Driving Anxiety & Complex Trauma
A personal anecdote… although I don’t struggle with driving much now, I remember after my dad’s death I struggled a lot, especially driving on the Chicago highways, which gave me immense anxiety. Surprisingly, my only car accident happened in a parking lot, the week my dad passed away. I was going to a thrift store in a strip mall. All I know is that I was highly dissociative at the time and probably should not have been driving, but I’ll give my 18 year old self some grace, and be grateful that no one was hurt. I was driving slowly and thought the driver to my left had a stop sign. They did not. I collided with them. To this day, I’m left thinking, what really happened there?
An interesting pattern I have noticed within my work with trauma survivors is concurrent driving anxiety. This can have nothing to do with actual traumatic experiences driving, accidents, etc. As a clinician who is intrigued by complex case conceptualization, I am curious if driving anxiety is simply separate but can be comorbid with experiences of trauma, or if there is something else behind it, and what that means for treatment.
My theory is that those who have experienced developmental trauma develop symptoms (the main criteria for diagnosis of CPTSD, for example) which exacerbate negative driving experiences.
Here are the following criteria I see folks struggling with when driving:
Emotional dysregulation - trauma survivors often have difficulty regulating their emotions. This is inherently unsafe when driving for both the driver and those around them. There is a spectrum from road rage to extreme panic or distress that can be very difficult to cope with.
Avoidance - trauma survivors often avoid situations that either make them uncomfortable or remind them of their trauma. This might lead to them allowing others to drive, and the more that they do not expose themselves to driving, the more their anxiety grows.
Dissociation - extremely important! Trauma survivors almost always dissociate on a spectrum, meaning they unwillingly disconnect from reality and often are not even aware of it. This could mean seeing the environment in a distorted way; perhaps blurry, poor depth perception, slower processing times, even “losing time” while driving. When I complete dissociation assessments with clients I often ask them how their symptoms have impacted their life, including causing car accidents, etc.
Hypervigilance - I see this with nearly all trauma survivors I work with. They notice every single detail; their nervous system is on high alert. This leads to higher cortisol levels, higher blood pressure, etc which will amplify anxiety. They might misinterpret another person’s driving, like thinking they’re following too closely, or have a lot of difficulty recovering from another driver’s mistake.
There are many other factors that can impact a person’s anxiety or phobia of driving, and these should be taken into account through further exploration and testing.
In terms of treatment suggestions for driving anxiety that is comorbid with complex trauma as a client’s main presentation, I will make a second blog post soon.
Further reading:
Pk Bernstein, J., Milberg, W. P., McGlinchey, R. E., & Fortier, C. B. (2022). Associations between Post-Traumatic stress disorder symptoms and automobile driving behaviors: A review of the literature. Accident; analysis and prevention, 170, 106648. https://doi.org/10.1016/j.aap.2022.106648
Greenfield J, Allen J, Rudisill TM (2025) Determining how individuals manage their driving anxiety. PLOS Ment Health 2(4): e0000163. https://doi.org/10.1371/journal.pmen.0000163
