FIT TO DIVE

The book starts by defining stress and the importance of the impact of stress on performance in diving.   The authors make the distinction between stress relating to a threat that can cause us harm and a challenge that can motivate/mobilise action.  The second chapter describes the observable signs of stress at different stages in diving (i.e. set-up, entries and exits and during the dive itself) now commonly listed within rescue diver training.  What the authors reflect in “perhaps tedious detail” (their words) is a helpful illustration of these features that would add to understanding for most divers.  Chapter 3, on factors leading to panic during a dive, is mainly focused on the physiological causes of panic, with limited reference to the psychological.   This, of course, includes a useful review of the role of breathing for management of stress and buoyancy.  Oddly, the effect of alcohol and drugs (including cocaine and marijuana!) on how a diver under stress would respond to a problem is given a surprising amount of attention, and makes one wonder about diving in the 1980s!

The 30 years since this book was written has seen huge developments in equipment technology, and this really does show!   Cold is frequently cited as a major stressor which, although still true today, is made much less of an issue by the improvement in exposure suits.  Also, buoyancy compensators are referred to as additions that can improve the outcome in an accident, indicating this was written at a time when these were relatively new devices.  The difficulties caused by the breathing specifications of regulators are unlikely to apply today.  Interestingly, the book contains several arguments, backed up by accident histories and psychological theory, calling for specific procedures to be adopted such as regular practice of ditching weights.   Remember this book was published in 1987; PADI brought the weight drop into open water training in 2014 and some agencies do not yet include this vital skill.  On the other hand, some of the procedures advocated by the authors are now standard practice in training, such as using an octopus and practicing out-of-air scenarios.  These passages reflect the history of dive education and give an insight into what went before practices we now view as commonplace.  There are also suggestions to standardise equipment configurations and emergency procedures in order to reduce the demands on the mental capacity of a diver when under stress, but with reflections that such standardisation is a challenge. 

The authors argue that panic is the overwhelming cause of injury and fatality in diving and that this panic stems from the loss of control that occurs when an individual is placed under the stress of solving problems for which they do not have available solutions (skills) to address and this leads to increased emotional arousal.  They provide an accurate critique on the 'stop and think' advice given to new divers facing a problem underwater; concluding it is of some limited use but “under conditions of stress ... when rapid problem-solving is crucial, over-learning of responses is essential.  The properly trained individual should have learned coping behaviour so well that responses become virtually automatic requiring less ‘stop and think’ performance.”  They emphasise the importance of practice and over-learning skills in order that they can be performed automatically under stress, rather than attempting to directly reduce arousal through conscious relaxation.  The book does review a series of psychological approaches that target emotional arousal and the authors conclude that relaxation techniques and cognitive rehearsal through mental imagery are of use in training.

Classic psychological theories of behaviour, emotion and personality are applied concisely to the diving context and show the value of a psychological approach to dive training and prevention of panic.  There is a review of the literature on anxiety in dive training referring to state and trait aspects of anxiety, and whether these can be altered using specific strategies. Techniques we understand from learning theory, such as shaping and chaining, are described and applied to training. This also gives the psychologist authors an opportunity to show photos of rats running mazes study (or in this case climbing ladders and playing tiny pianos!).  In addition, there are photos showing that psychological research methods that were used to develop our understanding of visual perception in water.

Much of the information contained in this book has been absorbed into training, but the extent to which we focus on understanding stress and preventing panic in diving is variable.  This book would be useful for anyone looking for a more in-depth account of stress and performance in diving.  It also illustrates the observable signs of the gradual onset of stress that any dive professional would want to be able to spot.  Finally, it describes, in detail, the options for reducing the likelihood, or improving the consequences of accidents in diving by applying psychological theory.