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Psychology of diving
PSYCHOLOGY OF DIVING

di Salvatore Capodieci



Introduction


Until the Eighties diving was practiced by very few sportsmen; nowadays, instead, the situation has deeply changed and this sport is practiced by million of people. Diving is an activity often advised to mass tourism and so it has become a social practice. The development of this activity led some researchers to study the various psychological aspects characterizing it. In this work we will examine the main studies pointing out the most important features about psychology of the underwater activity, through a literary and bibliographical review.
The record of the psychological approach about sea related activities belongs undoubtedly to Alain Bombard (1958). He was a French sailor, physician and biologist who in 1952 sailed without food or water across the Atlantic Ocean with a pneumatic raft called Hérétique, living exclusively on sea water and raw fish. During sailing Bombard tried to fight the sense of solitude recording his reactions, even in his most lonely moments, until he arrived in one of the islands of the Caribbean Sea. Here is how Bombard summarized his successful experiment: "Legendary survivors, stiff and hasty victims, I know you didn’t die of hunger or of thirst because of the sea: tossed about by the sea under the seagulls cry you died of fear".


The pioneers


“Psychological and psychiatric reactions in diving and in submarine warfare”: this is the title of an article written by Behnke and published in 1945 by the American Journal of Psychology. It was 1962 in Italy, when Gianfranco Bernardi (1968) introduced a paper at the First International Simposium of Underwater Medicine titled “Psychology of Underwater Sports”. In his paper he introduced a series of insights which are still modern. The scuba diver according to Bernardi, differently from the skin diver, is not a real sportsman, but an “amateur”; the first sensation the skin diver experiences is of being like a photographic plate to be impressed, like an inexperienced being, eager to gain experiences, willing to withstand any sacrifice to satisfy these wishes. In the early 60’s, Sessa, Pallotta and Fati (1964) found in their researches that the reasons prompting a person to practice diving come from an individual’s unconscious dynamics. When the contact line between air and water is crossed and diving becomes accomplished there would occur a gap between deep drives and conscious motivations.
In 1968 Tatarelli stated that "the reserved, introverted person” is not fit for underwater activity, which might prove harmful as it might emphasize his or her “already depressed moral qualities”. These are conclusions contrasting with the ones made by Caneva e Zuin, who, in 1970, in a research including 46 divers, found a high degree of introversion as a prevailing element. Other authors had already made preliminary researches about the personological evaluation of divers (Ross, 1968).


The 70’s


They were the years of experimental psychology. In those years the researchers studied the effects of depth and stress in dangerous situations such as the underwater environment. Researchers such as Ross, Biersner and Ryman (Ross, 1970a; Ross, 1970b; Ross, 1971; Biersner, 1971; Gunderson, Rahe & Arthur, 1972; Biersner & Ryman, 1974; Ryman & Biersner, 1975; Knapp, Capel & Youngblood, 1976; Ross & Rejman, 1976) studied the relations between narcosis and attentive ability, the performance in an underwater environment, space perception and the adaptation of the diver to the distortion existing underneath the sea surface more deeply. Also, the study of the diver’s personality and attitude were at the first stages of research. In Italy Zannini and Montinari (1971) published their remarks on the psycho attitudinal evaluation of divers in 1971; in 1975 Antonelli published “The diver’s psychology” and in 1981 Pelaia published “The diver’s subconscious mind”. In their researches Griffiths, Steel and Vaccaro (Griffiths, Steel & Vaccaro, 1978; Griffiths, Steel & Vaccaro, 1979; Griffiths, Steel, Vaccaro & Karpman, 1981a) examined the diver’s anxiety and the correlation between relaxing and diving techniques. John Adolfson (1974), who was then a researcher psychologist in the U.S. Naval Medical Research Institute at Bethesda (Maryland, USA) and was also the author of “Human Performance and Behavior in Hyperbaric Environments” and of many studies about the adaptability and human performances in an underwater environment, wrote in 1974, together with Thomas Berghage “Perception and Performance Under Water”.

