Article: Stress Management in Scuba Training - What can be done about the Panic Response?

[DevonDiver]

You can view the page at http://www.scubaboard.com/forums/content.php?r=277-Stress-management-and-Panic-Response-in-Scuba-Diving

 

[D_B]

Great article

My awareness of how I deal with stress is one big reason I took Rescue very soon after learning to dive
(this is not an indication of my instructor's training who is known for turning out well trained divers to help avoid as much as possible having those issues mentioned)

 

[SeaHorse81]

Nice job. I especially liked this very important point:

"Short-duration, minimum requirement certification courses can be the antithesis of this responsibility - and this leads to many student divers being certified before their comfort zones have sufficiently expanded to provide the necessary psychological tolerances."

 

[mselenaous]

Excellent article.

 

[VooDooGasMan]

Devon SeaHunt was an incredible show in where as it taught in a way that has stuck to my mind since a kid and on all dives. You have done a great job on this stress management for it is a huge part of diving if not everything to do with it. Just a token of a dive from last week, I have a divesite that is huge just around the corner in front of my house that I have dove more than likely more than anyone in the world ever has(My dive buddy is catching up) I moved to my current residence cause of the diving it presents. I was on the first jaunt of passing by my sea creature buddies before going deep, this wall cuts in and out and I can cut across to get further, in between these fingers there is slight current and usually it is a down current. With the gopro in front of speargun I was pointing it and was barely seeing the wall and then I felt my dry suit shrink wrapping me and then I was realizing that I was getting nervous cause I could not reach the wall, and dropping to the bottom was not an option as it might be over 300'. My SeaHunt memory kicked in and I knew from the work load I was doing gave me a co2 not narcosis. I then ascended to the surface and casually kicked back to wall when co2 cleared out I kicked very hard to get back, when I got to see sand dropped back down and paused till I was in control of myself. Then went back down over the wall and my buddy was getting some time in with a GPO out and about. then I ventured on my deep portion of the dive. This is the part where Stress management has to be defined by the diver himself, I commonly have gotten co2 hits in my particular way of diving. Deep Current Spearfishing. To know why the stress has hit and what form it is, narcosis, co2, scared, gear difficulty's, buddy separation, sea creature gonna get you http://www.youtube.com/watch?v=9ZRL4V-Xeds&feature=related. So Devon being unaware of what triggered your stress is what makes a diver quit diving, now 25 years ago when diving the great lakes wrecks I never went into it much when a diver decided to quit, they get embarrassed about it so I always took the benefit of waiting a few weeks and bought there gear for little to nothing. I have a guy who quit cause of a bad dive and he keeps wanting to go but every time he see's me launching and i ask him to go he just can not get over that one dive, after many times of happy hour and beach dinners I know it is a co2 hit and this scares the hell out of people. They get that starving for air and can not get to the surface quick enough. Your article is really what needs to be clear to new divers, I say the SeaHunt cause You actually see and remember how to solve the problem, and the story line puts it in a catergory.Example divers ask if you can put on a 1st stage underwater, in an episode where mike was with a girl and the tank was dry on one unit and the hose leaked in another, he changed it underwater and they buddy breathed it I think they were in deco was the reason. So somehow divers have to take the stress management and determine what form it is and have a memory form of how to solve, cause I do not ever think back of my own personal experiences on how to solve it is a image that reminds me. Devon become a stress management underwater movie star and just send me some royalty money is all I ask.

 

[TSandM]

Excellent article, Andy, one of your best.

These activities might increase a divers' comfort and familiarity with stress situations, but ultimately do little to actually influence their psychological threshold to panic. In essence, they widen the scope of a person's comfort zone, but do not impact on the reactions that occur when the limits of that comfort zone are exceeded. ​

It's an interesting chicken and egg problem. If you have experience with a number of problems and have always found that you can solve them, I do believe that your first reaction to a problem is attenuated. I base this not so much on my diving training and experience, although I think it has been consistent with that statement, but more on my residency training. We used to say that at the end of the second year of residency, your panic button had been pushed so many times, it didn't work any more. I do think the organism is capable of learning that an immediate adrenaline response isn't necessary.

That said, we all have a breaking point. When you've exceeded your tolerance for CO2 (as when holding your breath because you are unable to access breathing gas), or when you have run out of rational options (as when entrapped and unsuccessful at freeing yourself) irrational responses will ensue for the vast majority of people.

It is my personal opinion, from working with classes, that there are some people with very high trait anxiety (anxious as part of their personalities) who really are not suitable to become divers, no matter what their training is or isn't.

 

[jcfahy]

Excellent article, Andy. A corrollary of your point of learning to recognise stress points and tolerance is the ability to understand how jet lag, sleep deprevation, and physical fitness interact on stress management on specific dives. I personally manage stress much better when not jet lagged and near my physical peak. Fitness training is under emphasized in my opinion.

