Introduction: The loss of the conscious control of respiration on whole body cold water immersion (CWI) can result in the aspiration of water and drowning. Repeated CWl reduces the respiratory drive evoked by CWI and should prolong breath-hold time on CWl (BHmax(cwl)). Psychological skills training (PST) can also increase BHmax(cwl) by improving the ability of individuals to consciously suppress the drive to breathe. This study tested the hypothesis that combining PST and repeated CWl would extend BHmax(cwl) beyond that seen following only repeated CWl. Methods: There were 20 male subjects who completed two 2.5-min, head-out breath-hold CWI (BH1 and BH2) in water at 12 degrees C. Following BH1, subjects were matched on BHmax(cwl) and allocated to a habituation (HAB) group or a habituation plus PST group (H+PST). Between BH1 and BH2 both experimental groups undertook five 2.5-min CW1 on separate days, during which they breathed freely. The H+PST also received psychological training to help tolerate cold and suppress the drive to breathe on immersion to extend BHmax(cwl). Results: During BH1, mean BHmax(cwl) (+/- SD) in the HAB group was 22.00 (10.33) s and 22.38 (10.65) s in the H+PST. After the five free-breathing CWl, both groups had a longer BHmax(cwl) in BH2. The HAB group improved by 14.13 (20.21) s, an increase of 73%. H+PST improved by 26.86 (24.70) s, a 120% increase. No significant differences were identified between the groups. Conclusion: Habituation significantly increases BHmax on CWl, the addition of PST did not result in statistically significant improvements in BHmax(cwl,) but may have practical significance.