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Coping With Urges

May 12, 2014 - 16 comments
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COPING WITH URGES

By: Robert Westermeyer, Ph.D.

Habits and urges go hand in hand. In fact, many people in the throes of an addictive behavior problem, whether it is overeating, drug use or alcohol abuse, claim that they derive no pleasure from their habit--that it is nothing but the relentless craving that fuels ongoing addictive behavior. What is usually most difficult for people when changing a bad habit is coping with the sometimes relentless urges. The initial days of a habit kicking plan can be exhausting as urges dominate thinking and interfere with daily routine. Many people give up change efforts because they feel that there is no way they can function without their habit as the urges interfere too much with quality of life.

It is important to remember that urges, in and of themselves, are normal. We experience craving in varying degrees every day. And because your habit has been important to you for a long time, it may be unreasonable to expect urges to vanish completely. What is hoped is that you will come to experience urges with less frequency and that when they are experienced you will be able to react in a way that avoids relapse.

The "three Ds" can be helpful in coping with urges and craving, 'whether these urges are related to alcohol or drug use, overeating, tobacco use or any habit you are attempting to change. The Ds stand for Decatastrophizing, Disputing expectancies and Distracting.

Decatastrophizing

Especially early on in your change efforts, craving can seem excruciating. Your daily routine has been altered by the elimination of an important part of life and now you can't get your mind off it. Everything you see reminds you of your habit. If you smoke, every room you enter may bring to mind the image of> a cigarette and associated pleasure. The inability to satisfy the urge can lead to frustration and inner statements like, "I can't stand this!" or "There is no way I will be able to live without giving in. I'll just go crazy!" Statements like this can be overwhelming. So much so that people often give up efforts.

As is the case with anxiety, catastrophic thoughts can lead to a great deal of arousal which can, in turn, make things seem worse than they are. If you believe that you are completely out or control, your emotions will follow. What is important to remember is that urges are normal and typically decline in intensity as you continue implementing change. To combat catastrophic reactions to urges it is important to remind yourself of times in the past when you have successfully changed habits (think now, we all have done so at least once or twice!). Do you still experience urges? If so, are they as intense as during the initial phase of your change efforts? Probably not, right? Furthermore, think about other people you have known who have undergone significant change. Do they seem haunted by urges such that they cannot function? If not, who is to say that you cannot accomplish that also?

Try to take some of the power away from a black and white adjective like "horrible" or "unbearable." Belief in horrible extremes only makes you feel worse. Just how unbearable is your urge right now? To accurately answer this you may need to conjure images of what other types of suffering reported as unbearable are like. Is this as unbearable as getting stabbed in the stomach? Or better still, what have you endured which was worse than your current urge? Was that unbearable? lf so, does it folIow that your urge is less than unbearable and perhaps only "very uncomfortable."

Disputing Expectancies

Craving is, in essence, the activation of expectancies. Beck and his colleagues (Cognitive Therapy of Substance Abuse, 1993, Guilford Publications) believe that there are three beliefs associated with the acute decision to engage in substance abuse." They are Anticipatory, such as "I'm gonna be Mr. Wonderful after one line." Relief Oriented, such as "I won't have to think about work if I drink this bottle of wine." and Facilitative or Permissive, such as, " I've been good all week, I'm entitled to an evening high." Though Beck and his colleagues presented these fundamental beliefs in reference to substance abuse problems, it is this author's contention that these beliefs can function in any habit urge.

Since we rarely think about distant consequences when craving, bring them to mind deliberately. Bring to mind the negative emotions which may be
experienced at a later time due to engaging in your habit. Urges are "myopic" in that they can only see advantages. You must shed some light on your craving in order to effectively control it. Ask yourself questions like:
* How will I feel later if I give in to my urges?"

* What consequences might I suffer if I give in?"

* Will the negatives outweigh the positives in the long run if I give in?"

Another way to cope with urges is to imagine that someone very close to you is voicing the very urge you are experiencing. How would you go about convincing them not to give in. Sometimes distancing ourselves from our urges is imperative before you can subject them to any scrutiny.

