What is Amaxophobia? (2024)

Amaxophobia is an extreme and overwhelming fear of driving or travelling as a passenger in a vehicle. Someone with this phobia may experience fear and anxiety that are so intense that they are unable to travel in any vehicle. Other people only experience adverse symptoms in relation to certain types of vehicles.

Being unable to drive or ride as a passenger can significantly affect someone’s day-to-day life, their professional life, their social life and their overall well-being.

Today, we are going to look at amaxophobia in more detail, including the common causes, triggers, symptoms and treatments.

Amaxophobia is the extreme, irrational, overwhelming and persistent fear of travelling in a vehicle, either as a passenger or as a driver.

People with this phobia may fear driving or travelling in a variety of vehicles, including:

Also known as hamaxophobia or motorphobia, someone with amaxophobia will likely experience intense feelings of fear, anxiety, panic or distress when travelling in a vehicle or thinking about travelling in a vehicle, even if this is for a very short amount of time.

Travelling in a vehicle can be so anxiety-provoking that someone with amaxophobia may experience intense anxiety and panic at the thought of travelling in a car. They may be unable to think about vehicles reasonably or rationally and may be out of touch with reality in relation to vehicles.

In some people, their phobia can be so severe that they experience fear or anxiety just by seeing a vehicle or a vehicle driving close to them. Amaxophobia can be so severe that it can interfere with an individual’s social and professional life. Someone with this phobia may be unable to travel to work or to social events and may be unable to travel to any shops or other places that aren’t within walking distance.

Some people with amaxophobia may also miss important medical appointments or refuse to seek medical help when they need it because their GP surgery, dentist or the hospital are too far from their home. This can have a significant impact on someone’s health and can result in medical conditions going undiagnosed or untreated. Some people’s amaxophobia may be so severe that they are unable to leave their homes in case they see a vehicle.

Because amaxophobia is a highly individualised phobia, it can be connected to several different fears relating to vehicles.

• The fear of being involved in an accident – Many people with amaxophobia may fear being involved in an accident and the injuries or potential fatalities that can occur as a result of a vehicular accident. Statistics regarding vehicle accidents show that there are some risks involved with travelling in vehicles:
  – 27,450 people were killed or seriously injured (KSI) in 2021 in the UK in road traffic accidents.
  – 128,209 road traffic casualties occurred in the UK in 2021.
  – 640 aeroplane crashes occurred worldwide with 477 fatalities in 2019.
  Although travelling in vehicles is extremely safe and the number of fatalities and injuries per vehicle are extremely low (particularly for travel by train or commercial aeroplane), seeing or hearing about an accident can be quite traumatic, particularly if you witness a crash happen or see the aftermath of a vehicle accident. Someone with amaxophobia may focus on negative statistics and stories they hear on the news and from family and friends regarding vehicular accidents and crashes.
• The fear of not being in control – Some people with amaxophobia fear travelling in vehicles because they may feel a lack of control, particularly when travelling as a passenger. Knowing that a driver or pilot has complete control of the safety of the vehicle, and you cannot access the steering wheel or brake if you need to, can be extremely triggering for some people. Even if you are driving the vehicle, you may still feel a lack of control as even the safest, most careful driver can become involved in an accident if another driver is careless, under the influence of alcohol or drugs, or driving dangerously, or if adverse weather conditions, such as ice or snow, impact your ability to drive safely.
• The fear of being in a confined space – Vehicles are often confined spaces, particularly if you are travelling by public transport where you may be sitting close to other passengers, and in both private and public modes of transport where you may be unable to open the door and get out whenever you want. This can make you feel like you are trapped or out of control and that something bad is going to happen to you. Disliking confined spaces can make a space that may not usually be considered as small to other people feel very tight or crowded to you. The space may also seem to shrink the longer you spend there, making travelling in a vehicle for longer than a few minutes feel impossible.
• The fear of becoming trapped in a vehicle – Some people dislike vehicles because they have doors that close and lock. In many types of vehicles, the passenger has no control over locking the doors and the doors may be locked without your control (for example, in an ambulance, bus, train or aeroplane). This can make you feel trapped and like you cannot escape if you need to. Even travelling in a car can be difficult as you may fear the doors locking automatically or another person locking you into a car and kidnapping or hurting you in some way.
• The fear of being caught in an incident of terrorism – Terrorism is reported much more frequently on the news and is an issue that many people are now aware of. Terrorist incidents are often sensationalised on the news and reported constantly for weeks, months and even years. Even though terrorist incidents involving vehicles are extremely rare, this over-sensationalising can make them seem more likely to occur. Some people become afraid of vehicles and most particularly of forms of public transport, such as aeroplanes, trains and buses, in case they are caught up in a terrorist incident.

