Can Surfing Reprogram the Veteran’s Brain?

Four men in camouflage fatigues stop our car. “ID,” one says.

I pull out my wallet and hand him my license.

“What’re you doing on base?” the soldier asks.

“We’re going surfing,” I tell him, nodding at the boards stacked in the back of the car. He glances at my friend, in the passenger seat, who I’ll call Brian. Like me, he looks a bit wild after an eight-hour drive from Santa Cruz down the California coast to Camp Pendleton. “Pull off to the side over there,” the soldier says. I do, and another soldier walks over and asks for my ID again. “That guy’s got it,” I say.

“And yours?” he asks Brian.

“I don’t have one, but here’re my papers,” Brian says, handing over a sheet that says he was honorably discharged from the Navy SEALs in October 2012.

“Oh shit,” the soldier says when he realizes Brian was a SEAL. “OK, that’s fine. Go right ahead.” I pull back onto the street and hook a left toward the ocean.

Brian and I grew up together. Best friends. At 19, he went off to war and came back fucked-up. Post-traumatic stress, traumatic brain injuries, nerve damage. In May 2014, he cracked. “I’m in pain,” he wrote on Facebook, “and now will bring the pain to someone else. Some incompetent motherfuckers are going to die.”

I called him immediately. He said that Veterans Administration doctors had recently doubled the dose of his medication without following up to see how he was doing. He was not doing well.

“We can get you the care you need,” I said.

“Yeah. If I burn that place to the ground and shoot someone in the kneecap.”

I wasn’t the only one who saw his post. Friends across the country started calling and texting him and each other. Someone told me that his dad had called the sheriff in the family’s hometown, Santa Cruz. Brian quickly got off the phone with me but soon texted: “I’m a little whacked-out … But these weird drugs are in my system …” This wasn’t news. The last time we’d talked, he told me he couldn’t read because he kept imagining his house was being mortared.

I had heard about a program at Camp Pendleton, a Marine base on the coast between Orange County and San Diego, that used surfing to treat PTSD in enlisted men. Some of the volunteers were veterans who had learned to surf when they were young and now had service-related problems. A few months later, we drove down to check it out.

I first met Brian on the side of the road in 2001. We were both 15. He was pushing an old bike that had a flat tire, and a surfboard was tucked under his arm. I’d just started driving and was headed to the beach with a mutual friend, Matt, so I picked him up.

Brian was just under six feet tall and weighed about 170 back then. Like Matt, he had wide, square shoulders from more than a decade of competitive swimming. Brian’s face—jaw, nose, cheekbones—was all right angles. Years of chlorine, sun, and salt had turned his already blond hair a glowing white. I was a skinny kid with dark, curly hair who had just learned to surf. Brian looked and acted the way I thought all surfers should. I felt cooler just hanging out with him.

Brian’s father was an English teacher at the local community college. One of his brothers was at Columbia University, and the other would soon leave Harvard to work for an investment-banking firm. Brian had a prodigious vocabulary, spoke in a stream of references to Modigliani, Plato, and Tolstoy, and was on track to follow his brothers to the Ivy League. A lot of kids didn’t know what to make of him. But Matt, Brian, and I became inseparable, piling into my car and driving up and down the coast looking for waves. At night we’d steal beers from my dad and chuck the empties in a bush on the side of the house.

When we were 17, Brian’s mother committed suicide. In the aftermath, he put school on hold and started looking for a different path. “Subconsciously, I wanted to do something to protect people,” he says now. “Part of it, though, was I just needed to get the fuck out of Dodge.”

We were all pretty aimless. I went to college at the University of California at Santa Cruz, then dropped out to travel through New Zealand. Matt moved to Brooklyn to start a band. Brian thought about joining the Peace Corps, but instead, in 2005, he joined the Navy, hoping to become a SEAL. “I had something to prove,” he says. In the days before we both left town, I’d see him leading a few dozen other guys—like him, bound for basic training—through beach runs and marathon sessions of push-ups and sit-ups.

