Cravings, habits & relapse
What is urge surfing?
Short answer
Urge surfing is a technique for riding out cravings: instead of fighting an urge or giving in, you picture it as a wave and watch it rise and fall without being wiped out by it. It comes from psychologist G. Alan Marlatt's relapse prevention work at the University of Washington, and mindfulness-based relapse prevention uses the same idea of observing cravings without reacting. Many people find a craving fades within a few minutes.
Key takeaways
- Urge surfing means observing a craving like a wave that rises, crests and fades, without acting on it.
- It comes from G. Alan Marlatt's relapse prevention model at the University of Washington.
- The basic steps: settle and breathe, find where you feel the urge, and track how the sensations change.
- In a 286-person trial, mindfulness-based relapse prevention led to fewer substance-use days and less heavy drinking at 12 months than the comparison groups.
- Trials test whole programs, so the effect of urge surfing on its own is less clear.
Where does urge surfing come from?
Urge surfing is part of the relapse prevention model associated with psychologist G. Alan Marlatt of the Addictive Behaviors Research Center at the University of Washington. In a 1999 overview of the model, Marlatt and colleagues describe teaching people to visualize an urge or craving as a wave, watching it rise and fall as an observer and not being 'wiped out' by it. They call this imagery technique urge surfing.
The core idea is that an urge doesn't have to be obeyed or fought. Relapse prevention researchers describe teaching people to view urges as an ocean wave that rises, crests and diminishes, and mindfulness-based approaches treat thoughts and urges as transient events that need not be acted upon.
How do you urge surf, step by step?
A U.S. Department of Veterans Affairs clinical guide describes the practice in three steps, and Mindfulness-Based Relapse Prevention (MBRP) adds a short pause called the SOBER breathing space: Stop, Observe, Breathe, Expand awareness, Respond mindfully. Put together, a practical sequence looks like this:
- Stop. When you notice the urge, pause instead of acting on it right away.
- Settle in. Sit comfortably with your feet flat on the floor, take a few deep breaths and focus inward.
- Find the urge. Focus on one area of your body where you feel it and notice the exact sensations there.
- Follow it. Move your attention to each part of your body that feels the craving, and describe to yourself how the sensations change.
- Let it crest. Keep observing the physical, emotional and mental parts of the craving without judging them or trying to push them away.
- Then choose. When the wave has passed, decide what to do next on purpose rather than on autopilot.
Does urge surfing actually work?
The strongest evidence comes from trials of MBRP, an eight-week group program for people with substance use disorders that teaches people to observe craving states without habitually reacting. In a 2009 pilot trial, people randomly assigned to MBRP had significantly lower rates of substance use and greater decreases in craving than people in usual aftercare.
A larger randomized trial published in JAMA Psychiatry in 2014 followed 286 people for 12 months after initial treatment. At 6 months, both MBRP and standard relapse prevention lowered the risk of relapse to substance use and heavy drinking compared with usual aftercare. At 12 months, the MBRP group reported significantly fewer days of substance use and less heavy drinking than either comparison group.
There are limits. These trials tested whole programs, so they don't show how much urge surfing contributes on its own. Both involved people in aftercare for substance use disorders, so the results may not carry over to other habits.
Is urge surfing the same as distraction?
Not quite. Distraction pulls your attention away from a craving; urge surfing turns toward it. MBRP deliberately teaches people to stay in contact with a craving and examine it, rather than reactively trying to avoid it.
Quit-smoking guidance uses both. The CDC suggests practicing riding the wave a few times a day, while the NHS suggests having a distraction ready. It's reasonable to try each and see which helps you more in a given moment.
How Vow can help
Vow's Craving Shield (Premium) is a guided urge-surfing timer of about three minutes, with breathing modes called "Ride the wave", "Letting go" and "Box breathing", a short coaching line, and a quick log of whether the urge passed. It's also available on Apple Watch.
Sources
Each source below was read when this answer was reviewed. Open a source to see the passages the answer relies on.
PubMed Central — Larimer, Palmer & Marlatt (1999), Relapse Prevention: An Overview of Marlatt's Cognitive-Behavioral Modelpmc.ncbi.nlm.nih.gov
G Alan Marlatt, Ph.D., is a professor of psychology at the Addictive Behaviors Research Center
Department of Psychology, University of Washington, Seattle, Washington
visualize the urge or craving as a wave, watching it rise and fall as an observer and not to be 'wiped out' by it. This imagery technique is known as 'urge surfing.'
