Allison Kellaghar's Masters Thesis on Benzo withdrawal...this is excellent

In my "16 years on benzo recovery story" I referenced Allison Kellaghar's Master Thesis.  Here is where you can read it on the internet...I hope it encourages you as much as it did me...

[nobbc]www.bcnc.org.uk/allison.html[/nobbc]

eugene

 

Edit: The above link is dead. I've managed to find a copy and posted it further on in this thread. It is long (too long to fit within a single post), so be sure to read Part II in the follow-on post:

 

http://www.benzobuddies.org/forum/index.php?topic=57947.msg2977187#msg2977187

 

~Colin.

Allison knew Dr. Ashton personally.  In fact, Dr. Ashton proof read Allison's Thesis.  Before Allison died she started a support group in Boulder Co. where she lived and helped a number of folks like us get off benzos..

Thanks. 

Thank you, eugene. 

 

Patty  xo

Thanks Eugene, great to read a resource regarding benzos.  Very tragic ordeal with benzos and tragic ending for her. 

Faulk

Thanks Eugene, great to read a resource regarding benzos.  Very tragic ordeal with benzos and tragic ending for her. 

Faulk

 

faulk I just read the article did I miss it did something happen to her.

 

Eugene thanks so much for sharing was a powerfully positive story thats for sure.

 

Lizzy

Lizzy, she had a cycling accident and died a few years after writing her thesis.  She didn't die because of benzos I don't think,

Faulk

 

  Thank you for this story..Moe

Yes...she died in 2010 from a bicycle accident in Boulder Co.  She wrote her Thesis in 2006.  How sad...but she still continues to be an encouragement to many through her experience and this Thesis.  Eugene

omg how unfair is that poor thing that really does stink so she the benzos didnt kill her she survived that and a bike accident did aawww well she has definately made a difference hasnt she.

 

thanks guys and my benzo head missed that point.

 

Lizzy

Eugene.... Thank you for posting this.  So very well written with all the knowledge.  Such a loss with her tragic accident.. what a gift she left though.  Thanks again.  Patty

I'm in week 7 of withdrawal---still suffering with night panic and other problems that lead me to almost daily web searches for support.  I found Allison's paper today and felt incredibly comforted and validated by it, then was saddened to read about her very unfortunate death.  Such a loss, but she did leave something good behind---I never met her, but her life had value to me. 

I remember reading about her in Matt Samet's book "Death Grip."

Wow, Eugene, what a great paper!  Thank you so much for posting the link.  I'm going to send a copy to both my GP, who didn't get my problem at all but seems willing to be educated, and to my counsellor who instinctively provided what Alison pointed out we need.

The thesis link is dead now.

Is there a new link ?

Just tried to link to it and not found....

 

anyone have a copy perhaps or maybe a new link...would love to read it....

sounds excellent....

Hello. I’m wondering if anyone still has a file of her thesis? I tried looking all over the web but can’t seem to find it, and many links no longer work. Thanks

I was hoping somebody else knew where to find her thesis, too. I looked everywhere over the last few years. I learned about Allison back in 2015, and her life and what she'd done to help others had been so inspiring to me. I'd love to read her thesis. I imagine it was probably really well done.

 

The only couple of places that I found anything at all about Allison was from benzosupport.org web site, Matt's book and a couple of online articles written immediately after her death.

I'm sure the university where she defended it will have copies of it.  If you can find out which school she received her masters at, you should be able to find her paper. 

Hi all.

 

I've managed to retrieve this. This is the best I can do for now. I might try prettying it up at some stage. I can't imagine that Alison would have minded me reproducing this here in the circumstances. Her thesis is a nice legacy, continuing to do some good.

 

---

 

  Toward a Model of Psychological Support  for People Withdrawing From Benzodiazepine Tranquilizers
  
    A  Master’s Paper Submitted

      In  partial fulfillment of the requirements for the Degree of

      Master  of Arts

      Transpersonal  Counseling Psychology Department

      Counseling  Concentration

      Naropa  University
    Alison  Kellagher

      April  2006

    

    Table of Contents

    
    
Abstract…………………………………..…………….……..………………………3

    
    
Introduction……………………………..………….….……………………………..4

    
    
About the  Author………………………..………...………………………………….6

    
    
Literature Review……………………..………………………………………………11

    
    