Someone with amaxophobia may find it extremely difficult to think reasonably about their fear of travelling in a vehicle and may unintentionally sensationalise or overstate the risks involved with travelling in a car. Someone with amaxophobia may experience difficulties functioning normally or concentrating in certain places or situations because of their fear of travelling in a vehicle. They could become consumed with the thought of vehicles and may constantly look around them to check there are no vehicles close by.

The negative thoughts and feelings associated with travelling in a vehicle are likely to be overwhelming and can have a significant impact on a person’s day-to-day life, their mental and emotional health and their overall well-being. They may also experience anticipatory anxiety in the lead-up to situations where they may need to travel in a vehicle or may be close to vehicles.

The fear, anxiety and panic that someone with amaxophobia feels can have a significant impact on their life and can result in avoidance behaviours, whereby they avoid any place or situation where they are required to travel by vehicle.

For example, they may be unable to work unless they can work from home, or their workplace is within walking distance, and they may be unable to socialise with their friends or family away from their home. They may also be unable to engage in everyday tasks, such as going to the supermarket or going to the gym. Avoidance behaviours can negatively impact your day-to-day life and your physical and mental well-being. They can also make it difficult for you to function normally in society.

Although avoidance behaviours are designed to help you avoid travelling in vehicles and prevent you from experiencing negative thoughts and feelings and adverse symptoms, they can actually have a paradoxical effect and instead reinforce your fear and result in more severe symptoms in the future. Avoidance behaviours can also negatively impact your social life and professional life, your relationships and your ability to function normally.

Although disliking driving or travelling in certain vehicles isn’t uncommon, this doesn’t mean that every person who dislikes vehicles is experiencing amaxophobia.

To be classified as a phobia, your symptoms will include:

• Feelings of intense fear, panic or anxiety that are difficult to manage.
• Fear or anxiety that is out of proportion to the true risk.
• A fear of travelling in vehicles that lasts for at least six months.
• Engaging in avoidance behaviours to prevent the need to drive or travel in a vehicle.
• Fear that interferes with your day-to-day life, overall well-being or sense of safety.
• Experiencing anticipatory anxiety or worry when thinking about travelling in a vehicle.

Similarly to other phobias, amaxophobia can occur on a spectrum, with the amount of fear and anxiety someone feels ranging from mild to severe. Some people with this condition will experience symptoms in relation to all vehicles and will refuse to travel in any vehicle, regardless of the circ*mstances and how much they need to travel to a particular place.

Other people will only experience symptoms in relation to certain types of vehicles, may be able to drive (but not travel as a passenger) or may be able to travel with someone they trust, such as a parent or partner.

Someone with amaxophobia may be aware that their fear of driving or being a passenger in a vehicle is irrational and that the risk to them is relatively low. However, they may still find that they are unable to control their fear or anxiety and are unable to manage or prevent their psychological, behavioural or physiological responses to vehicles.

Amaxophobia is related to and can occur in conjunction with other phobias, such as:

• Aerophobia: An extreme fear of flying.
• Claustrophobia: An extreme fear of confined spaces.
• Agoraphobia: An extreme fear of situations where escape may be difficult.
• Thanatophobia: An extreme fear of death.
• Dystychiphobia: An extreme fear of accidents.
• Algophobia: An extreme fear of physical pain.
• Tachophobia: An extreme fear of speed.

Amaxophobia is a type of specific phobia which is characterised by an enduring, overwhelming and irrational fear of a specific object, situation, place or person; in this case, an extreme fear of driving or travelling in vehicles. Amaxophobia is also a type of anxiety disorder.

Because amaxophobia is officially categorised as a specific phobia, any diagnoses of this condition fall under the specific phobia umbrella. This means there are no individual statistics available that show how many people have a phobia of driving or travelling in vehicles.

Currently, approximately 5 million people are diagnosed with a type of specific phobia. However, it is thought that these figures are not representative of the true statistics and that many people with phobias either never seek a diagnosis, are misdiagnosed or go undiagnosed. Similarly to other specific phobias, many people with amaxophobia never receive an official diagnosis for their condition.