Your ability to conjure vivid images can be used in your favor when you experience craving. In the presence of a strong urge, try to imagine a very negative outcome. The more negatively graphic the better. The more true to your life the better. For example, if you have a problem with alcohol and experience a strong urge to walk down to the convenience store and buy a bottle of Vodka, imagine the worst hangover possible. Imagine vomiting all morning. Better still, imagine someone very important dropping by, someone you really want to impress, and seeing you in that condition. It is amazing how powerful our own imagination can be in fueling and impeding behavior. Use it to your advantage in your habit change efforts!

Distracting

Some urges are so relentless that talking back to them is insufficient. You still can't get your mind off your habit. Good old fashioned distraction is sometimes the only medicine that can pull your thoughts away. Distraction can be cognitive, in the form of some mental exercises, or behavioral, in the form of activity. Certainly the latter is going to be the most effective, in that urges tend to occur in environments which are the same or similar to those in which the habit occurred in the past. If you are trying to quit smoking, and you have previously smoked in your office all day, being in your office is going to elicit a strong drive to light up. Certainly if possible, taking your work into a conference room, or taking a break and walking outside will often be enough to decrease the urge to a manageable level. You must evaluate your schedule and determine which situations evoke the most intense craving and create as much flexibility as possible so that you can "escape" if necessary--especially in the initial days of your change efforts.

Cognitive distraction can be very powerful. Certainly imagery has been used as a means of helping stressed people learn to relax. You too can use imagery to take your mind off an urge which is dominating consciousness. Conjuring a pleasant place like a beach or on a raft in a lake can help you not only take your mind off the urge but relax as well.

However, "relaxing" images are not helpful for everyone. Some find that if they relax when craving they will only want it more. This makes sense as we have discussed that many habits are associated with relaxation and pleasure, and evoking these feelings in places previously associated with your habit can strengthen urges tremendously. I recommend that you find some mental task that will be very difficult to finish but which is interesting and consuming that you can activate in response to an urge. I like to refer to these as Mental Tapes. Some examples of tapes which have been helpful are:

* Writing the perfect epic novel or screenplay.

*Planning the perfect vacation.

*Creating the ideal money-making business.

*Interpreting a dream from the night before.

*Picking an acquaintance and trying to "figure them out."

Certainly what you choose will depend on your interests, but the key is to make it something that will be easy and perhaps interesting and fun to do. Choosing to think about all the mistakes you've made this year and how you could have done things differently is not going to prove a good distraction tape as it won't be enjoyable. In fact it may increase the power of your urge, especially if stress has precipitated your habit in the past.

It is sometimes best to try one urge control technique at a time so that you don't get overwhelmed. These techniques work, but they also require a great deal of mental energy and conscious effort. The aim here is not to make change excruciating or extraordinarily taxing, but to provide you with some tools which you can add to your armory at a your own pace.

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by weaver71, May 12, 2014
Thanks agAin buddy

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by nonights, May 12, 2014
I learn more everyday from you ABN. Thanks. Very interesting.

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by EvolverU, May 12, 2014
E,

You're going to make a powerful counselor (& perhaps educator), my friend! :)

I realized when reading through the section on controlling cravings that I (& most likely almost everyone here) have stumbled across or intuited & applied all of these methods in my personal struggle. As mentioned, it is more difficult/the resistance more intense -- at first & that entails expending a great deal of mental energy/focus. This is difficult without energy, clarity or discipline. So, it would be interesting to see how we could build a system of exercises to stregthen/magnify these qualities in ourselves. :)

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by EvolverU, May 12, 2014
Any thoughts, oh-super-disciplined one?:)

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by VICourageous, May 12, 2014
Very Nice info for sure. I would like to give you a bit of my experience here. The Big changes for me was to slow down and know that I will get my work done in time..It was ALL the things I wanted to get done around my house inside and out that brought on the cravings to get wired up and do it all NOW!!! When I would forget about the Laundry in the Dryer and get it days later.. I would tell myself this is a GOOD thing. With any of this work, I had to just do what I could or I would want to use..That right there was the BIGGEST change of it all since I have had that Compulsive Behavior for Many, Many Years.

