Urge surfing is a mindfulness-based technique that teaches clients to ride out cravings and impulses without acting on them - the way a surfer rides a wave without being pulled under. Originally developed within relapse prevention, it's now one of the most versatile tools in a clinician's toolkit for helping clients tolerate distress and break automatic behavioral cycles.

Key Takeaways

• Urge surfing is rooted in Alan Marlatt's relapse prevention model. It teaches clients to observe cravings as temporary, wave-like experiences rather than commands to act.

• The technique applies broadly across clinical presentations - substance use disorders, behavioral addictions, binge eating, self-harm urges, and anxiety-driven avoidance behaviors.

• Clinicians can teach urge surfing in a single session using a structured exercise that guides clients through noticing, describing, and riding an urge without engaging the target behavior.

What Is Urge Surfing?

At its core, urge surfing is a skill for tolerating discomfort. Rather than fighting a craving or giving into it, clients learn to observe it - to notice it as a temporary sensation that will rise, peak, and pass on its own.

Origins in Marlatt's Relapse Prevention Model

Urge surfing was developed by psychologist G. Alan Marlatt as part of his relapse prevention (RP) model in the early 1980s. Marlatt observed that clients in addiction treatment often felt overwhelmed by cravings, believing the urge would keep intensifying unless they acted on it. He introduced urge surfing to correct that belief - giving clients a practical, in-the-moment skill for staying with discomfort without surrendering to it.

The technique was later integrated into Mindfulness-Based Relapse Prevention (MBRP), an eight-session group aftercare program developed by Bowen, Chawla, and Marlatt that combines cognitive-behavioral relapse prevention with mindfulness meditation practices. Marsha Linehan also incorporated a version of the technique into DBT, where it appears as "emotion surfing" within the distress tolerance module.

The Wave Metaphor: How Urges Rise and Fall

The wave metaphor is central to how clients understand and accept the technique. Urges are not permanent states - they are time-limited experiences that naturally peak and subside without any behavioral response. Explaining this directly to clients replaces the belief that "the only way to make this stop is to give in" with something more accurate: this will pass on its own if I don't feed it.

The Science Behind the Technique

Urge surfing isn't just a metaphor - it has a meaningful evidence base behind it.

Mindfulness and Nonreactive Awareness

Mindfulness-based approaches train clients to observe internal experiences without immediately reacting to them. In urge surfing, this means noticing a craving as a mental event rather than an instruction. Research on MBRP has found that participants showed significantly lower levels of craving following treatment compared to a treatment-as-usual control group, with acceptance and nonjudgmental awareness identified as key mediating factors (Witkiewitz et al., 2013, Addictive Behaviors). The key mechanism is nonreactive awareness - the ability to witness discomfort without the automatic behavioral response typically paired with it.

Neurobiological Basis: Craving, Habituation, and Extinction

From a neurobiological standpoint, urge surfing is consistent with principles of habituation - the natural decrease in arousal that occurs when a stimulus is experienced repeatedly without reinforcement. When clients consistently ride out urges without acting on them, the urge-behavior connection weakens through a process similar to extinction learning. Research has also proposed that mindfulness practice may reduce activity in craving-related neural circuits and support greater cognitive self-regulation of impulse-driven responses (Witkiewitz et al., 2014, Drug and Alcohol Dependence).

How to Teach Urge Surfing in Session

Urge surfing can be introduced in a single session and assigned as between-session practice. Here's a step-by-step approach you can walk clients through directly.

Step 1: Noticing and Naming the Urge

Ask the client to bring to mind a recent situation where they felt a strong craving or urge. Guide them to notice whether any version of that feeling is present right now. The goal here is simply recognition: "There is an urge." Naming the experience - "I notice I'm having an urge to..." - creates psychological distance between the client and the impulse.

Step 2: Describing Physical Sensations and Location

Once the urge is acknowledged, guide the client to locate it in the body. Where do they feel it? What does it feel like - tightness, heat, pressure, restlessness? Shifting attention to physical sensation moves the client out of narrative ("I need to do this") and into direct experience. This is often the most grounding part of the exercise.