There are multiple reasons why amaxophobia may go undiagnosed, for example:

• Many people with amaxophobia have never heard of this condition so may not realise they are experiencing a diagnosable medical condition.
• Many people are unaware that there are effective treatment options available for phobias.
• Someone with a phobia of travelling in vehicles may implement successful avoidance behaviours to reduce the frequency with which they are exposed to their triggers or need to travel in a vehicle. This can make their phobia seem more manageable.
• Someone with amaxophobia may not discuss their thoughts and feelings with others so may not realise that what they are experiencing is abnormal.
• Someone with amaxophobia may be embarrassed by their fear and the way it affects their life and may not want to speak to their GP or admit that they have a problem.
• The symptoms of amaxophobia can be similar to the symptoms of other phobias, such as claustrophobia, so the condition may be misdiagnosed.

It is also important to keep in mind that not everyone who dislikes driving or travelling as a passenger is experiencing a diagnosable medical condition.

Negative thoughts and feelings concerning travelling in vehicles can occur on a spectrum, ranging from mild anxiety to severe fear, panic and anxiety that can impact your day-to-day life, affect your decision-making and result in changes in your behaviour. It can sometimes be difficult to differentiate between a dislike of travelling in vehicles and amaxophobia.

Although anyone can develop amaxophobia, certain risk factors can increase the likelihood of someone developing a fear of driving or travelling as a passenger in a vehicle.

These include:

• Having a previous negative, traumatic, scary or painful experience involving a vehicle or driving or travelling in a vehicle.
• Witnessing an accident, such as a car crash.
• Hearing traumatic or scary stories about crashes or seeing frightening pictures or videos, such as of plane crashes, particularly during childhood or adolescence.
• Having another related phobia, such as claustrophobia or aerophobia.
• Previously experiencing a panic attack or high anxiety when travelling in a vehicle, even if the vehicle was not the cause of your anxiety.
• Having a close family member, such as a parent or sibling, with amaxophobia.
• Having a close family member, such as a parent or sibling, with another phobia.
• Being exposed to the fear of driving or vehicles during childhood or adolescence.
• Having post-traumatic stress disorder (PTSD).
• Having another mental health condition, such as an anxiety disorder, depression or obsessive compulsive disorder (OCD).
• Having a sensory processing disorder or sensory difficulties.
• Being a naturally more anxious or nervous person.
• Experiencing a significant life stressor, having higher than usual stress levels or being in a heightened mental state (particularly if you are exposed to amaxophobia or have a negative experience involving a vehicle during this time).
• Having a substance use disorder, such as an addiction to drugs or alcohol.

It is important to note that even though the above risk factors can increase the likelihood of you developing amaxophobia, they do not guarantee this. Someone with none of the above risk factors can develop the condition unexpectedly, whereas someone with several risk factors may never develop amaxophobia and may be confident driving and travelling in a variety of vehicles throughout their life.

Unlike many other types of phobias, which often more frequently manifest or are diagnosed during childhood or adolescence, amaxophobia is more prevalent in adults. This could be because adults are more aware of the potential danger of travelling in a vehicle, may be more likely to have witnessed or heard about a traumatic vehicle accident or may be more likely to watch the news, which often sensationalises incidents such as train and plane crashes.

There are several medical interventions and medical treatments which effectively treat amaxophobia. However, there are also other strategies that you can implement yourself to help you successfully manage and reduce the symptoms of your phobia and reduce the impact your fear has on your life.

Coping and calming strategies can be combined with lifestyle changes to help alleviate your symptoms and reduce the impact your phobia has on your day-to-day life and your health and overall well-being.

Some coping and calming strategies are designed to be implemented long term, as part of your regular daily or weekly routine. Long-term strategies can help to reduce the frequency and severity of your symptoms over time and enable you to be exposed to your triggers in the future without experiencing negative thoughts and feelings.

Other strategies are most effective short term and should be implemented when you are travelling in a vehicle in the future. Short-term strategies are designed to minimise or prevent any physiological, psychological or behavioural symptoms in the moment and to prevent a triggering situation from worsening and your negative thoughts and feelings from taking over.

Some of the long-term and short-term coping and calming strategies you can implement to help you deal with your amaxophobia are:

