It is December, and time to look back over the previous year. This is a post I write every year to check what I’ve done against the intentions set for Fit To Dive. I would forgive you for thinking there is no point in reading what is essentially an informal self-evaluation report, as that does sound dull. However, working as I do with new services and ideas relating to diving psychology, there are some fairly unusual experiences. As a scuba diver, I’d urge you to at least glance through and see if you find anything useful in your own diving. Either in the services I’m developing, the research or the free resources I share.
But first …
Helping competent divers to fix a skills issue
Before I go back and look at my list from last year, I want to start with a couple of things that really stand out from this year. Both are down to the incredible and effective approach I use in both coaching and therapy: eye-movement desensitisation and reprocessing (EMDR). I trained in EMDR because I suspected it could be useful for divers. It is. EMDR has been really very helpful.
One of the ways I’ve really enjoyed using it is in coaching for divers who are pretty skilled and confident, but have that one little irritating hang up that is getting in the way. This is often something like a discomfort with mask or regulator skills, or perhaps DSMB deployment or another performance based issue. Frequently, it’s been generated out of a few bad experiences. Although the rest of their diving is okay, there is this one thing that can trigger stress and is a barrier that gets in the way of enjoyment or learning.
Where this has been really interesting is with divers who are looking to enter technical diving. These divers can dive well, but they have that one thing that is a bit of a struggle. They know that they have been able to get away with the issue in recreational diving, but in tech, that thing could be fatal. Sometimes these divers have had the block for years. And two or three sessions of EMDR removes it!
It is not always as fast as that, but with this specific group of people, skilled, resilient, psychologically secure divers, it can be. And it is very cool when it happens! It lets them drop the distress, and with the block gone, they are able to learn and build skills instead.
Rapid Access Psychological Decompression
The second of my favorite EMDR successes this year has been the rapid access psychological decompression service. This is for divers (in the UK) to access a short course of therapy to process trauma and support recovery after an adverse event in diving. It is basically to prevent the issues I described above from developing in the first place, as well as to reduce risk of post-trauma conditions and potentially address the issue before any diagnostic criteria are met!
Often these divers will score in the “at risk” level on screens for post-traumatic stress (PTS), but are too early to diagnose. Of course, people can recover from incidents naturally, without therapy, and a good two thirds of people involved in significant trauma do not go on to develop PTS. However, there is a bit of research that shows fairly dramatic reductions in risk of PTS with early EMDR.
I’ve found that the people I work with, within a month of a diving incident, do have something that needs a bit of support. For some people, the whole experience is still feeling very live, causing nightmares and mood issues, for example. For others, there is an aspect of the event that has got a bit stuck. Either way, EMDR helps these divers to process the memory of the event in a way that makes sense, allows them to let go of guilt, shame, embarrassment, anger or other emotional pain and extract what they have learned from it.
Quite often, the person will complete the therapy able to accept the experience and focus on what they have gained from it. That could be: a lesson that they apply to diving, such as changing processes to improve safety in future; sharing the lesson with other divers; shifting to embrace a part of themselves they previously struggled with and seeing themselves in a new, and more positive, way; or simply able to accept and move on. Seeing the relief when distress goes away and the smiles when they experience the shifts is always a privilege, and a part of my work I love. There is also something special about doing this for divers, knowing that it has helped them return to diving, improve their safety or just let them enjoy it again.
