G. Alan Marlatt and Jean L. Kristeller. 1999. Mindfulness and meditation. In William R. Miller (ed.), Integrating spirituality into treatment: Resources for practitioners, 67-84, at 78-79. Washington, D.C.: American Psychological Association.
As an example of ... insight meditation procedure, Marlatt (1994) developed the technique of "urge surfing" in the treatment of addictive behaviors. Designed as a relapse prevention method, the purpose of urge surfing is to help clients cope with craving or urges that otherwise might trigger a setback or lapse. Ask the client to first self-monitor any urges, cravings, or strong desires to engage in the target behavior (e.g., to ingest a substance or to engage in a high-risk sexual behavior). Encourage clients to identify the specific form that the urge takes when it occurs. Urges often take the form of a verbal intent or command, such as "I must smoke or I will go nuts" or "Just this once won't hurt me" or "Damn it! I OWE myself a drink after this!" Such verbal statements may or may not be accompanied by strong physical sensations or desire cravings. Such urge reactions often appear to take the form of classically conditioned responses, usually triggered by a cue or situation associated with the target behavior (e.g., a recent ex-smoker sees an open pack of cigarettes lying on the table). Contextual and environmental factors such as the client's mood and social environment may also elicit strong urges to indulge.
This method first arose in the course of working with a client who was trying to give up smoking. After he had quit for a week, he reported constant urges to smoke that felt like a growing ball of discomfort that was increasing in intensity to the point that he felt that he would "go crazy" unless he gave in. Recalling a prior account of his reputation as a surfer during his youth, the therapist asked, "What if you could see the craving in the form of a cresting wave instead of a growing ball?" We then discussed his experience as a budding surfer. He described how he learned to keep his balance as the ocean wave swelled up beneath his surfboard and he rode the wave as it finally crested and diminished in size. He learned to keep his balance without being "wiped out" by the wave. He agreed to transfer this surfing metaphor to his meditation practice. As soon as he experienced any indication of a rising urge in his thoughts or feelings, he would direct his full attention to this growing wave while keeping his balance until the wave gradually crested and subsided. Because many urges in fact take the form of conditioned responses elicited by trigger events, their duration and intensity do not necessarily last unless they are reinforced by engaging in a consummatory response (smoking or drinking). The client reported using this meditative urge surfing technique as an effective means of coping with cravings to smoke.