• Learn about your phobia – Take the time to understand your phobia, including what initially caused your fear and what your triggers are. Understanding the root cause of your phobia and any negative or damaging beliefs, patterns of thought, feelings and behaviours that are attached to it can help you to change your conscious and unconscious reactions to driving or being a passenger and can help you to manage the symptoms of your phobia more successfully. Having a more thorough understanding of your phobia can help you to understand and rationalise your thoughts, reduce your automatic fear response and reduce the frequency and severity of your symptoms.
• Create a fear ladder – A fear ladder can help you to analyse and understand your phobia and can help you to identify which of your triggers creates more severe anxiety and panic than others. Because phobias are highly individualised, everyone’s fear ladder is different. An example fear ladder is shown below:
  – 1 = Being on an aeroplane.
  – 2 = Being on a train.
  – 3 = Driving a car.
  – 4 = Being a passenger on a bus.
  – 5 = Being a passenger in a car with someone you don’t know.
  – 6 = Being a passenger in a car with someone you know.
  Once you have created your fear ladder, you can then confront your triggers one at a time, starting at the bottom of the ladder (the trigger that results in the least phobic response). This can help you slowly deal with your phobia and the triggers that are worsening the symptoms of your phobia.
• Visualise yourself overcoming your fear – Visualisation can be a very effective tool for overcoming your phobia. It works by visualising yourself successfully confronting your fear and overcoming the source of your phobia and any fear and anxiety you may be experiencing. To work effectively, you will need to visualise yourself facing your trigger (e.g. driving a car) and imagine how this would feel and the positive ways it would change your life; for example, you may feel empowered and accomplished and be able to start driving to work and visiting your friends. The brain often cannot distinguish between our thoughts and reality so visualising positive experiences driving or being a passenger can reassure your brain that there is no danger and that you can overcome your fear.
• Challenge negative thoughts and feelings – If you have a phobia, experiencing negative thoughts and feelings surrounding the object of your fear can be unconscious and automatic. You may think about travelling in a vehicle with increasing distress and find it difficult to prevent your feelings of fear, panic and anxiety. If you are in a triggering situation or find yourself thinking about your triggers negatively, you can prevent your fear from escalating by disrupting and challenging your negative thoughts and memories. Remind yourself that your fear is irrational, that the feelings will soon pass, that your fear is disproportionate and that you aren’t in any danger.
• Desensitisation – Desensitisation can be an effective way of reducing your automatic fear response. It draws on the principles of exposure therapy and is designed to be done gradually, in environments and situations where you feel safe and comfortable. You should begin with a trigger that only results in low levels of anxiety and once you are comfortable, move on to another situation that is usually more anxiety-provoking. The aim is to slowly build up to the situations that currently create the strongest fear and anxiety responses. Gradually desensitising yourself can prevent driving or travelling as a passenger from triggering a reaction or can result in a less severe reaction in the future. This can reduce the impact your phobia has on your daily life and your well-being.
• Join a support group – In order to manage your phobia and reduce the impact it has on your life, you can join a support group with other people who have gone through similar experiences to you. Support groups are usually led by experts and are comprised of people who have faced or overcome similar challenges. As well as providing you with information and advice, the sessions can validate your thoughts and feelings and provide reassurance and empathy. In-person and online support groups are available.
• Set goals – Setting a list of goals, both short-term and long-term, can ensure you stay motivated and hold yourself accountable. Goals give you a long-term vision, such as no longer being afraid of travelling in a vehicle. They also give you short-term motivation. Setting goals can also help to eradicate problematic behaviours and trigger new positive behaviours and can keep you motivated to overcome your phobia.
• Avoid negative depictions or negative stories – There are many different examples of TV shows, films and songs that portray vehicles negatively (e.g. by showing crashes, derailments and terrorist incidents). Negative portrayals can validate and reinforce any negative connotations you have already associated with driving or travelling as a passenger. Additionally, real stories, such as news stories or stories from friends and family, can also exacerbate your phobia and cause you to experience more severe fear and anxiety. Avoid any triggering or negative depictions of vehicles to prevent your phobia from escalating.
• Practise mindfulness – Mindfulness can teach you how to be grounded and present in the moment, how to accept your thoughts and feelings and how to overcome any fear and anxiety you may be feeling. Mindfulness teaches you to focus your breathing and attention and reduces the likelihood of you experiencing a panic attack. Mindfulness can also help you to manage stress and anxiety and be more in control of the connection between your mind and body and help you to control the symptoms of your phobia.
• Practise yoga and meditation – People who practise yoga and meditation consistently can achieve a meditative state of mind that can help manage the symptoms of amaxophobia. The practice of yoga and meditation helps you achieve a highly relaxed state and decreases your stress levels, which reduces your chance of experiencing a fight-or-flight response. You can also learn how to control your breathing and manage your body’s negative reactions to your triggers. Daily practice can help reduce the impact of your phobia and improve your symptoms over time.
• Learn deep breathing exercises – Deep breathing exercises can effectively help you manage or prevent the symptoms of your phobia if you encounter a trigger. Deep breathing prompts your brain to relax and calm down, which can help you to manage your anxiety. If you engage in deep breathing exercises every day, this can help you to effectively reduce your stress levels, relieve tension in your body and reduce your anxiety long term.
• Make lifestyle changes – Lifestyle factors such as lack of sleep, high levels of stress and a poor diet can exacerbate the symptoms of your phobia and increase your anxiety. By making lifestyle changes, you can reduce the impact your phobia has on your life. Some lifestyle changes you can make include:
  – Implement a successful sleep routine.
  – Reduce your daily stress.
  – Eat a healthy, balanced diet.
  – Implement an exercise routine.
  – Avoid caffeine, sugar and other stimulants.
  – Avoid alcohol and recreational drugs.
  – Stop smoking.

