Could you be holding onto a block … a feeling of something distressing, challenging or outright traumatic that seems to pop out of nowhere? Maybe you know that it is linked to an accident or other problematic diving experience, or perhaps you have no idea why it happens, just that you feel stressed by a specific scuba skill or situation. These mental blocks can really get in the way of enjoying diving and engaging enthusiastically in new learning experiences (frustrating efforts to learn the skills to feel more confident in the skill or situation).
This week I’ve been doing some advanced training in an approach for helping people to overcome trauma, fears and negative self-beliefs. It’s called EMDR (Eye Movement Desensitization and Reprocessing) and is an odd, yet highly effective, technique for helping people to let go of stuff (memories, traumas, anxieties). The point of it is to reprocess old, stuck, memories that are currently causing problems for people. It is one the two therapies recommended for PTSD, and has some advantages over the other one (trauma focused CBT): 1. It is less anxiety provoking & 2. It often works faster! I decided to sign up for the training now that there is evidence for it working well in remote sessions (online videocall). So far I’ve been really impressed. I’ve also realised it may be much more helpful for divers than I had originally thought.
What sort of mental blocks to diving?
EMDR is designed for helping people to move on after experiencing a traumatic incident. Although incidents can be limited by following safe practices, just like driving a car, it’s an activity where accidents can occur. When they do, divers may occasionally* encounter difficulties in dealing with what happened. There may be physical and/or psychological injuries to consider. Psychological injuries can be thought of as an insult to the mind and nervous system. These can make a person feel bad, depressed, anxious in general. Or sometimes they only show up when encountering specific triggers. They can create mental blocks to moving forward. The diver’s reaction to triggers can even be a safety concern – for example if a diver’s heart starts racing when reaching a certain depth, or doing a particular skill.
Examples of distressing or traumatic diving incidents
- Decompression Injury/Illness
- Other medical event while diving
- Being struck by a boat
- Witnessing an injury or fatality while diving
- Becoming entangled or trapped
- Being involved in a rescue
- Left at sea
These are some of the (rare / uncommon) events I was thinking of when I decided to add EMDR to my practice. However, during the training it became apparent that not only is the technique helpful for “big T” Traumas, it’s also very useful for the mental blocks that develop in response to the “little t” traumas. Examples in diving could include:
- Struggling with training because of negative beliefs like “I’m stupid”
- Avoiding practicing a particular skill (e.g. mask, or DSMB) due to a difficult experience when first learning it
- Wanting to do more in diving, but fears of failure and not being good enough
- Bad teaching / relationship with instructor – being shouted at, not being considered
- Events that did not cause physical injury at all, but left a tension, like choking on water in training
We often dismiss these events, but I’ve met so many divers who carry round some mental blocks as a result of these sort of experiences. And during the EMDR training, I could see a real option for permission to put it down!
How do blocks develop?
So, this is all to do with how human memory works and how the body / mind deals with t/Trauma. Here’s a quick run through:
In day to day life, we experience all kinds of things. All the time our brains are taking in information. The information is complex, but that’s okay, because our brains are built to process it. They filter it, sort it and break it down into nice, understandable chunks of thoughts, emotions and sensations that can be moved into our longer term store of “stuff we know about ourselves, each other and the world”. It’s a bit like the children’s puzzle where square blocks go into square holes. The blocks small enough, and the right shape to be pushed through the holes. This happens all day long, and we end up with a good store of information we can use when it’s needed. We feel okay about things, because it makes sense.
Even when something bad happens, our brain keeps filtering and sorting it. It can just take a bit longer if we’ve experienced something overwhelming. Remember, that event can be an injury to the mind and nervous system – hit by a lot of blocks in one go, while the brain was too busy keeping us safe to be able to sort the blocks out. But, our brains (like the rest of our bodies) heal, and natural processing does occur. (Like when something bad happens, but you feel better after talking to a friend.) Often, people can sort out even quite big and nasty blocks.
However, sometimes the blocks won’t go in the holes. They are too big and ugly. They are clusters of mixed up thoughts, emotions and sensations that our brain can’t break up and sort into the right holes. Perhaps the thing that happened was really very distressing, or it could be that it happened at a time the person was already stressed or overwhelmed. A blockage occurs. (At the risk of mixing metaphors, can you remember Tetris?). When that happens, the blocks sit around, causing trouble.
