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Visualization using all five senses can boost performance and ease anxiety during simulations.

Performance breathing, like box or diaphragmatic breathing, quickly manages physiological stress.

Adaptive self-talk and cognitive reframing counteract negative thoughts and improve outcomes.

During underwater egress training, aka helicopter dunker training, one of my fellow students panicked and stopped the training so that he could get out. This training teaches key survival skills for aviation personnel flying in helicopters over water. It involves being harnessed into a seat in a mock helicopter, which then “crashes” into a pool, sinks, and inverts. You are required to follow precise instructions in order to save yourself. Pretty much everyone experiences anxiety during the training.

The interesting thing about this training is that it doesn’t require much swimming ability or any advanced technical skills. What it does require is mental control during a time in which you are anxious and disoriented (upside down, underwater, with ineffective vision and hearing, and without air). The goal is to manage your anxiety during the evolution, while learning that you are capable of saving yourself despite the anxiety. The training builds skills, normalizes the stress, and instills confidence that you can do it in a real situation.

You might be wondering what happened to my classmate? He was referred to the mental health department to help him with his anxiety. The problem was that he didn’t have a mental health disorder, and meeting with the mental health provider didn’t help him. In a small-world story, he ended up in my office. He learned visualization,........

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