However, I sit here today after loosing yet another loved one (7 in 6 Months)so this has showed some Light on my Life..I want to LIVE not die..So I guess in some way deep inside I have been Scared Straight for the best..There have been Many Changes since 2012 but the last 6 months have been the Best Changes. See ABN if I was using still during all of this, then I would of for sure used it for a excuse..BUT I used it all in a good way..I feel very much closer to my God too! Right now I can say that I have not had any cravings or that they have come so far apart..I know I can not get ahead of myself here and that I always will have to hold tight to my sobriety, but I just get sick when I think of ANY Substances at all!! I also can NOT be around drunks or any one high right now becasue there actions make my anxiety go up and I can not stand the anxiety..lol
Just thought I would share this with you and if you find ANY info about these situation being true on helping some ones sobriety, please let me know..OK?
Bless U Always my Friend!
PS..You are going to be SO good at this for SURE!!!!!!

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by ActingBrandNew, May 12, 2014
Annie,

I see your point and wholeheartedly agree. Anything and everything can be hard in life without the needed energy. Mental energy can even control the physical energy at times (In a good or bad way..mind over matter theory). A system of exercises would be great and ideal for those of us who need it.

I thought the above article very interesting which is why I posted it. For me, I dont have cravings anymore. I do occasionally catch my mind "wondering" from time to time and some may call that an urge or craving. I deal with those by being cognitively adept with myself at all times and take a very simple approach to deal with it....I play the tape all the way through. For me, my drug use has led me to a lifetime of heartache. The prison time alone can cause me distress when I dwell on it too long. So when I have those fleeting thoughts...I play the tape past the euphoria I may feel from getting high. I play it to following days....months to where I'm sitting in a prison cell feeling suicidal. That does it for me.

But maybe that wont work for someone who has never experienced a loss so great as freedom. I think for a high functioning addict this method wont work because that tape will keep rolling and pollute the mind and possible even encourage one to get high. I dont know.

I like to learn and know more than what works for me and what makes me tick. I try to understand everyone's personal situations and see them for what they are them...not what they are to me. Sometimes I get frustrated because I feel recovery can be so repetitive. People repeat things they heard at a meeting without giving it much thought not really searching if that scenario applies to them. I encourage free thinking instead of slogan therapy. Everyone is unique and different things work for different people.

I guess I got a little off topic.

Id like to hear your ideas for exercises to stregthen/magnify these qualities in ourselves if you have any. Just me trying to soak it all in and learn something new everyday.


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by ActingBrandNew, May 12, 2014
Vic,

Im glad you shared that. Its like I was just saying above...different things work for different people. ALL situations are unique. I'm glad you shared yours.

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by VICourageous, May 12, 2014
ABN..I am so proud of YOU..You have been one of my favorites on here for providing such Great Information..YOU are going to be so good at this..I wish I was right next door to you.

My mental exercise is try to stay Positive. I can hear a certain positive song or even watch or read about how powerful the Brain is and how positive attracts positive and negative will succk you dry. Just like my Friend who drinks..Well it was her X that they found in the woods, she can use this for a excuse, but she also knows she will be next if she does not stop the insanity. For the first time in a very Long time I realized that people who use any Substances make a Pea on the floor out to be a big Meteorite. I had witness this just the other day when we had some one break in his house. We had it all under control and the cops came..Nothing was missing. Both the Ladies that had been drinking just went on & on with more & more that was not even happening nor did it happen. It is like we can not hear becasue we do not listen and the brain is all rattled any way..Then to add substances on top of it all..My eyes and ears have sunk in more lately then ever..AND NO I do not want to be like that anymore..lol Finally Mellowed out after 58 Years! hahaha
Thanks ABN YOU Rock!!!!

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by EvolverU, May 12, 2014
Evan,

I think it's an excellent article. This part, though, did give me pause:

'Choosing to think about all the mistakes you've made this year and how you could have done things differently is not going to prove a good distraction tape as it won't be enjoyable. In fact it may increase the power of your urge, especially if stress has precipitated your habit in the past.'

