Session 12: Introduction to Defusion and Urge Surfing

This chapter presents Session 12. The focus of this session is defusion (a psychological skill to gain distance from one’s internal experiences, such as thoughts and emotions, in order to view them as momentary experiences rather than absolute truths) and urge surfing (“riding the wave” of uncomfortable thoughts, feelings, and urges by noticing and monitoring the negative internal state without giving in to the urge to engage in unhealthy behavior) as strategies to promote acceptance and facilitate healthy weight control behaviors.

Session 12: Introduction to Defusion and Urge Surfing

This chapter presents Session 12. The focus of this session is defusion (a psychological skill to gain distance from one’s internal experiences, such as thoughts and emotions, in order to view them as momentary experiences rather than absolute truths) and urge surfing (“riding the wave” of uncomfortable thoughts, feelings, and urges by noticing and monitoring the negative internal state without giving in to the urge to engage in unhealthy behavior) as strategies to promote acceptance and facilitate healthy weight control behaviors.

Session 3: Developing the In vivo Hierarchy and Craving Management

This chapter describes session 3 of the COPE therapy. The therapist will be guided in this chapter on how to provide the rationale for in vivo exposure exercises and will generate an in vivo hierarchy with the patient. This chapter provides the therapist with instructions for how to teach patients to use the Subjective Units of Distress Scale (SUDS). Cognitive behavioral techniques for how to manage cravings to use are reviewed for the therapist, such as decision delay, healthy distracting activities, breathing retraining exercise, play it out technique, cognitive restructuring, and urge surfing.