Key points

• Surf therapy fosters belonging, presence, and symptom relief for PTSD and depression.
• In one study, 58 percent of veterans with PTSD/MDD achieved remission after six weeks of surf or hike therapy.
• Surf therapy can aid addiction recovery, autism, at-risk youth, people with physical disabilities, and more.
• The ocean’s sensory environment and surf community create a unique space for healing, awe, and meaning.

I have had the privilege of taking veterans surfing on the Oregon Coast since 2019. Before each session, there is a nervous energy—some have never touched a surfboard, others have not been in the ocean since childhood. Once veterans hit the water together, something shifts. Laughter breaks the tension. Each effort is cheered on. Veterans look out for each other. Those new to the sport watch experienced surfers catching waves outside. The sense of safety, joy, and belonging—so often lost after trauma—is palpable. My experience is reflected in the research. As one veteran stated, “When I was surfing with those guys, I was surfing with family” (Marshall et al., 2020).

Why Surf Therapy?

In a recent randomized controlled trial with vets who have PTSD and major depressive disorder (MDD), hiking and surfing were shown to have equal efficacy (Otis et al., 2024). And yet, a subset of high-performing veterans I have worked with needed something as difficult as surfing to take them out of the war in their mind. Once, after I worked with a veteran in the water for three hours, he finally dragged himself out of the ocean, exhausted. He told me, “Thanks, I really needed to wrestle something down till I couldn’t fight anymore.” This veteran went on to become a regular in the Oregon surfing scene.

For many trauma survivors, especially those with PTSD and dissociative symptoms, being present can feel impossible. Traditional mindfulness practices may be frustrating. But the ocean demands attention; cold water, crashing waves, the uneven ocean floor, unseen creatures—all these sensations anchor you in the here and now (Benninger et al., 2020; Rogers et al., 2014). Carly Rogers, a pioneer in surf therapy, described surfing as the antithesis of PTSD: “In surfing, instead of avoidance, it’s complete engagement. Your senses are aware, your body is aware, you’re present. Instead of reexperiencing the trauma, you’re completely present in the moment. So many participants said, ‘I wasn’t thinking about anything but being in the water’” (Rogers, 2014).

As someone who practices exposure therapy, I love the graduated exposure opportunities surfing provides. A core challenge in PTSD recovery is decoupling fear from actual danger and reestablishing gradients of safety, trust, power, esteem, and intimacy. The ocean provides a natural laboratory for this process. Each session offers choices—how far to go, when to rest, when to push. Participants learn to assess risk, trust their bodies, and support each other in facing challenges (Marshall et al., 2020). This graduated exposure is not just physical—it’s social and psychological. The process of learning, falling, and celebrating small victories together helps participants internalize new beliefs: “I can handle this. I can trust others. I can grow.”

The Science of Surf Therapy

A robust body of research supports surf therapy as an effective intervention for PTSD and related symptoms:

• Randomized Controlled Trials (RCTs): In a 2024 RCT, veterans with both PTSD and major depressive disorder (MDD) were assigned to either surf or hike therapy. Both groups showed significant improvement, with 58 percent achieving remission from PTSD after just four hours per week for six weeks—surpassing the 33 to 50 percent remission rates seen in some studies of first-line psychotherapies for military PTSD (Otis et al., 2024; Steenkamp et al., 2015).
• Symptom Reduction and Pain Management: Surf therapy has been shown to improve pain management for active-duty military service members. Participants also reported decreased stress, reduced narcotic use, and increased self-efficacy (Benninger et al., 2020; Rogers et al., 2014).
• Belonging and Connection: The surf community fosters rapid connection. Both beginners and experienced surfers can share the same break, and the shared challenge of the ocean creates instant camaraderie (Marshall et al., 2020; Caddick et al., 2015).
• Awe and Meaning: The natural beauty and power of the ocean evoke awe, which research links to increased well-being and a sense of meaning. Participants often describe feeling “part of something bigger” and rediscovering purpose (Caddick et al., 2015; Benninger et al., 2020; Keltner, 2023).
• Benefits for Diverse Groups: Research and practitioner accounts have demonstrated broad mental, physical, and emotional health benefits to diverse populations, such as individuals in recovery, on the autism spectrum, at-risk youth, those with physical disabilities (including those who are blind or visually impaired), and more (Lambert, 2024).

Learning From Pioneers

Since 2007, the Jimmy Miller Memorial Foundation (JMMF) has been working with active duty Marines from the Wounded Warrior Battalion stationed at Camp Pendleton. Initially, military command was skeptical—surfing was seen as “too dangerous” for veterans. But after the first session, the transformation was undeniable: “The change at the barracks is visceral” (JMMF, 2023). Veterans reported sleeping better, feeling more alive, and experiencing joy and connection that had been absent for years. Since then, JMMF and other organizations have continued to expand offerings to the military and veteran population and beyond. In collaborating with JMMF and learning from them, I have come to call the work “Ocean Therapy”—it’s not just about surfing, but partnering with the more-than-human world, intentionally creating opportunities for participants to experience communion with each other, the ocean, and its inhabitants. Whether it’s watching a sunrise paddle-out or simply floating beyond the break, these moments of shared awe can be profoundly restorative.

According to Joiner’s interpersonal theory of suicide, a lack of belonging and purpose are key drivers of suicidal desire (Joiner, 2005). Surf therapy directly addresses these needs. JMMF and other organizations have created consistent places of belonging year after year, helping form strong communities. In the water, everyone is a beginner at some point. The ocean is a great equalizer—status, rank, and history fall away. Helping each other navigate the waves, sharing small victories, and even laughing at wipeouts, participants quickly form bonds that can be hard to find elsewhere (Marshall et al., 2020). As one participant put it, “Out there, you’re not alone. You’re part of something, and that changes everything” (Marshall et al., 2020). At JMMF, participants circle up before and after to both recognize what each person is coming in with and reflect on lessons learned in the waves. This is a powerful reinforcer, helping participants generalize ocean lessons to the rest of their lives.

If you or someone you know is struggling with PTSD, consider exploring surf therapy programs that might be available. If surfing isn’t an option, consider how else you might partner with nature to meet the needs of safety, awe, and connection? If you are more of a hiker and biker, join me and seven time world champion Rebecca Rusch and me in Santa Fe at the Modern Elder Academy to boost your Wild Resilience!