The Personal Limits of Fear – Mind and Body

It was one of the scariest dives of my life. The March winds were blowing over the chilling 50° (F, 10°C) waters of Narragansett Bay as we swam across the barren bottom, following nothing more than a compass bearing to our destination. At a depth of 80 feet (24 m), the bottom turned to sand and sloped away into murky darkness, and it was there that my troubles began. Our pace had been only moderate, but for some reason I was having problems breathing. It seemed that my regulator wasn’t producing enough air. Had I not started the dive with a full tank, I would have thought I was out of air. I signaled my buddy to stop for a moment and glanced down to check my pressure gauge. What I saw both shocked and surprised me. The gauge read nearly 2,000 psi, but with each breath, the needle would unwind and bounce off the zero mark. The fear welled up inside me as the thought of a regulator failure in this deep, dark, dismal corner of the bay materialized in my mind. My options were limited, and the thought of buddy breathing seemed as intimidating as an emergency free ascent to the surface.

Fear is not always a bad thing. It can be a positive emotion, promoting survival by leading us to cope with anticipated danger. Fear prevents us from exposing ourselves to undue hazards and prepares us to deal with surprise situations. Whether we’re rank beginners or seasoned divers, situations sometimes develop in diving that raise our stress levels and make us anxious, triggering the warning-siren emotion we call fear.

THE NATURE OF FEAR

Whenever we encounter a stress-provoking situation, an emotional response is activated. These responses vary depending on the nature of the stressor and our perception of the situation.

At one end of the spectrum is the tingly sense of elation one experiences when challenged with the unknown. For many, this contributes in large degree to the allure of diving. It keeps us on edge, attentive, ready to act or react to our environment. As the stressors increase, we may begin to lose our perspective and develop tunnel vision as we focus on the object of our stress.

At the extreme end of the spectrum is panic — an overpowering fear caused by a real or imagined loss of control over a situation. When the stress becomes overwhelming, we experience panic and lose the ability to function in a rational manner.

STRESS AND FEAR

Most recreational divers think of diving as a form of recreation, but there’s plenty in the underwater world to raise fear in divers. Physical, physiological, and psychological factors contribute to anxiety, and induce stress and fear. Physical stress can come in the form of cold water, or strong surge and currents. Physiological stress can take the form of a long, tiring swim or sucking on a regulator that only grudgingly surrenders air. More often than not, it’s psychological stress that is the most formidable opponent in the game of safe diving.

Learning about psychological stress is important for all divers, but the subject is strongly emphasized in cave diver training. In the National Speleological Society (NSS) Cave Diving Manual, author Mary Brooks writes about numerous stressors in diving. One such stressor is task loading, or the mental overload that can occur when a diver has too many things to do and think about. For a cave diver, the numerous physical and mental tasks, such as operating line reels, manipulating lights, navigating, and monitoring depth, time, and air supply, can be overwhelming. Even for open-water divers, task loading can be a heavy burden.

Seeing is believing, and when we lose our sense of sight underwater, it’s easy to believe we’re in deep trouble. As Brooks notes, “Silting (stirred-up sediment)…has been known to produce claustrophobic reactions, with a suffocating feeling that the cave is closing in.” Being consumed by a blinding cloud of sediment can spook anybody, but it’s not the only cause of claustrophobia. Sometimes new divers, or those just starting their training, get a touch of claustrophobia by simply putting on a mask.

When I was a child, the fear of darkness haunted me, and kept me safely out of the basement and the surrounding woods. It wasn’t things I had seen that scared me, it was the thought of things unseen lurking in the darkness that fueled my fear. Although a night dive can be fun and exciting, when the lights unexpectedly go out, it’s easy to imagine any number of denizens of the deep swimming around.

While we often equate darkness and poor visibility with heightened anxiety in diving, conditions of excellent visibility can present problems, too. Peering into the depths while gliding along a submerged canyon wall in crystal-clear conditions can create the sensation of great height, fostering acrophobia, or the fear of high places. In a similar vein is something called agoraphobia, the fear of open spaces. Known in some circles as the Blue Orb syndrome, this fear can arise when diving in open water where no visual references exist to provide orientation.

Our air-breathing cousins, dolphins and whales, can stay submerged for extended periods without requiring a breath of air, but our ability to survive without breathing is measured in minutes or seconds. For us, the fear of drowning, of not being able to breathe, represents a natural instinct which has contributed to the survival of our species. Should we run out of air or experience a regulator malfunction, we know the fun will end rather abruptly.

This time pressure we sense when our air supply is limited can add tremendous stress to any dive. Especially when air runs low, a minor entanglement, overexertion, or a poorly performing regulator can cause the fear of drowning to rush in like the tide. With time pressure ticking in the back of the mind, being lost or disoriented underwater can scare anyone. Inside a wreck, cave system, or beneath the ice, disorientation can put divers squarely on the losing side of the safety equation.

