When I was old enough to drive, back in the mid-eighties, I lived in the SF Bay Area. I tried to learn, but it was too scary, so I stopped. Several years later I was living in upstate New York, in a place where there were hardly any cars at all. I learned to drive there, and did fine. Once in a while you'd hit a patch of ice and slide into a snowbank, but that wasn't much of a problem.
I can drive in rural areas just fine. I mean areas where, when you need to go somewhere, you get on THE road, and you drive past fields until you get there. Or when you need to get on the freeway, you get on THE freeway. You know you're on the right one, because there is only one. And you know nobody is going to crash into you, because there is nobody driving that close to you.
I'm back in the Bay Area now, and it's very frightening. I can't drive on freeways here at all; it's just too terrifying. They are many lanes across, and there's always someone a few feet behind you, cutting in front of you, driving in your blind spot, and all of that. And of course none of them look or signal. Meanwhile, there are exits every half mile or so, with people getting on and off. And overpasses, and underpasses criss-crossing all over the place. It's dizzying and sickening. And you can't even just get used to one area, because it's constantly changing. They widen the road, and only half-scrape of the lane markings. So, sometimes you can't even tell where the lanes are.
I limit my driving to a very small area, which I know well. Even so, I get nervous.