Dear patients, dear colleagues,
We have created a new self-help technique to reduce craving in addiction. We provide this technique to people with substance use problems free of charge. In the following, we briefly introduce the method, which is available as free download beneath.
With Imaginal retraining our research group has developed a new self-help technique to reduce craving. For this purpose, we have further developed and improved this technique, which was originally computer-based, so that it can now be adapted to address each user’s individual issues and be used flexibly without a computer. The technique has already been successfully tested in people experiencing problems with alcohol consumption, smokers and overweight women. The manuals "Think before you drink" and "Dunk the junk" are available for free below. The manual for smoking ("Retrain you brain") is currently only available in German.
Craving for certain substances is common, for example in alcohol consumption or smoking (Carvalho, Heilig, Perez, Probst, & Rehm, 2019), but also in excessive, uncontrolled eating habits (Verzijl, Ahlich, Schlauch, & Rancourt, 2018) and contributes to high relapse rates in these populations (Boswell & Kober, 2016; Stohs, Schneekloth, Geske, Biernacka, & Karpyak, 2019). Therefore, our research group has developed a new self-help technique called imaginal retraining, which is intended to reduce craving for certain substances or foods.
This technique utilizes unconscious processes that cause us to automatically bring things we like closer to us (e.g. hugging someone, waving to us, approaching objects with curiosity) and to automatically reject, push away or distance ourselves from things we do not like. This is strongly anchored both physically and linguistically (for example, we talk about finding someone attractive or repulsive) and is roughly equally prevalent in all people. In addiction, this tendency to attract things we like and push away things we do not like is pathologically increased. The previous version of imaginal retraining, conventional retraining, is a computer-based method which is meant to reduce this increased tendency. In conventional retraining, patients are instructed to push craving-inducing images on a computer-screen away from themselves using a joystick and to pull neutral/positive images close to them. Studies have shown that this simple device reduces the risk of relapse. However, the task is considered monotonous and rather boring. Patients’ interest in participating is low, and the effects are small (Cristea, Kok, & Cuijpers, 2016). The imaginal variant of retraining, in which craving-associated/neutral stimuli are to be pushed away/pulled toward oneself before the ‘inner eye’, offers the advantage that the imagined substance-related images can be individually adapted (e.g., type/brand of an alcoholic beverage). Furthermore, it is easy to implement in everyday life and less monotonous than the conventional computer retraining.
Imaginal retraining has been evaluated regarding efficacy and acceptance in three randomized controlled trials. Results showed that craving for and consumption of alcohol (Moritz, Paulus, et al., 2019), cigarettes (Moritz, Göritz, Kraj, et al., 2019 and high-calorie foods (Moritz, Göritz, Schmotz, et al., 2019) were significantly reduced compared to a wait-list control group. The technique was also described as easy to use in all studies and showed a high acceptance by participants.
The following manuals aim to reduce craving for alcohol ("Think before you drink") and high-calorie foods ("Dunk the junk") and can be downloaded free of charge. We are counting on your experience and suggestions to further improve the technique itself and the comprehensibility of the manual. Please take the time for feedback: Steffen Moritz (firstname.lastname@example.org).
Fridland, E., & Wiers, C. E. (2018). Addiction and embodiment. Phenomenology and the Cognitive Sciences, 17(1), 15–42. https://doi.org/10.1007/s11097-017-9508-0
Moritz, S., Göritz, A. S., Kraj, M., Hottenrott, B., Tonn, P., Ascone, L., … Kühn, S. (2019). Imaginal retraining reduces cigarette smoking: A randomized controlled study. Submitted.
Moritz, S., Göritz, A. S., Schmotz, S., Weierstall-Pust, R., Gehlenborg, J., Gallinat, J., & Kühn, S. (2019). Imaginal Retraining decreases craving for high calorie food in overweight and obese women. A randomized controlled trial. Translational Psychiatry, 9, 319. https://doi.org/10.1038/s41398-019-0655-7
Moritz, S., Paulus, A. M., Hottenrott, B., Weierstall, R., Gallinat, J., & Kühn, S. (2019). Imaginal retraining reduces alcohol craving in problem drinkers: A randomized controlled trial. Journal of Behavior Therapy and Experimental Psychiatry, 64, 158–166. https://doi.org/10.1016/j.jbtep.2019.04.001
Wiers, R. W., Boffo, M., & Field, M. (2018). What’s in a trial? On the importance of distinguishing between experimental lab studies and randomized controlled trials: the case of cognitive bias modification and alcohol use disorders. Journal of Studies on Alcohol and Drugs, 79(3), 333–343. https://doi.org/10.15288/jsad.2018.79.333
Wiers, R. W., Eberl, C., Rinck, M., Becker, E. S., & Lindenmeyer, J. (2011). Retraining automatic action tendencies changes alcoholic patients’ approach bias for alcohol and improves treatment outcome. Psychological Science, 22(4), 490–497. https://doi.org/10.1177/0956797611400615