How we change what others think, feel, believe and do
Craving is an important concept and activity in addiction. Here is a definition and a number of models.
Craving is the powerful desire that an addict has for the addicted substance or activity. Craving is a deep hunger, a lust that does not go away. In fact the more it is ignored, the stronger the feeling of need becomes.
Craving is often relatively low to start with, but when the feeling starts, the addict quickly moves to feeding the desire. Craving is more powerful when the addict is trying to give up, and is a major reason for relapse.
Craving can also be erratic and the feeling be intense even after the addict has successfully indulged.
Even after having given up, the desire does not go away and just the sight of a bottle of vodka can still make a person who has given up years ago go weak at the knees.
The principle of conditioned craving is that withdrawal symptoms become a conditioned response. Addictive behavior then occurs to avoid the withdrawal effects. Withdrawal may also be connected to particular locations, such as a therapist's room. Craving in this model is hence caused in a chain of cause and effect.
This is a variant of Schachter and Singer's (1962) Two-Factor Theory where emotion arises from a combination of physiological arousal and cognitive thought.
In this way an alcoholic perceives alcohol-related cues that lead to physiological arousal and cognitive response, and so identifies the result as craving. The extent of the craving is related to the intensity of the arousal.
In this model, environmental cues trigger expectations about the effects of the addictive behavior. This expectation has two components: informational, about various effects, and motivational, about the desire to experience the benefits. Overall, expectancy is related to action, with greater expectation of positive outcomes leading to deeper addictive indulgence.
Craving here is seen as the desire for experience. The desire then triggers intent and urges that lead to action.
In the dual affect model, craving can be created by both negative and positive emotions, including getting away from negative experience and moving toward positive ones. This is a pain-and-pleasure pattern, avoiding pain and seeking pleasure.
Notably, pain and pleasure are seen as mutually exclusive as people cannot simultaneously experience both negative and positive emotions.
Craving here is a propositional network of memories, stimulus and response. Any given network is triggered through appropriate environmental cues. The greater the activation of the network, the more consistent will be the response.
This model differentiates automatic processing, where the addict indulges whenever they are stimulated to do so, from non-automatic processing, where they are prevented from indulging. This block then leads to the excessive desire of craving.
The blocking off of the desired route and the subsequent craving requires cognitive effort in deciding what to do next. Craving thus creates cognition.
Tiffany, S. T. (1999) Cognitive concepts of craving, Alcohol Health and Research, 23, 215–224.