Non-Reconstitution of Craving Architecture During Deliberate Alcohol Re-Exposure: A Satipaṭṭhāna-Informed Neurophenomenological N-of-1 Case Study

Abstract

BACKGROUND AND AIMS:Contemporary addiction models typically treat craving as a persistent vulnerability requiring ongoing management. This N-of-1 case study examines whether intensive Satipaṭṭhāna (mindfulness) practice can alter the experiential structure of craving itself, rather than merely helping a person tolerate or redirect it. METHODS:Longitudinal self-observation by a physician with adult-onset Alcohol Use Disorder (arising in the context of grief and trauma, without prior recreational substance use history). High-resolution attention was trained at the level of vedanā (affective tone) during a period of deliberate alcohol re-exposure under conditions of significant psychosocial adversity, including housing instability, sleep disruption, and social isolation. RESULTS:Across repeated exposures, the previously integrated craving experience — sensory effects, affective tone, narrative, and motivational urge — did not reconstitute. Sensory and pharmacological effects remained intact, yet no compulsive craving architecture emerged. Alcohol-related dreams were also absent throughout the observational period and follow-up. CONCLUSIONS:These observations suggest that craving may function, at least in part, as a constructed perceptual gestalt rather than solely a fixed neurobiological trait, and that this gestalt may be susceptible to deconstruction through sustained attentional training at the vedanā stage. Limitations of the N-of-1 design, partial retrospective framing, and the difficulty of fully ruling out expectancy effects are discussed transparently.