This blog post examines the potential of surfing subjectively mind-bending waves as a therapeutic approach for mental health, akin to the effects of psychedelic-assisted therapies. I draw parallels between the impact of psychedelic experiences on the 5-HT2A receptors and neuroplasticity, and the intense experiences of surfing mind-bending waves. I dip into scientific literature, personal narratives, and extreme sports insights to suggest surfing's unique capacity to promote mental well-being and proposes new research directions in this emerging field.
I’m aware we have a mental health crisis. I just didn’t realise we were at this level: “Mental ill health is the single largest cause of disability in the UK, accounting for 23% of the total burden, compared to 16% for cancer and 16% for heart disease” (Gov.uk, 2023).
Clearly, many and new ways of treating and protecting against mental ill health are required. I’m becoming more convinced that surfing, and specifically, mind-bending waves, can produce durable protection against mental ill health. The concept of blue health, a sense of wellness and elevation of mood due to immersion or proximity to water, is a familiar one (Grellier et al, 2017). However, my proposition is very different in both application and results. The type of experience I would prescribe has more in common with the intensity of psychedelic experiences than say, open water swimming or dipping.
Psychedelics as a treatment for mental ill health
The use of psychedelics, in particular psilocybin assisted therapy (PAT), in mental health treatment has shattered longstanding prejudices and opened new avenues for healing. Chopra et al (2024) produced a fascinating report on how one lady’s long-COVID symptoms reduced by 80%, allowing her to return to work and resume her PhD studies. Duggan and Walker (2024) provide a broader perspective on psychedelics for treatment of PTSD and intractable depression. Psychedelic therapies are showing promise where conventional pharmaceutical treatments are failing; PAT can provide decreases in depression for up to 12 months after treatment (Levin et al., 2024)
Psychedelics work by activating the 5-HT2a receptors in the brain. This drives neuroplasticity which may allow patients to develop new ways of responding to triggers, forming positive associations, and improving cognitive function. Neuroplasticity is a function of the formation of dendritic spines. These are small protrusions in the neuron’s dendrites that grow rapidly in response to new stimuli. This allows the neuron’s dendrites to form new and lasting connections with the axons of other neurons, building new neural networks and possibilities for new behaviours and learning.
This is great, but there are three key barriers to psychedelic prescription: the side-effects of the hallucinatory trip, legal status in many countries, and the specialised nature of the therapy: it’s not just pill popping, and unsupported use may precipitate mental ill health.
Why psychedelics activate the 5-HT2AR
During a trip, subjects often report feeling cold, increased heart rate, and heightened anxiety. This might sound familiar if you can recall being in a threatening situation: a shift towards the sympathetic nervous system dominance (fight or flight response). So is it pushing beyond your comfort zone that sets off the neuroplastic cascade?
Brouwer and Carhart-Harris (2020) suggest it might be. They argue a pivotal mental state (PiMS) can be achieved when chronic, acute or immediate stress upregulates the 5-HT2aR system, in the same way that psychedelics can. The result is elevated cortical plasticity (changes in the conscious regions of the brain), enhanced associative learning, and an increased ability to process a psychological transformation afterwards.
Ocean Experiences and 5-HT2a Activation
Drawing a parallel to the world of psychedelics, I believe that the challenge of surfing intense waves, can activate the 5HT-2aR in a similar way. When an individual is pushed beyond their comfort zones in a manageable way that aligns with their value system, and with a sense of achievement, it's possible that 5-HT2aR are stimulated, triggering neuroplasticity.
This theory hinges on the concept that extreme physical and mental challenges, particularly those in nature, can elicit a profound state of mental reconfiguration. Why? This would allow one to better anticipate a similar event in future, and increase the likelihood of surviving it. Interestingly, just putting one's self in a near-death experience without context or alignment with a value system doesn’t seem to have the same effect. Michael, et al. (2008) reported on a patient who had a near-death experience whilst in a coma due to bacterial meningitis. He asserted that his experiences (lucid, wild dreams) could not be attributed to endogenous psychedelics. He had taken DMT on an unrelated occasion and said the experiences were not similar enough to be related.