My Theoretical  Perspective……………..…………...………………………………...17

    
    Case Studies
    


         Genie…………………………………………………………………………...…18
    


       Debra……………………………………………………………………………...20
    


       Steve………………………………………………………………………………21
    


       Matt……………………………………………………………………………….24
    


    
    
Discussion………………………………..…………………………….………….….27

    
    
Conclusion……………………………..……………………………………….…….31

    
    
Further  study………………………..…………………………………….……….….34
    
 
    Abstract
    
This paper discusses elements of an  effective support system for people wishing to withdraw from benzodiazepine  tranquilizers (aka “benzos”). The author’s experience undergoing withdrawal  from benzos is briefly discussed. Because benzo withdrawal syndrome is  under-recognized, misdiagnosed, and often misunderstood, there is little appropriate  support of any kind available today. This paper attempts to define a system of  support that combines gradual taper with an appropriate psychological container  within which the person’s suffering is reduced, and chances of success are  improved. The crucial properties of such a container include: information,  belief in intrinsic health, and encouragement. These elements are discussed as  they apply to individual and group support. The case studies of four people who  have withdrawn from benzos are discussed in terms of the roles of information,  belief in intrinsic health and encouragement in each person’s withdrawal  process. By defining a container of support I hope to move closer to an  adequate model of care for people going through benzodiazepine withdrawal.
    
 
    Introduction
    


       The subject of this paper stems from  experience with withdrawal from benzodiazepine tranquilizers, both my own and  that of other people. I was dependent on benzos for 15 years and withdrew from  them in 2002. Prior to that I had made four painful attempts, beginning in  1993. Following my ordeal and through the body of information I’ve collected  about benzo withdrawal since 2002, I have identified what I believe are the  three most important aspects of support for people in the process of  withdrawal. These are: information, belief in intrinsic health, and  encouragement. These elements provide a humane container within which people  who wish to can successfully withdraw from benzodiazepines.

       The most commonly prescribed benzos  in the US include Xanax, Ativan, Klonopin, Valium, and Restoril. All  benzodiazepines exert five major therapeutic effects, used either for help with  anxiety, with problems sleeping, as a muscle-relaxant, anticonvulsant, or for  induced memory impairment (i.e. for surgery) (Ashton, 2002). Manufacturer’s  prescribing guidelines advise against prescribing benzos for longer than one  month of consistent use (Roche, 1990).

      There  are three overlapping types of benzodiazepine-dependent populations. The largest  group is comprised of long-term users who have become dependent as a result of  regular repeat prescriptions over months or years. A second group comprises  high-dose abusers and a third consists of poly-drug abusers (Ashton, 2005).  This paper is primarily concerned with the first group. There are an estimated  4 million people who fall into the category of therapeutic dose benzodiazepine  dependence in the US today (Ashton, 2005). While it is impossible to be sure  how many in this group would like to go off their medication, it is safe to  assume that a significant number would, based on the prevalence of adverse  effects of Benzos. Adverse effects include over sedation, memory impairment,  emotional blunting, depression, dependence due to physiological adaptations,  increased anxiety, and dose escalation with concurrent escalation of adverse  effects (Ashton, 2002; Tyrer, 1984). 

      In  this paper, dependency is defined by the occurrence of withdrawal symptoms upon  cessation of the drug. Withdrawal symptoms occur because of the physiological  adaptations due to chronic administration of the drug (Ashton, 2002; Lenanne,  1986). While this paper is primarily concerned with therapeutic dose-dependent  individuals for whom drug abuse is not a central theme, it also hopes to offer  support for all who would like to go off of benzos, regardless of how he or she  became dependent.

       There is a great deal of misinformation,  mythology and ignorance surrounding the benzodiazepines. An attitude of denial  by many in the general medical establishment has had a severe impact on many  patients trying to go off of benzos (Peart, 2000). Benzo withdrawal, when done  improperly, can cause extremely disturbing symptoms in people who have become  physiologically dependent, but still, the very existence of this syndrome is  under-recognized by many physicians (Peart, 2000). Where it is recognized its  potential severity and longevity are often grossly underestimated and because  of this many doctors are mismanaging withdrawal from benzos, even when  attempting to be of help. In the worst, and common scenario, the person is sent  to a detox facility and taken off abruptly, causing massive protracted  symptoms and setting the person up for months and often years, of  debilitating symptoms. In other instances, well-intentioned doctors, having a  misguided concept of the gradual tapering method, along with underestimating  the intensity of symptoms, set the person up for failure by administering a  too-rapid withdrawal schedule. This situation has ramifications beyond merely  the discomfort of the patient, as we shall see, often setting in motion a  cascade of misunderstanding, misdiagnoses, and unnecessary, prolonged  suffering.