After completing basic at the Great Lakes naval base in Illinois, Brian went to Coronado, on the coast near San Diego, for the six days of Hell Week, the rigorous stretch of sleep deprivation and fitness challenges designed to weed out weak-willed SEAL prospects. On day three, he got caught between a 700-pound boat and some rocks, which fractured both of his tibiae and his right fibula, and he was forced to fall back into the next class of recruits. There, he herniated a disk in his spine while lifting heavy logs. The disk pinched a nerve, resulting in permanent loss of feeling in three of his fingers.

Eventually, Brian excelled in that brutal environment. Once, he won a push-up contest by doing 330 in five minutes. In 2008, he graduated and became a member of SEAL Team Two.

For the next four years, Brian was based in Virginia Beach. Initially, he deployed only for training, but even that was dangerous. The stories he tells are fragmentary, but there’s enough information to get the picture.

One night, off the coast of Panama, his team was fast-roping from a helicopter onto a boat that was getting tossed wildly by high surf. Brian came in too hot, and his head smacked the ship’s deck. He sustained the first of approximately seven traumatic brain injuries.

Starting in 2010, he made several trips to Europe to train with special forces from Israel, Sweden, Germany, and France, and more injuries followed. He suffered a nearly fatal arterial-gas embolism while diving. At a firing range, a 7.62-millimeter rifle round skipped off the ground and nicked his ear, shattering his sunglasses. Brian was trained to be an explosives expert, or breacher, so he was in charge of opening and clearing locked doors. He carried a 12-gauge shotgun and C4. Usually, he was the closest man to the blast. In Poland, after a night out, Brian and a group of SEALs were jumped in front of a bar. He limped home with a deep stab wound in his thigh. “You should see the other guy,” he wrote on Facebook.

In 2012, he went to Afghanistan on a combat deployment, a period he rarely talks about. All I know is that he worked in a tactical operations command in Kandahar. At one point, the Taliban attacked an Afghan Local Police graduation ceremony with grenades and machine guns. A dozen charred bodies were loaded onto a helicopter and transported to an operating room on base. Brian spent the afternoon huddled over them, running communications between the surgeon and his superiors.

Over the phone once, Brian told me in a hollow voice that he’d killed a woman. “She was shooting at us,” he said. “I didn’t have a choice.” SEAL buddies seemed to die constantly. He went to nine funerals one summer.

Brian got back from Afghanistan in the spring of 2012. He needed surgery on his spine. Chronic pain in his neck, knees, and hips, along with the head injuries, had started to take their toll. He was depressed and contemplated suicide. “Special Forces are abused,” he says. “They always have been.” In the fall of 2012, he left the military.

Over the following weeks, he interviewed with seven private security firms, but he didn’t find a job he could stick with. He usually couldn’t sleep, and when he could he’d dream about getting stabbed, drowning, or being in a firefight with no cover. When awake he was overcome by nausea, cold sweats, and a constant feeling that “everything is fucked”—telltale signs of PTSD. The VA had given him meloxicam, for pain, and the antipsychotic quetiapine fumarate. He took them but refused to admit to himself that anything was seriously wrong.

By that winter, thoughts of a job had evaporated, and he was road-tripping alone in his Toyota Tacoma. He’d grown a beard, put on weight, and become “kind of feral.” Traveling back east, he climbed Mount Rogers in Virginia, kayaked the Gauley River, and fished small Appalachian tributaries, catching and eating what he could. He cut through Nashville and headed northwest, making his way along I-70 toward the Rockies. Driving was hard; he’d developed hypervigilance, always scanning roadsides for improvised explosive devices or other threats.

One night in Missouri, he made camp in a saddle between two hills, still about 14 hours away from Denver, when, as he put it, the dust began to settle. Brian couldn’t shake the image of the charred bodies in the helo. But it was the smell of burned human flesh he remembered most, “like roast pork.” He’d stopped taking his meds and was feverish with withdrawal. Self-medicating with a bottle of bourbon didn’t help. Lying in his military-issue tent with a Springfield .45-caliber pistol clutched to his chest, he hallucinated that wolves were attacking him. As the sun began to rise, he finally drifted off. When he woke up, he was soaked through from melting snow. He thought to himself, You know, Brian, maybe you’re not really that squared away after all.

