Craving refers to a subjective experience of intense desire, an urgency to use a substance or to engage in a behavior [Drummon et al., 2001, Drummond et al. 2002]. Currently, craving is recognized as one of the main criteria for the Diagnosis of Substance-Related Disorders and Addiction Disorders (DSM5, Apa, 2013), included in the grouping of criteria related to the impairment of substance use control and is a central factor in the maintenance of addiction (Hasin et al., 2013; Romanczuk-Seiferth, Van Den Brink, & Goudriaan, 2014). According to the DSM - 5, craving can be defined as an 'intense urgency or desire' readily stimulated by internal and external factors previously associated with the substance, elements capable of playing a 'trigger' role, that is, 'trigger', which initiate through a mechanism of conditioning, and by association of ideas, the desire for chemically obtained gratification (Tiffany and Conklin, 2000).
Two distinct forms of craving from the patient's expectations perspective: on one hand, the concern of taking the substance to avoid withdrawal, referred to as "negative craving"; on the other hand, the compulsion towards the substance driven by the expectation of incentives, of gratification. In this case, the search for a "reward" would produce a "positive craving." (Tiffany and Conklin, 2000) Research has shown that craving is qualitatively similar across all target domains, including alcohol, tobacco (Castellani & Rugle, 1995; Field, Schoenmakers, & Wiers, 2008). Over the past 40 years, several models have been proposed to conceptualize craving; behaviorist models have conceptualized it as an epiphenomenon of classical and operant conditioning processes (e.g., Ludwig & Wikler, 1974; Stewart, Dewit, & Eikelboom, 1984), while cognitive models have emphasized that higher-order cognitive functioning and the way of processing information is central to the activation of craving (Tiffany, 1999). Among the cognitive constructs proposed in recent years is that of 'desire thinking' or wanting thought, which seems to play a role in the escalation and persistence of craving in dependent individuals (Caselli & Spada, 2010, 2011; Kavanagh et al., 2009). The purpose of this brief article is to stimulate, among clinicians working with patients affected by substance use disorders (SUD), a reflection on the existing analogies between the construct and the mechanism of action of 'desire thinking' and that of 'temptation' as theorized by the Church Fathers. The analogy and comparison between temptation and desire thinking should be understood here as entirely free from ethical-moral and/or religious connotations and considered solely and exclusively as a comparison between two well-defined cognitive-emotional constructs. In the narrative accounts of patients, both lay and Catholic, collected by clinical therapists (both lay and Catholic), the expressions "temptation" and "liberation" related to craving are often present. At the end of the article, we will discuss the possibility of modifying such dysfunctional and maladaptive coping strategies.
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