      A  wide range of benzodiazepine withdrawal symptoms has been documented. The short  list of common symptoms of abrupt (cold turkey) benzo withdrawal includes fear,  depersonalization, hallucinations, seizures, insomnia, dysphoria, nausea,  tremors, pain, and hypersensitivity to light, noise, and smell, and mental  confusion. Contrary to common assumption, these do not last for two to three  weeks. Following an abrupt withdrawal, the symptoms will often last between six  months and two years of gradually diminishing mixed psychological and somatic  symptoms (Ashton, 1986). Individuals who have experienced benzo withdrawal  describe it as the most horrific, evil, cruel experience a person can imagine.  In the words of celebrity and benzo survivor Stevie Nicks, describing her  experience of withdrawal from Klonopin: ”I felt like someone opened up a door  and shoved me into Hell” (Stevie Nicks, n.d.). When faced with these symptoms,  and not realizing that they are part of a temporary syndrome, many people  choose to stay addicted, because, sadly, this must seem to them to be the  lesser of evils. 

      A few  pioneering individuals, Dr. C.H. Ashton in particular, have developed a humane  and sensible method of gradual taper from benzos. Withdrawal from benzos is  rarely easy, but when properly managed, and combined with appropriate  psychological support, withdrawal can be accomplished with a minimum of  suffering. The chances of completing withdrawal are overwhelmingly improved by  the provision of psychological support throughout the process. This paper looks  at exactly what is involved in providing proper psychological support for  people in benzo withdrawal.  

      For  those interested, a comprehensive explanation of benzodiazepine withdrawal can  be found at: www.benzo.org.uk. In this paper I refer to  withdrawal as the entire process of healing from the organic brain changes  caused by chronic benzo use, whether taken off abruptly, or by the gradual  tapering method. I do not necessarily mean the time frame during which the drug  is leaving the body. 

      The benzodiazepine experts agree that  accurate information and sustained encouragement are central in helping the  person successfully endure the withdrawal process. A small number of experts,  and it is the view of this paper, believe that a belief in the intrinsic health  of the withdrawing person is also a key factor leading to successful withdrawal  and healing.
    About the Author
    
I was first prescribed benzos in 1986  when I consulted a doctor because I was experiencing  panic episodes at my job. The drug worked  well for me for the first eight years, but the dose escalated over those years  due to tolerance (the body adapts to the drug and needs more to prevent  withdrawal symptoms), and by 1993 had reached a dosage (7 mg Klonopin per day)  that began to cause serious negative effects. I tried unsuccessfully to go off  four times, beginning in 1993, before eventually succeeding in 2002.  

      After finally succeeding in getting free  of benzos, I became interested in researching better ways than what I had  encountered, to manage the process of withdrawal. I became acquainted with a  comprehensive source of information about benzo withdrawal on the Web, at  www.benzo.org.uk. From there I was introduced to a 3500-member benzo support  group at Yahoo.com. I gained an education about this drug, and became a  proponent of Dr Ashton’s gradual tapering method.

      Since becoming a member of the Yahoo  support group, I’ve seen, and often participated in supporting the successful  withdrawal of approximately forty people. I’ve also worked with a number of  people in-person and have provided support by telephone. I have seen the  positive results fomented by providing people with information; of believing,  as a support person, that they could get well and conveying this to the person  and of the availability of constant encouragement to those in the throes of  withdrawal.

      During my initial attempts to go off   benzos, my doctor, a highly respected psychopharmacologist, was undereducated  and misinformed about methods of benzodiazepine taper, and was ignorant about  the severity and duration of the withdrawal syndrome. When I continued to be  highly symptomatic at four months following abrupt withdrawal, he diagnosed me  with a return of my original anxiety and a newly-aquired diagnosis of bipolar  disorder. According to DR. Reg Peart (2000):

      There is a strong knee-jerk reaction  geared to diverting the blame from the drugs and  prescribing practices onto the patients. A  range of speculative reasons is offered e.g. the symptoms are a return of the  original complaint, latent mental problems exposed by the drugs and the old  chestnut, personality disorders (p.11).