The 80’s
In the early 80’s, Odone and other researchers (Odone, Reggiani, Vassallo, Oelker & Rotunno, 1983a; Odone, Reggiani, Oelker, Rotunno & Vassallo, 1983b) through debating groups formed by divers and trainers, tried to detect the psycho dynamic basis of underwater psychology. Using psycho diagnostic techniques and phenomenological analysis, they tried to explain the seeming inconsistency in the personality traits noticed in the divers’ groups. According to Odone and his partners, as most of underwater accidents are not accidental but they are due to unconscious reasons, it is essential to understand the psychodynamic mechanisms existing in the underwater activity and explain them in the didactical methods. In 1985, Spigolon and Dell’oro followed the same line of thought stating that autogenous training may be useful to the diver. Learning this technique may allow, as a matter of fact, to break the negative circle ranging from the predicament to the panic attack. In the 80’s, coinciding with the technological revolution which modified the diving technique, many were the studies of experimental psychology and of the relation between the diver’s stress and cognitive performance. Worth mentioning is Morgan’s study “Psychological characteristics of the female diver” written in 1987, which emphasized that, back in those years, after decades of man’s supremacy, diving began to be practiced by women as well. William Morgan, Director of “Sport Psychology Laboratory” at University of Wisconsin-Madison, was one of the researchers who, since the Eighties, contributed most to the psychological research in underwater activity especially with anxiety and panic studies. Morgan (Morgan 1981; Morgan 1983a; Morgan 1983b) examined over 500 experienced recreational divers and found out that over half of them experienced panic attacks and that at least one of these attacks occurred during diving. A strategy – claimed Morgan – to prevent panic attacks would be to identify the persons having the highest probability to have a panic attack before they start diving, by way of an easy anxiety tract test which might predict a panic attack in the 88% of the cases. Studies about the diver’s stress, its cognitive and personological aspects continued in the 80’s as well (Lewis & Baddeley, 1981; Griffith, Steel, Vaccaro et al., 1981b; Heyman & Rose, 1980; Mears & Cleary, 1980; Biersner, McHugh, & Rahe, 1984; Biersner & La Rocco, 1983; Allen, 1983).
Bachrach and Egstrom (1987) were the researchers who, in that period, did the most remarkable studies about anxiety and panic in diving in the book “Stress and performance in diving”, which is nowadays an essential reference for all researchers of underwater psychology . In Italy, De Marco (1987) in his article “Psychology and psychodynamics in diving” collects a literary review of works about this subject.

From the 90’s to the present
The 90’s testified the birth of many important studies about the psychological aspects of diving (Grouious, 1992). Worth mentioning are Jennifer Hunt’s works (Hunt, 1993; Hunt, 1995; Hunt, 1996), who is still a professor at the Sociology Department in New Jersey. She used psycho-analytical analysis to examine the challenge of risk and diving related accidents. She examined the unconscious conflicts which seemed to increase the diver’s involvement during deep water diving, leading the diver to an almost deathly accident. Her research was based on interviewing people practising both recreational and technical diving.
Gary Ladd (2002) was another important researcher. He had been a diver since 1975, and he had also been the very first psychologist diver. In his both clinical and research activity he studied diving induced panic, underwater accidents and he also performed specific therapies for the persons who lost their “buddy” while diving.
In 1999 Nevo and Breitstein published the volume “Psychological and Behavioral Aspects of Diving” which collected their most important researches. From their many studies it comes out that, in comparison with the persons who do not practice this sport, the diver has more taste for risk and adventure, he is more masculine and aggressive and he is also less prone to anxiety and healthier. In that same year in Italy, Diego Polani (1999) published the book “Psychology of diving”, a manual fit for diving trainers, so that they may have a basic knowledge of psychology while teaching.
In psychiatric literature there are few DP(Decompression pathology) related cases; some reports point out that DP may cause personality changes, depression, Munchausen and pseudostroke syndromes. Hopkins and Weaver (2001) recently reported two cases of psychosis that hit some divers after diving and suspected it to be a DP. The divers treated in the hyperbaric chamber did not show any improvement of their psychotic symptoms and the researchers concluded claiming that it was unlikely that DP might cause a psychotic episode.
In 2001 Capodieci founded the column “Sports and Psyche” on Psychomedia, the first Italian portal of Psychiatry, Psychology, Psychoanalysis, collecting articles by the main researchers on this subject and with the purpose to develop the research and the present knowledge about Psychology of underwater activities.
Gargiulo (2002 a, 2002b, 2003a) published on “Alert Diver”, DAN magazine, interesting articles about underwater psychology, which probe deeper into the emotional aspects and the present motivations during diving.
In 2002 Capodieci founded the Internet site “Psychodive” (www.psychodive.it) which, besides activities and articles connected with underwater psychology, deals with the testing of anxiety and panic. The site offers, as a matter of fact, the opportunity to all divers to be able to evaluate their own state of anxiety and this, in line with the most authoritative studies about panic during diving, is a way to know their own anxiety level and prevent the risk of having panic episodes while diving.
Lately, the research has become more and more sophisticated and some researchers studied the relation among underwater activity, the brain and the behaviour. In one of these studies an équipe of Swiss researchers investigated the relation between the Cerebral Haematic Flow (CHF) and the cognitive performance of 215 divers, both recreational and technical, who dived over 40 metres deep, either in cold waters or in warm seas. Through SPECT, psycometric and neuropsychologic tests and haematochemical analysis, the researchers came to the conclusion that divers can get long term neuro functional consequences when diving in extreme conditions (mostly in cold waters ), if they have to their credit over 100 dives more than 40 metres deep a year (Slosman, De Ribaupierre, Chicherio et al., 2004). Also, more recent studies emphasized the risks connected with diving and recommended that besides being in good physical conditions the diver be in good psychological conditions (Kemmer, 2004).