A trigger, also known as a stressor, is an object, person, place, situation or thought that triggers a negative reaction and negative thoughts and feelings, such as fear, panic, anxiety or distress. A trigger can also lead to physiological, behavioural and other psychological symptoms. Your brain perceives a trigger as a threat to your physical or mental safety or well-being and will react accordingly.

Because amaxophobia is an individualised phobia that manifests in different ways, there are many potential triggers and different people with this condition often have different triggers. The types of things, places and situations that trigger your phobia can vary from person to person, with some people having only one trigger and other people having multiple triggers.

The types of triggers and the number of triggers experienced by different people can vary depending on what initially caused their phobia to develop, their perception of the potential risk, the severity of their symptoms and their current mindset and mental health.

The most common triggers for amaxophobia are:

• Getting into a vehicle.
• Driving a vehicle.
• Travelling as a passenger in a vehicle.
• Being in a vehicle and seeing or hearing the doors close.
• A vehicle driving past you.
• Hearing the sound of a vehicle, such as the beep of a horn, the sound of an aeroplane flying above or the siren from an ambulance.
• Booking a ticket for transport, such as a train ticket or flight ticket.
• Going to a train station, bus terminal or airport.
• Being in an enclosed space that reminds you of a vehicle.
• Seeing an accident involving a vehicle.
• Hearing about incidents such as a plane crash on the news.
• Watching a TV show or film featuring vehicles, particularly if it involves a negative incident or accident.
• Thinking about vehicles or remembering a previous time you travelled in a vehicle.
• Smelling something you associate with vehicles, such as petrol.
• Someone you love travelling in a vehicle.
• Walking down a busy street or being in a busy city centre.

The symptoms of amaxophobia are varied and often differ significantly from person to person. The symptoms can differ in the way they manifest, their severity and the type of symptoms a person experiences. Some people with amaxophobia only experience a few mild symptoms whereas other people experience more severe symptoms.

It is also possible to experience different types and severities of symptoms in different situations and when faced with different triggers. For example, your symptoms may be more severe travelling on an aeroplane compared to travelling in a car with your partner.

Differences in the severity of symptoms, how frequently they occur, and their manifestation can also occur for other reasons, such as how acute your phobia is, your triggers, your perception of the situation and your current mental health and mindset.

The symptoms of amaxophobia can occur at any time, including when you are travelling in a vehicle, when you think about travelling in a vehicle and when you encounter another trigger. The symptoms of amaxophobia are often automatic and uncontrollable. It may feel like you are unable to control or manage your thoughts or feelings and that your phobia is taking over your body. To be classified as a phobia, you will need to experience symptoms for at least six months.

The symptoms of amaxophobia can be psychological, behavioural or physiological. The most common symptoms are:

Psychological symptoms refer to the symptoms of your phobia that are cognitive or emotional.

The most commonly occurring psychological symptoms of amaxophobia are:

• Intense, overwhelming persistent, excessive and unreasonable fear, anxiety, panic or dread when travelling in a vehicle or thinking about travelling in a vehicle.
• Feelings of fear, anxiety or panic that are out of proportion to the risks.
• Being unable to control your fear, anxiety or panic even if you are aware that they are out of proportion to the risk.
• Catastrophising the possible risks of travelling in a vehicle and envisioning the worse possible outcome, for example, the car you are in is going to drive off a bridge.
• Experiencing anticipatory anxiety in the lead-up to travelling in a vehicle.
• Experiencing depersonalisation or derealisation (where you feel like you no longer understand what is happening around you or you have lost touch with reality) when in triggering situations.
• Feeling immobilised or frozen by your fear.
• Feeling defenceless or vulnerable.
• Being unable to concentrate or function normally in a vehicle or in another triggering situation.
• Feeling like you are losing control or are not in control.
• Experiencing frequent or distressing nightmares involving vehicles.
• Feeling like you are in danger or having a sense of impending doom.
• Feeling like you are going to die.

