricts freedom, harms careers and causes social embarrassment.

It is not unusual. In a New Zealand study of 2,491 people aged 55 to 72, between 4% and 6% had moderate to severe driving anxiety, and another 17 to 20% had mild driving anxiety. Women scored higher than men.

Where fear of driving comes from

Many people assume there must be a crash behind it, but that is not always the case. A study from the University of Toulouse of 260 people with driving anxiety found that the most common starting points were panic attacks and criticism, ahead of crashes: only 11.4% of those who had been in a crash saw it as the origin of their fear. Those who had never been in a crash scored higher on social concerns, such as getting it wrong in front of others. And both in people whose fear began with a panic attack and in those who had been in a crash, the physical sensations that weighed most were the same: palpitations and sweating.

This changes the treatment. If it all started with a panic attack at the wheel, what frightens you is feeling it again without being able to stop, and we explain this in Panic attack: what it is, why it feels like a heart attack and what to do. If the fear also shows up on public transport, in queues or in crowded places, there may be agoraphobia: the NHS describes it as fearing that you would be unable to escape from a place if you had a panic attack. And if there was a serious crash and you relive it, have nightmares or avoid everything that reminds you of it, it may be post-traumatic stress disorder, which has its own treatment; we explain it in PTSD: symptoms, when to get help and which treatments work.

To put numbers on it before you seek help, the Anxiety Test asks, for example, whether you have noticed "palpitations, a racing heart, sweating or shortness of breath without any physical exertion", exactly what people feel most at the wheel. And the Social Anxiety Test covers the fear of getting it wrong with someone watching: "When someone watches me doing something (working, writing, signing, paying), I freeze up for fear of making a mistake".

How a psychologist treats fear of driving

The NHS lists cognitive behavioural therapy (CBT) among the treatments for phobias, and for specific phobias the best-supported tool is exposure, as we explain in Therapy for phobias: how fear of flying, heights or needles is treated. With fear of driving, exposure is gradual: you build a ladder of situations, from the least frightening to the most, and climb it one step at a time. For example:

  1. Sitting in the parked car with the engine running.
  2. Driving round the block with someone you trust beside you.
  3. Making a short, familiar journey at a quiet time, on your own.
  4. Adding what is hardest: big roundabouts, heavy traffic, the motorway, driving at night or in the rain.

Each step is repeated until it is no longer so frightening, and then you move on to the next.

Safety behaviours

As well as avoiding, many people drive with what therapists call safety behaviours: going very slowly, never overtaking, gripping the wheel as hard as they can or never going out without someone beside them. A review by Hidalgo-Muñoz and colleagues links driving anxiety with excessively cautious driving, negative feelings and avoidance, and in the Brazilian study distorted thoughts helped to explain those behaviours. Therapy removes them gradually, because they keep alive the idea that something would happen without them.

If it all started with a panic attack, therapy also works on the fear of the sensations themselves: learning that a racing heart or dizziness is unpleasant but not dangerous. And if there is post-traumatic stress after a crash, the NHS recommends trauma-focused treatments such as trauma-focused CBT or EMDR.

Woman at the wheel with a companion in the passenger seat, one of the first steps of gradual exposure for fear of driving

Virtual reality and simulators

When going out on the road is still too much, you can start in a simulator. In a German pilot study by Kaussner and colleagues, 14 patients had two preparation sessions and five exposure sessions in a driving simulator tailored to their fear ladder. In the final test, in real traffic, all of them managed tasks they had avoided before, 71% drove appropriately according to the driving instructor's assessment and 93% kept their progress at the telephone follow-up. It is a small study without a comparison group, and a 2023 review of 14 studies concluded that virtual reality is feasible and well accepted but that better-quality trials are needed.

What about medication?

The NHS includes some medicines among the treatments for phobias, such as antidepressants, beta blockers or sedatives, which are always prescribed by a doctor. With driving you need to be especially careful: the review by Hidalgo-Muñoz found that benzodiazepines, the most studied anti-anxiety drugs, affect attention and can slow reaction times. In Spain, medicines that can reduce your ability to drive carry a warning pictogram on the box, according to the Spanish Agency of Medicines. If you are prescribed something for anxiety, ask whether you can drive while taking it.

How long therapy for driving anxiety takes

In the simulator studies, treatment fitted into a few weeks: in Kaussner's, two preparation sessions, five exposure sessions, a final test in real traffic and a closing session. Outside research, it depends on how long you have been avoiding driving, on what lies behind it (a phobia, panic, agoraphobia or a crash) and, above all, on how much you practise between sessions. If you have not driven for years, a few refresher lessons with a driving school can complement therapy.

Does online therapy work for driving anxiety?

We have not found trials of online therapy designed for fear of driving, so it is worth being cautious. For specific phobias in general there are promising data on internet-based interventions built around exposure, as we explain in Therapy for phobias: how fear of flying, heights or needles is treated. In practice, the split is simple: you do the driving yourself, between sessions, in your own car and on your own roads; the online session is for preparing each step, reviewing how it went and adjusting the next one. That is exactly where the fear appears.

How to choose a psychologist for driving anxiety

These checks help you get it right:

  • Registration as a health professional. This comes first.
  • Experience in cognitive behavioural therapy and exposure for phobias and anxiety disorders.
  • Someone who assesses what lies behind it: a phobia, panic, agoraphobia or trauma from a crash.
  • Someone who plans real exposure. Talking about the fear helps, but what reduces it is driving again step by step.
  • Someone who helps you drop safety behaviours, rather than simply helping you get through each drive.
  • Flexibility: online sessions to review your practice during the week.

A psychologist for driving anxiety

At MyPsicoTest we recommend Xènia Capel Salcedo, a licensed clinical psychologist (COPC 14982) with a master's degree in Clinical Psychology and Psychotherapy. She sees clients in Igualada and Sant Sadurní d'Anoia and also through online therapy, and on her blog she has written an article about amaxophobia, or fear of driving. In it she explains that she works on it with a tailored plan: first understanding where the fear comes from and what keeps it going, then learning to manage the sensations of anxiety and to take apart catastrophic thoughts, and finally gradual, planned exposure at each person's pace, so that you can trust yourself at the wheel again. She works from an integrative, evidence-based approach: on her website she explains that she uses tools from cognitive behavioural therapy, EMDR, systemic therapy and person-centred therapy. Sessions are available in English, Spanish or Catalan, and the first contact is a free, no-commitment information consultation. She herself points out that in a serious crisis or psychiatric emergency, immediate in-person care is what is needed.

If your result worries you or you want a professional assessment, you can talk to Xènia Capel Salcedo, a licensed psychologist (COPC reg. 14982), who offers a free first consultation call and online therapy from anywhere.

MyPsicoTest team · Updated: