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Urge Surfing: Distress Tolerance Skill

Urge surfing is a technique for managing one’s own unwanted behaviors. Rather than giving in to an urge, a person learns to ride it out, like a surfer riding a wave. After a short time, the urge will pass on its own.

This technique can be used to stop or reduce drug and alcohol use, emotional reactions such as “blowing up” when angry, gambling, and other unwanted behaviors.

The Urge Surfing handout describes how urges work, and how to “surf” them effectively. Like an ocean wave, urges gradually build intensity, they peak, and then they fade away. This worksheet teaches clients to use mindfulness as a tool to accept an urge and its discomfort, rather than attempting to suppress it.

While riding out an urge, it can help to practice basic relapse prevention skills. This handout also offers education on managing triggers and using delay and distraction.

Before urge surfing, clients should have some insight into their triggers, and the ability to recognize urges. Like any skill, urge surfing requires practice to master. While practicing, keep in mind that it is normal to experience emotional discomfort while riding out an urge, but giving in is not the only way to remove that discomfort.

Urge surfing is very popular in the treatment of addictions, as a distress tolerance skill in dialectical behavior therapy (DBT), and as a tool for emotional management in many other disciplines (e.g. ACT, CBT).

Oh, and one last bit of optimism: When urges go unfed, future urges gradually become weaker. The first waves are some of the most difficult to ride.

Check out the Urge Surfing audio exercise for a guided version of this technique.

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References

1. Abouzed, M., Kamel, A., Amer, M., Mamdouh, H., & Bakeer, M. S. (2020). Urge surfing intervention in patient with chronic atopic dermatitis. Al-Azhar Assiut Medical Journal, 18(4), 449.

2. Dharmadhikari, A. S., & Sinha, V. K. (2015). Psychological management of craving. J Addict Res Ther, 6(230), 2.

3. Didonna, F. (2009). Clinical handbook of mindfulness (pp. 447-462). New York, NY: Springer.

4. Lloyd, A. (2003). Urge surfing. Cognitive behavior therapy: Applying empirically supported techniques in your practice, 451-455.

5. Marlatt, G. A., Bowen, S., Chawla, N., & Witkiewitz, K. (2008). Mindfulness-based relapse prevention for substance abusers: therapist training and therapeutic relationships.

6. Narayanan, G., & Naaz, S. (2018). A transdiagnostic approach to interventions in addictive disorders-third wave therapies and other current interventions. Indian journal of psychiatry, 60(Suppl 4), S522.

7. O'Donohue, W. T., & Fisher, J. E. (Eds.). (2008). Cognitive behavior therapy: Applying empirically supported techniques in your practice. John Wiley & Sons.

8. Ostafin, B. D., & Marlatt, G. A. (2008). Surfing the urge: Experiential acceptance moderates the relation between automatic alcohol motivation and hazardous drinking. Journal of Social and Clinical Psychology, 27(4), 404-418.

9. Semple, R. J., & Briere, J. (2020). Adolescent Trauma Training Center.

10. Shonin, E., & Van Gordon, W. (2016). The mechanisms of mindfulness in the treatment of mental illness and addiction. International journal of mental health and addiction, 14(5), 844-849.

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