Behavioural symptoms refer to any changes in your behaviour that occur as a direct or indirect result of your phobia. These symptoms may be negative, harmful or abnormal and may be different from your typical behaviour or the expected behaviour in society.

The most commonly occurring behavioural symptoms of amaxophobia are:

• Avoiding any place or situation that may require you to travel in a vehicle.
• Becoming socially withdrawn.
• Being unable to work if your workplace isn’t close to your home.
• Not engaging with medical appointments as you cannot travel to them.
• Being unable to walk in a city centre or another area with lots of vehicles.
• Being unable to eat or having a lack of appetite during or in the lead-up to a potentially triggering situation.
• Difficulties sleeping or insomnia in the lead-up to a potentially triggering situation.
• Refusing to talk about or think about driving or travelling in a vehicle.
• Being unable to watch a TV show or film that features cars, buses, planes or trains, particularly if they involve a negative event, such as a crash.
• Feeling like you want to run away and hide if you are required to travel in a vehicle.

Physiological symptoms are the physical disturbances or changes you feel in your body that are caused by your phobia. Because travelling in a vehicle causes a fear or anxiety response, seeing a vehicle or thinking about getting into a vehicle can result in a fight-or-flight response.

The fight-or-flight response is an automatic physiological reaction that occurs when your brain perceives the object of your fear as a threat or danger. This can result in a sudden release of hormones, such as adrenaline or noradrenaline, that activates your sympathetic nervous system and prepares your body to fight or flee from the perceived danger.

These hormones can cause physiological symptoms such as:

• Unusual or excessive sweating or clamminess.
• Muscle tension or feeling like your muscles are stiff.
• Unusual pain or headaches.
• Shaking or trembling.
• Feeling dizzy or lightheaded.
• Feeling confused or disorientated.
• Hot flashes or chills.
• Being unusually sensitive to hot and cold temperatures (e.g. feeling like you are extremely hot even though the room temperature is normal).
• Difficulties breathing, rapid breathing or hyperventilation.
• Feeling like you cannot catch your breath.
• A fast heart rate, heart palpitations or feeling like your heart is pounding.
• Elevated blood pressure.
• A tightness in your chest or chest pains.
• A choking sensation, finding it difficult to swallow or feeling like something is stuck in your throat.
• Stomach pain, nausea, vomiting or feeling like you need to go to the toilet.
• Feeling like you have butterflies in your stomach.
• Numbness or tingling, particularly in your hands, feet, arms or legs.
• A dry or sticky mouth.
• Feeling unusually tired or fatigued.
• Pale or flushed skin, particularly in the face.
• Experiencing a panic attack.

Some people with amaxophobia only experience some of the symptoms, for example, they may experience fear, anxiety and avoidance behaviours but no physiological symptoms. Other people experience a variety of psychological, behavioural and physiological symptoms.

You may also experience different types and severities of symptoms at different times. For example, you may experience symptoms such as a racing heart, shaking, breathing difficulties and panic attacks if you are sitting on an aeroplane but experience more mild symptoms if you are travelling on a train.

There are many possible causes of amaxophobia. It could be that your phobia has one clear cause that you can easily identify or that multiple factors contributed to you developing a phobia. Some people with amaxophobia find it difficult to identify exactly what caused them to develop a fear of driving or travelling as a passenger. It can be more difficult to identify the cause or causes of your phobia if it developed a long time ago, such as during childhood, or if your symptoms manifested gradually over time.

Identifying the root cause or causes of your phobia can be extremely beneficial, as it allows you to address your initial triggers and any negative patterns of thought or feelings that are attached to your initial triggers. This can make it easier to manage your symptoms and reduce the impact your phobia has on your life.

The causes of amaxophobia can be psychological, environmental, societal or genetic. The cause often varies from person to person.

The most common causes of amaxophobia are:

