Several weeks ago, Sally Murray took an incredible trip, and like any adventurous traveler couldn't wait to talk about it.
"I went home and told my daughter, `Do you know what I just did?!'"
She had ridden all the way to the top of the escalator at Bethesda Metro station. By herself.
For mountain climbers, skydivers and other serious daredevils, that doesn't sound like much. But for Murray, who had gotten so skittish about escalators she hadn't been on one in six years, scaling Mount Metro was an inportant step forward in conquering more stubborn fears.
"That's a very steep escalator," says Jean Ratner, offering her congratulations. "I often use that with people who have a fear of heights."
It's a rainy Monday night and the two women are chatting inside Ratner's Honda Accord, which is parked, engine running, in the lot of Bradley Hills Presbyterian Church in Bethesda.
Ratner, a 61-year-old clinical social worker in private practice, has the wheel. Murray, a 56-year-old education specialist at the National Institutes of Health, is in the back seat, hands clasped loosely in her lap, as if ready to spring into full prayer position.
Escalators make Murray uneasy. But that's small-potato turmoil. She and Ratner are about to go for a spin in the Honda to confront her biggest, most nerve-wracking nemesis: amaxophobia.
Fear of driving.
Sally Murray makes her way in the world's most mobile society with difficulty, heavily dependent upon public transportation and lifts she can wangle from her daughter, Olivia, and sympathetic friends.
While most Americans look forward to being on the move during summer-vacation season, for millions of men and women, this is the time of year they have to work even harder to avoid anxiety-producing encounters with cars, planes, trains, buses, bridges, tunnels and highway overpasses.
"It does turn up the anxiety flame," Carl Robbins, a counselor at the Anxiety and Stress Disorders Institute (ASDI) in Towson, says of the summer travel season.
Approximately 10 percent of Americans have some type of phobia. "Some people call them the common cold of psychiatry," says William Eaton, chairman of the department of mental health at Johns Hopkins' Bloomberg School of Public Health.
Nobody keeps specific tabs on people saddled with travel phobias, but about half of Jean Ratner's patients fall into that category, which is why she and a nurse-therapist partner operate what they call the Center for Travel Anxiety.
A handful of other therapists in the Baltimore-Washington area focus at least part of their practices on travel phobias.
In this region, the Chesapeake Bay Bridge looms large among the travel-anxious. According to Maryland Transportation Authority spokeswoman Teri Moss, in 1997 Bay Bridge police and road crews served as "driveover" chaperones for 2,151 motorists who were too rattled to venture across the 4.3-mile span. Last year, the MTA came to the rescue of 3,374 drivers; an average of almost 10 per day. Moss attributes that 50 percent jump to the overall increase in bridge traffic over the years.
For those with travel-related phobias, a particular incident can trigger avoidance behavior. Having a loved one killed in an automobile or airplane crash, for example, might understandably turn somebody into an armchair traveler.
Usually, however, the roots of the disorder are in an underlying condition such as claustrophobia or something more amorphous: a kind of creeping, Doomsday-scenario angst that manifests itself in the extreme as a knee-knocking, heart-pounding panic attack.
"Anxieties are very much what we call a `what-if' disease," says Harold Steinitz, co-director of ASDI. "It's an illness of catastrophic thinking."
The phobic response can be narrowly defined (one of Ratner's patients has all but given up driving because she has a crippling fear of making left turns) or broader in scope. Some 30 years ago, Sally Murray was cruising down a highway in Massachusetts in her car when she got blindsided by a panic attack. Afterward, she decided to drive highways only in an emergency, then eventually began ducking them all together. Over time, every road became a torture chamber.
Controlled by fear
"It has come to the point," Murray says, "I don't like having the fear control me."
Donna Dodson, a 42-year-old paralegal, had a similar experience compressed into a much shorter period of time. She was driving to a convention in Ocean City last September when she suddenly got hit with a panic attack midway across the Bay Bridge.
The ride home to Baltimore took six hours as Dodson searched in vain for a bridge-free route. Within a couple of months she was becoming unglued driving past construction sites. Elevated stretches of the Jones Falls Expressway seemed fraught with danger.
"It was just ruining my life," says Dodson, who turned to ASDI for help.