Can surfing heal Lyme disease? Steven Kotler, New York Times best-selling author, Lyme Warrior, and Director at Flow Research Collective, thinks so - and there’s science to back it up.
Defining the Flow State
Have you ever felt “in the zone” - professionally, socially, or athletically? If so, you likely were in a flow state.
You may know the flow state by other names: runners high; basketball players call it “unconscious;” jazz musicians refer to it as “being in the pocket;” and stand-up comedians call it the “forever box.”
While we commonly see flow with (extreme) athletes, anyone can achieve flow with the right conditions. Steven, who credits surfing for saving his life (from Lyme and suicide), even admits that the flow state sounds like “crazy hippy nonsense.” He defines flow as an optimal state of consciousness, both mental and physical, where you transcend into a hyper-focused state and achieve peak performance. Moreover, it is defined by rapt attention, profound focus, and total absorption in the moment. Time dilates, everything seems to disappear, a sense of self vanishes, and actions and awareness merge creating effortless momentum. 
The consulting firm Mckinsey, for example, observed that people are 5x more productive in a flow state. Additionally, “…a flow state is responsible for all the skills we most need in the twenty-first century workplace, increasing productivity by 500%, creativity by 600%, and skill acquisition by 230%.”
The “godfather” of flow - Mihaly Csikszentmihalyi - notes that flow “usually occurs when a person’s body or mind is stretched to its limits in a voluntary effort to accomplish something difficult and worthwhile…and has a clear goal and immediate feedback.” This is exactly what occurs with surfing.
In addition, Csikszentmihalyi states that our brains are capable of processing about “110 bits of information per second, and when you are in a state of flow, all 110 are engaged in the task, so you don’t have any attention left over” (to worry).
There are six classically defined characteristics of a flow state: “intense and focused concentration on the present moment; merging of action and awareness; loss of reflective self-consciousness; a sense of personal control over the situation or activity; distortion of temporal experience (perception of time); experience of the activity as intrinsically rewarding.”
The Science Behind Flow
Scientific studies show that a flow state dampens activity in the prefrontal cortex (sense of morality, complex decision-making, and long-term planning), the limbic system (learning, motivation and stress response, in this case), and the amygdala, which essentially takes your thinking brain out of the experience. Anxiety vanishes; sense of self (inner critic) disappears by “temporary inactivation;” release of nitrous oxide flushes stress hormones out of your system, providing a nervous system reset.
A flow state also engages the brain’s central executive network. A 2021 review suggested that the brain's locus coeruleus-norepinephrine system is also involved in different aspects of flow.
Surfing, like painting or heart surgery, has a psychotropic effect, activating neurochemicals such as serotonin, dopamine, norepinephrine, endorphins, and anandamide. In fact, a flow state is the only time when our brains are flooded with these five neurochemicals simultaneously. While these potent, feel-good neurotransmitters can amplify your intellectual and cognitive performance, they can also strengthen your immune system.
By binding to adrenergic receptors, norepinephrine, for example, can modulate immune activity. Dopamine, on the other hand, can regulate biological things such as endocrine functions. And endorphins can regulate your stress response. Dopamine and norepinephrine, in conjunction, tune “signal-to-noise ratios,” meaning they strengthen pattern recognition (link ideas together) and amplify information processing.
From an immunological perspective, neurotransmitters can in fact be immune modulators. “Immune cells express receptors that can be stimulated by these neurotransmitters and neurochemicals.” They can activate cells such as natural killer cells, macrophage, mast cells, dendritic cells, monocytes, eosinophils, T and B lymphocytes.
Benefits of Experiencing Flow
In addition to the aforementioned neurocognitive and neuroanatomical benefits, those who experience flow on a regular basis are statistically happier and have more satisfaction and self-actualization. Flow has also proved beneficial for depression and burnout and increases motivation through the release of dopamine. You also have massively improved learning and creativity, along with physical benefits such as and improved reaction time and positive cardiovascular implications.