• A negative, traumatic, scary or painful experience that occurred when you were driving or travelling as a passenger – Also known as traumatic conditioning or a direct learning experience, this is the most common cause of amaxophobia. The traumatic experience may or may not have involved real danger or risk. However, as long as you experienced significant fear, distress or trauma, this could have led to the development of a phobia. A traumatic experience is more likely to lead to a phobia if it happened during childhood or during a particularly vulnerable time in your life. The experience can be direct, meaning it happened to you, or indirect, meaning you witnessed the event happening to someone else. Examples of traumatic experiences include:
  – Experiencing severe turbulence or a forced landing on an aeroplane.
  – Being involved in a car crash.
  – Being a victim of abuse or violence while on public transport.
  – Being in a car that slid or lost control on ice.
  – Witnessing a traumatic incident involving vehicles.
  Following the traumatic experience, you may begin to have intrusive and negative thoughts or memories of the trauma and begin to avoid trauma-related triggers. This can cause the fear or anxiety you felt at the time of the experience to linger or worsen and can lead to you developing a phobia. Even if the traumatic event took place in one type of vehicle, your fear could spread to any form of transport.
• The media portrayal of traumatic events – There have been several examples in recent decades of traumatic incidents involving forms of transport. These incidents are often widely reported on the news and on social media and are often accompanied by distressing photographs and reports of the incident. Some examples include:
  – The 9/11 terrorist attacks when nearly 3,000 people died.
  – The Malaysian Airlines flight 370 that disappeared with 239 people on board.
  – The 2004 Madrid train bombings, where 193 people died and more than 2,000 were injured.
  – The death of Princess Diana when travelling in a car.
  When events such as these occur, it can be almost impossible to avoid hearing the details and seeing the traumatic pictures and videos, and many of these news stories are still revisited today. Traumatic events can cause someone to associate travelling on transport with danger or fear and they may begin to avoid transport, which can then develop into amaxophobia.
• Fear rumination – This is a common cause of phobias and usually occurs following a negative experience involving transport. Fear rumination involves engaging in repetitive negative thought processes and persistently and repeatedly recapping a traumatic, scary, negative or painful experience. Over time, these thoughts and memories can become increasingly upsetting and intrusive and can make you remember the event as being more negative or scary than it was in reality. Fear rumination reinforces your natural fear responses, creates additional anxiety and can result in you developing amaxophobia.
• The startle response – Amaxophobia can be triggered by the startle response in your brain. The startle response is a mainly unconscious defensive response to something that we perceive to be dangerous or threatening. The threatening stimulus is usually a surprise or occurs suddenly. The stimulus ‘startles’ you and causes your brain to release chemicals that heighten your feelings of anxiety and your perception of danger. If a vehicle caused the startle response, for example, if a car swerved towards you, or you experienced the startle response while you were driving or travelling in a vehicle, this could have created a future negative association between transport and danger which can result in you developing amaxophobia.
• A learned phobia – Also known as an observational learning experience or modelling, a learned phobia usually means you observed a fear of driving or travelling in another person and learnt to be scared of these situations yourself. You are more likely to learn a phobia if you are exposed to it during childhood or adolescence; for example, children who grow up with a close family member, such as a parent or sibling, with amaxophobia are more likely to develop the condition themselves. However, a learned phobia can also develop during adulthood.
• An informational learning experience – Being exposed to information that scares you or creates feelings of fear or anxiety can contribute to you developing amaxophobia. For example, hearing about the number of car accidents that occur every year, the different ways that an aeroplane can fail or crash and the number of people that die every year in a car or another form of transport can lead you to think of driving or travelling as a passenger as being dangerous and can create feelings of fear, anxiety and panic. If these feelings are not addressed and dealt with, they can then develop into a phobia.
• Negative depictions in popular culture – There are many examples in TV shows, films and music where negative or traumatic events involving vehicles occur. For example:
  – Artists such as The Beach Boys, Elton John and Eminem who sang songs about car crashes.
  – Films such as Air Force One that depict terrorist incidents on planes.
  – Films such as The Fugitive and The Commuter which depict negative incidents on trains.
  – Films such as Thelma and Louise, The Italian Job and Final Destination that feature car crashes.
  Exposure to negative portrayals such as these can result in a phobia, particularly if the exposure occurs during childhood or during a vulnerable or stressful time in your life. Negative depictions can cause you to view driving or travelling in certain types of vehicles to be dangerous and you could begin to experience fear and anxiety responses at the thought of travelling, which can then develop into amaxophobia.
• Experiencing significant or higher than usual stress levels – Significant, long-term stress can result in a disproportionate fear response or an inability to manage intense situations. This can make it more likely that you will develop a phobia, such as amaxophobia, particularly if you have a negative experience in a vehicle or are exposed to amaxophobia while experiencing higher levels of stress. A stressful or distressing event, such as a death, can also trigger a phobia, as you may be less able to manage your emotions and thought processes when experiencing grief, which can result in a disproportionate fear response.
• Having another related phobia – Amaxophobia is closely related to other phobias, such as claustrophobia and aerophobia. In fact, many people with these phobias also experience amaxophobia, particularly if they have never addressed or dealt with their original phobia and the initial onset of their fear. Someone who has a phobia of enclosed spaces, aeroplanes or pain and injury may also have amaxophobia as they fear that being inside a vehicle, such as a car or a train, could trigger their phobia and result in adverse symptoms, such as a panic attack.