Okay, so that was the main experience I wanted to note this year. Now, time to reflect on the list:
Review of 2023 Intentions
The pilot study on divers’ experience of trauma or distress when scuba diving
I created and shared the survey; collected and analysed the data. I have drafted the methods section of a journal paper, with the intention to submit for publication. The responses were interesting and, I believe, show how important it is to study the topic further. I shared one of the aspects that most fascinated me in a live, online meeting, and this talk is still available to access as part of the free trial for a course I’ll be running next year. The Mind Ghosts in Scuba Diving course can be accessed here. (The free trial button is there, next to the purchase button, it’s just hard to see and I have not managed to fix it – of course, you can also sign up for the whole course, which is the next item …
Create a course to learn about psychological trauma
Well, this, I have not actually done yet. I’ve been working a lot on connecting with people who would like to take the course, and had planned to do it in March, then diving took over and I said September, .. then November .. and then I got invited to stay in Iceland for a month and well …it’s Iceland!!! But now I have absolutely set a start date (it’s actually pretty soon now). I have also created the outline for the curriculum and I have blocked off the time to build it. Creating these courses is highly demanding on my time and energy (and I love to make them), so it reduces the number of individual appointments I offer (and with that, my income), so I do need to have enough people on the course. If this is something you would like to learn about and support as a diver, the course sign up page is here. (Oh, that page is another part of the intention I’ve done! – it is getting there!). Seriously, it is going to be interesting and useful, it’s surprising what understanding trauma can do for your diving!
If you want to know about all the benefits of understanding trauma and distress, sign up for the newsletter and select “Talk Trauma Waitlist”. There is such a lot to it, and it is out of scope.
Create self-help guide to support divers after adverse events
There is a rough draft. I haven’t pulled it all into one booklet yet, but I have built it across the web pages that make up the online resource. The resource is something I have developed a lot this year. As well as the main page with signposting and self-help tips, there are pages for: divers worried about PFO; people who want to know how to support their buddy/friend/relative/spouse; and divers who are considering or already involved in legal proceedings and want to also access therapy. I am also working on a page about trauma debriefs, which is quite a complex topic. There are several other pages to be done,
In addition to building the resource, I have been sharing it with divers, diving professionals and diving medical professionals. This is gradually building, but if there is one thing that you could do that would help right now, it would be share the resource. There are details about my psychology services for divers there, however, I aim to make the free information as useful as I can, and potentially reduce the need for therapy, or at least lengthy therapy, with the self-help options.
Continue to offer ScubaFlex
Hmm. Honestly, I have not ran it yet this year. There are a few people on the waiting list, and I do intend to contact with an availability poll. The only thing I need to run this course is a handful of divers who are interested in learning skills and strategies to build psychological flexibility (and reduce anxiety, improve performance or both). If you might be one of those, join the waiting list on the sign up or preferences form. It’s a fun course, and I enjoy doing it.
Upload the ScubaFlex manual to the ACBS website
Done!! With a little help from ChatGPT (which is another thing I’ve been learning this year!). This is not of much interest unless you are a psychologist, counsellor or mental health practitioner type, but if you are, you may join the ACBS and download the manual. The annual membership fee is partly optional and lets you access lots of resources. If you can provide ACT, and have experience in diving, maybe you can offer it yourself! (Although I’d recommend attending it first, it is up to you). I can also provide supervision/consultation services.
Combine the original scubapsyche essays and publish with a reflective work book
I am revising the draft right now! I have been learning about self-publishing and this one is almost there. If you are a deep thinking diver who likes to reflect on diving experience, this is probably for you. Watch this space, fingers crossed, I get this ready before Christmas, along with another couple of Fit To Dive products I have planned.
Continue individual sessions for divers and also offer a rapid access psychological deco service
Yes. I’ve been doing this all year. I can’t say all that much about it, as these are confidential services. I do have some service evaluations to share. This year I’ve been working with divers affected by boat incidents, anxiety when diving, rescuing and rescusitating dive buddies and skills performance issues. Where this is therapy, I’m a bit limited geographically, mainly to UK though there are exceptions. Sometimes, it’s is genuinely more of sports performance issue, without a severe traumatic event, and then I’m fine to offer coaching, with the EMDR being just as powerful as in therapy.
The only real issue I have on this one is that I know there are many more divers who would benefit from these services, and just do not know about them. Something else to be aware of, this year, I have had divers access therapy via their health insurance. If you are a diver who has private healthcare insurance (I don’t mean travel insurance) then it may be worth a call to see if your cover would include psychological therapy in the event of a diving accident or incident (as it most likely would if you were involved in a road traffic collision, or other traumatic event). Once you have finished the recompression therapy or any other immediate medical treatment, it could be there is an option there open to you for a few sessions to support your psychological recovery! And if they do not cover you for scuba diving, you may want to review your cover.
