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Addressing PTSD With Surf Therapy

"If everybody had an ocean ..." perhaps Western militaries could start addressing cases of combat stress without medication, trading hang fire for hang 10.

For the last handful of years, Britain and the United States have done quiet experiments with a new form of therapy for veterans suffering from combat stress, using a resource neither nation lacks along their coasts: surf.

"Ocean therapy," or surf therapy, will surprise longtime surfers mainly because of the official-sounding name; the idea that an ocean and a surfboard can be good for the body and mind is otherwise not very new. But recent studies have tried to quantify just what happens in the water.

The United Kingdom's National Health Service is still conducting trials in Cornwall, where waves wash in from the Atlantic, to determine whether "surf therapy" deserves taxpayer support. The idea caused outrage at the Daily Mail, where outrage is a business model.

"It's important that the NHS uses its funds for medicine and equipment rather than watersports," a British taxpayers' advocate, Fiona McEvoy, told the Mail late last year. National Health defended the trials on the grounds that they were cheap — £250, or about $400 per person — and aimed at saving money on demand for antidepressants and other drug therapies.

But the U.S. Marines Corps has also worked "ocean therapy" into its post-traumatic stress disorder treatment regime. Until recently, Lt. Col. Greg Martin commanded the so-called Wounded Warrior Battalion West at Camp Pendleton. "Anything a guy really enjoys" will ease combat stress, he says, "but there's nothing like surfing to touch the mind, the body and the spirit all at the same time. And that's our approach in the Marine Corps, we have a whole-Marine focus, so it's not just the medical side."

The nonprofit Jimmy Miller Memorial Foundation developed the program of ocean therapy that the Marines use; the foundation sends therapists and surf instructors to Camp Pendleton every two or three weeks.

One reason it works, says Jim Miller, father of Jimmy and founding member of the board, is that surfing can wear out a vet so much that he sleeps. Miller tells a story about one Marine who turned up for a surf lesson with a number of problems, including insomnia. "This guy couldn't sleep more than three or four hours a night, and he was on heavy medication," Miller said. "But after his first session in the water, he slept for eight hours — without drugs."

Carly Rogers, the occupational therapist who developed the program for the Jimmy Miller Foundation, says surf lessons in the water and group therapy afterward on the sand are meant to shape other parts of a patient's life. "By achieving this goal [of learning to surf]," she says, "in this dynamic environment where they're broken down to nothing [in the ocean], they'll learn to be self-sufficient in other areas."

Her program is based on Mihaly Csikszentmihalyi's flow theory, which argues that a person learning to be "in the zone" — a joyful, focused, un-self-conscious state — can learn to be happy. And a microbiologist in Munich, Ulrike Schmidt, who runs the lab at the Max Planck Institute, isn't surprised. She's studied minute physical changes caused by post-traumatic stress, and she says it makes sense that surfing might help change the chemistry and structure of a veteran's brain. "We already know that moving your body is fundamentally good for healing," she says. "And there's evidence that through movement and physical effort you can encourage metabolic processes in the brain."

Which is not quite how the vets themselves describe it. For them, the intense focus and strenuous work in the water tends to take their minds off whatever haunts them.

"In combat," one L.A.-area vet named Louis Scott explained to me, "you look to your left and you look to your right, and you're always worried about your brother. In the surf, you look to your left and you look to your right," he said, "and you're out there with your brothers. And yet you're havin' fun."

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