Targeting craving with EMDR therapy: Future directions

Abstract

Eye movement desensitization and reprocessing (EMDR) therapy may be a promising approach when targeting addiction-related memory representations that trigger craving. We propose a link with cue-reactivity mechanisms targeted by both cognitive bias modification training and cue-exposure therapy, including increased cue-devaluation, reduction in cognitive biases, and violation of dysfunctional expectancies. In this commentary, we propose a framework explaining the effects of addiction-focused EMDR therapy based on insights from working memory and inferential processing accounts, empirical evidence of underlying EMDR mechanisms, and the broader cue-exposure literature. It points to new directions for future addiction-focused EMDR therapy, by optimizing procedures, by more strongly taxing working memory, better violate dysfunctional expectancies, inhibiting cue-reactive related memories and lowering craving and inhibiting addictive responses. We hope that this framework will inspire future research investigating the underlying mechanisms as well as potential boundary conditions (e.g., arousal) that may moderate these mechanisms across a wider set of addictive-like domains.