Step 3: Using the Breath as an Anchor

Introduce slow, deliberate breathing as a tool for staying present with the sensation without being swept away by it. The breath doesn't eliminate the urge - it gives the client something stable to return to when the wave feels intense. Diaphragmatic breathing also activates the parasympathetic nervous system, which can reduce physiological arousal associated with craving states.

Step 4: Observing the Wave Without Acting

Guide the client to observe the urge as it shifts and changes - rising, plateauing, beginning to subside. The explicit instruction here is: don't try to make it go away, and don't act on it. Just watch. Reinforce the wave metaphor: this is the peak, and what comes after the peak is the other side.

Processing the Experience Afterward

After the exercise, debrief with the client. What did they notice? Was the urge as overwhelming as expected? Did it change over time? This processing step is clinically important - it consolidates the insight that urges are survivable without behavioral response and builds the client's self-efficacy for future use.

Clinical Applications Across Diagnoses

One of urge surfing's greatest strengths is how broadly it applies. The core skill - tolerating a time-limited internal experience without acting - maps onto a wide range of clinical presentations.

Substance Use Disorders and Behavioral Addictions

This is where urge surfing originated, and the evidence base is strongest here. In a randomized clinical trial, MBRP produced significantly reduced relapse risk to drug use and heavy drinking compared to treatment as usual at 12-month follow-up, with added benefit over standard relapse prevention at that time point (Bowen et al., 2014, JAMA Psychiatry). The technique is appropriate across substance use presentations as well as behavioral addictions including gambling.

Binge Eating and Eating Disorder Urges

In eating disorder treatment, urge surfing helps clients tolerate the distress that precedes binge episodes or purging behaviors without acting on the urge. It pairs naturally with DBT distress tolerance skills and can be integrated into CBT-based eating disorder protocols. Clinicians should be thoughtful about introducing body-based awareness exercises with clients who have significant body image disturbance or trauma history.

Self-Harm and OCD-Spectrum Compulsions

In OCD treatment, urge surfing complements exposure and response prevention (ERP) by giving clients a mindful stance toward anxiety and compulsive urges. For clients with non-suicidal self-injury (NSSI), it can be taught as part of a broader distress tolerance toolkit - though it should not be used in isolation without adequate crisis planning and safety assessment.

Anxiety-Driven Avoidance and Safety Behaviors

Clients with anxiety disorders often act on urges to avoid, escape, or seek reassurance. Urge surfing can help clients notice the urge to avoid and choose to tolerate it instead - which aligns directly with the behavioral goals of exposure-based treatment. Framing it as "riding out the urge to leave" or "sitting with the urge to check" makes it concrete and actionable.

Limitations and Adaptations

Like any clinical technique, urge surfing works best in the right context with the right preparation.

When Urge Surfing May Not Be Appropriate

• Clients in acute crisis or active suicidal ideation need stabilization before introducing urge-tolerance exercises

• Clients with severe dissociation may find body-based awareness exercises destabilizing rather than grounding

• Clients who are highly alexithymic may struggle to identify or describe physical sensations and require more scaffolding or an alternative approach

• In early addiction recovery, urge surfing should complement - not replace - coping skills training, psychoeducation, and social support

If a client becomes overwhelmed during the exercise, ground them using a concrete sensory technique before continuing or closing the session.

Adapting the Technique for Adolescents and Trauma Survivors

With adolescent clients, concrete and visual framing tends to work well. Some clinicians draw a wave on paper or use a "craving thermometer" to make the concept tangible. Keep language simple and normalize the experience without minimizing it.

With trauma survivors, body-based exercises require particular care. Interoceptive awareness can activate trauma responses in clients with PTSD or complex trauma histories. Introduce urge surfing gradually, ensure the client has adequate grounding skills first, and always follow trauma-informed principles - including giving the client control over pacing and the option to pause or stop at any point.

Documenting Urge Surfing in Your Notes

When you use urge surfing in session, your notes should capture which technique you used, the client's response, and how it connects to treatment goals. Tracking what works over time supports personalized care and demonstrates clinical progress.

