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The question

My mom is a terrified driver. She'll stop in the middle of an intersection, paralyzed by fear. She's recently been involved in a few traffic accidents, although none of these were her fault. She recently ended a 30-year marriage. Are these incidents related? I'm afraid to criticize but I'm concerned for her safety.

The answer

Driving-related fears and phobias can be attributed to a number of causes. Some people are just naturally more nervous drivers - individuals who don't drive often, older adults, and those who have moved from smaller communities to higher traffic-populated areas tend to be less comfortable behind the wheel.

It sounds as though you have noticed some recent changes in your mother's driving behaviour, both in terms of her fear (which I'm imagining she has told you about or you have witnessed directly) and also a higher than average number of accidents over the last short while.

Even though the accidents were not her fault, there could be the possibility that she is engaging in less defensive driving behaviours which may indirectly have increased the likelihood of her being in several accidents in a short period of time.

If she has recently ended a 30-year marriage she is likely under a higher than average level of stress (even if she chose to end the marriage) and it may be that her elevated stress is manifesting in her driving behaviour. When there is an increase in our baseline level of stress, we tend to have amplification of already existing fears or anxieties. For example, it could be that she was always a slightly nervous driver but the increased stress has now contributed to tipping that nervousness into more concerning fears.

Being in a number of accidents over a short while can in and of itself lead to an increased fear of driving, which may from the outside look out of proportion to the severity of accidents that occurred. A number of factors can contribute to quite significant driving-related phobias developing from even minor accidents. Some of the factors include previous number of accidents, physical/emotional health history, other existing stressors, and the nature and circumstances of the accident.

Finally, it is important to keep in mind that other changes in her physical or cognitive health status may be influencing her driving-related fears and behaviours. Health conditions that in particular impact one's cognitive processes or eyesight (e.g., cataracts, stroke, early onset dementia) can also play a role.

I can appreciate the concern about not wanting to criticize, but given the safety risks (both to your mother and to other drivers) this is something you need to bring up with her.

Take a non-accusatory approach with her. Explicitly state that you don't want to come across at all critical, but that you have concerns about her safety and have been worried about her recent accidents. Make sure you emphasize that you know they were not her fault, but that you are concerned nonetheless.

Be specific and objective about the concerns you have (i.e. give specific examples that lead you to say she is "terrified" or "paralyzed by fear"). Offer to go to her family physician with her.

This can be helpful to ensure she has had an examination of her physical function, including eyesight. If it seems that stress-related causes are the sole cause of her fear, the most effective treatment is cognitive-behavioural treatment (which focuses on addressing anxiety-related thoughts and behavioural responses to these thoughts).

Send psychologist Joti Samra your questions at psychologist@globeandmail.com. She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

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The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.



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