Open the sourcePubMed Central — Murphy & MacKillop, Mindfulness as a Strategy for Coping with Cue-elicited Cravings for Alcohol (citing Marlatt, 2002)pmc.ncbi.nlm.nih.gov
cravings are conceptualized like waves in the ocean and individuals are encouraged to 'surf the urge by allowing it to pass without being wiped out by giving into it'
Open the sourcePubMed Central — Hendershot, Witkiewitz, George & Marlatt (2011), Relapse prevention for addictive behaviorspmc.ncbi.nlm.nih.gov
clients are taught to view urges as analogous to an ocean wave that rises, crests, and diminishes
transient events that need not be acted upon
Open the sourceU.S. Department of Veterans Affairs, MIRECC — Urge Surfingmirecc.va.gov
Take inventory of your craving experience. Sit in a comfortable chair with your feet flat on the floor and your hands in a comfortable position. Take a few deep breaths and focus inward.
Focus on one area where you are experiencing the urge. Notice the exact sensations in that area.
Refocus on each part of your body that experiences the craving. Pay attention to and describe to yourself the changes that occur in the sensations.
Many people notice that after a few minutes of urge surfing the craving vanishes
Open the sourcePubMed Central — Witkiewitz, Lustyk & Bowen, Re-Training the Addicted Brain: A Review of Hypothesized Neurobiological Mechanisms of Mindfulness-Based Relapse Preventionpmc.ncbi.nlm.nih.gov
break habitual stimulus-response patterns, such as seeking an immediate 'fix' to alleviate a craving experience, by teaching clients to pause and make conscious, mindful choices.
observe challenging or uncomfortable emotional or craving states without habitually reacting.
in a nonjudgmental examination of their physical, affective and cognitive aspects, rather than reactively attempting to avoid or ameliorate the experiences.
Open the sourcePubMed Central — Witkiewitz & Bowen (2010), Depression, Craving and Substance Use Following a Randomized Trial of Mindfulness-Based Relapse Preventionpmc.ncbi.nlm.nih.gov
randomly assigned to either an eight-week closed-cohort MBRP course or their standard rolling admission treatment-as-usual aftercare (TAU).
Results suggested those receiving intensive stabilization + MBRP, when compared to intensive stabilization + TAU, demonstrated significantly lower rates of substance use, greater decreases in craving
Open the sourcePubMed Central — Bowen et al. (2014), Relative Efficacy of Mindfulness-Based Relapse Prevention, Standard Relapse Prevention, and Treatment as Usual for Substance Use Disorders: A Randomized Clinical Trialpmc.ncbi.nlm.nih.gov
JAMA Psychiatry. 2014 May;71(5):547–556. doi: 10.1001/jamapsychiatry.2013.4546
a total of 286 eligible individuals who successfully completed initial treatment for substance use disorders at a private, nonprofit treatment facility were randomized to MBRP, RP, or TAU aftercare and monitored for 12 months.
Participants were randomly assigned to 8 weekly group sessions of MBRP, cognitive-behavioral RP, or TAU.
Compared with TAU, participants assigned to MBRP and RP reported significantly lower risk of relapse to substance use and heavy drinking
At the 12-month follow-up, MBRP participants reported significantly fewer days of substance use and significantly decreased heavy drinking compared with RP and TAU.
Open the sourceCDC Tips From Former Smokers — Tips For Quittingcdc.gov
Practice riding the wave a few times a day.
Open the sourceNHS Better Health — Understand your smoking triggers and cravingsnhs.uk
Cravings usually only last a few minutes, so have a distraction ready.
Open the sourceMedlinePlus Medical Encyclopedia — How to stop drinkingmedlineplus.gov
If you have withdrawal symptoms, such as trembling hands, when you go without alcohol, you should not try to quit on your own.
It may be life threatening.
Open the sourceCDC How Right Now — Find Services and Treatmentcdc.gov
to find resources near you or connect with SAMHSA's National Helpline: Call 1-800-662-HELP (4357)
Open the source
This page is general information, not medical advice, and it does not replace care from a qualified professional. If you are in immediate danger, call your local emergency number. Vow is not a medical service.