Friday, April 6, 2012

Urge Surfing

A novel concept for many clients entering recovery from any problematic or addictive behavior is having - but not acting on - urges or cravings. Urges to return to old habits are inevitable, so it's crucial for clients to learn that (1) thoughts do not have to be acted upon, (2) urges are tolerable, and will stop, even if they are not acted upon.

The skill of experiencing an urge, tolerating it, and allowing it to pass is often called "urge surfing." Based largely on mindfulness practices, urge surfing involves noticing and observing the thoughts, feelings and sensations of the urge without judging, fighting, or getting swept up in any aspect of the experience. The trick is adopting a stance of curiosity about one's own experience while also maintaining a degree of detachment from one's thoughts, feelings and sensations. Doing so allows one to experience the rise, crest, and decline of the urge's "wave" as it grows, peaks in intensity, and then fades.

This, of course, is easier said than done. Especially early on in recovery, when urges are most intense, and alternative coping skills may not yet be well developed, mindfully riding the wave of the urge may not be possible. In this case, distraction is a good strategy to fall back on. While distraction should not be the "go-to" strategy for managing emotions (because, over time, the result is to suppress rather than deal with emotions). However, for time-limited things like urges, distraction is just a way to wait out the natural progression. Distraction can be behavioral (getting up, changing environments, doing some other activity) or cognitive (occupying the mind with something, such as a puzzle, problem, or interesting task that is not quickly finished). The forms of distraction that work best differ based on problem and personal preferences.

I advise clients to practice both mindfulness, and various forms of distraction, when they're feeling relatively safe and stable, so that these skills are honed and available when urges (or other forms of distress) arise. However, I offer one caveat: urge surfing is much less useful when the problematic behavior is NOT doing something. For example, it is useful for Bulimia, where clients have urges to binge and/or purge, but less so for Anorexia, where clients have the urge to not eat. In the latter case, mindfulness and distraction can be useful if used to assist the client in eating, but they are counterproductive if used as ways to delay or avoid the need (urge) to eat.

How do you think about, and help clients cope with urges?

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