Surf therapy connects people to water – ocean health depends on this ‘blue attunement’

As a lifelong surfer, born to pioneering surfing parents and named after a wave, the ocean has shaped my identity and sense of belonging. The movement and touch of ocean waves ignites a whole cascade of changes in emotions in me and affects how I sense the world around me. Scientific research is now evidencing what I have intuitively known and felt my whole life – the power of the sea to heal.

Ocean therapy or blue care involves ocean programmes and water-based activities designed to help people cope with mental, emotional and physical illness by accessing the ocean. Engaging with blue spaces – from marine and coastal environments to inland lakes and rivers – can have restorative health and wellbeing outcomes. As a marine social scientist, I firmly believe that this so-called “blue attunenement”, the ability to create a connection with these blue spaces, is at the core of improving efforts to restore ocean health.

In my book, Ebb and Flow, I investigate how restoring our connection with water through therapeutic settings can help recovery from trauma. Ocean therapy can help the body feel emotions that get lost in highly traumatic situations. “We live the world through our body,” explains environment and health researcher Nick Caddick, who researches how surf therapy helps combat veterans who have experienced severe trauma.

Immersion in water, and surfing in particular, requires a form of mindful embodiment, or “blue mind” that supports the repair of the mind-body connection. This rewires the brain and rebalances hormones, reducing fears and anxieties.

As an embodied way of experiencing the natural world, surf therapy is emerging as one of the most rapidly growing blue care activities. There is strong evidence to support the restorative benefits of immersion in the sea and surf, especially for our psychological wellbeing.

The mechanisms for how ocean therapy affects our wellbeing are not yet well understood, but research shows that benefits are linked to its fluid and dynamic nature — surfing demands a focus on the present, offering respite from everyday anxieties. Feelings of presence, flow, joy and a connection to nature were often reported by participants across various surf therapy studies, in some cases reducing dependency on conventional treatments for mental illness such as antidepressant medication.

Swimming, sailing, even just building a sandcastle - the ocean benefits our physical and mental wellbeing. Curious about how a strong coastal connection helps drive marine conservation, scientists are diving in to investigate the power of blue health.

This article is part of a series, Vitamin Sea, exploring how the ocean can be enhanced by our interaction with it.

The multisensory nature of being immersed in the ocean activates the entire sensory system at a cellular level. This is believed to enhance neuroplasticity, the ability of brain cells to modify their connections, helping the brain become more agile and adaptive. Physically responding to the movement of waves and learning to balance on a surfboard can help improve functional mobility for those with acquired brain injury and other physical injuries. This can lead to a reduction in the use of narcotics for pain management.

Surf therapy can help people overcome fears in a playful way. According to surf therapy expert Jamie Marshall, the dynamic learning environment associated with surfing builds resilience and helps people cope with stress. Learning to surf in a group can enhance a sense of belonging and identity through shared ocean encounters too.

Attune to the blue

Despite these positive findings, there is growing tension between the desire to engage with blue space for the restoration of human health and the fact that many of our local blue spaces are polluted, harmful, considered dangerous or exclusionary.

This stems partly from the growing disconnect in modern society between humans and nature. The dominant narrative within nature therapy literature, including blue health, has tended to emphasise what nature can do for us. Terms like “back to nature” and “nature-deficit disorder” emphasise our separation from nature.

Nature therapy is largely aligned with western values to the exclusion of other value systems and interpretations of nature with a tendency to neglect race, ethnicity or sexuality from these studies.

As interest in blue health grows, it’s important to consider the ethics of how we interact with the ocean beyond controlling and extracting resources from it for our own benefit. By embracing the value of bringing play, love and intention into that relationship, our encounters can incorporate a sense of stewardship and marine custodianship.

Robin Wall Kimmerer, a leading Indigenous scientist and author calls this renewal of relationship with the living world “reciprocal restoration”. She argues that the restoration of our relationships with land and water are as essential as the work to clean up pollution.

Ocean therapy provides a lens to see, understand and experience the ocean as restorative and health-enabling. Even when coastal blue spaces are considered places of exclusion, danger or risk, the ocean can be transformed into a place of healing and connection through initiatives like Sea Sisters in Sri Lanka, a social enterprise that empowers local girls and women using swimming and surfing as tools for social change. I co-founded another project in Iran, Be Like Water, with triathlete Shirin Gerami to make surfing more accessible to minority groups of women and girls while strengthening their connection to nature.

Ocean therapy opens up possibilities for new health care interventions and time spent immersed in the sea can awaken a deeper understanding of the vulnerable nature of the ocean.

This blue attunement – becoming aware and responsive to the body of water we interact with – enables a deeper form of listening and can encourage more pro-environmental actions, collectively demonstrating care for the ocean. To realise the potential of blue care, the ocean must be restored as a safe and healthy space for all. My hope is that we will understand our interdependence with watery places, and sense the aliveness of these connections. To feel that we too are water.