      My original problem with intermittent  panic states was a walk in the park compared with the state I found myself in  in the aftermath of benzos. Before benzos I was a healthy person responding to  an overwhelming work environment. But my doctor did not appear to believe in  my intrinsic health, and when I struggled with withdrawal symptoms, did not  encourage me to continue benzo cessation after about four months following my  cold turkey withdrawal.  I don’t know if  he simply didn’t know what to do with me, or if he honestly believed I was  flawed in some fundamental way that required medicine. The fact that I had been  basically healthy and high-functioning prior to benzo use seemed irrelevant to  him. It may be that it was much easier for him to do “damage control” by  keeping me on the drug indefinitely. Whatever the case, the three critical  elements of support were certainly absent.

      The ramifications of this scenario were  serious for me. Misinformation led to a decision to submit myself to detox  facilities, where I was taken off of the escalated dose of 7 mg of Klonopin per  day (equals 140 mg Valium) in two weeks. Had I tapered appropriately, using the  Ashton method, my withdrawal would have been accomplished over a period of two  years, not two weeks. The abrupt withdrawal from high-dose benzos was a violent  act on my brain and my person. It is perhaps difficult to believe, but the  professionals at the detox facility also appeared to be misinformed about how  to withdraw a person form benzos. It may be that they had little choice  however, due to the constraints of an insurance system that recognizes and  accommodates only a thirty-day program.  The  absence of the critical elements of support was to continue to affect major  negative consequences for me as my situation developed. 

      Following each of the four violent  detoxes, I experienced extremely distressing symptoms for months without  substantial relief. These symptoms are very difficult to describe because they  fall so far outside the range of normal experience. My feeling of consciousness  was completely altered. The world seemed to have changed into a horrible,  odious experience and there was nothing I could do to change this. Fear was  constant, as a state, and not in reaction to external conditions. A sense of  non-reality was constant, as were sensory distortions and physical pain. I now  know that I was in a normal process of healing from the benzos and the violent  cold turkey (c/t), and that the timeframe needed to heal was one of months and  years. But at the time, having been misinformed about the proportions of benzo  withdrawal, I interpreted the symptoms as signs that I might have somehow lost  my mind. Experiencing constant fear, a sense of non-reality, sensory  distortions, and more, I gave up hope that I could heal. I was encouraged by my  doctor to give up hope that I could function without medication. The doctor  misunderstood my symptoms as a sign of mental illness, and told me I would need  to be on benzos the rest of my life.   Believing he knew what he was doing, and in deep distress and confusion,  I agreed to go back on benzos, along with a “cocktail” of adjunct drugs, which  were supposed to mitigate the “side-effects” of the benzodiazepine, and treat  my newly acquired bipoplar disorder. 

      Because of my own confusion and ignorance  about benzos, I allowed myself to be put back on benzos (reinstated) four times  in this same sequence over a period of eight years. The cycle consisted of  reinstating, reaching tolerance, dosage increases, finally reaching a point  where I could no longer tolerate the sedation and other effects, having myself  taken off abruptly, and reinstating again after about four months. The person I  had been before benzodiazepines had entered my life was forgotten. Sadly, this  is a very common scenario among people trying to go off of benzos. Most  psychiatrists do not appear to be interested in finding the person’s core of  intrinsic health; rather, they are shockingly ignorant about how to help a  person withdraw from benzos, and instead of encouragement, promote mental  illness and offer us drugs.

      Eventually, in the spring of 2002 I  reached a point of complete desperation. The high dose of benzos and all of the  adjunct medications were literally killing me, and I faced the decision to  either go off of all medications or to die. I decided to go off, walk away from  my doctor, leave my job, and take as long as I needed, not reinstating any  medication and never again seeking the “help” of a psychiatrist. I went off of  Klonopin in April 2002. From that point, every moment was mental torture for  three solid months, because even while cognitively I knew what was happening, I  was trapped in a place where I was unable to experience any sense of safety and  goodness. After about three months I began to have brief moments when normal  experiencing broke through. These moments increased only very slowly over the  following months, and by six months I experienced several hours each day when I  felt normal. Gradual healing continued and by one year I felt basically well,  experiencing mild symptoms that continued to gradually abate over the next  year, and by two years, I was completely well. Throughout this process I had  believed at my core that I was sane and healthy underneath all of the medicine.  I had to believe in my intrinsic health, because I had no other choice except  death from the medications and thankfully time proved that I was indeed  fundamentally well. 

