The Complete Panic Prevention Program

by Tom Griffiths, Ed.D., NAUI 6448

(reprinted from NDA NEWS May/June 1987)

A decade of research and testing on sport divers at the University of Maryland and Indiana State University have led to some interesting findings. Those who elect to take up scuba diving have significantly lower levels of general trait anxiety than those who do not dive.

· The most stressful situation for novice divers is the first open water “check out” dive. The stress levels attained just prior to this dive are significantly higher than pool training situations. The complex “bail-out” scuba training skill is perhaps the most stressful event which can be presented during pool training. Novice divers reporting high levels of pre-dive stress perform poorly, both in the pool and on the open-water dives.

· Divers dropping out of experiments and scuba classes have higher levels of general trait anxiety than those who complete experiments and the class.

· Underwater respiration rate is positively correlated with underwater performance and is highly significant.

· Diver stress is not caused by fear of possible physical danger, equipment failure, or drowning, but rather “social evaluation”, that is, how the diver’s performance is perceived by his/her peers. This type of stressor is especially significant for females.

· Concerning experienced divers, levels of general trait anxiety correlate negatively with bottom time (as trait anxiety increases, bottom time decreases).

· Trait anxiety in experienced divers correlates positively with age (as age increases, trait anxiety increases). This is especially true for older divers not diving on a regular basis.

· Most importantly, it has been repeatedly shown that specific relaxation and mental practice programs do in fact:

1) Decrease specific state anxiety;

2) Improve underwater skill performance; and

3) Increase bottom time.

Practical Program

Based on the research findings just cited, along with thousands of clinical observations, a practical program for diagnosing and treating diver stress has evolved. Stress management and sport psychology experts were consulted in producing a two-hour audio program entitled Stress and Panic Management for Divers: Training Exercises for Controlling Diver Stress & Panic*. This is a teaching tool that works. It is a “self-help” program designed for divers and may be used by students and instructors alike.

The two-hour program is divided into four 30-minute segments. Each half-hour segment gives the listener just enough theory to understand the causes, symptoms, treatment, and prevention of diver stress. Relaxation skills and mental rehearsal exercises are introduced throughout the program and should be practiced while listening to the audio program. The beauty of the program is that the instructor is not required to conduct “therapy.” Once a stressful student is recognized, the audio program may be loaned to the student who may take them home to listen and practice at their leisure in the comfort of their own surroundings.

Undercurrent magazine states that this audio program should be a staple in the library of anyone who teaches diving. Undercurrent (Vol. 8. #9) goes on to add:

“…For our money, it’s the best effort in the diving community to come up with a practical means to control diver stress. The audios will no doubt keep many divers active who might otherwise surrender to stress and stop diving.”

The audio program is excellent for several audiences:

· Diving students who are worried about forthcoming pool exercises and tests;

§ Certified divers who have yet to enter the open ocean and are concerned about their first big dive;

§ A diver who has scubbed a dive out of stress or who has panicked or nearly panicked underwater and is contemplating giving up the sport;

§ A person who would like to learn to dive, but has resisted out of fear;

§ Any diver who would like to better prepare himself to react safely in stressful situations.

The four parts of the audio program are as follows:

Part 1 - The Causes and Symptoms of Diver Stress

The listener learns the causes and symptoms of diver stress and how to recognize these traits in themselves and others. Under the headings of “Causes and Symptoms of diver stress, detailed discussions follow, which include:

Physical Causes of Stress:

Overloading

Sensory Deprivation

Time Pressure

Equipment

Cold Water

Poor Fitness/Swimming Ability

Strong Currents, Waves, Obstructions

Dangerous Marine Life

Psychological Causes of Stress:

Peer Pressure

Social Evaluation

Ego Threat

Fear of the Unknown

Fear of Evaluation

Pre-Dive Physiological Signs:

Increased Heart Rate

Rapid Respiration

Muscle Tension

Frequent Urination

Increased Perspiration

Voice Changes

Decrease in Skin Temperature

Pre-Dive Behavioral Signs:

Introversion

Tardiness

Mental Errors

Forgetfulness

Extreme Cockiness

Irritability

In-Water Symptoms:

Rapid Respiration

The “Wide-Eyed” Look

Inefficient Swimming

Clinging and Clambering

Fixation and Perceptual Narrowing

Sudden Surfacing

High Treading/Trashing

Equipment Rejection

Part 2 – Specific Techniques for Panic Prevention - The Calming Breath Response (Diaphragmatic Breathing)

The key point is understanding that breath control and relaxation go hand-in-hand. The listener also learns the “Calming Response”, a technique combining stomach breathing and autogenic phrases. The calming response is a fast and effective way of improving relaxation and performance. Scuba divers, using this technique, can significantly increase breath control and relaxation within 5 – 10 breaths. Many on-site treatments are discussed for nervous divers preparing to make a dive or already in the water.

Part 3 – Mental Rehearsal for Controlling Underwater Stress

The authors place the listeners into a deep state of relaxation and then guide them through mental rehearsal utilizing imagery. This is the same technique that world class athletes use prior to their events. Slow breathing, relaxing, and thinking clearly are strongly emphasized, especially when stressful scenes are rehearsed.

Part 4 - Systematic Relaxation Training

The authors lead the listeners through a number of exercises designed to increase their awareness of physical and muscular stress, while providing several techniques to directly relieve that stress. The listeners are taken through steps for full body relaxation, so when this side is completed they will hopefully have reduced their own physical stress symptoms. If not, they may simply listen to the audio again or go through the same process without the benefit of the audio.

After reading and hearing so much about diver stress and panic, instructors finally have a total training package which not only promotes relaxation and performance, but also reduces diver stress and ultimately panic.

*DISCLAIMER: These exercises are NOT intended to be a substitute for professional treatment. Consult your personal physician or therapist before using them if you have a history of Panic Disorder or Claustrophobia or any other anxiety problems.