Written by Julie Faccini

March 16, 2020

C2Drive is an application dedicated to the management and treatment of amaxophobia or fear of driving. The impact of Fear of Driving is significant and tends to affect the whole lives of people who suffer from it: loss of autonomy, isolation, solicitations from those around them, restrictions on the geographical area during a job search and inability to pass the driving permit … 

The list of disabilities caused by amaxophobia is long. Virtual Reality is an efficient solution for treating this disorder. Based on the principles of cognitive behavioral therapy, in virtuo treatment is based on the need to gradually confront the patient with the most feared and disabling driving situations. To do this, it has been up until today necessary to have access to environments that could elicit the same activations as reality. 

C2Care has thus designed software dedicated to the treatment of fear of driving. With a steering wheel and pedals, therapists are able to expose their patients to different simulated driving contexts. To create a complete immersion, the application puts patients in similar situations they would experience in reality. Accessories such as steering wheels and pedals are used for the app, and they activate muscular recruitment inherent in driving. This facilitates the dysfunctional and emotional activation during the exposure. 

The real life simulation of driving in VR, makes it possible to maximize the transfer of learning for the patient, as the experience is so realistic and creates a strong sense of presence for the patient. T  

C2Care has been dedicated to create a virtual context as close as possible to reality. In the context of this application for treating amaxophobia, anxiety provoking environments have been conceptualized and implemented throughout the app, in order to target problematic behaviours in their singularity. In the app, the patient can be exposed and active as a driver  in the following road contexts:

  • The highway: This scene is a real virtual highway available for exhibitions and is a  real source of anxiety for amaxophobes. Perceived by the patients as an immense potential for dangers and accidents, this results in a high rate of avoiding using the motorway, a factor which plays a role in maintaining phobia. In the app, the therapist can gradually expose the patient to situations related to the motorway theme in complete safety. In fact, the considerable advantage of virtual reality is that it allows effective and safe therapeutic support, both for the patient and for the therapist. In addition, the gradation of situations is made possible by control over environmental stimuli. The management of the highway flow is placed under the therapist’s controller: fluid traffic, medium or dense traffic and traffic jams. It is thus possible to expose the subject in the same context (the motorway) by gradually increasing the anxiety load with regard to the singularity of his disorder. In addition, the quality of the stimuli is also placed under the therapist’s examination, he may, depending on the anxiety-provoking elements reported by the patient, add trucks and motorcycles to the environment.  Obstacles and unforeseen events may also be placed on the route such as an accident with audio and visual stimuli (ambulance, siren). These features make it possible to expose the patient to road events to which they do not have access due to the avoidance implemented. It is clinically relevant to be able not only to expose the anxiety-provoking realities of patients with a driving phobia but also to accustom them to the potential stimuli they will encounter on the road. In addition, the progression of exposure can be achieved by not placing the patient immediately as a driver but starting in the passenger seat. These driving options are accessible from the software controller: immersion with an environmental perspective from the driver’s seat or from the passenger seat. Some people suffering from amaxophobia have generalized their disorders to the point of no longer supporting a car journey even as a passenger. For the latter, it is essential to expose them in the first place to situations where they will not be responsible for the conduct. This solution is made possible by automatic piloting requiring no additional equipment (steering wheel, pedals). In addition, among the many functionalities allowing to adjust the treatment to the clinical reality of the patient, it is also possible to choose the speed of the vehicle. These alternatives give rise to multiple exposures. For example, to extinguish an anxious response aroused by highway driving, the therapist could place the patient on fluid traffic with a vehicle traveling at 90 km / h, repeat the exposure until the anxiety subsides, then progress on a more severe anxiety level by increasing the speed to 110 km / h and increasing road traffic. The weather is also under the clinician’s control. He can change from good weather conditions, to rain or even to fog

All the features mentioned above, in this case a virtual highway environment equipped with features designed for the exposure exercise, also exist in the night version.

  • The tunnel: Tunnels are contexts often cited by driving phobics among the situations causing a high rate of anxiety. These environments has been recreated in virtual reality. The user will experience the sensations inherent in passing through a tunnel, anxiety necessary to allow the counter-conditioning to act. In this application, the therapist will have the same possibility of control over the environment: adjustable vehicle speed, road flow management, additions of specific vehicles (motorcycles, trucks), perspectives from the car (passenger, driver), reversible weather ( rain, fog, sun).


  • In city driving: The fear of driving has a characteristic that distinguishes it from many other phobias, namely that it can lead to dangerous situations (accident, loss of control of the vehicle). These harmful potentials are very significant when driving in the city environments because of the number of stimuli present in the surroundings: signs, red lights, shop windows, heavy road traffic, pedestrians, proximity to other vehicles, etc.). These facts make the in vivo exposure particularly delicate and dangerous for the patient and the therapist in charge of the treatment. The virtual city makes it possible to overcome these difficulties and immerse the patient in an interactive environment, being an ideal reflection for the exhibition of urban road contexts frequently encountered. Thus, the patient is able to experience the reality of driving in the city: red lights, sound stimuli, pedestrians and priority crossings. A true city, the exhibitions will be able to be graded in terms of the singularity of each patient’s phobia and repeated as many times as necessary for the appearance of therapeutic gains. Typical situations causing fear activation have been placed on the road course of this environment: bridge, narrow passages, road with unsafe borders …

Amaxophobia is, like other anxiety disorders, a pathology whose aetiology and manifestation of symptoms remains unique to the patient. Its treatment requires a secure framework for undertaking exposure therapy. Virtual reality appears to be the most optimal solution. C2Drive conceptualizes software offering access to a set of road environments typical of the anxiety-provoking theme of driving phobia. Exposure therapies are the most effective treatments to date for the treatment of amaxophobia. Virtual reality frames this methodology with its properties that are perfectly suited to the active principles of behavioral therapies: security, repetition, accessibility, graduation.

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