Scuba-Phobia!
June 2007
By Selene Yeager
Phobias are intense, irrational fears of an object or situation that trigger a classic fight or flight response. Your heart pounds, your thoughts race, your breathing becomes out of control and more than anything you just want to get the hell out of there. That's fine if you need to bolt from a backyard barbecue because you've spotted a snake. It's far less OK if you feel yourself starting to freak out 60 feet underwater.
The real rub: They can develop at any time. More than 12 percent of the population will experience a phobia at some point in their life. "Most people have symptoms that start to occur in childhood, but a large number develop phobias in their mid-20s," says Bob Mankoff, Ph.D., professor of medical psychology at Medical University of the Americas. Even daredevil diving types aren't immune, says David Carbonell, Ph.D., author of Panic Attacks Workbook. "I see people who own planes and drive fast cars all of a sudden become afraid of those very things." Why? It could be a change in brain chemistry, something in your DNA or, quite often, a frightful experience that got under your skin and set up permanent residence.
Self-Preservation Gone Awry
The first tool for fighting phobia is understanding fear. Mother Nature hardwired fear into us as a way of saving us from killing ourselves in a world filled with danger. It's healthy to have some fear of heights--falling can be deadly. What makes a phobia different from a healthy fear is that it is exaggerated if not completely unfounded. For instance:
Selachophobia: Fear of sharks is a very healthy, natural response to a large, carnivorous animal with razor-sharp teeth. Paralyzing fear that prevents you from enjoying the colorful reefs of Bonaire is not. Yet divers sometimes develop such intense shark anxiety (most often not from real-life sharks, but "reel-life" sharks--like the ones they've seen in Jaws and Open Water) that they can barely stand the swimming pool.
Claustrophobia: Fear of confined spaces, especially those in which there's no way out, makes sense for survival. Most of us can rationalize our way through it during daily life (i.e., "the elevator door will open at my floor and I'll be fine ..."). This one is particularly sneaky for divers, however, because what might be a mild aversion to crowded elevators can become crippling anxiety if you have to go into a recompression chamber. Caves are an obvious trigger. Particularly deep, dark or murky dives where visibility is poor can also provoke claustrophobia. Even the restrictive feelings brought on by wearing a mask with limited visibility and being confined in a snug wetsuit can cause an uncomfortable claustrophobic reaction.
Agoraphobia: This one is often mistakenly identified as a fear of open or crowded spaces, but in reality, it is a fear of leaving a safe place, so its sufferers end up never leaving the house. In divers, this type of phobia can rear its scary head in that nether-land space between the surface and the bottom when you're floating in nothing but blue sea and have lost all points of reference. Like a claustrophobic reaction, it can be something you don't even know you're averse to until you find yourself feeling panicky.
Nyctophobia: Children often have an intense fear of the dark because their imaginations are so vivid; what they can't see scares them silly. As adults a little fear of the dark reminds us to lock our doors at night and avoid lightless alleys. It's not surprising that this one can surface with childhood strength in scuba divers, who are inherently out of their natural element in an open body of water where creatures from the deep really can make an appearance.
Hydrophobia: It seems highly unlikely that a diver would be afraid of the water. But breathing underwater is anything but natural. All it takes is one episode of gulping water instead of air or running a tank dry to bring this very primal fear bubbling to the surface.
Once you've experienced any of these panicky situations, they can become full-blown phobias (which means you start avoiding those circumstances entirely) that drive you from the sport or at least from fully enjoying the sport. Fortunately, the success rate for treating phobias is excellent, says dive panic researcher and psychiatrist David F. Colvard, M.D., of Raleigh, N.C. "But you have to be willing to subject yourself to the treatment." Facing Your Phobias The only way around your phobias is straight through them. "What works best is prolonged exposure with response prevention," says Colvard. In other words, you have to expose yourself to what you're afraid of to "reset" your automatic response to that thing or situation.
You can start with visualization, says Colvard. "Imagine yourself in the situation that you're afraid of and concentrate on being calm while practicing deep diaphragmatic, or belly, breathing," he says. Then slowly and carefully expose yourself to the real thing. You might need an experienced mental health professional or an experienced dive instructor to walk you through it. "What's most important is that you take your time. It takes 90 minutes to two hours of prolonged exposure to a situation to change your response to the feared situation," says Colvard, who recently spent hours in a pool helping a diver who'd been so spooked from a rough dive she could barely get her face wet.
To assist this slow process, Carbonell uses a technique he calls AWARE. "Smart, accomplished people struggle most with phobias because they're convinced if they just work hard enough they can make them go away. This is counterproductive with phobia because you need to 'relax' it away." He recommends:
Accept: Instead of fighting your anxiety, accept that you feel the way you do. It helps disarm the situation and prevents you from acting in ways that make it worse (i.e., getting anxious about your anxiety). It also frames the situation more positively. You are feeling frightened, but you are not in real danger. It's just a feeling.
Wait: Give yourself a few moments to see if the feeling passes.
Act: The first action you should take is breathing, because it's physiologically almost impossible not to calm down when you're breathing deeply and slowly. "Start with an exhale, like a sigh," says Carbonell. "That relaxes you and lets your diaphragm ride down enough to make room for a full belly breath."
Repeat: Work through these steps again as needed.
End: "There's no great urgency to have your negative feelings stop, so don't rush yourself," says Carbonell. "Just make yourself as comfortable as possible as you wait for the feelings to end."
Finally, remember the basics of dive safety. Brushing up on your basic dive skills and knowing your emergency procedures--what will you do if you have an equipment failure, lose your buddy or see a shark--can help prevent healthy fears from becoming irrational.