Conventions and Meetings
The first convention dedicated to the subject “Psychology of diving” took place in Mestre-Venice (Italy) on 11th november 2000 and was organized by Salvatore Capodieci from the Association of Medical Psychotherapists in Venice.
Here is an excerpt of what Capodieci said at the Convention as an opening speech: “Underwater activity, like all other risky sports, contains the glamour of a challenge with the unknown, which is often equal to the need to find new emotional drives, and the craving for adventure and for an intimate contact with nature with the sea in particular. Some emotional states might stir in the diver’s subconscious mind, as in all other persons’, which might devastatingly surface to the conscious mind even following seemingly meaningless pressures, especially if in a phase of tiredness and of altered attentiveness. This condition might determine the insurgence of stress and panic for the diver, which is very important that we are able to recognize and prevent” (Capodieci, 2000).
The first International Meeting dedicated to the Psychology of Underwater Activities, titled "Psyche and diving”, took place in San Vito lo Capo (Sicily) from 17th to19th October 2002 (Longo, 2002; Gargiulo, 2003b). It represented a specific moment of confrontation and reflection amongst the professionals of mental health and the professional teachers of amateur diving. Lately, papers about diving psychology begin to appear in other conventions about Sports Medicine, Underwater Medicine and Skin and Scuba Divers (Capodieci, 2003). Also in San Vito Lo Capo, from 23rd to 25th October 2003, the second Meeting about "Psyche and diving” took place (Longo, 2003). The subject was the direct exploration, through the activation of small discussion and elaboration groups, of some aspects of relational and psychodynamic processes which are active in underwater diving such as, for example, the aspects about motivational dynamics and emotional problems which may affect the security in diving, the management of recreational diving groups from professional leaders, as well as the management of communication processes during training activities.
On 27th March 2004 in Mestre-Venice (Italy) took place the Convention titled “On Colapesce’s tracks: the one thousand faces of diving” where Capodieci dealt with the subject “Emotions and experiences of underwater activity”(Capodieci, 2004).
In Siracusa, Sicily, from 19th to 21st May 2004, took place the First International Convention of the Psychology of diving titled "Underneath the Sea and to the bottom of the Soul” (Freghieri, 2004; Longo, 2004) organized by the Italian Psychology of Diving Association (A.I.P.A.S.), whereas from 23rd to 26th September 2004 the International Meeting on the Psychology of Diving took place in Palermo (Italy) and was organized by COJI, CONI and by the University of Palermo.


Conclusions

If in 1945, Behnke’s article marked the beginning of the scientific interest for the Psychology of underwater activities, we can state that after 60 years this field of research still remains in a pioneering phase. Being placed at the border among Underwater Medicine, Psychology and Sports Medicine, Psychology, Psychiatry and Psychotherapy, this new discipline needs to increase its scope with new studies and deeper researches. Despite the important contribution lately made by some researchers, we still have little knowledge of the mechanisms leading to panic attacks during diving; the recreational and technical aspects of the diver’s personality as well as the psychodynamic basis of this activity and its correlations with other extreme sports were studied too little. Nowadays there is no psycho attitudinal protocol collaborating with the medical protocols in the selection of the persons practicing diving both for sports and professionally; the social and psycho educational aspects which are essential to this activity are also dealt with only occasionally and to a very limited extent. I conclude this historical digression wishing that this new discipline may continue to increase with the help of new researches and investigations.


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