 

[Couv]

Nice article, Andy.

Primarily I agree with Lynne on the "broken panic button" concept; but I wonder if most people with "hair triggers" learn to avoid such situations she and the majority of physicians come to the table already equipped to deal with.

If I were still teaching, I'd encourage my students to listen to the audio files found at the DivePsych web site. http://www.divepsych.com Scroll down to "Stress and Panic Management for Divers" and download the "tapes." Then, transfer them to an MP3 player or disc.

The audio files contain relaxation techniques even experienced divers may find helpful.

Thanks Andy for the excellent article,

Couv

 

[-hh]

Well presented, although at one point I almost suspected that you were trying to recommend that diver learn to die gracefully, rather than panic while they're drowing

I keyed in on this particular part:

If training drills are only conducted in clear-cut, easily definable sequences, then the diver will only develop the capacity to utilise those skills within clear-cut, easily definable circumstances. Whilst individual divers will possess different natural capacities to improvise and problem solve, the instructor can be pro-active in developing this capacity as a skill. Neglecting the development of this essentially reduces student safety to the base-line of their genetic pre-disposition for problem solving. The ability to maintain a flexible approach, improvise and apply existing skills under novel circumstances to achieve a safe outcome is beneficial for all divers.

However, it must be recognised that any personal capacity to problem-solve is ultimately determined by the individuals' reaction to, and threshold for, tolerable stress, as previously mentioned. In short, the ability to problem solve is the preserve of divers who have the psychological capacity to resist instinctive, acute stress reaction and apply intelligence and rational thinking under stress. An instructor can develop this as a skill, but cannot develop the divers' psychological traits that determine whether they can utilise the skill under stress. Psychological stress thresholds will always determine whether skills can be applied.

To apply this pragmatically, what we really have here are various pool exercises - - and more importantly, they need to be is non-discrete. What I mean by this is that after a student has been taught (a) mask clearing, (b) regulator recovery, (c) etc ... they need to be given a scenario where they need to do both, but it is up to their own problem-solving to decide the order (sequence) in which to solve their problems. This is where there's many great old pool drills that have been kicked to the curb as "unrealistic" play their part: an exercise that helps a student to learn how to problem-solve while he only has one breath of air doesn't need to be pedentically 'high fidelity' realistic, because that's not yet the objective. The objective is to introduce a problem with a controlled stressor to let the student (a) experience it, and (b) work it out on his own. Students who have problems can be given some tips for how to solve the puzzle (eg, establishing an air supply is more important than a cleared mask, etc). And in letting the student Do It Himself ultimately becomes a Confidence-Builder that will reduce the likelihood of panic when they're ever confronted with a real problem on a real dive. Of course, the trade-off is that doing this requires time, and we all know that they're pressure to minimize the instructor's time investment. Nevertheless, it is a core element to what ultimately defines a diver who is comfortable in the water and thus, one who will be more likely to continue with the sport, rather than to be afraid of it.

It has been too many years to be sure that I'm 100% correct on the names of these various sorts of controlled pool exercises, but two that I can still recall are:

Doff N Don (or Remove & Recover):
A) Doff:
- with kit on, dive to bottom of pool;
- remove all gear (make a pile on the bottom); turn tank air valve off;
- Surface (caution: air embolism risk if fail to exhale on ascent).

B) Don:
- freedive down to bottom of pool;
- sort through gear pile; stay down until you've put it all on;
- surfacei in full kit.


"NAUI Bailout(?)":
- stand at edge of pool, with entire kit on left arm; tank valve has been turned off;
- exhale & drop in; sink to bottom of pool;
- put all gear on;
- surface

Are any of these "realistic" to real world scenarios? Of course not. But what they do have are the core elements to most dive problems: the disruption of equipment and/or air supply. Two of these drills employ freedive breathholding as a means to artificially introduce a time constraint ... and stress ... on the problem-solving. If the student decides that they can't do it, they can generally bail out safely and return to the surface, to regroup and try again. And the "Doff" exercise will usually reveal to the student some challenges on buoyancy control as they disassemble their kit. And if we want to kick this up another notch, we might also consider bringing back (mild) harassment sessions too, earlier in a diver's training timeline too.

Finally, what my observation has been of these sorts of drills is that some students looked forward to them as a challenge, while another segment more-or-less dreaded the idea. But at the end of the day, everyone was successful and was really glad that they tried it and were gratified with their accomplishments.



-hh

 

[nimoh]

I would also look to increase the stress level (if comfortable) by doing things like putting your mask on last.

Maybe even to the point of after removing equipment at the bottom of the pool and going to the surface, another diver goes down and does something like removing a fin strap.

Obviously, nothing to the point of dangerous, just to push the stress level.