Dive into Wellness

Traditionally, recreational Self-Contained Underwater Breathing Apparatus (SCUBA) diving (diving) conjures up images of tanned humans clad in swimwear interacting with marine wildlife in pristine blue waters. More recently however, the spotlight has turned to the therapeutic benefits of diving for stress-reduction in the general population (Beneton et al., 2017), veterans with chronic psychological injuries such as post-traumatic stress disorder (Blumhorst et al., 2020; Gibert et al., 2022; Morgan et al., 2019; Walker and Kampman, 2021).

Distinct from diving with the purpose of exploring the underwater world or interacting with wildlife, therapeutic diving focuses on the meditative aspects of being in the water; an exploration within the self. As Ecott (2001, pp.102-104) notes:

Usually, just being underwater is enough for me, the ease of movement and the rhythmic sound of my air bubbles are soothing and the weightless hovering is its own reward…This liberation from gravity’s tiresome pull frees not just the body, but also the mind… Underwater there is freedom from everything terrestrial…The mental release that neutral buoyancy brings is even more valuable than the interaction with creatures of the deep.

Indeed, diving facilitates a connection to the mind-body and in turn, a return to wellness.   

I. Body

Diving is a sensorially immersive experience - the sensation of water or the snug wetsuit on the skin, the taste of salt water on the tongue, the lack of terrestrial noise but amplified speed at which underwater sounds reach the ears and the increasing pressure of water on the body – the effects of which all increase as one descends further beneath the water surface.  

The feeling of weightlessness specifically, has been reported to promote relief from both physical and psychological symptoms (Walker & Kampman, 2021). Negotiating movement underwater activates proprioceptive awareness and heightens kinaesthetic sensation: movement felt by the muscles, tendons and joints. Straughan (2012, p.21) explains, “In diving, the vestibular system intertwines with buoyancy perception as it picks up bodily orientation and works with other somatic sensations to keep a diver balanced.” Haptic perception – sight resting on the surface of an object to discern texture rather than form – enables our vision to “touch” objects specifically for the purpose of guiding movement.

II. Mind

Submerged in a world where our sensorium and physical responses differ to that we habitually experience on land, a new space emerges in which we may feel differently to what we habitually feel on land (Straughan 2012). Simply put, diving offers an environment in which the body experiences changes in sensation, perception, and response, opening space for the mind to experience differently as well. It is also an activity that demands the mind’s presence: diving involves real and significant risks to life that must be constantly mitigated. An uncontrolled ascent to the surface for instance, places divers at potential risk of life-threatening pulmonary barotrauma:

Something, most certainly, happens to a diver’s emotions underwater. It is not merely a side effect of the pleasing, vaguely erotic sensation of water pressure on the body. Nor is it alone the peculiar sense of weightlessness… the diminishment of gravity to a force little more emphatic than a suggestion. It is not solely exposure to an unfamiliar intensity of life. It is not a state of rapture with the bottomless blue world beneath one’s feet…it is some complicated mix of these emotions, together with the constant proximity of real terror.”
(Lopez, 1999)

Similarly, there is growing recognition of the therapeutic potential offered by natural environments, with evidence that one’s dynamic relationship with “green” (grass, trees or other vegetation) and “blue” (water) spaces are supportive of mental health and wellness (Bratman et al., 2019; Mantler & Logan, 2015; White et al., 2010).

The precise mechanisms for the way in which our environment influences our mind state have yet to be defined. However, it is worth noting that the underwater environment is unique in offering a geographical separation from the terrestrial landscape, providing space and insulation from life above land. Sound waves are interrupted in passing from air to water, diminishing noise pollution from land. While diving alongside others, communication is limited to hand signals drawing attention to the present. Such elements facilitate stillness: “an internal state of calm in which a person becomes more aware of their immediate embodied experience of the world and less concerned with events occurring ‘out there’”, the experience of which may “encompass an enhanced clarity of thought, or act as a portal to new modalities of feeling” (Conradson, 2007, pp.33-34, as cited in Straughan, 2012).

III. Breath

Many meditative practices utilise the breath as a focal point for grounding one’s attention in the present and for providing feedback regarding our physical and emotional state (Kabat-Zinn, 2019). In diving, the most prevalent and constant sound a diver hears is that of their breath, accentuated by the regulator (breathing apparatus). Breathing over time is monitored by the air pressure gauge which tracks air consumption – rapid, panicked breaths lead to greater consumption while calm, relaxed breathing reduces consumption, allowing for more time underwater.

