How can I get over fear of drowning?

Want to wild swim, snorkel or even scuba dive? Confidence, when immersed, is important for enjoyment and safe swimming, so what do you do with water-related worry? Drowning is the third leading cause of death worldwide, and non-fatal drowning is so common that it is difficult to estimate.  

Apprehension around water is not unusual, but it does not help when you want to engage in some blue-minded activities. So how can you get over fear of drowning?

Jump straight in the deep end?

Considering taking up a new water-based activity with the intention to get over a fear of drowning? Please don't! (At least not yet). While facing fear can be a part of overcoming it, the "sink or swim" approach has some significant disadvantages.  Even if you can swim, if panic is triggered you could become incapacitated. This puts you and those around you at risk of injury or death by drowning. Added to this is the possibility of making things worse due to (re)traumatisation: when experiences are triggered that further convince the brain that water is to be feared.  

Is the fear a rational one? Think about your skills and abilities in water. Do they match the demands of the environment, or is there a gap? For example, if you can only swim a few strokes, then the deep end of the swimming pool is a challenging place. Maybe you can swim a few lengths, but are not a strong swimmer? Then being out in ocean waves is likely to be hazardous for you. If this is the case, then improving swimming and water-skills ("bobbing", "drown-proofing" and "floating") would be recommended.

Dive into the source of the fear

Instead of heading straight into the water, start by getting into the fear itself. Is the fear adaptive and genuinely protecting you from drowning? This would be the case if you either can not swim or have limited swimming ability. It makes sense to be fearful of a situation in which you can not function effectively. If you can swim, or the fear is so incapacitating that it prevents you from learning to swim, then something deeper is going on.  

Get under the surface of the fear. Most fears and phobias are based in some kind of trauma or distressing event. Have you had an experience where either you yourself survived drowning or witnessed another person drown?  

Drowning is defined as: “…the process of experiencing respiratory impairment from submersion/immersion in liquid.” This can include the sea, ponds, lakes, rivers... as well as bathtubs and indoor swimming pools. Drowning can be fatal or non-fatal. Some people experience drowning without injury, and may not realise that this is also considered a drowning event. This is particularly common with children, where a supervising adult quickly helps the child. It is possible to be impacted by experiences that are not remembered.  

Fear can also be learned, perhaps from a parent who was frightened of water. For some people, there is a clear index event, such as being swept out to sea, falling into water, entrapment/entanglement or a difficult experience during water-based training.

Therapy to get over the fear of drowning

Whatever the cause, a psychologist can help you to assess and understand the fear. Therapies that are recommended for traumatic incidents are cognitive-behavioural therapy (CBT) and eye-movement desensitisation and reprocessing (EMDR).  

For single-event traumas, EMDR can often help within a few sessions, and there is also some evidence that early intervention can prevent the development of post-traumatic stress. This can be particularly helpful as a brief intervention for athletes or water enthusiasts who are keen to stay in the water after a difficult experience.  

Whether targeting trauma, phobia or anxiety, most therapeutic approaches will involve some form of exposure. In CBT, this will often be graded exposure.  Starting shallow (perhaps as shallow as the bathroom sink for some) and gradually heading to deeper water (or as deep as the person wants to go). It is also important to consider safety: particularly for people diving into outdoor water bodies, this presents hazards and risks need to be managed.  

Imaginal exposure and mental rehearsal are effective ways to get over the fear of drowning, before getting wet! These techniques, such as future templating in EMDR, can help to calm an over-reactive fear and so reduce the risk of panic. Once the person is confident of being able to regulate fear and anxiety, they will be safer to enter the water.