If the thought of running out of air sends shivers down your spine, imagine the fear scared up by an honest-to-God regulator failure. Even minor equipment failures can escalate to more serious situations if we’re unable to resolve the trouble. That’s the direction I was heading when I watched the needle of my pressure gauge knocking on zero — my stress level was soaring.

While our fears are natural reactions to what we perceive as actual dangers, often the threat is only imagined, or at least exaggerated out of proportion. Whether a threat is real or imagined, the degree of our fear determines our ability to cope. Once we feel we can no longer control our situation, fear can easily turn to panic.

THE MECHANICS OF PANIC

Physical, physiological, and psychological factors often work together to cause panic in a diver. Referred to as the psycho-respiratory cycle, panic can begin when a diver’s respiration and heart rate increase in a physiological response to a stressful situation. Increased respiration and heart rate cause anxiety, and combine with the original stressor to fuel a vicious cycle. Increased respiration can cause carbon dioxide buildup, leading to hyperventilation. The results are feelings of suffocation and loss of control, the key psychological ingredients for panic.

While most stressors by themselves appear insignificant, the effect is like an incoming tide. When enough stressors combine on a dive, pressure rises and we may lose the ability to successfully deal with the situation. As John McAniff, Director of the National Underwater Accident Data Center at the University of Rhode Island writes, “…panic in and of itself is the end result of a stepladder-type procedure which may start with something as simple as the flooding of a mask.”

ENTERING THE DANGER ZONE

Fear may have a positive effect on our ability to deal with hazardous situations, but when it takes over our lives, even for a brief period, it can be debilitating, dangerous, even fatal. As instructor and Diving Medical Technician Dennis Graver points out in his book, Scuba Diving First Aid, “Stress and panic leading to an incorrect reaction or the repetition of an ineffective action are frequent accident-initiating causes that lead to decompression illness and near-drownings.”

In fact, there are numerous instances where panicking divers have responded contrary to their training. A panic-stricken diver often makes a rapid ascent to the surface, and on the way suffers an air embolism. Graver goes on to say that an out-of-air situation is the most frequent cause of panic, but even a relatively minor equipment malfunction can precipitate panic. In fact, a panicking diver can abandon a perfectly functioning regulator on a tank with plenty of air.

Dr. Judy Lasher is a psychologist at the University of Miami Jackson Memorial Medical Center and has studied the phenomenon extensively in both divers and firefighters, who use a self contained breathing apparatus (SCBA) system similar to scuba. “When you go into hyperventilation,” explains Dr. Lasher, “excess carbon dioxide accumulates in your system, which increases the panic. At that point, divers and firefighters can feel like they’re suffocating, and they rip off their masks to get more air. In fact, this type of scenario is thought by some to account for many unexplained diving fatalities.” (For more information about carbon dioxide, refer to “The Air We Breathe” in Dive Training’s February 1998 issue.)

WHO’S AFRAID?

Divers tend to be a cool-headed lot, but even within this group there’s a broad variation. A situation that is merely exciting for one diver, such as seeing sharks in the water, may be enough to provoke fear or panic in another diver. So how do we know when or if a diver is prone to panic?

Several years ago Dr. Lasher completed a study that examined trait anxiety, thrill-seeking, age, and experience as predictors of scuba accidents. Her study found that among male divers, those who are older or have more experience in the water, are less likely to have accidents. Oddly, she found no correlation with any of the factors among female divers. It could be, offers Lasher, that by nature women are more cautious and less likely to be sensation-seekers, thrill-seekers, and risk-takers.

While most of us like to think we would never panic underwater, the SSI Diver Stress and Rescue manual warns, “Most healthy individuals are capable of panicking under extreme duress.…” In fact, a survey conducted by psychologist William P. Morgan of the University of Wisconsin-Madison found that over 50 percent of the recreational divers surveyed (245 total) experienced panic at least once while diving.

Morgan’s figures at first glance suggest a major hazard to diving safety, particularly when we consider the potentially tragic consequences of panic. However, only about 100 of the 3 million certified divers in the U.S. have fatal diving accidents each year, and 60 percent of those are due to known medical, environmental, and equipment causes. Still, our ability to cope with fear and forestall the onset of panic plays an important role in our continued underwater safety.

FACING OUR FEARS/ FIGHTING BACK THE PHOBIAS

All divers eventually face some degree of fear in the underwater realm. The trick is to control fear, maintain a feeling of control over the situation, and avoid the pitfalls of panic.

Several strategies are routinely used by individuals to successfully cope with stress and fear in everyday life. These include biofeedback, transcendental meditation, and various relaxation therapies. Some divers, including Dr. Lasher, find such strategies effective for dealing with stress underwater.

“A meditation is what saved me on my first dive at Palancar reef in Cozumel,” explains Dr. Lasher. “The thought of diving in deep water scared me. When I entered the water, I meditated, telling myself, ‘Breathe slowly, in and out…you don’t have to look down, just look straight ahead…you’re fine just the way you are…continue to breathe,’ and after a while I was just fine.”

