'There's no such thing as a bad session.'

I know it, you know it, the tradie who rocks up for his daily constitutional knows it - surfing makes you feel good. Even when the waves are terrible, immersing yourself in saltwater, or communing with other surfers, lifts our spirits,

Not many people question why - as in the physiological basis for the lift in mood - but a new frontier of science is opening that incorporates surf therapy, and it's providing answers to the things we feel but can't explain.

In this article, Tom Donaldson lifts the lid on surf therapy.

In June last year, I was at my classroom desk in a south England school, ruing the onshore winter past, daydreaming of the upcoming visit home to Australia and its winter swells. I clicked to Swellnet, a daily habit, even after five years away. I was struck to see an article about Hallie Clute’s work with veterans through Waves of Wellness and its reflections on surf therapy.

I had briefly worked with a British charity called The Wave Project through COVID and saw first-hand its extraordinary effects on vulnerable children. As someone who'd spent their life growing up in and around the ocean, I’d known, like the rest of us, how good it made me feel, yet I had rarely given further thought to the physiological basis for this. My work, and becoming aware of the work of individuals and groups like Hallie and WoW and the Project, prompted me to the academic literature. As Hallie outlined, and the numerous readers commenting below the line, surfing did seem to have an unusual impact beyond the usual exhilaration we’ve all experienced. It really can be therapeutic.

Uplifting moments of emotion (Greg Button)

You might be surprised to learn that before you’ve even stroked for a wave or duckdived some whitewater, the therapy is already beginning. It started when you arrived at the coast. Much like gazing into a campfire, the ocean’s waving, wobbling and rippling does a fine job at holding our attention. It’s almost hypnotic, no? 

'Attentional Restoration Theory' suggests that the never-ending sights and sounds of urban environments: billboards, horns, jackhammers, cars, the madding crowds, force you to use your limited attention/energy to ignore this stimulus, eventually leading to mental fatigue. This barrage of attractions creates what's called 'hard fascination' - stimuli that forcefully grabs our attention.

Instead of hard fascination, natural environments can produce 'soft fascination', where the scene might capture your attention and bring on feelings of pleasure. The more picturesque, the better. Importantly, the environment should promote a feeling of 'being away' from the spaces where you feel stressed or energy-demanded.

A sense of 'escape', the 'extent' - as in size and vastness - of the environment, and a sense of connectedness with that environment  all helps to encourage these feelings.

Most interestingly, when an element of dynamism is included in the scene – say, the ever-changing sea surface – preference for that environment is significantly increased. As a result, your mental fuel is restored, or never exhausted in the first place.

Exhale...

Or consider immersion in this environment, particularly at the colder latitudes. What is it about cold water surfing that makes it so beneficial for our mental health, as anecdotes and research increasingly recognise? Scientists believe there could be a few mechanisms at play. 

First, a sudden change to your immediate environment – dry and warm to wet and cold – is a shock, and potential danger, to your body. Accordingly, your body goes into fight-or-flight mode and releases a cascade of stress hormones such as adrenaline and cortisol to deal with this. Crucially, your body also does this whenever it is faced with any stress. Too much stress and cortisol over time is, of course, terrible for our well-being. This is where the 'body-hack' element comes in. By regularly jumping in cold water, your body adapts to the cold and by association, the stress response as well. Over time, your body is not responding as strongly to any stressors, not just cold water.

Secondly, when you immerse your face in cool water, the vagus nerve is stimulated - the vagus nerve runs from the brain to the heart, lungs, and abdomen. Among other beneficial effects, vagus nerve stimulation leads to a strong anti-inflammatory response. Inflammation and its triggers are significantly associated with depression and poor wellbeing.

Laurie Towner stimulating his vagus somewhere above the Arctic Circle (needessentials)

And then there are the studies on 'flow'. When do we feel happy, a true sense of well-being in the moment? The influential studies of psychologist Mihalyi Csikszentmihalyi suggest that the 'flow state', as he coined it, is when people are most creative, productive, and happy. Interviewing musicians, artists, and athletes, he wanted to discover the drivers of happiness and performance. His findings have since been observed across the vast range of human experience, from classrooms to climbing walls, surgery to the surf.

The flow state is when you experience a state of complete absorption, effortless concentration, and full engagement in an activity. When this focus is particularly intense, the experience has been characterised as ecstasy, with total clarity on what you want to do from moment to moment. Sensations like timelessness, personal control over the situation and outcome, serenity and loss of self-consciousness are all features of pronounced flow states. Shaun Tomson may have uttered the famous words: “When you get into a deep barrel, it feels like time is expanding, like life is slowed down," but he won’t have been the only surfer to have felt that experience. It's a desirable state for anyone, let alone traumatised or vulnerable people.

