We often have individuals engaging in driving exposures for both panic disorder and fear of driving. From our office in Mission Viejo, we have people driving locally south to San Clemente, north through Newport Coast, Irvine, and east to Rancho Santa Margarita. As they head farther afield, they are driving to Los Angeles, the Inland Empire and Las Vegas. Sometimes we go with them, and often they go by themselves.
As we do these exercises (and others like getting on an airplane), we remind our patients to ‘go naked.’ This is shorthand for the concept of not taking anything with them that would make them feel safer, or less anxious. Common ‘safety items’ often include:
- Cell phone
- Water
- Mints
- Medication
- House keys
- Purse or wallet
The goal of ‘going naked’ is for the individual to see that he or she can conquer the situation without the help of any object:
- “I did it! I drove all the way to Newport Beach by myself!”
What we don’t want is for an individual to learn that he or she can do it, but only if they have their safety items to ensure their success:
- “I did it! I drove all the way to Newport Beach, but that would’ve been impossible if I didn’t have my water to keep my throat moist.”
- “I did it! I drove all the way to Newport Beach, but that would’ve been impossible if I didn’t have my medication, just in case I had a panic attack.”
We want to change people’s lives, which means changing thinking patterns of thinking they need safety items to survive, and changing behaviors of not bringing safety items. As we do this, we are excited to see not only how much farther our patients can drive, but ultimately a change in thinking from “I can endure this” to “I can do anything – there’s nothing to fear.”