Teaching Clients to Surf Cravings Instead of White-Knuckling Them

How Teaching Clients to Surf Cravings Instead of White-Knuckling Them
helps you turn chaos cravings into clear steps you can teach in any room

 

You know that look.

Jaw tight. Hands locked. Breathe shallow.

Your client swears they will “just power through” the next craving.

You nod, you empathize, and a part of you already knows how this movie ends.

White knuckle, hold the breath, tense the body, then snap. Use, shame, repeat.

Teaching clients to surf cravings rather than white-knuckle them gives you and your client a different script.

Not “try harder”.

Learn a skill.

I did not learn this skill in a clean therapy office.

I learned pieces of it on a shelter bunk with heroin sickness ripping through my body.

I remember staring at the ceiling, counting breaths, and telling myself, “You do not need to move for the next ten seconds”.

Ten seconds at a time kept me from running out the door.

That is the heart of urge surfing skills.

You turn a giant wave into one small choice, then another, then another.

You already use many substance use counseling tools.

This one drops straight into what you do now.

No incense. No mystical voice.

Just clear steps for you and your client.

 

 

Why white-knuckling keeps clients stuck

White-knuckling is a tension strategy.

Clamp down.

Push the feeling away.

Pretend the wave is not there.

On paper, it sounds strong.

In the body, it backfires.

The client holds their breath.

Their heart rate jumps.

Their thinking narrows to one idea.

“Make this stop.”

In that state, the brain reaches for fast comfort.

Old patterns jump in.

Use makes sense in that moment.

Urge surfing skills give the client something else to do with that energy.

Stay with the wave, watch it, ride it, and come down on the other side.

When you frame it that way, you turn cravings into practice instead of proof that someone is broken.

That shift alone starts to rebuild hope.

 

 

 

 

What urge surfing is and why it works

Urge surfing emerged from work on mindfulness-based relapse prevention.

The idea is simple.

Cravings rise, peak, and fall.

They do not stay at one level forever.

Teaching clients to surf cravings rather than white-knuckle them means teaching clients to notice the whole curve.

Not just the ugliest thirty seconds.

You help them:

• Name the urge in plain language

• Notice body cues without fighting them

• Track the rise and fall over time

• Link the end of the wave to their own effort and patience

This method aligns with motivational work, CBT, and everything else you already do.

It does not replace your other substance use counseling tools.

It gives those tools a calmer place to land.

Here is the question that matters.

If your client trusted that every craving had an end, how would that change their choices in the middle of it

You already know the answer.

Panic drops.

Options open.

 

 

A simple protocol for one-to-one sessions

Teaching clients to surf cravings rather than white-knuckle them in a single hour.

You do not need a whole new workbook.

You need a clear frame and a short script.

Set it up with three moves:

• Psychoeducation

• A guided practice with a mild urge

• A plan for real-life practice

For psychoeducation, keep it concrete.

Draw a quick craving curve on paper.

Start low, rise, peak, then fall.

Link that to a real story from your client.

Then walk them through a short practice.

If they have a live urge in the room, work with that.

If not, use a memory or a small trigger.

You can say something like:

“Right now, rate your craving from zero to ten.

Notice where you feel it in your body.

Stay with it for three slow breaths.

Watch what changes.”

That is the core of mindfulness-based relapse prevention in action.

You are not telling them to be calm.

You are inviting them to notice change.

To build urge surfing skills in that hour, move step by step:

• Have them rate the urge every thirty to sixty seconds

• Ask what shifts in the body, even tiny shifts

• Remind them that the goal is not comfort, the goal is to stay present

• Point out the first sign that the wave starts to drop

You can tie this to other substance use counseling tools the client already knows.

For example, link the wave to high-risk thoughts from CBT work.

“Notice what your mind says at the peak, and what it says two minutes later.”

Give them a short home plan:

• Pick one regular trigger in the next week

• Commit to staying with the urge for two to five minutes

• Track ratings on paper or in their phone

• Bring that data back to you

That last step matters.

You turn this from a nice idea into real practice.

 

 

How to run this in a group

Teaching clients to surf cravings rather than white-knuckle them works even better in groups.

People see that they are not the only ones who feel hijacked by cravings.

You can run a short group exercise in twenty minutes.

Set the frame:

• Explain the craving curve

• Share a short story from your own life or from a composite client

• Name ground rules around safety and choice

I often share a memory from my methadone days.

Standing outside the clinic, sick, watching people argue, deals going on, my brain screaming for a bump, and me trying to stay in my body long enough to walk away.

That story lands.

Clients know the feeling.

Then guide the group through a mild urge.

You can ask them to think about a common trigger, like payday, a particular street, or a fight at home.

Walk them through:

• Rating the urge from zero to ten

• Naming one body cue

• Breathing with the feeling for a short count

• Watching the numbers rise and fall

This sets up mindfulness-based relapse prevention as a shared practice, not a private chore.

People hear how others describe their waves.

They borrow language and strength.

You develop urge-surfing skills across the whole group.

You can weave this into other substance use counseling tools in that same session, like trigger mapping or coping cards.

 

 

Adapting urge surfing for trauma and MAT

Not every client feels safe in their body.

Some shut down or freeze when you ask them to notice sensations.

This is where your trauma lens comes in.

You still focus on Teaching Clients to Surf Cravings Instead of White-Knuckling Them; you widen what “surfing” can look like.

You can:

• Let clients keep their eyes open and look around the room

• Have them focus on hands or feet instead of the chest or stomach

• Use objects in the room as anchors, like the chair or the wall

• Keep windows of time short and check consent often

Clients on methadone, buprenorphine, or naltrexone fit here, too.

Mindfulness based relapse prevention is not only for abstinent people.

Cravings still show up around missed doses, old patterns, and stress.

You can teach urge surfing skills around:

• The urge to skip a dose

• The pull toward extra benzos or alcohol

• Old rituals linked to use, like routes or contacts

Tie this back to their dose plan, their goals, and the rest of your substance use counseling tools.

You are not asking them to pick between medication and mindfulness.

You are giving them greater control over their own nervous system.

 

 

 

 

Do the work yourself first.

Here is the part most training programs skip.

You need this skill too.

Teaching Clients to Surf Cravings Instead of White-Knuckling Them lands harder when you practice it in your own life.

I still use it when my brain lights up with old thoughts on bad days.

I use it when my nervous system jumps during a conflict or when I get a bill I did not expect.

Pick one place in your week where you feel that strong urge to escape.

Scroll, snack, drink, pick a fight, whatever your flavor is.

Then run the same drill you teach:

• Rate the urge

• Notice one body cue

• Stay with it for a short, set time

• Watch the rise, the peak, and the drop

That one act changes how you sit in front of your clients.

You know what you are asking them to do.

You know it is hard and possible.

As you stack that practice, your whole set of substance use counseling tools gets sharper.

You listen with more patience.

You challenge with more respect.

You believe clients when they say “this urge feels endless,” and you can hold the line that it will pass.

Teaching Clients to Surf Cravings Instead of White-Knuckling Them is not a nice add-on.

It is a concrete skill that can sit beside every treatment model you already use.

You teach people to stay present in the ugliest minute of their day.

That minute often decides everything.