Explore options for memberships/packages to bring more affordable access
I have explored this. I have been looking at it for years. The learning platform, where the courses are hosted, has all the capacity for it, and at no extra cost. The plan is to build a subscription service with levels of access, such as group live sessions, online courses, video lessons to help you do things that support physical, mental and emotional wellbeing for diving, and a premium level to include individual sessions. I’m sure it would be valuable and would work. That, I could do right now. But before that, I need to let divers know about it. That is the part that takes more time than I have available. I am working on it. Early next year. If this interests you, make sure you are getting the monthly(ish) news.
And that’s the list!
Other reflections?
Professional Talks
Talking to diving and hyperbaric doctors
In November I attended the “fitness to dive” day of the joint conference of the UK Diving Medical Committee (UKDMC) and the British Hyperbaric Association. The UK DMC have been updating guidelines and needed to consider neurodiversity in diving, particularly attentional conditions and autism. I co-presented a on the topic with another diving instructor/clinical psychologist who specialises in neurodiversity, and was able to learn a lot through the talk and discussion. I was also able to meet an occupational medicine doctor who worked with a clinical psychologist to study ADHD in commercial and navy diving in South Africa. These are some of the only current studies there are in psychological aspects of diving, so it was great to learn more about what has been motivating that research.
The talks on diving medicine and the legal aspects were all informative to my work, for example, I was able to learn more about Immersion Pulmonary Oedema (IPO/IPE). This is a condition of interest in my work with divers and something I intend to write more about. I noticed many of the talks, included points about mental health and trauma in diving, mainly relating to commercial diving. This was included in an occupational medicine talk, highlighting the importance of addressing conditions and contexts that contribute to diver health issues. As well as the Health and Safety Executive, which is bringing more attention to mental health in working environments in all sectors. And we even had a videocall from a saturation diver at work (in saturation during the presentation), who is advocating for diver’s mental health.
I also enjoyed catching-up with and meeting diving doctors attending from Cornwall to Orkney, learning about their work and perspectives. Diving medicine is a small niche, with few doctors specialising, so the conference was a great way to find out about important issues, and also inspires my thinking for diving psychology.
Risk Management seminar
In September, I gave a short online talk within PADI’s risk management series for PADI professionals. The focus for the webinar was adverse events in diving, balanced across prevention of, and response to, incidents. My talk was about what we, as diving professionals, can do for divers who have been involved in distressing or traumatic incidents in diving. I also got to learn more about the immediate medical responses to diving injuries in the UK. The audience was somewhere over 400 PADI members, and it was good to be able to raise awareness of psychological trauma in diving.
More I’d like to offer
There are so many resources I’d like to build, such as short videos for clients about trauma and EMDR, or ways to make the rapid deco service more affordable. There are also so many ideas for useful blogs and articles. But in looking back this year, I realise I’ve virtually stopped writing blogs! This shortage of new reading, as well as almost no social media sharing, has meant a significant dip in visits to the website. It often seems like a choice between doing the work and telling people about the work! Of course, one is meaningless without the other, and it does seem that blogs and social media posts make a difference.
AI
With all these ideas and not enough time, like everyone in 2023, I’ve been playing with artificial intelligence (Which is not a sentence I was expecting to write when I set intentions at the end of 2022!!) I am still a bit unsure about the use of AI writing. Although it is a lot faster and can help with the my long list of blog ideas, it’s not the same as writing personally, I am working on how I integrate AI as a tool for writing, while keeping the human element.
Conclusions
If you’ve read these annual posts before, you may remember I pick a word for each year to focus intentions for Fit To Dive. The word I choose for 2023 was experience. It’s certainly been interesting to reflect on that experience, and see just how much more experience it has brought. Experiences are vital in building any area of expertise and, because diving psychology is so new, I actively work to find that experience.
blog.fittodive.org 