June 2007
By Selene Yeager
Phobias are intense, irrational fears of an object or situation that trigger a classic fight or flight response. Your heart pounds, your thoughts race, your breathing becomes out of control and more than anything you just want to get the hell out of there. That's fine if you need to bolt from a backyard barbecue because you've spotted a snake. It's far less OK if you feel yourself starting to freak out 60 feet underwater.
The real rub: They can develop at any time. More than 12 percent of the population will experience a phobia at some point in their life. "Most people have symptoms that start to occur in childhood, but a large number develop phobias in their mid-20s," says Bob Mankoff, Ph.D., professor of medical psychology at Medical University of the Americas. Even daredevil diving types aren't immune, says David Carbonell, Ph.D., author of Panic Attacks Workbook. "I see people who own planes and drive fast cars all of a sudden become afraid of those very things." Why? It could be a change in brain chemistry, something in your DNA or, quite often, a frightful experience that got under your skin and set up permanent residence.
Self-Preservation Gone Awry
The first tool for fighting phobia is understanding fear. Mother Nature hardwired fear into us as a way of saving us from killing ourselves in a world filled with danger. It's healthy to have some fear of heights--falling can be deadly. What makes a phobia different from a healthy fear is that it is exaggerated if not completely unfounded. For instance:
Selachophobia: Fear of sharks is a very healthy, natural response to a large, carnivorous animal with razor-sharp teeth. Paralyzing fear that prevents you from enjoying the colorful reefs of Bonaire is not. Yet divers sometimes develop such intense shark anxiety (most often not from real-life sharks, but "reel-life" sharks--like the ones they've seen in Jaws and Open Water) that they can barely stand the swimming pool.
Claustrophobia: Fear of confined spaces, especially those in which there's no way out, makes sense for survival. Most of us can rationalize our way through it during daily life (i.e., "the elevator door will open at my floor and I'll be fine ..."). This one is particularly sneaky for divers, however, because what might be a mild aversion to crowded elevators can become crippling anxiety if you have to go into a recompression chamber. Caves are an obvious trigger. Particularly deep, dark or murky dives where visibility is poor can also provoke claustrophobia. Even the restrictive feelings brought on by wearing a mask with limited visibility and being confined in a snug wetsuit can cause an uncomfortable claustrophobic reaction.
Agoraphobia: This one is often mistakenly identified as a fear of open or crowded spaces, but in reality, it is a fear of leaving a safe place, so its sufferers end up never leaving the house. In divers, this type of phobia can rear its scary head in that nether-land space between the surface and the bottom when you're floating in nothing but blue sea and have lost all points of reference. Like a claustrophobic reaction, it can be something you don't even know you're averse to until you find yourself feeling panicky.
Nyctophobia: Children often have an intense fear of the dark because their imaginations are so vivid; what they can't see scares them silly. As adults a little fear of the dark reminds us to lock our doors at night and avoid lightless alleys. It's not surprising that this one can surface with childhood strength in scuba divers, who are inherently out of their natural element in an open body of water where creatures from the deep really can make an appearance.
Hydrophobia: It seems highly unlikely that a diver would be afraid of the water. But breathing underwater is anything but natural. All it takes is one episode of gulping water instead of air or running a tank dry to bring this very primal fear bubbling to the surface.
Once you've experienced any of these panicky situations, they can become full-blown phobias (which means you start avoiding those circumstances entirely) that drive you from the sport or at least from fully enjoying the sport. Fortunately, the success rate for treating phobias is excellent, says dive panic researcher and psychiatrist David F. Colvard, M.D., of Raleigh, N.C. "But you have to be willing to subject yourself to the treatment." Facing Your Phobias The only way around your phobias is straight through them. "What works best is prolonged exposure with response prevention," says Colvard. In other words, you have to expose yourself to what you're afraid of to "reset" your automatic response to that thing or situation.
You can start with visualization, says Colvard. "Imagine yourself in the situation that you're afraid of and concentrate on being calm while practicing deep diaphragmatic, or belly, breathing," he says. Then slowly and carefully expose yourself to the real thing. You might need an experienced mental health professional or an experienced dive instructor to walk you through it. "What's most important is that you take your time. It takes 90 minutes to two hours of prolonged exposure to a situation to change your response to the feared situation," says Colvard, who recently spent hours in a pool helping a diver who'd been so spooked from a rough dive she could barely get her face wet.
To assist this slow process, Carbonell uses a technique he calls AWARE. "Smart, accomplished people struggle most with phobias because they're convinced if they just work hard enough they can make them go away. This is counterproductive with phobia because you need to 'relax' it away." He recommends:
Accept: Instead of fighting your anxiety, accept that you feel the way you do. It helps disarm the situation and prevents you from acting in ways that make it worse (i.e., getting anxious about your anxiety). It also frames the situation more positively. You are feeling frightened, but you are not in real danger. It's just a feeling.
Wait: Give yourself a few moments to see if the feeling passes.
Act: The first action you should take is breathing, because it's physiologically almost impossible not to calm down when you're breathing deeply and slowly. "Start with an exhale, like a sigh," says Carbonell. "That relaxes you and lets your diaphragm ride down enough to make room for a full belly breath."
Repeat: Work through these steps again as needed.
End: "There's no great urgency to have your negative feelings stop, so don't rush yourself," says Carbonell. "Just make yourself as comfortable as possible as you wait for the feelings to end."
Finally, remember the basics of dive safety. Brushing up on your basic dive skills and knowing your emergency procedures--what will you do if you have an equipment failure, lose your buddy or see a shark--can help prevent healthy fears from becoming irrational.