Shaun in the flow state

And it’s not just the mental state that is altered: a 2010 study on classical pianists revealed that musicians in a flow state showed deepened breathing and slower heart rates. Over time, regular attainment of flow state is associated with greater well-being, life satisfaction, better emotional regulation, and general happiness.

So how can we reach it? Engage in meaningful activities that are challenging but perceived as achievable. Remove distractions and set a goal. Interestingly, the feelings are amplified when the activity is undertaken in a group. Enter the Wave Project, Waves of Wellness, and similar groups, where participants engage as a collective. It's a matter of ABC: Activity, Belonging, and Commitment.

Research has credited a lifestyle with plenty of outside activities works to foster positive emotions and protect our brains from decline. An active mind and body, particularly in the company of others, can be naturally rewarding and a healthy alternative to worrying, overthinking, or engaging in substance use.

Don't question it just hook your elbows and join in (The Wave Project)

The literature also affirms that our relationships with one another are fundamental to mental health in terms of providing a sense of identity, acting as a source of support, and being an important coping resource for dealing with pain, stress, and difficult life events. From the start, surfing has fostered community along coasts the world over. Perhaps you started surfing with friends, but eventually, surfing starts bringing new mates to you as well.

A sense of meaning and purpose is vital to our well-being and has been shown to help extend life expectancy and maintain a healthy brain. Committing to a hobby, a challenge, a good cause or helping others, all boost feelings of self-worth while protecting against the opposite: feelings of hopelessness and worthlessness. Scouring the forecasts and cams, spot checking, booking the next Indo trip, or just doing a strike down the coast, devotees derive nothing if not a sense of purpose from their commitment to swells.

Related to this is the positive identity one forms from engaging in meaningful activities. You’re not 'someone who surfs'. You’ve become 'a surfer'. For people with low self-esteem, perhaps due to chaotic and traumatising backgrounds, who may have even experienced the horrors of war, 'becoming' a surfer offers a comparatively wonderful new identity compared to the self-perceptions they had previously developed.

Of particular relevance to groups like the Wave Project, where volunteers are paired 1:1 with the young participants, social participation and contributing to the community can preserve brain function, promote thoughts of 'making a difference' and reduce feelings which aren’t helpful for well-being, such as self-centredness. It’s not only the clients that are benefitting from therapeutic programs.

How effective are programs like Waves of Wellness and the Wave Project? The Wave Project’s pilot program in 2013 produced the following: a selectively mute child, whose own parents hadn’t heard them speak for years, was prompted to talk again; confidence, calmness, happiness, social connectedness and well-being was lifted across the group, which included individuals who had been self-harming, experiencing depression, or living with schizophrenia. The pilot’s success led to the UK-wide establishment of 'Projects', reaching over 14,000 young people since then and continuing to this day. The most poignant stories are the ones where families and children directly attribute the Project’s intervention to saving their lives, having been suicidal.

(Waves of Wellness)

Feedback from some of the Wave Project’s referral partners and other specialists (e.g. counsellors and psychologists) report a striking theme: surf therapy can, and has, created greater and more rapid outcomes than long-established (and empirically supported) methods like talking therapy (otherwise known as Cognitive Behaviour Therapy). 

The Project was a founding member of the International Surf Therapy Organisation (ISTO), referenced in Hallie’s article. It is a body that includes member organisations from around the world that advocate for surf therapy as a physical and mental health intervention. ISTO nations include the Philippines, Spain, Netherlands, USA, Australia, New Zealand, Portugal, South Africa, Peru, and even Sierra Leone where surf therapy was used to support former child soldiers. Surf therapy has also been used in Somalia to the same end.

Lots of studies informed this article. Dedicated research has been undertaken that focuses specifically on surf therapy. Like all research, the findings prompt further questions, with perhaps the most obvious being: will the feelings of wellbeing persist following the surf sessions? This seems to depend on the difficulties facing the participant. Caddick et al (2014) indicated that the feelings of respite tend to “fade into the background” of the participants’ lives, veterans who were experiencing PTSD. However, keen to continue their respite from PTSD, the veterans became motivated to engage in health work, which was anything that cares for or improves one’s health. It could be as simple as walks outside or picking up a guitar.

The vast majority, if not all, the clients served by these programs were not surfers. Which means we must also ask, will surfing provide therapeutic outcomes for someone who is already a dedicated surfer and facing a novel crisis? Although the research is scant on this point, I am confident that anecdotes will shortly arrive below the line that attest to the support that the waves offered in our lowest points.

Discussions around mental health continue, thankfully, to lose their former stigma. Given that horses, painting, hiking, games, and even just talking are considered valid forms of therapy, surfing must belong in that list in light of the research above. It's something we've all felt, though we understand it as another word: stoke.

// TOM DONALDSON