In surfing, I’ve experienced (and met many others who have too) frankly terrifying situations that I wasn’t prepared for. I can’t say that I remember too much about these scenarios now, and don’t feel they are particularly important beyond a quick reminder in knowing your limits. I have however had several sessions with mind-bending waves (to me) that still live with me to this day. The idea of catching waves that ‘will stay with you forever’ is a familiar one in surfing.
The feeling of catching mind-bending waves
I can find no research on surfing or intense sport experiences and 5-HT2aR activation. However, Brymer and Schweitzer (2012) found a strong relationship between self-transformation and moving through fear in extreme sports athletes. They interviewed BASE jumpers, big-wave surfers and rock climbers. They reported deep positive feelings, changes in behaviour, a sense of uniqueness, peace with one’s self, and self-transformation, felt as an aura that remained after the event.
Recalling the immediate sensations during extreme events, the athletes spoke about changes in time perception and meta-perspectives in which intense experiences are controllable. Buckley (2019) hypothesises that surfing intense waves unlocks self-perceived time dilation. Under this condition, a surfer is able to pay attention with extreme focus and respond to events unfolding in sub-second time scales.
In my experience of surfing intense waves, this phenomenon is felt as if a camera is behind your shoulder recording everything in a very fast frame rate. You are able to perceive and visualise what is happening, but the signals are not received as language-based thoughts. This is especially noticeable on the ‘take-off’: the transition from prone paddling to catching the wave’s power and standing up and dropping down the face. The process takes less than a second but invariably several spikes of information will stand out. I’ve been able to match these with shutter-burst photos after the event that show what I was sensing at the time (i.e. board angles, body position). Interestingly, in the few seconds immediately after the spikes I typically feel an ‘explosion’ in the mind. Sometimes accompanied by spontaneous bars of music from a soundtrack in the mind that quickly fades. After the session there is a sense of peace and calm, and happiness in just being. The after-glow stretches for years; self-fulfilment, positive reinforcement of mindset and methods, and simple happy memories.
Are these phenomenological accounts of 5HT2-aR activation and neuroplasticity? There are two possible routes for investigation. Ask an extreme sports athlete who has received psychedelic therapy about similarities, or have an extreme sport athlete take a 5HT2-aR antagonist before practising their sport.
Quantifying mind-bending waves
The simplest way to define mind-bending waves is that they are big waves. Big waves are subjective. Extreme sports pioneer and big wave surfer Laird Hamilton explains that if the biggest wave you have caught is 2ft, then 6ft is big wave surfing for you. If though you have surfed 20ft waves, you cannot say you are big wave surfing when it is 10ft.
The intensity of the experience should be suited to the individual. Brouwer and Carhart-Harris (2020) caution about the bifurcation of outcomes from extreme experiences that produce pivotal mental states (PiMS). They explain that processes that lead to PiMS act like currents that sweep a person along to an outcome that could be post-traumatic growth, or post-traumatic stress disorder.
It is important to scale the challenge appropriately. I have been involved in numerous surf rescues and the mechanism of distress is never a positive experience for the survivors. Therefore, I don’t believe that artificially assisting people into big surf that is unrealistic for their ability will have a healthy outcome. I have taught thousands of people to surf. I do believe that developing anyone to surf a wave of greater intensity than they have caught before, can have a healthy outcome.
In addition to the dependence of bifurcation on the scale of the challenge, external assistance for an activity removes the requirement for planning, learning and training, and reduces the experience to passive consumption, similar to a theme-park ride. I believe self-guided activities are important for the sense of discovery and reward (thus popping the dendritic spines?)
Practicalities of prescribing mind-bending waves
One-off, arbitrarily scheduled surf sessions are unlikely to yield mind-bending waves that a person can catch. This is due to the high variability of surf conditions (e.g. poor quality, or too intense), and the specific demands on the person. This isn’t to say that one-off scheduled surf lessons are not of benefit; most of the thousands of people that I have taught surfing took their experience this way and invariably they had a great time. While I am convinced they yield mental health benefits I don’t believe they trigger the 5-HT2aR in the way that mind-bending waves might.
