“I can’t help it,” Christine says. “When he makes that face at me, I just start yelling.” Her husband, Bob, is just as sure that when he hears “that tone,” it is his cue to storm out of the house.
Sabrina tells me, “I can’t stop eating. As soon as the kids are in bed, it’s just on.”
Jack comes in for “anger issues.” His girlfriend is terrified of the way he responds to other drivers. “If you cut me off,” he says, “you’re not gonna get away with it.”
My newly sober clients have every feeling under the sun, including cravings—a powerful urge to use.
Many, if not all, of your clients are struggling with urges. The good news is that an urge is just a feeling, and we therapists know that feelings are temporary. Helping your clients identify their urges and move through them safely is simply critical.
Start using the language of urges. “When someone cuts you off, Jack, this strong feeling comes over you—mostly anger, and a desire to chase them down.” Talking about these feelings as “urges,” “wants,” and “desires” leaves room for your client to separate the urge from the action.
Slow down the process. “Christine, in that moment when you see Bob’s face, before you start yelling, something happens inside of you. Let’s take a moment to really be with that feeling. Can you tell me what happens in your body?” (If your client finds this difficult, it may help for them to close their eyes, breathe deeply, and take their time. The pace of your session should mirror what you want to teach—nice and slow, leaving room for whatever arises.)
Help them see that they have choices. I like to say, “the urge is there, but the action is optional.” This is a good place to suggest homework. “Sabrina, now that we know the action is optional, let’s try something new. Tonight, after the kids go to bed, I would like you to go directly to your tub and fill it up. You can always choose to eat after the bath.”
Book Titles: The Gift of Recovery
Julie S. Kraft, MA, LMFT, is a licensed marriage and family therapist. She has been working in the fields of addiction and mental health since 2008. Julie is an adjunct faculty member at the University of San Diego, where she teaches systemic treatment of substance abuse. Julie has a private practice in San Diego, CA, where she works to help her clients find all the gifts that they deserve.