It can be that the trauma leads to lots of problems, jangling up the nervous system into anxiety or anger. Though often it is more like people are okay most of the time, but then are suddenly very not okay. That’s because something happened in the “now” that reactivated that big cluster of unprocessed memories. The something could be a depth, a dive site, a skill, a person, seeing people diving, watching underwater scenes on tv, or even just thinking about something related to diving. The brain then (very unhelpfully) replays the memory, sometimes over and over in a loop … trying to make sense of it to figure out which hole it needs to go into .. but since it’s unprocessed it just won’t fit. The effect is stress, anger, frustration, panic … or any other emotion, and difficulty in doing whatever you were wanting to do before it all got stirred up. It can feel like a weight, a sinking feeling, a tension in the body, or a haze or buzzing of thoughts – not being able to think clearly. Not being able to focus (which is really not ideal underwater! or even while getting ready to dive).
It’s a mental block in the sense that you know where you want to go and what you want to do, but it feels so hard that it makes you turn the other way. Don’t do the course, turn off the tv, stop diving. And of course, sometimes that may be appropriate – if the issue is triggering panic episodes and a loss of control of actions while diving, then that is not safe. Though it’s not always as extreme as that. More often, it’s an avoidance of doing something that is avoidable (until it is not), such as not practicing a skill that sets of the reaction – which is fine, right up to the point that skill is needed unexpectedly. Even then, people can keep it under control quite a lot – but it’s tiring. It can also make you irritable or avoidant. That means missing out on dives and activities you’d like to do.
How are the mental blocks removed?
Think about that store of information, the wooden box, it is what we know about ourselves, others and the world. That’s where we want the big, clustery, t/Trauma block to be moved into. Our brain naturally wants to do the breaking-up and sorting needed to get that lump into the box. But it’s stuck. So at this point, some tools are needed to help the brain complete this task – to process the unprocessed memory.
There are various options for this, including psychological approaches. (Within the UK I offer these services). This particular technique, EMDR, seems to be gaining ground over the others. I was excited to see how helpful this could be to scuba divers, not just for better diving, but for the more general effects on confidence and relief of letting go. The approach is similar to other therapies in that it starts with talking about the difficulty, the person working together with the psychologist to develop a shared understanding of the problem. The next step is some relaxation and regulation techniques and some practicing of that at home. Then (and here’s where it gets a bit odd) the next part is basically just thinking about the difficult memory while following a moving finger, flashing lights or tapping your hands. There is a strict process, as has been drilled into me this last week. (and, I mean drilled, it’s an approach used by the military and the training reflects that to an extent). From there the next steps would be doing the things that previously brought up the stress and anxiety levels, and letting that change. A good result is being able to do the stuff you want to do, without all that stress or disconnection. Feeling engaged, focused and in control of your actions.
What happens to the memories? People still remember what happened, but the distress is gone. Images of the memory fade, or are harder to grasp. The memory remains, but the mental blocks reduce or disappear. It’s pretty weird, but it works! And the evidence is so good that it is recommended in healthcare guidelines. How it works, we are actually not entirely sure, but it does. The main theory is that the technique helps process the stuck memories by overloading working memory capacity. As working memory is taxed, it becomes harder to hold onto the memories or belief. It’s also not that hard to do and can take less time that other therapies. For people who have had a single, traumatic event, 8-12 sessions are usually about right. Sometimes as little as 1 or 2 sessions of EMDR can be significantly effective.
Does it work for divers?
Well, divers are human beings, so it should of course work just the same as for any other human. But the diving environment is different from the land/air environments, so I did have questions for the trainers (EMDR consultants with decades of experience). Firstly, I outlined the plan to offer this to scuba divers – they were reassuringly unperturbed and confident in the method. One of the the trainers scuba dives and couldn’t see any reason not – trauma is trauma, whether it happens on the motorway or underwater – it’s the same psychological processes. Secondly, safety and risk management, which we concluded was not really any different and involves drawing on awareness of diving practices and limits, and the need for medical clearance to dive. Thirdly, that I’d be building in the other practices I already know are useful in diving contexts.
EMDR is a bit different in that the therapist does not need to know a lot about the event, yet there remain a range of reasons I would continue to recommend seeking a diving psychologist, or at least a therapist who is a diver.
I am surprisingly impressed by this technique so far, and will be reporting more. Consider signing up to the newsletter below to stay updated. If you are a UK based diver, interested in accessing this approach to address your mental blocks, details and contact information is available here.
*Not all divers who are involved in an incident will experience this. In fact, the vast majority of people experiencing traumatic incidents like road traffic accidents do not develop PTSD, and it’s likely that is also the case for scuba diving. People are frequently able to heal from psychological distress in the same way the physical body can heal from an injury.