Surfing, or exercise in general, has many incredible benefits on the brain and body. A Yale study showed exercise “lowers blood pressure and stress hormone levels, reduces nervous system arousal, enhances immune system function, increases self-esteem, reduces anxiety, and improves mood.” Furthermore, exercise increases blood flow (which helps you
to think more clearly), stimulates your lymphatic system, and positively impacts your circadian rhythm. Rather intriguing, a study by UC Davis notes that all of the positive effects of exercise are amplified in nature, especially when there is water.
Surfing has also proved extremely helpful for veterans struggling with PTSD and suicidal ideation. An initiative called “Operation Surf,” for example, gets veterans struggling with mental health in the water and surfing.
Achieving Flow in Your Life
In order for a flow state to transpire, the activity must be enjoyable (intrinsically motivating), voluntary, require a skill-set, and be challenging with clear goals towards success. Moreover, flow ensues when our abilities and the difficulty of the activity at hand are balanced. Meaning, if a task is too easy, it doesn’t captivate our attention and, if it is too hard, we naturally get stressed. In other words, you want to stretch but not snap. 
Neurobiology asserts flow has 22 “triggers” and action sports, such as surfing, are packed with them. Some “internal” triggers include autonomy, complete concentration, and purpose, passion, and curiosity, while some of the external triggers include unpredictability, complexity, and risk. There are also creative triggers and group flow triggers.
It is the flow state and its triggers which inspired Steven to follow extreme athletes around the world for years as a journalist, breaking 82 bones in the process.
Steven Kotler's Journey
Steven spent two years in bed undiagnosed with Lyme disease. He had been misdiagnosed with over 20 diseases - ranging from AIDS to schistosomiasis to mad cow disease. Doctors eventually took him off all drugs because they believed there was nothing more they could do.
Lyme disease stole his job, girlfriend, home, and, ultimately, all his money through his journey to try and heal himself. He describes Lyme disease as a combination of the worst flu and paranoid schizophrenia. After suffering for so long, Steven had become suicidal, stating that it “wasn’t a matter of ‘if,’” but rather ‘when.’”
He could barely walk across the room. He was lucky if he could get out of bed for 1 hour a day. His neurocognitive symptoms were so debilitating he couldn’t remember how to make coffee and would keep a notebook that described how to turn on the computer or put socks on, for instance.
One day a friend came to his house and demanded Steven come surf, declaring that they wouldn’t leave until he capitulated. He could barely get out of bed but thought: “what could I lose?” Little did he know surfing would become the perfect antidote to his vast ranging symptomology.
While his friends had to carry him out in the water, Steven had such a profound experience, exclaiming he didn’t have any physical pain, brain fog, and was happy for the first time in years. After just seven months of surfing, Steven explains his health went from 10% to 80%. Today, Steven has fully recovered and is a 4x New York Times bestselling author, 2x Pulitzer Prize nominee, and the Director at the Flow Research Collective
Slater's Personal Experience
I wrote this blog because I wanted to shine a light on something that could prove valuable for my fellow Lyme Warriors, whether it be for mental, physical, or neurocognitive health; and, secondly, I wanted to give hope to those feeling as low as Steven did.
I was diagnosed with Lyme, Bartonella henselae, and Babesia microti in 2016 and my brain felt like it was on fire. I had horrible brain fog. Brain imaging showed my temporal lobes were inflamed, affecting my word retrieval, speech, and auditory processing. I felt like a shell of my former self. I know a flow state would have benefitted me. 
For me, a flow state is a sense of calm that overwhelms me, producing a truly meditative state. My mind becomes centered and focused. Stress and worries evaporate without effort, and I return to shore rejuvenated and sharp.
Having gone through the trials and tribulations of Lyme disease, I have learned no two treatments are alike. Some heal from an allopathic approach, while others have cured themselves holistically. Flow may not be a cure in of itself, but it could prove beneficial to combat stress, depression, or PTSD – consistent hallmarks we experience treating tick-borne diseases.
In addition, the science on the immune system implications is sound, whether it is activating killer cells or modulating endocrine functions. And regardless of the “trigger,” a flow state statistically increases productivity, creativity, and skill acquisition, concurrently inducing focus, attention, and happiness – benefits we could all use irrespective of our health.
Remember - never, ever give up. As Churchill said: “if you’re going through hell, keep going.”
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