PTSD is one of the most widespread health problems faced by United States veterans; treating it costs the VA upwards of $3 billion a year. There are two common approaches: prolonged-exposure therapy (PE), which involves repeatedly and vividly revisiting the traumatic experience, and cognitive-processing therapy (CPT), which focuses on how a patient responds to events in his or her postwar life. PE and CPT have the best pedigree of any recognized therapy available, but neither technique works for everyone. In his book The Evil Hours: A Biography of Post Traumatic Stress Disorder, ex-Marine David Morris writes of his experience with PE: “I began to think of the treatment not as therapy so much as punishment.”

Soldiers who also experience chronic pain, like Brian, are typically prescribed a cocktail of powerful narcotics, including oxycodone and Vicodin. The opioids blunt a patient’s suffering for a while, but they interfere with physical and mental functions, and over time can lead to addiction or overdose.

Outside of the conventional methods, just about everything you can imagine has been used to alleviate PTSD. After World War I, doctors tried milk diets, electroshock therapy, and plain old shouting. More recently, art therapy, yoga, mountain climbing, hypnosis, and cross-country skiing have been tried, with varying degrees of success.

In 2003, Carly Rogers, a Los Angeles County lifeguard and graduate student at the University of Southern California, began developing a program called Ocean Therapy, in which soldiers learn to surf, bracketed by structured group discussions on the sand. In 2007, she tested the program with a dozen soldiers at Camp Pendleton. After just a few waves, they were laughing in the lineup. “Oh, my God, our Marines are talking,” said the lieutenant who had approved the experiment. “They don’t talk. Ever.”

Since then more than 1,000 Marines have been treated with Ocean Therapy, and hundreds of veterans and surfers have worked as volunteers in the program, including 11-time world champion Kelly Slater. In a paper published last year in the American Journal of Occupational Therapy, Rogers wrote that most participants in the study reported significantly decreased PTSD symptoms after being in the program for just five weeks. Attendance at such things is usually spotty, but with surfing it was roughly 75 percent.

Nick Caddick, a psychologist at Loughborough University in the UK, spent 18 months studying the effects of surfing on British soldiers. One of Caddick’s subjects had been hatching concrete plans to hang himself from a tree in his yard, but every time he went surfing he put it off for at least another week. “Regular surfing,” Caddick wrote in a paper published last year, “was necessary for disrupting the cycle of PTSD symptoms that would otherwise remain a continuous or uninterrupted source of suffering.”

The reasons for this are not well understood. Rogers developed Ocean Therapy with psychologist Mihaly Csikszentmihalyi’s flow theory in mind. The physical exertion and intense focus required to surf often produces flow states, which flood the brain with neurochemicals like anandamide and serotonin, the same substances found in antidepressants. In addition, it’s believed that when people are submerged in water, their bodies alter the balance of epinephrine and dopamine to the levels achieved during meditation.

“The emotional aspect of the weightlessness I feel is analogous to curling up in the fetal position,” Brian says. Ben, his eldest brother, notices it, too. “Surfing is one of the major ways he and I connect now. Anytime we’re able to get in the water, everything seems to fall into place. We get into a rhythm together.”

Rogers has seen similar results. “In combat you wait and you wait, and then you engage in a firefight,” she says, quoting a participant. “In surfing, you wait and you wait, and then you get a beautiful adrenaline rush.”

Last fall I asked Brian if he wanted to volunteer at surf therapy with me. His mental state was alarming, and the VA wasn’t helping, so I figured anything was worth a shot. A few weeks later, I picked him up in Santa Cruz at the house he shares with his retired father and their pit bull, Eli. Brian was wearing jeans, flip-flops, and the brown T-shirt they give you when you become a SEAL. Eli ran around the house as he packed a beige field jacket, khaki shorts, a camo hat, insulated camo pants, and a black Patagonia jacket, slammed a shot of tequila, and walked across the street to put two surfboards and two wetsuits in the car. “Shit,” he said, patting his pockets. “Where’s my wallet?”

PTSD has been linked to changes in the neurocircuitry and neurotransmitters that balance the retrieval of memories. “People have profound changes in how they think of themselves in the world,” says Paula Schnurr, acting executive director of the VA’s National Center for PTSD and a psychologist at the Geisel School of Medicine at Dartmouth College. Brian has a hard time remembering what he was like before the military.

