Urge Surfing
Urge surfing is a practical technique used to manage different types of cravings and urges. This technique was originally developed by Dr. Alan Marlatt who is a well-known expert in the field of addiction psychology. The technique has proven itself quite useful and, today, it’s routinely used to deal with a wide variety of urges including basic needs like hunger, or to help with smoking cessation. Even though body-focused repetitive behaviors are not addictions, we can, nonetheless, successfully use urge surfing to deal with strong urges to pick or pull.
This technique is meant to be used when the urge comes about, in that moment when it’s too late to do anything to make it go away, when there’s no way to escape it, when stimulus control techniques no longer apply and you feel like your competing responses alone won’t do.
The technique itself resembles mindfulness quite a bit although it is not a form of meditation. Before I guide you through the steps, let’s consider a few things about the mechanics of urges and their dynamics.
Location. When the urge to pick or pull first arises, it can be quite overwhelming. Because BFRBs have a lot to do with avoidant tendencies, a person’s first reaction might not be to carefully inquire about the specific ways in which the urge manifests itself in the moment, but to run away from it. If you mindfully examine the urge, you might notice that it always comes from your body. In fact, it’s nothing more than a complex of body sensations. In fact, we can put it the other way around: what you call the urge is a set of body sensations that mark a state of arousal. We put a label on those sensations and call them the urge. Furthermore, the need to pick/pull is just an interpretation of the label you put on those body sensations. Sensations themselves, don’t say “pick” or “pull”, they say nothing, they just exist.
Duration. If you don’t feed the urge, it won’t last more than 30 minutes (on average). You feed the urge by actively engaging in rumination and allowing yourself to get lost in thoughts: I will feel better if I pick this pimple, What is my skin like now? If I could only pull this rough hair, etc. Another way that urges are commonly fed is by coming up with justifications such as I will cave anyway, so I might as well do it now. The more you feed it, the longer it lasts.
Pushing away is making the urge stronger. If you try to suppress the urge, force yourself to not feel it, push away the thoughts or try to „convert“ negative thoughts into positive ones, you are giving more strength to the urge. Every strategy that leads to direct confrontation with the urge feeds it energy.
Avoidance. Trying to „distract“ yourself from feeling the urge by burying yourself in work, talking to people or doing chores is a short-term strategy that doesn’t yield long-term results. The urge comes back because the need it communicates comes back. In fact, it’s a kind of double avoidance. The urge is a result of trying to avoid needs and emotions instead of attending to them, and then you employ more avoidance to distract yourself from the urge.
Letting be. We don’t have much of a choice when it comes to what we feel in the moment when we feel it. When feelings arise, we can either deal with them in a healthy way or not, but that’s about the only choice we have. You can’t be feeling sad and then consciously deciding to feel happy. To process feelings appropriately (including the urge) we need to let them take their course without interfering and, while feeling them, try to figure out the message they carry for us. That will lead to feelings dissipating and you can take constructive action that will prevent them from arising as often in the future.
The natural lifespan of an urge
Let’s take a look at different phases through which the urge passes when it’s uninterrupted by pulling or picking.
1. The initial phase – The urge begins with a trigger. A trigger can be nearly anything, an event, a memory, a thought, a task, an emotion, etc. The bottom line is that whatever triggers you triggers you because of what it means to you. To simplify things, if you’re triggered by stress, restlessness or any other feeling, the urge begins because of your implicit (or fully unconscious) theory of what would happen to you if you had to live through the urge. Urge surfing shows you that the actual answer is: nothing.
2. Rising - Just like any wave, the urge begins rising after it’s given that initial impulse. Once the urge is triggered, you can expect it to develop and become more intense. If you feed the urge along the way, this phase will be more acute, and the rise will be ever sharper. When we talk about gradual vs sudden urges, we usually refer to how steep this phase would look like on the image you see above.
3. Peak – Everything that goes up, must have a peak, a point of maximum intensity and the same goes for the urge to pick or pull. When your urge reaches this point, you might feel like it will never go away, it feels impossible to withstand a moment further, and this is usually when you give in and pick or pull. The truth is that this peak may seem like a moment of defeat, but it’s actually a moment when the urge starts losing its momentum, it’s energy only lessens from that point onward.
4. Decline – If you don’t pick or pull, however, the urge enters its final stage, which is a slow decline, until it finally fades away.
The technique
Urge surfing is meant to help you go through all four stages without resorting to picking or pulling. At first, when you try out this technique, it will likely be an intense experience. The second and third time might be intense too. But just like exercising in the gym, muscle ache is not something you can avoid if you want to gain more muscle mass. The more you practice, the stronger your “urge muscle” gets and you become less affected by the urge because you become stronger and that strength increases your tolerance.
Here's how to do it:
1. You begin by acknowledging the urge, accepting what’s happening. Sometimes it’s enough to sit with it and begin feeling it, other times it helps to put words to it, even out loud and say something like “I am now experiencing the urge to pick/pull”. A few deep breaths could help to mark the beginning of urge surfing.
2. Knowing that after the initial phase, comes a rise in intensity, begin looking for it intentionally. As I mentioned in the beginning, the urge is nothing but a set of sensations of varying intensity, so focus on looking at what’s happening in your body and look for signs of increased intensity. While you do this, it helps to use a little trick. Anchor yourself in your breath. Focus on your breathing and observe body sensations in the background. Map them out for yourself: now I feel tightening in my chest, my breath is becoming shallow, I have thoughts about pulling/picking, etc. You can label the sensations like this, but always coming back to the safety and stability of your breath. If it's hard for you to describe body sensations, here are some qualities to consider:
a. Fast/slow
b. Tight/loose
c. Warm/cold
d. Sharp/blunt
e. Static/dynamic
f. Single sensation/ multiple sensations
g. Visualize it as red/blue
3. Use supportive phrases. Stay away from affirmations as they are usually empty of any actual content or meaning. You can pause to see what you need to hear in the moment, or you can have a pre-defined phrase or two that works for you. When you pre-define them, however, make sure that they pack a punch, that they resonate with you emotionally and that they re-iterate your intention: why is it that you’re doing this in the first place?
This technique relies on the wave metaphor. If you like visualizing, it helps to visualize the whole process as a wave coming, peaking and then crashing down. To represent the intensity of the urge, you can visualize the size or the speed of the wave. Alternatively, you can visualize the progression of the wave through your physical body. Apply the metaphor in a way in which it works for you. Don’t try to squeeze your experience into a metaphor or an approach you like intellectually. Allow the in-the-moment experience to determine whether you visualize or use the more standard approach described above.
A few more tips
· This technique can be applied to nearly any craving or urge, but if you’re practicing it for the urge to pick or pull, stick with it until you master it in that domain, and then practice on something else. We change one step at a time, not five steps at a time.
· Sitting on your hands, especially in the beginning, is not a bad idea, it gives a layer of security. Wearing gloves for the duration of the exercise, also a good idea if time permits.
· Reward yourself for success, that will likely to accelerate your progress.
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