This belies both your technique that you just mentioned (i.e. playing the tape past the Euphoria to previous experiences in order to gain mastery/clarity over the urge -- I too, find this to be one of my more powerful weapons) & my conviction & many other's (from what I've read & discussed with friends & on forum) that stress -- (how we process it neurally/physically/emotionally) -- of one form or another is a central trigger. Ergo, I find the final sentence puzzling as stress is huge in addiction. Any thoughts? Give me both barrels if I have tunnel vision or am making too much of this.

I applaud your approach of staying away from mindless 'sloganeering' !! (I think you already know that, though :)) I think people shut down eventually (or sooner!) around this sort of thing. I think this approach shows a real dearth of understanding of the dynamics of both addiction & of the constant movement & adaptation of the mind/subconscious. For better or worse, we become quickly inured to these sorts of things if they don't reach & address our issues deeply enough. I believe it's the same reaction that thinking folks have to advertising & political blandishments/come-ons. It turns them off & they shut down either consciously or otherwise. In fact it alienates them & therein lies the danger for a certain segment of the addict population. It's so true that everyone is different!! (& yet retain central themes/commonalities). So, the trick, I would think, as a counselor -- here or 'loacally' -- would be to identify these commonalities we all share, then pinpoint the patterns & triggers of the specific individual, the genesis of their addiction/the past & suggest different techniques & see what works for different 'sub-types' (I have a feeling that we definitely fall into a bunch of these sub-groups.) I mentioned consistency/energy/discipline as that is my current bugaboo. Sometimes (I now believe), 'strength'/will can work in the same person for both good & bad @ once! :)

You mentioned that your experience in prison was terrible enough to make your 'tape' work for you & that perhaps for others who haven't encountered this sort of horror, their tape might not be enough. I have never been to prison but I would humbly suggest that there are other ways to lose your freedom (one of them being the 'incident' I mentioned to you in our last conversation). I feel it actually stripped away a part of me & I was trapped inside of myself & felt rudderless for quite a while. I'm still coming out of it. The problem for me might be that it was not a direct result of my addiction. I think this is where some sort of anomalous faith comes to the rescue -- call it the will to live -- sanity -- God -- whatever. I only know that I'm still here & fighting. Gratitude is the order of the day.

I don't have any concrete ideas on the exercises that I mentioned -- only that how we address this stuff has to be much deeper & continual than what I usually see mentioned here or elsewhere. I was wondering, if you (who I sense is a highly disciplined no nonsense individual) had any thoughts. Something to think about for your future practice & your work here on MH. (Also, I'd like to benefit if inspiration strikes you!!) In the meantime, I'll be pondering & formulating -- as ever. :))

I'm Grateful that I'm off today & caught this! (Good to see you.:))

A

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by ActingBrandNew, May 12, 2014
Annie,

Your right...that part you pointed out belies my technique. But like I mentioned, different things work for different people so Im sure the author of the article has found in his experience that playing the tape through may have the opposite effect that it has on me and others. Even though the case doesn't apply to me...I found it interesting. A different way of looking at it. It sounded like the author acknowledged stress being a huge part of addiction...at least that's how that sentence reads to me.

"You mentioned that your experience in prison was terrible enough to make your 'tape' work for you & that perhaps for others who haven't encountered this sort of horror, their tape might not be enough. I have never been to prison but I would humbly suggest that there are other ways to lose your freedom (one of them being the 'incident' I mentioned to you in our last conversation)."

Prison is not the only horror someone can experience to make the tape work...I just mentioned mine. Everybody has there own horrors at there own level. The part where I mentioned playing the tape through not working would be for someone who hasn't experienced a horror at all. Someone who is a "high functioning addict" who only then realizes that he is an addict by missing a dose and experiencing withdrawals. Someone who gets high on whatever drug they chose but has no bad experience to correlate or associate with there drug use. Then the whole "playing the tape" method wouldn't work because the tape would associate using with all positive things. I know people who got 1 ticket for a DUI and never drank again. His tape was that DUI. Everybody has a different level of what hurts them. For some it could be loss of custody, overdose, sexual abuse, etc. I'm saying for those that experience none of those (because there are plenty of them out there) the tape method is a moot point.

