I also find myself drifting towards thoughts of hurting/killing myself while I'm driving long distances. Not always, but if I'm already struggling with those thoughts, they more readily crop up when I'm driving. When I was describing this to my T, she noted that the way I describe it, it's like the thoughts are the main focus and everything else is a brief distraction. For example, I told her that I was having the thoughts, then got distracted from them by the scenery.

T suggested I try changing my perspective to lessen the thoughts hold over me. The reality and the perspective I should try to hold is that my thoughts are distracting me from the scenery, not the other way around. It's like when you look at the image that could be a vase or two faces...change of focus changes what you see. So, my goal for the next long car ride is to try and see the intense/intrusive thoughts as a distraction, label them as a distraction, and then get back to focusing on something else. That something else might be an audiobook, music, scenery, traffic, whatever, but something concrete and outside myself.

Not sure if that's helpful or even makes any sense. For me, it was kind of enlightening.