      Looking back to the situation when first  prescribed benzos, I believe I understand the reasons for the panic I was  having at my job. I believe I had adrenal fatigue (which has now been diagnosed  and treated) after a decade of competitive cycling as a member of the US  Cycling Team. After cycling, I became highly ambitious in my new career and  found myself moving forward into a position of exposure and responsibility more  rapidly than I was emotionally prepared to handle. These two elements combined  and resulted in systemic overload that manifested as panic. A much better  choice than taking medication would have been to enter therapy and inquire into  the reasons for the panic episodes. As they say, hindsight is twenty-twenty.
    Literature Review
    
The literature on psychological support  for people going off  benzodiazepine tranquilizers is strikingly sparse. Much  of what is available stems from the UK, where since the 1980’s there has been  an effort to reduce the number of people who are addicted to this class of  drug and to help those already addicted to go off. In more recent years,  awareness of the need to help people withdraw from addictive medications  appears to be on the increase, as we hear from iconoclastic doctors such as  Peter Breggin and David Cohen, authors of Your Drug May Be Your Problem  (1999).
    Belief in Intrinsic Health
    
The importance of the fundamental belief  that the person is inherently well and can function without medication is one  of the central themes in Your Drug May Be Your Problem (1999). The  authors discuss the impact of the therapist’s orientation to withdrawal, and  how this will affect the client. They state that the therapist must have faith  in him/herself, and must have a firm belief in a non-pharmaceutical approach to  healing. Breggin and Cohen go on to say that when helping a person go off of a  medication, the therapist is essentially saying to the client: “You and I  together, with the help of others, possess the necessary resources to solve or  transform your suffering or crisis for the better” (1999, p.192).

      Belief in intrinsic health is a core  value of transpersonal psychology. It underlies an optimistic, hope-centered  therapy that is necessary when helping a person through difficult times, such  as benzo withdrawal. According to Cortright (1997), a transpersonal therapist  continually views the experience of the client as meaningful, no matter how  bleak, painful, or apparently meaningless it may appear on the surface.  

      Chogyam Trungpa discusses the phenomenon  of belief in intrinsic health in the article Intrinsic Health: A  Conversation With Health Professionals (1979). He discusses the intrinsic  value of the recognition of basic goodness, or basic health and sanity, in both  the helper and help in the therapeutic relationship. According to Trungpa,  “Because of that faith, individuals can begin to learn to help themselves, work  with themselves and take some pride in their existence” (p.111). For the benzo  person, belief in their basic sanity is often in question. The person in  withdrawal is typically in a very fragile condition, and the experience of  having a professional cast doubt on what the person is going through can  perpetuate the fear that one has permanently lost his or her mind.  

      Trungpa (1979) goes on to say that the  therapist should remain available whether or not things are going well. The  idea, according to him, is of being with a human being, responding and working  with that person, whether that person is doing well or is experiencing terrible  turmoil. The process of benzo withdrawal is often a long one and there can be  many periods of turmoil. The person needs the support of a therapist who will  remain available, credulous, and willing to listen throughout an often long and  difficult process. 

      According to Cortright (1997), faith in  intrinsic health allows the therapist to be with the client’s pain in a more  spacious way. A transpersonal therapist has an unshakable belief in the  client’s movement toward a higher state of health and the wounds, suffering,  and stumbling along the way all make a contribution toward the birth of the  emergent being.  

      It is such an unshakable faith that  Breggin and Cohen (1999) refer to as critical at this time, when going against  the grain of the psychopharmaceutical movement has become increasingly  difficult for psychotherapists.  Breggin  and Cohen (1999) have found the following:

      Many professionals are afraid to take a  stand. They lack confidence. They hope for a greater power to rely on beyond  themselves, their clients, and other mere mortals. Nowadays the ultimate Higher  Power is medication. It is especially frightening to reject this “power”  because drug companies and biological psychiatry have convinced as large  segment of the population that drugs are the answer, perhaps the only answer.  (p. 191)
    Information and Sustained Encouragement
    
Dr. C. Heather Ashton is Professor of  Clinical Psychopharmacology at the University of Newcastle, England, has  researched the effects of benzodiazapines since running a withdrawal clinic  from1982 to 1994. She has published approximately 250 papers on the topic,  including the seminal work The Ashton Manual (2002). Dr. Ashton  stresses, both in the Manual and in her many articles, that in her experience  working with people going through benzo withdrawal, information and simple  reassurance, coupled with a gradual tapering schedule, have been enough support  for many of her clients to succeed in going off of benzodiazepines (Ashton,  1994). Dr. Ashton  (1994) has found the following:

      Many patients fear the process of  withdrawal itself because of misconceptions derived from lurid accounts of  others’ experiences. It is helpful to provide, at the first consultation,  clear  information about benzodiazepine  withdrawal and to emphasize that slow and individually titrated dosage  reduction rarely causes intolerable distress. Other patients become frightened  by particular symptoms that are over interpreted as signs of physical or mental  illness. Information may need to be repeated in these cases; in practice the  realization that a symptom is a “withdrawal symptom” is temporary, and is not a  sign of disease, is immensely reassuring to some patients. (p.6)

      Pam Armstrong, a co-founder of The  Council for Involuntary Tranquillizer Addiction (CITA), states that counseling  for those addicted to benzodiazepines should be very directive, and, more than  anything, should take the role of providing information and support. She adds  that reassurance is an initial part of the help that should be offered;  reassurance that it is possible to withdraw, and reassurance that help will be  there. Armstrong believes, as Ashton, that understanding the nature of benzo  withdrawal, and understanding the symptoms, can go a long way in helping  convince a client that they are not in the grip of a severe illness, which  helps give the client hope that they can endure the withdrawal process  (Armstrong, 1987). 

      In Break Your Prescribed Addiction  (2004), Sahley and Birkner also discuss the importance of constant  reassurance. Similarly to Ashton and Armstrong, they emphasize the value of  continuous reminders that the symptoms are just that and not signs of mental  illness, and that withdrawal symptoms will not last forever. They suggest that  therapists continually remind clients to be patient with himself or herself, to  take one day at a time, and to remember that the problem developed over a long  period of time (Sahley and Birkner, 2004).

      Beyond Benzodiazepines (Ree, 2000) is a manual designed to help educate those helping  people go off  benzodiazepines. Reassurance and encouragement top of the list  of recommended strategies for helping the client work with anxiety and  insomnia, the most common withdrawal symptoms. Ree stresses that the client  should be reassured these are normal in withdrawal and that they will  eventually subside.

      Ree places a high value on providing  supportive, empathetic counseling and making sure the person has all the  relevant information to help him or her make informed decisions. Ree shares  Ashton’s view that it is common for people to fear withdrawal symptoms during the  recovery process. This is because lack of information, misinformation, or  doubts about managing the physical stress of symptoms can cause fear. Once  people have understood their own pattern of withdrawal, and how to manage  symptoms, the fear usually disappears   (Ree, 2000).

      Lennane (1986) underscores the importance  of consistent reassurance for those experiencing benzodiazepine withdrawal  symptoms. She discusses the frequency of therapy appointments, recommending  that throughout the process therapists see a client in benzo withdrawal twice a  week to offer support, explanation, and reassurance. In addition, particularly  during the early stages of withdrawal, the therapist should be available by  telephone, at least during business hours (Lennane, 1986).
    Support Groups
    
Elin Ree is a proponent of benzo support  groups. According to her, these can be an important addition to individual  treatment. Through exchanging information on strategies for managing withdrawal  and sharing of experiences, support groups can be very reassuring to those  experiencing the symptoms of withdrawal, especially in the early stages. Ree  states that support groups alone are insufficient, stressing the value of  accessing a combination of individual counseling and a support group (Ree, 2000).

      Dr. Ashton views self-help groups for  benzo withdrawal with a certain degree of skepticism. She agrees that these  groups can be helpful to some in withdrawal, but feels that professional,  individual therapy is more helpful during benzo withdrawal than group support,  especially during the earlier stages. She points out that many patients are low  in confidence and self-esteem and fear being around others. In addition to  this, many have unresolved personal and social problems that are the reason for  their anxiety and long-term benzo use (Ashton, 1994). Benzo support groups are  in a way antithetical, because the very people they would serve are typically  too anxious and uncomfortable to tolerate a group setting.

      Lader and Morton also take a cautious  view of support groups. It is their opinion that often the founders of  self-help groups for tranquilizer dependence are individuals who have had the  worst withdrawal experience.  Because of this they may inadvertently instill gloomy expectations in the  client. They add that in spite of this, support groups may, depending on the  particular group, be a valuable adjunct to individual therapy (Lader &  Morton, 1991).

      According to Breggin and Cohen, peer  counselors or members of a support group can offer the most valuable support of  any form of therapy during withdrawal. They suggest that people who have been  through the process of going off  benzos will usually be nonjudgmental and  accepting of the person’s situation, and can reassure the person in withdrawal  that coming off of benzos is possible (Breggin & Cohen, 1999).