My professor always brings up this dr he treats who is an IV meth user. This doc has been using for years and is still practicing medicine. He is high functioning with no bottom. He is a case example of someone the tape theory would not work with.

In terms of ideas for the exercise you mentioned...Id say its right in front our faces and something we already practice and that's through fellowship. Support groups and peer interaction to me is what will make up for energy shortcomings whether physical or mental. Nothing like having someone give you a push eh?



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by EvolverU, May 12, 2014
Thanks for the nudge today (& always) :))

I agree that interaction is key but there are times in between when we must maintain through thick & thin. (In fact, that's most of the time & I've found that being thrown back on oneself & oneself alone without running for 'shelter' is the crux of the whole thing). The problem, at least for me, w/ a lifetime of use & hardened emotional/mental thought patterns is that some of us must totally remake our lives while continuing to undergo anhedonia, complete uncertainty in terms of direction, our 'new' selves & other miscellaneous hardships. (Man, I sound whiny!) I find that it's been a slow & intricate process -- like peeling back layer after layer of an onion. (The initial skins being thick & coarse/obvious & more resistant -- the inner ones being smaller, almost translucent & more elusive). Each time I peel one back, I feel that I get closer to the 'Truth' of how I 'do' & why. As I said (& think you did too), it's a highly individualized process after the initial 'peel' we all share.

I don't always find peer interaction grouped around addiction to be necessarily uplifting or edifying. In fact, sometimes it has a negative effect on me. (I feel like a pariah saying that but it's true! Like I said above, sometimes it's alienating). I do however, find myself supported by the simple & sometimes surprising moments of joy interacting at work, home, w/ strangers on the street & in natural surroundings when I least expect it. The ultimate task, as I see it though, is to be able to maintain enough equanimity when alone, bored, restless or hurting -- a practice that guides us to safe harbor when the gale threatens to capsize us.

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by toothfairie, May 12, 2014
Annie, your last paragraph fits me as well. Almost perfectly.  :))  

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by AShellof_Me, May 12, 2014
Fantastic post.... and an AMAZING discussion. Thank you... No matter how long we've been doing this... life... this sobriety walk... there's always so much more to know - learn and grow.  Thank you Annie, Vic, and ABN for sharpening me today. wow. good stuff.

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by timothy141, May 12, 2014
As always great post, fits in well with what is and isn't in my life. In the very first paragraph I knew it would be good. Being able to cope seems to drive many of us to do those things we do. And of course when that ray of sunshine does get in, what is seen in that light becomes terrifying and the remembrance of what drove us to binge again creates more grief and causes a person to seek relief.
  So starts the craving process, and the rituals kick in, the hows, wheres and preparation to complete the act, put ice in a glass, clean you works polish your favorite spoon turn down the air conditioner turn up the stereo. Whatever goes hand in hand with a person particular, drug and necessary things that go with it.  
But back to coping, back in '92 when I found my self in the Hope House in Anaheim, one of the graduates had spoken many times about having a broken cooper.
      

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by ActingBrandNew, May 13, 2014
Annie,

You make some great points and I can relate with a lot of what you say.

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by timothy141, May 13, 2014
I look up Dr.Westermyer,

Being carefully taught!

Dr. Robert Westermeyer is a licensed psychologist that for over 10 years has been devoted to the application of scientific research into psychotherapy practice.He graduated Magna *** Laude from San Diego State University, and subsequently completed his Master's and Doctoral Degrees in Psychology from California School of Professional Psychology He has aided in the increase of cognitive therapy programming in both inpatient and outpatient settings, and recently wrote a manual on the treatment of depression for one of San Diego's most respected psychiatric hospitals.He developed one of the first websites (www.habitsmart.com) geared towards helping people fight addictions.He has had articles published in many professional journals and newsletters.Dr. Westermeyer lives in Encinitas, California, with his wife and three children.

He has devoted years to his field of study.  

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