“Have you ever seen a dog that’s been abused?” says Ben. “It will all of a sudden get very aggressive, start shaking, snap at someone for no reason. Brian is like that. I don’t know what happened to him in Afghanistan, but whatever it was jacked him up something serious. He’s so tightly wound, it’s scary.”

Brian still suffers from insomnia and depression. Crowds put him on edge. Often he’ll send me something random, like a Rilke poem (“How we squander our hours of pain / How we gaze beyond them into bitter duration to see if they have an end”) or a photo of a graphic painting like Goya’s Saturn Devouring His Son.

“He’s trying to sort out how to be in the world around him, given that he has a new understanding of how violent and destructive we can be as a species,” Ben says. “I can’t say for certain, but I think he’s trying to come to grips with a pretty grim version of the world that he has encountered up close and personal.”

The pain in Brian’s spine rarely stops—for some reason, it’s at its worst in the morning and at sundown. A good, pain-free stretch lasts up to three hours. Every day he has to wake up and decide whether he can even leave the house. He can’t work a steady job, and interacting with friends can be daunting.

My parents live in Santa Cruz, and over the course of a year, whenever I visited, Brian and I would make a 7:30 a.m. surf date. At least a dozen times, I waited on the couch for an hour before calling to ask why he hadn’t come by to pick me up. “I’m just not feeling good,” he’d say. I wouldn’t take it personally, but it made me miss the kid from high school who would wake up everyone in the house at six, pounding on the front door.

“How’s it going?” I ask Brian as we pull away from the curb and head south to Camp Pendleton. Two weeks before, he stopped using his computer. He’d ditched his cell phone a couple of months before that, so the only way to get in touch was to hope he picked up the landline at his house.

Discussing his problems is difficult. Some days he’ll be very open, saying that it’s cathartic to talk. But at other times he’s so psychologically drained, in so much pain, or just so sick of all the questions that he’ll ignore my calls for weeks.

He’s seeing a new therapist, he tells me as we drive, a family friend. It’s helping, but he still doesn’t feel like himself. In addition, he’s paying out of pocket from his Navy savings to see a chiropractor three times a week and trying to meditate daily.

As we weave through weekend traffic on Highway 1, I bring up the VA. “It wasn’t just that they weren’t giving me everything that I wanted,” Brian says. “It was that they weren’t giving me anything I wanted. They were recommending the medication-only approach and absolutely deterring every other option. Going to the VA made me a lot worse.”

The VA’s track record isn’t good. In 2014, veterans across the country were forced to wait months before getting an appointment with a mental-health professional. Meanwhile, officials falsified wait-time data, and several veterans died while bureaucrats twiddled their thumbs. The fiasco was especially infuriating because studies have shown that the strongest predictor of trauma morphing into full-blown PTSD is a lack of positive social support, something that many vets, Brian included, weren’t getting from the government.

“I have been unsuccessful in my attempts to enlist the weekly assistance of a medical doctor that specializes in PTSD,” he wrote on Facebook when these trends were in the news. “A person with my diagnosis, uncared for by mental health professionals, does not have a high rate of survival.… What are my options? I don’t want to die.”

Before the sun sets, we pull off at a wide beach fronted by clapboard condos and sand berms. We quickly shimmy into our wetsuits and paddle out through waist-high surf to sit on our boards, silently looking out to sea, waiting for a set.

A shimmering green line rises up from the horizon. The wave isn’t big, but there’s a nice corner on the right and a long, walled-up left. We start paddling into position to split the peak when four bottlenose dolphins pop up in the wave’s face. The edges of their dorsal fins are missing large chunks, and their sides are raked with white scars. The wounds could be from sharks or fishing nets, but they’re probably from fighting other dolphins over mates, territory, or a thousand other reasons we’ll never understand. We sit and watch as they share the wave, ride it nearly to the shore, and somersault back for another.

The beach at Camp Pendleton looks like it’s been groomed. There are no rocks or seaweed, and until half a dozen volunteers arrive, there aren’t any footprints. Wooden Adirondacks sit on the sand in pairs, beneath umbrellas. The surf is small, about a foot or two, and a warm Santa Ana wind blows out to sea, kicking spray off the back of the waves like sparks from a fire.

