Hit and Run OCD or Driving OCD

At times, people who experience difficulties with OCD may struggle with a theme focused on hitting someone while driving (this is sometimes called Hit and Run OCD or Driving OCD). They may think that if they have hit someone they will be charged with a crime because they have left the ‘accident.’

The patient may struggle with what they believe may come of the situation and fear the outcome and how it may affect them. When working with clients who struggle with this theme it’s important not to jump to ritual reduction and exposure. In fact, they would likely benefit from understanding more about how their thinking is likely being influenced by certain cognitive distortions. With understanding, the patient may be better prepared and willing to accept the uncertainty and be further engaged in exposure and response prevention protocol (which is the gold standard in treating this phobia).

Exposure assignments may not even be necessary when working with this patient group given that the opportunity to drive can happen daily (which may not be the case for other phobias where the opportunity to expose is much harder to come by - like vomiting fears). Therefore the most important part of the work is ritual reduction. We want to help patients eliminate all avoidance and compulsions. This may include encouraging clients to drive in areas where they typically avoid and eliminating the checking behaviours like re-tracing steps, scanning the rear-view mirror or observing traffic reports.

Lastly, the program helps patients better understand the mental compulsions that also keep them stuck in the OCD loop. Patients may imaginably retrace their steps, seek reassurance, and logically analyze the situation, which all only further contributes to the maintenance of the OCD fear. Rumination is a compulsion and it’s necessary to stop to overcome this fear.