Virtual Reality Therapy for Driving Phobia￼: What You Need to Know
For a lot of people, driving isn’t just a milestone to overcome in life. Driving phobias can cause people to become so fearful of driving that they’re unable to even attempt to learn how to do so. It’s not hard to see why: having control over a speeding piece of metal, surrounded by other people in speeding pieces of metal, and you have no control over what other drivers are going to do? It can be challenging for people whose brains make it hard to rationally overcome this fear and learn proper driving techniques to keep them safe on the road.
There is some conflict over what a phobia of driving should be classified as. Some believe that a phobia of driving should be categorized as an amalgamation of social phobia, panic disorder, and agoraphobia. There may also be underlying anxiety that drives the fear of driving. Whatever the definition, a fear of driving affects a large amount of people in the world to the point where it greatly impacts their lives.
This is where a special kind of therapy comes in: virtual reality therapy. For people whose fear of driving is negatively affecting their livelihoods, this special therapy can sometimes be the only thing that helps.
What Exactly is Virtual Reality?
Virtual reality describes artificial environments created by the use of computer technology. Users place a device over their heads that completely covers their eyes, much like safety goggles, so that the inside screen can completely immerse them in their virtual world. This is called the head-mounted display (HMD). The use of the HMD means that, when a user turns their head, they’re able to see 360 degrees around them in a virtually created environment. Virtual reality technology also relies on audio to be able to help create a sense of space around the user.
For the most part, virtual reality technology has been used to create video games and has been marketed for such. Virtual reality is often equated with entertainment: videos, simulated roller coasters, adventure story rides, etc. But virtual reality isn’t just limited to immersive video games. This technology is now being used to help treat different kinds of psychological illnesses through virtual reality therapy.
What is Virtual Reality Therapy?
Virtual reality (VR) therapy is a type of exposure therapy wherein patients can be exposed to virtual situations where they can face their “fear stimulus”, or phobias, in a controlled environment by their psychologists. VR therapy is used in place of typical exposure therapy scenarios, which often include either taking the patient to a real environment with their phobias, like a large crowd or a room with a spider in it, or encouraging the patient to imagine their phobias in the room with them.
Exposure therapy is used to engage patients with maladaptive behaviors in order to make a positive change. In most cases, exposure therapy is used to engage with extreme avoidance. The point of exposure therapy is to slowly expose patients to the things that they are avoiding in order to overcome the anxiety or fear of the situation, whether that fear is based on a real-life experience or an imagined scenario. The ultimate goal of exposure therapy is completely eradicating the anxiety of the situation or stimulus in order to improve a patient’s quality of life.
VR therapy is starting to become the preferred method of exposure therapy due to an increased ability to safely control the environment for the patient. Real-life environments can often be unpredictable, which can make it harder for patients to safely work through their fear response. With VR therapy, virtual situations can be set through coding by the psychologist to help patients work through their phobias at their own pace. The goal is to desensitize the patient to the fear response they get when facing a particular stimulus.
VR therapy used to be extremely expensive, which limited the availability to only certain clinics. In recent years, however, VR technology has become more widespread and available, with some virtual reality technology costing only a couple of hundred dollars. These devices can be computer-based or even work with your smartphone. The cheaper alternatives make it easier for most people to have access to this technology that can be life-altering for people with phobias.
The reason VR exposure therapy works is that psychologists find that people react to their phobias in the same way they might in real life, even if they know that the environment isn’t real. Being immersed in a 3D environment, complete with sound and the ability to walk through the environment as if it were real, simulates the benefits of exposure therapy without any of the drawbacks of being in a real, fear-inducing environment.
How Virtual Reality Helps Driving Phobias
Psychologists agree that one of the key aspects to facing any anxiety disorders, including phobias, is being able to face your fears. When it comes to driving phobias, trying exposure therapy can be dangerous for both the patient and the people around them, since it does involve getting behind the wheel.
If a patient has a phobia of driving, doing so can make it harder for them to be a safe driver and to be aware of the people around them on the road. Psychologists who work with patients with an extreme fear of driving find that these people often adopt “defensive” driving techniques, including sudden braking or going too slow on a freeway.
Real-life exposure therapy in driving be dangerous and it can also be impractical. Some people might have a fear of driving through tunnels, which might not be easy to find locally. Others might have a fear of driving at night, which is impractical to do in real-life exposure therapy. Psychiatrists can’t be expected to go on long drives with their patients, or go out in a car at night.