      Breggin and Cohen represent a minority  who include a discussion of the value of online support groups. According to  them, there are thousands of people engaged in Internet groups discussing  issues of withdrawal who can support one another during difficult times.  Breggin and Cohen remind us that on-line groups are especially useful for  people in benzo withdrawal, who often have trouble engaging in face-to-face  interpersonal relationships. They go on to describe exchanges they have seen in  the groups, including expressions of relief upon discovering that their  discomfort is drug-induced and that they are not alone. These individuals  clearly receive comfort and encouragement when others validate their experiences,  even complete strangers (Breggin and Cohen, 1999).

      Lennane points out that the person in  withdrawal often needs constant reassurance and support groups can provide  helpful contact between individual therapy appointments. She adds that support  groups can be especially effective in instilling the belief that the person is  capable of going off of benzos by talking with others who have successfully  done so themselves (Lennane, 1986).
    My Theoretical Perspective
    
I am in strong agreement with Breggin and  Cohen in their orientation to psychotropic medication. My opinion is derived  from personal experience of the utter failure of medication, along with an  alignment with a belief system mentioned by Trungpa, which states that human  beings are not broken, even when they are in deepest despair and confusion.  While I am not Buddhist, my theoretical perspective draws largely on the  perennial wisdom of the Four Noble Truths of Buddhism. 

      The central teachings of Buddhist thought  are concerned with suffering and how to work with it. The existence of  suffering and how to work with it are the central themes in working with people  dealing with tranquilizers that are taken in a misguided attempt to reduce  suffering. The First Noble Truth tells us that suffering is a normal part of  life. The following three deal with how to work with suffering. I don’t think  tranquilizers were what the Buddha had in mind as a way to work with suffering. 

      By believing that suffering is normal, it  follows that I believe human beings are designed to cope with it. They often  need guidance, and they need others who uphold the same view, believing in  their intrinsic health. It is just as Breggin and Cohen point out. A struggling  person needs a therapist who deeply believes in that client’s innate capacity  to heal and learn. I not only believe in it, I believe it is each person’s  birthright to learn and change through the challenges of life.  I hold a transpersonal view that we often  cannot know the ultimate meaning of anyone’s present struggles and that it is  healthy to work through life’s challenges in order to learn and change. Chronic  use of benzos prohibits psychological growth, robbing the person of the  opportunity to learn and develop new coping skills. I am not absolutely opposed  to the use of all types of psychotropic medications, but I believe they should  be used sparingly and with great care, especially the benzodiazepines. I  believe that every person who wishes to go off of benzos should have access to  help in doing so.

      The second key element of my framework is  the fact that I believe wholeheartedly in the existence of benzodiazepine  withdrawal syndrome and I know its dimensions intimately. This knowledge  enables me to sustain my conviction that the person will recover, throughout  the usually long and challenging healing process. I believe firmly that all  people heal from the changes to the brain structure caused by benzos. I know  this through the work of Dr Ashton and others. In the withdrawal clinic that  she ran from 1982 to 1994, Dr. Ashton helped over 300 people successfully heal  from benozdiazepines (Ashton, 2006). I know it from my personal healing from  benzos, as well as being witness to the healing of others. This knowledge  combines with my belief in intrinsic health, along with my trust that suffering  is normal and can be dealt with, allowing me to say to my client, “You and I,  with the help of others, are enough to bring you through benzo withdrawal.”

      I believe in the value of on-line support  groups for people in benzo withdrawal. I read posts on a daily basis from group  members who are reaching out and receiving support through the on-line forum. I  am aware of numerous people who have successfully withdrawn from benzos using on-line groups as either their primary or secondary support system.
    Case Studies
    
Four case studies will be presented. Two  are people whose primary support during withdrawal was a support group, while  the other two are people with whom I worked directly as their primary support  during withdrawal.
    

      Genie
    
Genie is 58-year-old married woman who  was put on Valium for insomnia in 1999. She has a Ph.D. in German language and  literature and is a performing vocalist and concert pianist. For the past five  years Genie has been a volunteer support person in the Yahoo group. Genie’s  Valium dosage increased to 60 mg per day over three years, an amount that  caused her to feel sluggish and depressed and to want to get off of the drug.  Genie’s path of getting off  benzos took her through a terrifyingly negative  experience in a detox facility, eventual reinstatement on Valium, followed by a  successful gradual taper that she finished in 2005.  