Streamline Your Documentation with Berries AI

Documentation shouldn't eat into the time you spend with clients. Berries AI is an AI scribe built specifically for mental health professionals. It listens to your sessions and generates HIPAA-compliant notes - SOAP, DAP, treatment plans, and more - in seconds. When you use techniques like urge surfing in session, Berries automatically captures the intervention and reflects your clinical approach in the note, so there's no extra documentation time required.

• Supports CBT, DBT, MBRP, ACT, and other modalities

• Learns your writing style and formatting preferences over time

• Works with any EHR system for in-person and telehealth sessions

• Free trial: 20 sessions, no credit card required

Start your free trial at heyberries.com.

Frequently Asked Questions

How long does it take clients to learn urge surfing? Most clients can grasp the basic technique in a single session, but the real benefit comes with repeated practice. Assign it as homework and revisit the debrief regularly - tracking how urge intensity changes over time helps clients see their own progress and strengthens motivation to keep using it.

Is urge surfing the same as thought suppression? No - and this distinction matters clinically. Thought suppression ("don't think about it") tends to increase the frequency and intensity of unwanted thoughts. Urge surfing does the opposite: it encourages full acknowledgment of the urge without behavioral reinforcement. The goal is acceptance and observation, not avoidance.

Can urge surfing be taught in a group format? Yes. MBRP is designed as an eight-session group program and includes urge surfing as a core group exercise. Group formats add the benefit of shared normalization - hearing that others experience the same urges and use the same technique reduces shame and builds collective self-efficacy.

How does urge surfing fit within DBT? Urge surfing maps closely onto DBT's distress tolerance module. Linehan adapted Marlatt's technique into "emotion surfing," which applies the same nonreactive observation stance to difficult emotions in addition to behavioral urges. For clients already familiar with DBT's mindfulness component, urge surfing is a natural extension and tends to click quickly.

Urge surfing gives clients a powerful, portable skill for managing intense impulses - and for clinicians, it's a low-barrier, high-impact intervention that fits naturally into mindfulness-informed treatment across a wide range of diagnoses.

This article is for educational purposes and professional development only. It does not constitute clinical supervision or replace professional judgment in therapeutic practice.

Sources

1. Larimer, M. E., Palmer, R. S., & Marlatt, G. A. (1999). Relapse prevention: An overview of Marlatt's cognitive-behavioral model. Alcohol Research & Health, 23(2), 151–160. https://pmc.ncbi.nlm.nih.gov/articles/PMC6760427/

2. Bowen, S., Chawla, N., Collins, S. E., Witkiewitz, K., et al. (2009). Mindfulness-based relapse prevention for substance use disorders: A pilot efficacy trial. Substance Abuse, 30(4), 295–305. https://pubmed.ncbi.nlm.nih.gov/19904665/

3. Bowen, S., Witkiewitz, K., Clifasefi, S. L., et al. (2014). Relative efficacy of mindfulness-based relapse prevention, standard relapse prevention, and treatment as usual for substance use disorders: A randomized clinical trial. JAMA Psychiatry, 71(5), 547–556. https://pubmed.ncbi.nlm.nih.gov/24647726/

4. Witkiewitz, K., Bowen, S., Douglas, H., & Hsu, S. H. (2013). Mindfulness-based relapse prevention for substance craving. Addictive Behaviors, 38(2), 1563–1571. https://www.sciencedirect.com/science/article/abs/pii/S0306460312001335

5. Bowen, S., Chawla, N., & Marlatt, G. A. (2011). Mindfulness-Based Relapse Prevention for Addictive Behaviors: A Clinician's Guide. Guilford Press.

6. Marlatt, G. A., & Gordon, J. R. (1985). Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors. Guilford Press.

7. Witkiewitz, K., et al. (2014). Mindfulness-based treatment to prevent addictive behavior relapse. Drug and Alcohol Dependence. https://pmc.ncbi.nlm.nih.gov/articles/PMC5636047/