Externalizing the Urge

Allan Marlatt:

The most effective cognitive coping strategy with craving and urges is to develop a sense of detachment with regard to these experiences. Most clients tend to "identify" with the urge; they equate the urge with a volitional desire to indulge in the addictive behavior. Identification with the urge makes it more difficult to resist the temptation to indulge, whereas to "remove oneself" from the experience is to gain some control over it. The client is likely to think, "I'm dying for a cigarette," instead of "I am experiencing an urge to smoke—this is a useful signal to me that I need to cope with the situation." The best way to facilitate "disidentification" with the urge is to externalize it—to perceive it as a response to some external cue or situation instead of stemming from an internal physical source. By externalizing the urge, the client is more likely to assume an objective position of detached awareness instead of a subjective identification with the experience.

Defusion

The handout for the cognitive defusion group was titled ‘Seeing your thoughts differently’. The rationale section explained that thoughts can sometimes sabotage intentions and that in situations like these it can be helpful to think of oneself as different from one’s thoughts. The strategy section went on to describe the mindbus metaphor (i.e., viewing oneself as the driver of a bus and one’s thoughts as passengers, see Hayes & Smith, 2005; Hayes et al., 1999) and gave three examples of strategies the participant could use in response to difficult ‘passengers’ (i.e., difficult thoughts; describing them, letting them know who is in charge, making them talk with a different accent, or sing what they are saying; see Hayes & Smith, 2005; Hayes et al., 1999).

In the practice exercise section, participants were asked to select one of the three strategies and spend 5 min imagining themselves using it, either in response to recent difficult chocolate-related thoughts or in response to the types of difficult chocolate-related thoughts they might experience over the next 5 days. The instructions section asked participants to carry the bag of chocolates with them at all times over the next 5 days, to try to resist eating any kind of chocolate, and to use the strategy outlined in the handout whenever they were tempted to eat chocolate. In order to try to limit social desirability bias, the instructions also noted that resisting chocolate is difficult so the participant may find that they cannot always manage this. In which case, they should simply make a note of what they have eaten in their diary.

Jenkins KT, Tapper K. Resisting chocolate temptation using a brief mindfulness strategy. Br J Health Psychol. 2014 Sep;19(3):509-22. doi: 10.1111/bjhp.12050. Epub 2013 May 17. PMID: 23678870.

From GYE Members

• ...Seeing the fantasy thoughts as the nisayon they are, clarified it as something outside of me and not a reflection of me, as I used to think. Once I identified it for what it was, I could now actually work on overcoming it. #aa thoughts