Therefore, I propose a long-term programme of a minimum of six months. The person should be assessed for physical, technical, cognitive and emotional suitability to surfing. This can be done by fitness tests, interview and exploratory surf and ocean experiences. Once the person’s suitability is baselined, it can be matched to the type of conditions that would provide a subjectively mind-bending surf experience. In general, I have found that there is a positive correlation between a person’s physical fitness level and the wave size needed to bend the mind. A plan can be drawn up to develop the physical, technical, cognitive and emotional capacity. Resultant activities need not take place on the beach; gyms, cross-over sports, home study, and talk sessions can all contribute and are location independent of the surf zone. A six month plan for someone in middle-England may involve three sessions a week where they live, and one session a month at the beach.
The big risk of a long-term programme is adherence. Check points, milestones and achievements must be celebrated. As a personal trainer and instructor trainer I know that well programmed workouts and lectures can produce elation equivalent to a really good surf lesson.
Conclusion
This blog post into surfing as a mental health intervention aligns its therapeutic potential with that of psychedelic treatments, focusing on neuroplasticity and emotional well-being. While research in this area is nascent, I feel there is a case to build an empirical study to validate surfing's effect on 5-HT2aR and neuroplasticity. I propose that self-directed engagement with challenging natural activities like surfing under a programme led by an expert, could be a tool in promoting and protecting mental health. Although further research is required, surfing subjectively mind-bending waves emerges as an innovative and promising approach, offering a new perspective on treatment strategies.
Photo: A truly mind-bending experience at The Cribbar for the author (left, upright). Credit: Geoff Tydeman
References:
Gov.uk (2023) No health without mental health: A cross Government mental health outcomes strategy for people of all ages. Available at: https://assets.publishing.service.gov.uk/media/5a7cab32e5274a2f304ef5a3/dh_123993.pdf (Accessed 6th March, 2024)
Grellier, J. Et al (2017) ‘BlueHealth: a study programme protocol for mapping and quantifying the potential benefits to public health and well-being from Europe's blue spaces’ BMJ Open, Available at: https://doi.org10.1136/bmjopen-2017-016188
Reynolds, S. (2023) How psychedelic drugs may help with depression. Available at: https://www.nih.gov/news-events/nih-research-matters/how-psychedelic-drugs-may-help-depression (Accessed 6th March 2023)
Duggan, P. and Walker, S. (2024) ‘Could the medicalization of psychedelics lead to the next generation of antidepressants?’, The Biochemist, 46 (1), pp. 6-10. Available at: https://doi.org/10.1042/bio_2023_164
Brouwer, A. and Carhart-Harris, R. L. (2020) ‘Pivotal mental states’, Journal of Psychopharmacology, 35 (4). Available at: https://doi.org/10.1177/0269881120959637
Levin, A. W. et al. (2024) ‘The therapeutic alliance between study participants and intervention facilitators is associated with acute effects and clinical outcomes in a psilocybin-assisted therapy trial for major depressive disorder’, Plos One, 19 (3): e0300501. Available at: https://doi.org/10.1371/journal.pone.0300501
Brymer E, Schweitzer R. (2012) ‘Extreme sports are good for your health: a phenomenological understanding of fear and anxiety in extreme sport.’ J Health Psychol., 18(4), pp. 477-87. Available at:https://doi.org/10.1177/1359105312446770
Buckley, R. (2019) ‘Cognitive timescales in highly skilled physical actions learned through practice: A 20-year participant observation analysis of recreational surfing’, Journal of Outdoor Recreation and Tourism, 27. Available at: https://doi.org/10.1016/j.jort.2019.100231
Fantastic article as always Dom; read top to bottom. The Brymer and Schweitzer study that found ‘a strong relationship between self-transformation and moving through fear in extreme sports athletes’ resonates with me and my recent experiences. I’ve experienced rather liberating clarity with processing my own thoughts and feelings. It leaves you seeking more as the ‘subjective’ comfort zone moves!
As I seek more ways to improve my mental health reading this makes me wish I had more opportunities close to home to find some mind bending waves; Goring shore dump doesn’t quite cut the mustard!
Craig