Not only this, but some studies have shown that patients who are offered real-life exposure therapy may refuse to do so entirely or terminate their treatment altogether. Exposure therapy is incredibly useful in creating new neural-pathways in anxious and phobic patients, but getting over that hump can sometimes be too much for people to handle.
Many driving phobias often stem from events that have happened during someone’s life. For example, a fear of driving can often be the result of being in a car accident, or even just witnessing one. The problem arises when the stress and anxiety of the situation becomes disproportionate to the event that spurred the phobia in the first place.
For example, getting into a small fender-bender might be startling and a little scary to begin with, but the reaction of being too afraid to get back in the car again means that one has developed an undue amount of stress and anxiety about the situation.
Being a nervous driver is normal when you’re inexperienced, but the problem arises when the issues begin to negatively affect how someone lives their day-to-day life. Some people may be able to live with a fear of driving without any negative impact - such as people who live in a big city with a robust public transportation system. For other people, however, a fear of driving can leave them isolated and unable to connect with the rest of the world. It can affect getting a job, going to school, seeing family, and living a full, robust life.
Psychologists at the University of Manchester have begun to do testing with patients who have a variety of phobias that involve driving. Patients who participate in VR exposure therapy for driving are able to put on the HMD and face each particular fear in a safe, enclosed environment.
With the use of computer technology, psychiatrists can populate an entire driving-based world for patients to work through their phobias, whether that be driving on the highway or just doing day-to-day surface street driving. This allows patients to be treated for their own specific and individual phobias when it comes to driving.
With the use of VR technology, exposure therapy for driving can be slowly ramped up and monitored by psychologists. For someone who has a fear of driving on the freeway, psychologists can start them off with using VR technology to simulate driving on an empty freeway and then slowly adding more cars. Likewise, a patient who has an irrational fear of driving at night can safely practice night-time driving from the comfort of their psychologist’s office.
Studies have found that patients who engage in VR exposure therapy with simulated roadways report that their anxiety decreased across three sessions over a period of 10 days. The study also found that patients were rating their avoidance of driving and their anxiety lower than they were rating them before the treatment occurred. As well, day-to-day disturbances having to do with their fear of driving also decreased.
C2Drive is an example of the kind of software that psychiatrists might use to help expose their patients to driving with virtual reality. There’s HMD, headset, steering wheels, and pedals that fully immerse the patient in the environment. This software uses an incredibly high degree of realism in order to not break the “reality” part of virtual reality for patients who need this kind of exposure therapy.
Virtual Reality in Treating Post-Traumatic Stress Disorder
A phobia of driving is not the only therapeutic use for VR exposure therapy, however. While a phobia usually implies a disproportionate amount of anxiety and fear of something, extreme driving accidents can often cause post-traumatic stress disorder (PTSD). Someone who has been in an extreme car accident might find that they must deal with PTSD surrounding being in a car or driving one after the incident.
Studies on PTSD have found that both men and women cite “car accident” as the most common traumatic event. Not only that, but 9% of people involved in car accidents report being diagnosed with PTSD after the event. PTSD can greatly affect a person’s general mood and anxiety, along with their ability to get back behind the wheel.
Exposure therapy is considered a behavioral tool for treating PTSD. This means that, theoretically, the use of VR technology works for PTSD in the same way that it works for general driving phobias, in that the trauma can be worked through with a psychiatrist in a safe and secure manner.
Rather than treating a general phobia of driving, however, people using VR to treat driving-related PTSD can be slowly exposed to the exact environment in which the trauma had occurred, so that they can overcome it and change the outcome. Exposure therapy, when treating PTSD, works best when a patient is exposed to the thing they fear most as closely as possible.
While this might not work for some PTSD cases, the efficiency of VR exposure therapy for driving-related PTSD is quite high. For example, for a patient who was in a car accident on a small, crowded road, VR exposure therapy will allow that patient to recreate that environment in order to overcome the PTSD-related anxiety and avoidance that arises.
The use of Virtual Reality Therapy for driving phobia￼ among the psychological field has opened up doors to helpful therapy that people might not have had access to otherwise. A phobia of driving can cause a person to struggle with their day-to-day lives and cut them off from the rest of the world. Not only that, but driving is seen as a milestone to be passed in modern life.
When a person allows a fear of driving to overtake their lives, they may be cut off from friends, family, job opportunities, and even access to higher education. Thankfully, virtual reality exposure therapy has become more affordable and more available to a wider range of psychologists. Virtual reality has no small effect on people who are plagued with either a phobia of driving or PTSD.
Anyone suffering from a fear of driving no longer has to let their anxieties control their lives. Virtual reality can slowly help people face their fears and overcome them.