If you think you may be experiencing amaxophobia, you should make an appointment with your GP. Your GP will ask questions about your symptoms and will likely look at your medical history. They may also ask about any medications or supplements you are taking, to ensure your symptoms cannot be explained by anything else. If your GP thinks you could be experiencing amaxophobia, they will then make a referral to a psychologist or another mental health professional.

To gain more information about your symptoms and your thoughts and feelings surrounding driving or travelling as a passenger, the psychologist will conduct a phobia questionnaire.

As part of the questionnaire, they will likely ask questions relating to:

• The types of symptoms you experience, how frequently they occur and how severe they are.
• The initial onset of your phobia, including when your symptoms first began and what initially triggered your fear.
• Your medical history, including whether you are currently or have previously had any anxiety disorders, panic disorders, phobias or other mental health conditions.
• Whether you have a family history of phobias.
• How much your fear interferes with your day-to-day life, your well-being and your behaviour.

Because amaxophobia is a type of specific phobia, your symptoms will be compared to the diagnostic criteria for specific phobias.

Your symptoms will need to correspond with the seven key criteria listed below:

Medical interventions and medical treatments for amaxophobia are usually effective, with treatment estimated to be successful for approximately 90% of people with specific phobias. However, not everyone with amaxophobia requires treatment.

If your symptoms are mild, your fear doesn’t impact your daily life or well-being or you have already implemented successful coping strategies, then formal treatment may not be required. However, you should always consult your doctor before making any treatment decisions.

Nevertheless, many people with amaxophobia find treatment to be beneficial. If your phobia is frequently triggered, if you find yourself changing your behaviour, if your symptoms are severe or if your phobia negatively impacts your life, then treatment will likely be advantageous.

As multiple treatment options are available, your psychologist will create a treatment plan that is specifically designed to treat your phobia.

Your treatment plan will be based on several factors, such as:

• The severity of your symptoms.
• The frequency of your symptoms.
• The root cause of your phobia.
• How significantly your phobia impacts your life.

Exposure therapy is one of the most effective ways of treating amaxophobia. Sessions involve gradual and repeated exposure to your triggers in a safe and controlled environment. The aim is to expose you to your fear so that you eventually become desensitised and no longer experience a fear or anxiety response.

Exposure therapy takes place over multiple sessions, with the number of sessions you require depending on how severe or complex your fear is. You will be required to talk about your fear, visualise your fear and be exposed to real triggering situations.

Exposure will begin gradually in escalating phases, with the situation that is the least anxiety-provoking, such as watching videos of someone driving or travelling in a vehicle. Once you are comfortable with this level of exposure, you will progress to other triggering situations, such as sitting in a stationary car.

With each exposure, you should experience progressively lower anxiety and you will gradually build up to the most anxiety-inducing situations. The aim is that you can eventually be in triggering situations without experiencing a negative fear response. During your sessions, you will also learn breathing and relaxation techniques that can be used before and during exposure and if you are faced with your triggers in the future.

By creating realistic thoughts and beliefs surrounding vehicles, unlearning negative associations and patterns of thought, decreasing negative reactions and feelings long term, and learning relaxation techniques and coping and calming strategies, exposure therapy can help you overcome your phobia.

CBT can be effective in addressing any negative or irrational patterns of thought that are contributing to your phobia. It is a type of psychotherapy, often referred to as talk therapy. CBT aims to help you understand your phobia and its underlying cause and change the way you perceive and respond to triggering situations.

Someone with amaxophobia will experience irrational and overwhelming beliefs and thoughts about driving or travelling as a passenger. These beliefs and thoughts will negatively affect your emotions and behaviours. CBT teaches you how to challenge these negative thought patterns and replace them with healthier more realistic thoughts.

During the sessions, you will identify negative thoughts and memories and deconstruct them into smaller pieces, which can then be focused on individually. This can help you to change the way you think, feel and respond to your triggers and eliminate any negative connections you have between vehicles and fear or danger.

CBT sessions can be conducted individually or as part of a group. During your sessions you will:

• Discuss your triggers and symptoms.
• Explore what caused your fear of driving or travelling as a passenger.
• Learn how to recognise your negative thoughts and change the way you are thinking.
• Learn coping strategies and calming strategies, such as deep breathing exercises, distraction techniques and coping statements.