As Dr. Morgan points out in his review, the use of relaxation, meditation, and other strategies isn’t always straightforward. Studies have shown that relaxation techniques can actually increase stress levels in some divers. But part of the problem might be technique.

“When it comes to meditation,” explains Lasher, “you have to be very careful about the language. If you tell yourself, ‘Don’t think of a zebra,’ you’re immediately thinking about a zebra. You can’t tell yourself not to think about something, not to experience something or not to do something, you have to tell yourself what you will do. Telling yourself, ‘Don’t think about sharks,’ won’t work. Your mind can only entertain one thought at a time, so that thought has to be positive, not one which focuses your thoughts on the object of your fear.”

Back in the ’70s, researcher and therapist Donald Meichenbaum developed a series of techniques to help his patients inoculate themselves against stress. These procedures for mentally or rationally dealing with fear-producing stress may be helpful to divers. Among these, Meichenbaum would instruct his patients to:

1) assess the reality of the situation,

2) control negative, self-defeating, anxiety-arousing thoughts,

3) acknowledge the anxiety, and

4) “psych themselves up” to perform well.

An accurate assessment of a problem underwater is critical to resolving it appropriately. For example, a free-flowing regulator still delivers air, so it shouldn’t present a major problem as long as we’re not in an overhead environment. The problem simply suggests that we signal our buddy, terminate the dive, and proceed to the surface.

Negative thoughts are seldom helpful in resolving a problem. Instead of focusing on the negative prospects of a problem, we do better to focus on the desired outcome and take the steps necessary to achieve success.

Acknowledging fear is healthy. Without fear, we might blindly dive to the depths of danger. We should remind ourselves that fear is both natural and positive, and use it as a tool to guide our planning, preparation, and execution of dives. By psyching ourselves up mentally, we are often better prepared to cope with the stressors that may accompany a dive.

Another strategy is to prepare ourselves in a way that limits the fear and panic-inducing stressors. Take for example a fear of sharks. Just the mention of sharks in the water can induce or heighten any diver’s anxiety, but divers who participate in shark behavior courses and learn the true nature of these creatures often transform their fear into a healthy respect.

Perhaps the best strategy for safe diving is to avoid the situations that can lead to panic. Although divers with claustrophobic tendencies may find that a mask with a translucent skirt will relieve some of the symptoms, they may still want to refrain from cave diving or wreck penetration. For those adversely affected by the sensation of high altitude, wall diving is something that should be eased into under the guidance of a professional instructor or avoided altogether. Whatever our personal fears or limits are, we must be careful not to exceed them.

PARTING THOUGHTS

My fear was real on that blustery day in Narragansett Bay, but panic did not override my ability to handle the situation safely. I worked to remain calm as my buddy and I turned around and headed back toward shore. As the depth decreased, my regulator began to breathe easily again. It turned out the only problem was that the tank valve was only partially open, and the resulting flow restriction became more pronounced at depth. Despite the fear I faced that day, I kept my composure and learned another important diving lesson.

Tips for Reducing Fear and Preventing Panic

Stay in Shape — Overexertion can lead to stress and panic, and an out-of-shape diver will fatigue more quickly and easily. Find an exercise regimen that works for you, and stick with it to keep in shape.

Keep Current in Diving — Even a short break from diving can degrade your skills. Active divers are more comfortable and better prepared to deal with problems underwater. If it’s been more than six months since your last dive, consider taking a refresher course, or get some one-on-one time in the water with an instructor.

Maintain Your Equipment — Gear maintenance is critical to safe diving. Periodic preventive maintenance of regulators and BCs will help ensure their continued reliability and performance underwater.

Plan Your Dive — There’s a saying that “prior planning prevents poor performance,” and it goes double for divers. By planning your dives, and sticking to the plan, you avoid many stress-inducing surprises. Know where you’re going, how deep you’ll go, and how long you’ll stay. Having a backup plan to deal with potential problems also reduces the stress should problems arise.

Make a Pre-Dive Safety Check — Equipment problems underwater can precipitate more serious situations. A thorough pre-dive safety check will help ensure that your gear will function properly during a dive.

Monitor Your Progress — The last thing you need underwater is a big surprise like running out of air or exceeding your no-decompression limit. Make it a habit to closely monitor air pressure and bottom time. In addition, take stock of your physiological and psychological condition. If you become cold or tired, end your dive early.

Observe Your Personal Limits — Any time you push the envelope, you put yourself in a position where you can become over-stressed and mentally lose control. Any time you don’t feel up to par, refrain from diving. Don’t push yourself to dive in excessively rough conditions, strong currents, or conditions of low visibility or strong surge. Avoid peer pressure, and keep your diving depths well within your experience and personal limits.

Learn More — Philosopher Sir Francis Bacon once wrote, “Knowledge itself is power.” Learning more about the object of your fears is an important step in overcoming them. Numerous specialty courses are available to help divers learn about the underwater environment and its natural inhabitants. Advanced courses also help divers develop the techniques and skills necessary to deal with more demanding diving environments and stressful situations.

By Robert N. Rossier