Erin O’Donnell, an occupational therapist from El Segundo, California, is filling in for Carly Rogers, who’s home on maternity leave. As everyone trickles in, O’Donnell tells me that each session is structured around a theme, like trust or transitions.

“The ocean has a lot to teach us,” she says. “Today we’re working on acceptance.”

It sounds like AA talk, but she has a point. When dealing with the ocean, there are so many things out of your control. Big-wave surfers often say that when you’re held under by a massive wall of water, the last thing you want to do is struggle; fighting wastes valuable energy that’s best conserved for survival.

Soon all 20 of us sit in a circle on the sand. At O’Donnell’s request, everyone shares what they’re working on. The Marines call this their “kumbaya circle.”

A man named Gabe, from Ohio, has his wetsuit on backward. “I’m accepting new things,” he says. Gabe has never surfed. He grew up playing football but was hit by a rocket-propelled grenade and can’t run anymore. Brian has trouble remembering names and calls him Buckeye.

“I can’t swim,” says Mike, a Marine from Texas who’s shaped like an action figure, his chest and shoulders covered in tribal tattoos. “So I’m accepting that there are lifeguards here and y’all will look out for me.”

Brian talks about his physical limitations. He used to surf longer than anyone I know, for hours on end. These days surfing is an escape from his injuries—the water makes him feel weightless—but too much of it leaves his spine aching for days. “It’s been more about learning how to live with the condition I’m in,” he says, “and less about trying to recover the condition I used to be in.”

After everyone speaks, large soft-top surfboards are handed out to the enlisted men. I talk to Daniel, from Colorado, who was hit by two improvised explosive devices, in 2004 and 2009. “The first one got me pretty good,” he says, laughing a little. All the men here have physical injuries, but there are no prosthetic legs or wheelchairs. Their most serious wounds are internal.

“I count this as one of my appointments,” Daniel says. “There’s something about the water. Sitting out there.” He owns a dog-training business and plans to expand it now that he’s out of the military. “I’m never going back home,” he says. “I’m gonna run my own business and surf all day.”

Each soldier is partnered with two volunteers—Brian works with Buckeye—and for a while the beach becomes a playground. Two dozen grown men laughing and pushing each other into little waves, wiping out and laughing some more. When someone stands and rides all the way to the sand, the group explodes with hoots and whistles. After every wave Buckeye rides, he paddles back out and bellows, “Let’s get a bigger one!” Armored personnel carriers run maneuvers up the beach, and Black Hawk helicopters fly overhead. Nobody seems to notice.

“The more time I spend with these guys, the better for me,” Brian says in the parking lot later. An unintended consequence of Ocean Therapy is that it can be useful for both participants and volunteers. “There’s no quitting them,” says Sean, a former special-ops soldier with PTSD. “What helps me is helping others who have it.” Vets spend years as part of a team, eating, living, and training together. Then they’re cut loose into the world, alone. Surfing seems to help largely because it gives soldiers and vets a group of guys to hang out with.

“It’s really cathartic to people in my situation,” Brian says. In a way they’re circling the wagons, creating a support structure that’s otherwise absent from their lives. Daniel regularly surfs with a few men he met through the program. “They talk me into going out,” he says. “When I don’t want to go, they get me to anyway.”

We leave Camp Pendleton and drive north, kicking around plans for a trip to Indonesia. Or maybe Nicaragua. In the meantime, Brian has filed two disability claims with the VA, one for his PTSD and one for the brain injuries. And he’s trying to find his way back to school. He plans to attend the community college where his father once taught.

After eight hours, I pull into Brian’s driveway late at night, just as the car’s fuel indicator blinks on. He pulls his boards from the back and throws a pair of soaking wetsuits on the porch.

“You wanna surf tomorrow?” I ask. “Yeah,” he says. “I’ll pick you up at 7:30.” I drive home wondering if he’ll show up, or if I’m going to be setting my alarm just to wake up and sit on the couch for an hour.

The next morning, at half past seven, Brian’s truck rolls to a stop in front of my parents’ house. A light rain is falling as he bangs on the front door. I’ve got the coffee on. We each get a cup and sip it slowly while we load the boards.

Matt Skenazy is Outside‘s features editor.

To participate in, volunteer at, or donate to the Ocean Therapy program, please visit: jimmymillerfoundation.org