Desensitizing Addiction: Using Eye Movements to Reduce the Intensity of Substance-Related Mental Imagery and Craving

Abstract

Eye movement desensitization and reprocessing (EMDR) is an effective treatment for posttraumatic stress disorder. During this treatment, patients recall traumatic memories while making horizontal eye movements (EM). Studies have shown that EM not only desensitize negative memories but also positive memories and imagined events. Substance use behavior and craving are maintained by maladaptive memory associations and visual imagery. Preliminary findings have indicated that these mental images can be desensitized by EMDR techniques. We conducted two proof-of-principle studies to investigate whether EM can reduce the sensory richness of substance-related mental representations and accompanying craving levels. We investigated the effects of EM on (1) vividness of food-related mental imagery and food craving in dieting and non-dieting students and (2) vividness of recent smoking-related memories and cigarette craving in daily smokers. In both experiments, participants recalled the images while making EM or keeping eyes stationary. Image vividness and emotionality, image-specific craving and general craving were measured before and after the intervention. As a behavioral outcome measure, participants in study 1 were offered a snack choice at the end of the experiment. Results of both experiments showed that image vividness and craving increased in the control condition but remained stable or decreased after the EM intervention. EM additionally reduced image emotionality (experiment 2) and affected behavior (experiment 1): participants in the EM condition were more inclined to choose healthy over unhealthy snack options. In conclusion, these data suggest that EM can be used to reduce intensity of substance-related imagery and craving. Although long-term effects are yet to be demonstrated, the current studies suggest that EM might be a useful technique in addiction treatment.

Eye Movement Desensitization and Reprocessing vs. Treatment-as-Usual for Non-Specific Chronic Back Pain Patients with Psychological Trauma: A Randomized Controlled Pilot Study

“…EMDR has now become an empirically validated and recommended first-line treatment for posttraumatic stress disorders (PTSD) and other conditions that are specifically related to (emotional) stress [e.g., Ref. (23–26)]. The EMDR intervention, as an established procedure for exposing emotional response from trauma therapy, can be used specifically to process emotional distress in patients suffering from chronic pain with the clear objective of processing this dysfunctional emotional shift.…”

Exploring expectation effects in EMDR: does prior treatment knowledge affect the degrading effects of eye movements on memories?

“…Using this laboratory design, different variables can be manipulated in order to examine the underlying working mechanisms of EMDR. Studies that have adopted the model have shown, for example, that memories are not only degraded by EM, but also by other WM taxing dual tasks, such as complex counting (van den Hout et al, 2010) and mindful breathing (van den Hout et al, 2011), and that not only negative memories can be altered by EM, but also positive memories (Engelhard et al, 2010; Hornsveld et al, 2011; Littel, van den Hout, & Engelhard, 2016), providing evidence for the abovementioned WM account.…”

Die Rolle des Eye Movement Desensitization and Reprocessing (EMDR) bei Substanzgebrauchsstörungen: Ein systematischer Überblick

“…Dementsprechend wurden 37 Treffer aufgrund des Publikationstyps (Buchkapitel oder Dissertation) verworfen, 33 Artikeln wurden aufgrund eines mehrfachen Treffers (unterschiedliche Wortkombinationen, in beiden Datenbanken gefunden) ausgeschlossen und 37 Artikel wurden aufgrund weiterer der eingangs beschriebenen Ein-und Ausschlusskriterien nicht weiter berücksichtigt. Es wurden vier Artikel eingeschlossen [33][34][35][36], welche insgesamt 122 Probanden untersuchten; bei je 30 Probanden lag eine Alkohol-bzw. Zwischen den Gruppen zeigte sich ebenfalls in der TAU + EMDR Gruppe eine signifikante Verbesserung der PTSD-Symptomatik (T = 9,60, p < 0,05).…”

“…Bei Littel et al [34] wurden Probanden Bilder gezeigt, welche zum Rauchen animieren sollten. Nach dieser Craving-Induktion zeigte sich bei Probanden die eine EMDR-Behandlung absolvierten, eine niedrigere Emotionalität hinsichtlich der negativen Erinnerungen.…”

“…Selten wurden gleiche oder auch nur ähnliche Erhebungsverfahren verwendet, sodass die Ergebnisse meist nicht verallgemeinert werden können und die Aussagekraft geschmälert wird. Nichtsdestotrotz wurden bei EMDR-Behandlungen Evidenzen für eine Reduktion des Cravings bei Alkohol-und Nikotinabhängigkeiten gefunden [33,34], Depressionswerte konnten gesenkt werden [33,35] und das Selbstwertgefühl stieg an [35]. Die Verbesserung in diesen Parametern sollte sich als förderlich für den weiteren therapeutischen Prozess erweisen.…”