Controlling the breath is essential to controlling buoyancy and a diver’s position underwater – inhales fill the lung leading to ascent and exhales, descent.  The position of one’s body provides immediate feedback of one’s breathing. Typically, a diver who is feeling anxious is likely to take more rapid and heavy inhalations, leading to unintended changes in their position in the water, which often exacerbates their anxiety in a vicious cycle. In such situations, other divers may assist by looking them in the eye, bringing them back to the present with slow, deliberate hand motions prompting them to slow and regulate their breathing.

IV. The Other

One of the golden rules of diving is to never dive solo (unless trained to do so), and even then, only in specific circumstances (Denny, 2022). This buddy system of diving creates mutually reliant relationships amongst divers. While submergence underwater facilitates a connection with the self - body, mind and breath – it also facilitates connection with others through the sharing of novel experiences. Studies in veteran populations have likened this to the “sense of brotherhood, shared support and innate trust” found in military life – providing a sense of comfort for veteran populations participating in diving as therapy (Morgan et al., 2019).

Similarly, meditation is often associated with a deeper connection to the self, and at times, compassion for others. Meditative practices are thought to be most conducive to shifting one’s preoccupation with self to a sense of connectedness with others when specifically framed in the context of being attuned to the needs of others (Kirsteller & Johnson, 2005). The buddy system of diving provides this context.

This social aspect of diving is especially important when considering that social isolation and loneliness are said to be “serious public health concerns” of our time due to its association with poor physical and mental health outcomes (Newman & Zainal, 2015).

 V. Conclusion

The modern world is one of sensory overload – disconnecting us not only from ourselves, but each other and the natural environment. In the natural aquatic setting, diving offers therapeutic benefits by connecting us back to our self (body, mind and breath) and others.

References:

• Beneton et al. (2017) Recreational diving practice for stress management: An exploratory trial. Frontiers in Psychology. 8: 2193

• Bratman et al. (2019) Nature and mental health: An ecosystem service perspective. Science advances. 5(7): eaax0903

• Lopez B (1999) About this life: Journeys on the threshold of memory. Knopf Doubleday, New York

• Blumhorst E, Kono S, Cave J (2020) An exploratory study of adaptive scuba diving’s effects on psychological well-being among military veterans. Therapeutic Recreation Journal. 54(2): 173-188

• Denny M (2022) Scuba diving solo: what you need to know. PADI: Professional Association of Diving Instructions. http://blog.padi.com/solo-diving/

• Ecott T (2001) Neutral buoyancy: adventures in a liquid world. Penguin, New York

• Gibert et al. (2022) Comparing meditative scuba diving versus multisport activities to improve post-traumatic stress disorder symptoms: a pilot, randomized controlled clinical trial. European Journal of Psychotraumatology. 13(1): 2031590

• Kabat-Zinn J (2016) Mindfulness for Beginners. Sounds True, Colorado

• Kristeller J and Johnson T (2005) Cultivating loving kindness: A two-stage model of the effects of meditation on empathy, compassion and altruism. Zygon. 40(2): 391-408

• Mantler A and Logan A (2005) Natural environments and mental health. Advances in Integrative Medicine. 2(1): 5-12

• Morgan et al. (2019) Can scuba diving offer therapeutic benefit to military veterans experiencing physical and psychological injuries as a result of combat? A service evaluation of Deptherapy UK. Disability and Rehabilitation. 41(23): 2832-2840

• Newman M and Zainal N (2020) The value of maintaining social connections for mental health in older people. The Lancet Public Health. 5(1): e12-e13

• Straughn E (2012) Touched by water: The body in scuba diving. Emotion, Space and Society. 5(1): 19-26

• Walker P and Kampman H (2022) “It didn’t bring back the old me but helped me on the path to a new me”: exploring posttraumatic growth in British veterans with PTSD. Disability and Rehabilitation. 44(24): 7455-7463

• White et al. (2010) Blue space: The importance of water for preference, affect and restorativeness ratings of natural and built scenes. Journal of Environmental Psychology. 30(4): 482-293.