Craving in the Body

forthcoming

Despite extensive research and numerous therapeutic efforts, addiction remains a chronic condition for many individuals, with relapse rates alarmingly high. Traditional approaches predominantly emphasize cognitive and neural aspects of addiction, often overlooking the crucial interoceptive dimension, the perception of internal bodily states. Even though evidence suggests that physiological states contribute to the development and persistence of addiction, and patients report intense bodily sensations during craving episodes, we still lack tools to measure bodily processes associated with craving, understand their role in addiction risk, and effectively address them in therapy. Through a transdiagnostic and multidisciplinary approach, I will address the interoceptive basis of craving. Work Package 1 involves experimental craving induction and self-administration procedures in non-clinical alcohol and tobacco users to establish how interoceptive processes influence the motivation to consume substances and contribute to escalation in substance use severity. Work Package 2 extends this research to real-world settings using Ecological Momentary Assessment (EMA) in patients diagnosed with alcohol and tobacco use disorder. By integrating real-time data on craving, stress, and interoception into network analyses, I aim to identify interoceptive markers predictive of craving and relapse. Finally, a randomized controlled trial will test the effectiveness of incorporating individualized interoceptive feedback generated from EMA data into cognitive-behavioral therapy. By focusing on the bodily dimension of craving and relief, this approach brings novel perspectives to the aetiology of addictive disorders and can yield breakthrough interoception-based treatments that can improve therapeutic efficacy and reduce relapse rates, addressing what it feels like to be in the body of someone suffering from addiction.