Virtual reality applied to amaxophobia

Amaxophobia or fear of driving is defined as a specific situation-type phobia that is accompanied by a irrational, intense and persistent fear of driving but also of the idea of ​​having to travel by car and even in the face of the many stimuli that occur around driving; climate change, lane change, acceleration or reduction, braking and above all car breakdowns, which can present a risk to the patient himself and to other people who are, at the same time, on the road.

Although different studies indicate that the prevalence of amaxophobia is around 4%, the truth is that the numbers are around 22% of the population with some kind of fear associated with driving (whether as a driver or as a co-driver) being one of the phobias. for which more people request an appointment in our Cabinet.

    Symptoms of amaxophobia

    Amaxophobia is a phobia that causes clinically significant discomfort and interference with the patient’s work and social life. being the symptomatology of four types:

    • Cognitive: negative automatic thoughts, fear of losing control of the car, fear of not knowing how to react to the road, fear of having an accident …
    • Emotional: anxiety, stress, restlessness before driving.
    • Physiological: anxiety and restlessness before driving accompanied by tremors, precordial pain or tightness, tachycardia, hyperventilation and tingling in the hands and feet.
    • Behavioral: Feeling of blocking the ability to drive and, therefore, try to always be accompanied if you must drive, avoiding as much as possible.

    At first glance, nothing happens to the patient except that avoid, as much as possible, the use of the car for your usual trips, Use of public transport; this ends up affecting the patient’s autonomy and can lead to real anxiety attacks, if he has no other option to move.

    the causes

    Among the main ones, he would have suffered a traumatic accident on the road, even if he does not seem to be the only one because there are studies (Barp and Mahl, 2013; Sáiz, Bañuls and Monteagudo, 1997) which say that social factors such as social pressure to drive and verbal aggression from other drivers are also believed to be causes.

    Finally, a study by Alonso et al (2008) indicates that, among Spanish drivers, 21.9% suffer from depression and 11.2% from another type of anxiety disorder.

      therapeutic goals

      When a patient arrives at the practice, we mark with him the therapeutic objectives to be achieved, from which the entire treatment plan is drawn up. We work both with patients who, in their role as patients, suffer from amaxophobia and with those who feel the same fear but in their role as co-pilots.

      Anyway, the main therapeutic objectives to be achieved son:

      • Change the patient’s irrational thoughts and beliefs about trafficking.
      • Change the patient’s perception of their driving competence.
      • Stop conditioning driving on an anxiety reaction.
      • Eliminate evasion and avoidance responses to feared stimuli.
      • Improve coping strategies.

      All of this is usually done as part of a Cognitive Behavioral Protocol and using the Multicompetent Program which encompasses relaxation techniques and cognitive behavioral strategies to control anticipatory activation and cope with the phobic situation. However, this program (cuves, 2015) analyzes the effectiveness of cognitive behavioral therapy as well as exposure techniques. And this is where we differentiate ourselves.

      Virtual reality for face-to-face treatment

      Unlike exposure techniques, virtual reality (VR) allows you to control various parameters which act as variables. Thus, for each of the environments, the variables that we can control as therapists are:

      • Road: time, climate, type of road, absence or presence of bends, speed, lane changes, distractors (mobile, passengers, loud music), car wrecked on the road and breakdown
      • City: traffic density, climate, time, number of passengers, speed, horn, braking, ambulance, traffic jam, less or more anxious circuit

      If it is an amaxophobia without serious interference in professional life, an average of eight sessions might be enoughBut it will depend a lot on the patient, the duration of the phobia, the severity of it, the associated symptoms …

      Virtual reality for online processing

      Due to containment and doubts about how continue to treat our patients using virtual reality, A new tool has appeared that we continue to use in our Cabinet; it’s called Psious at Home. This tool allows, using a mobile phone or a tablet and both Android and IOS, to perform both guided sessions and “send homework” to our patients who usually do sessions in line for geographic distance or health issues at the present time.

      The only difference is that in face-to-face sessions VR is done through glasses which allow the experience to be 3D, while in the online format therapy is done in 2D and, for example, therefore, the sense of presence decreases, although there are “tricks” such as being in a dark room and with the light turned off duplicating the image on the wireless internet TV (although this may make the quality worse. image) or increase the brightness of the screen of the mobile or tablet to increase the clarity of the image.

      Bibliographical references:

      • Alonso, F., Sanmartín, J., Esteban, C., Calataiud, C., Alamar, B. and López-de-Cózar, I. (2008). Road health Diagnosis of Spanish drivers. Valence: Attitudes.
      • Vats, A. (2015). Specific phobias: personality, evaluation and treatment. Downloaded from:
      • Barp, M. and Mahl, AC (2013). Amaxophobia: a study of the causes of fear of driving. UNOESC and Science – ACBS, 4, 39-48. Retrieved from
      • Sáiz Vicente, I., Bañuls Egeda, R. and Monteagudo Soto, MJ (1997). Explore anxiety in novice and professional drivers. Annals of Psychology, 13 (1), 65-75 []

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