In-Person Exposure Therapy for Driving Anxiety,
Fear of Flying & Panic Disorder
If you’re avoiding airplanes, BART, freeways, bridges, tunnels, or long drives because of panic or fear, you’re not alone. Transportation-related anxiety and phobias are very common and can become extremely limiting over time, especially when avoidance begins to shape how you live your life.
I provide in-person, extended-session exposure therapy for transportation phobias throughout the Bay Area, including treatment for:
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Fear of driving
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Fear of freeways
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Fear of bridges
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Fear of tunnels
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Fear of flying
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Panic attacks
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Fear of riding BART or other public transportation
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Fear of taking the ferry
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Fear, anxiety, or panic while traveling, including crowded travel environments
If you choose to work with me, treatment will involve a combination of Talk Therapy and Exposure Therapy. Talk Therapy is important for developing insight into your anxiety cycle, but to change that cycle, you must try something new. Effective treatment moves beyond the office, working directly with the situations your brain has learned to fear. When these situations are approached gradually and with support, you can relearn safety and build trust in yourself that you can handle them. I specialize in creating individualized road maps to help you overcome your fears in a way that feels empowering and hopeful. It’s challenging work, but it works.
Phobias can be effectively treated with
evidence-based Talk Therapy and Exposure Therapy.
Why Transportation Anxiety Persists:
The Cycle of Avoidance
Many people with transportation phobias begin organizing their lives around avoiding anxiety triggers. For fear of driving, this can look like avoiding freeways or bridges, always driving with a "safe person," avoiding certain lanes, or only driving a handful of familiar routes.
For fear of flying, avoidance might mean skipping plane travel altogether, only flying on specific airlines or at particular times of day, only sitting in "safe" areas of the plane, or relying on rigid routines every time you fly. For BART and other forms of public transportation, you might avoid rush hour or going through tunnels. Each person with a phobia has their own constellation of avoidance behaviors that keep them feeling safe, but also stuck.
While avoidance can temporarily reduce anxiety, it strengthens fear in the long term. When you avoid something, you don't get the chance to have a new experience of it or learn that you can handle it. Without any new information, the nervous system keeps associating transportation situations with danger, panic, loss of control, and overwhelm. Exposure therapy can help change this cycle.
What Is Exposure Therapy for Transportation Phobias?
Exposure therapy is one of the most effective treatments for phobias and panic disorder. Rather than avoiding feared situations, we approach them gradually, in a structured and supported way, so your brain can relearn safety.
Treatment starts with a functional assessment. We begin by exploring the history and origins of your anxiety, then identify the patterns keeping it going in the present. That includes the situations you've been avoiding, the specific experiences that trigger your anxious response, the ways you try to control it to feel safer in the moment, and the thoughts and predictions that show up when you encounter a feared situation.
From there, I'll help you create an individualized exposure hierarchy, which is a step-by-step plan that begins with exposures that feel mildly challenging and gradually builds to harder ones. For driving anxiety, that might start with sitting in a parked car, then driving around the block, then briefly entering the freeway, then crossing a bridge. For public transportation, it could mean riding BART for a single stop before working toward a longer commute. You'll always know what the next step is because we design each step together. By the time you get to the hardest exposures, they'll feel more within reach.
Treatment may include:
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Psychoeducation about anxiety and panic
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In vivo (in real life) Exposure Therapy for anxiety and phobias
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Interoceptive Exposure Therapy for panic attacks
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Cognitive Behavioral Therapy (CBT) for anxiety
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Acceptance and Commitment Therapy (ACT) for anxiety
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Mindful Self-Compassion (MSC)
In-Person Exposure Therapy in Real-World Settings
If you work with me, much of our time together will be spent outside the office, directly in the environments that trigger your anxiety.
For driving anxiety, common focus areas include freeway driving, bridge driving, navigating traffic and directions, and driving longer distances or farther from home. We may also practice riding BART or other transit systems and taking the ferry. For panic attacks, we may return to places where you've had panic before, like a certain stretch of freeway or a BART station, so you can reclaim them. For flying anxiety, we can work through the full travel sequence, from preparation and airport arrival to completing a round-trip flight.
By joining you in person in the actual situations you fear, I'm able to see what is happening for you in real time. I will help you stay present and cope with what you are experiencing so that you can have a new experience of feeling capable. We'll do each new exposure together the first time so that you have therapist-guided support. As you work your way through your exposure hierarchy, you'll learn how to relate to your anxiety more effectively and eventually be able to face each exposure on your own.
Between sessions, you'll practice the easier exposures independently. Consistent practice is one of the strongest predictors of success. I'll help keep it at a manageable level so you can follow through.
Fear of Flying Treatment
You know flying is statistically safe, but you still can’t make yourself get on a plane. Or maybe you fly occasionally, but your anxiety shows up the moment you book your tickets. If this sounds like you, more facts and information about flying probably won't help. What helps is having a better understanding of your cycle of anxiety and learning how to respond to it differently. Flying phobias often involve multiple overlapping fears, including panic attacks, a fear of being trapped, worry about catastrophic events, fears of embarrassment or shame, and anticipatory anxiety before travel. In therapy, we’ll explore which of these are driving your fear and work on them directly.
Treatment typically begins well before a planned trip and includes a structured exposure plan tailored to your specific fears and avoidance patterns. The focus is helping you build tolerance for uncertainty, discomfort, and physical sensations, rather than trying to eliminate anxiety completely.
My approach blends Talk Therapy, like CBT and ACT, with Exposure Therapy. We first gain an understanding of your anxiety cycle in virtual talk sessions and then apply what we learn in exposure sessions out in the real world. We may also incorporate interoceptive exposure to reduce fears of physical sensations associated with panic, such as dizziness, shortness of breath, or a racing heart.
For clients ready for more advanced work, therapy can include in-person practice at airports, where we work through anticipatory anxiety, navigation, and the sensory experience of being in a busy travel environment. I also offer in-person support for same-day round-trip exposure flights, allowing you to apply these skills in real travel situations with guidance and support. Throughout the process, we use evidence-based approaches such as Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) to help you respond differently to panic symptoms, reduce avoidance, and regain a sense of confidence when flying or traveling.
Extended In-Person Sessions for Phobias
Transportation and phobia treatment often works best when we have enough time to do something meaningful in a single sitting, so longer in-person sessions can make a real difference. Depending on what you are working on, a session might be a standard 60 minutes, an extended 75 or 90 minutes, or a full day intensive.
Longer sessions are especially helpful for fear of flying treatment, hands-on driving exposures, and public transportation practice on BART, MUNI, or the ferry. They are also a great fit for intensive phobia treatment and for clients traveling from outside the Bay Area who want to make the most of their visit.