      Misinformation about benzo withdrawal at  the detox facility brought about a misguided cold turkey withdrawal, which  caused horrific symptoms from which Genie feared she would never recover. The  major symptoms Genie experienced include mental anguish, insomnia, and extreme  physical pain. The pain was so strong and relentless that Genie, never before  having been mentally ill or suicidal, actively considered suicide as her only  way out of the pain. The psychiatrists caring for Genie lacked the qualities  needed to help her. They had poor knowledge of benzo withdrawal, and refused to  believe that symptoms as severe as hers could be a result. Instead of believing  her, they tried to convince Genie that she was mentally ill, demonstrating an  egregious lack of belief in any possibility of her intrinsic health.  Fortunately, Genie had enough belief in her  inner sanity to know they were wrong. Genie lacked knowledge about benzo  withdrawal, but she knew she had never been mentally ill prior to this. She knew in  her heart that she was fundamentally sound, underneath the withdrawal symptoms.

      After leaving the facility, Genie  continued to experience horrific symptoms, and in desperation, began to search  the Web for information. She found the benzo.org.uk website as well as the  Yahoo group, and began to do her own research. She gained a good understanding  of benzo withdrawal, and began to understand the causes of her extreme  symptoms. She was advised by group members to consider reinstating and  beginning a gradual taper. Genie was fortunate in locating a doctor in her area  who agreed to help her, and after weighing her options, reinstated and began a  gradual taper that was eventually successful. 

 Genie says that throughout her taper  the group’s encouragement was a Godsend without which she would not have  succeeded. She believes that this support, combined with the information she  learned on the Web after the disastrous experience at the detox facility, were  central to her healing. Genie has been active in the benzo support group since  2001, giving back through knowledge, belief in the intrinsic health of others,  and sustained encouragement.

 
    Debra
    
Debra is a  54-year-old mother of seven.  A retired  nurse, Debra was put on Ativan and Prozac in 1989 following the death of her  grandson. During the years that followed, she was on as many as five  psychotropic drugs at the same time, which in Debra’s words, caused her to lose  her mind. Now off  all drugs, she says she feels 100% better than she did  during the years on them.
    
On medication, Debra had become deeply  depressed and was preparing to sign papers for electroshock therapy, when she  came across Breggin and Cohen’s book, “Your Drug May be Your Problem.” She says  that reading this book helped her realize that she was in tolerance withdrawal  to the benzo and that her symptoms were not a sign of an underlying mental  illness, as the doctors insisted. Reading Breggin’s book led to research on the  Web. Debra absorbed information quickly, reading numerous articles and learning  from other people’s experience going off  benzos.  As she learned more about benzos, Debra prepared  to taper herself off of her daily dose of four mg Ativan, and would later taper  off of all psychotropic medications. Her major symptoms were depression,  anxiety, and fatigue.

      In addition to gathering information,  Debra, who has a deep belief in God, asked two pastors from her church for support  and prayer. She also asked God to help her through her withdrawal process.  Debra’s belief in her innate sanity is tied  to her belief in God, because, put simply, she believes that God’s creations  are fundamentally perfect. She was certain that the drugs were the root of her  problem, but also knew that she was chemically dependent on them, and that the  process of going off would be difficult. She says that it was not as bad as she  feared, even though she had many symptoms. This, she says, was because she  understood what was happening to her, and because God stayed with her  throughout the process.

      For Debra, the value of the support group  was primarily in the information it provided. Emotional support and  encouragement were important, but were secondary to information. Information to  her is the key. As she puts it: “Number one, you have to have the information.  Number two, you have to have the support – God, doctor, family, etc.  But no information equals people dying.” 

      Debra has been working for the Yahoo  group for a number of years, and is now lead moderator. When not helping  others, Debra is busy with her children, home-schooling her youngest, and  enjoying her many grandchildren. 
     

    Steven
    


      Steven is a 50-year-old Doctor of  Chiropractic, married, and father of two. He was put on benzos for panic  attacks that began in 2002, during the second year after re-entering medical  school to become a physician. At first the medication seemed to help, but after  about a year Steven began to experience side effects of fatigue, interference  with concentration, and increased anxiety, as he gradually became tolerant to  the drug. When Steven reached the daily dosage of 4 mg Ativan, he decided to go  off. His physician recommended going off by removing one milligram every two  weeks, and by doing this Steven experienced an extreme withdrawal syndrome that  lasted much longer than the eight weeks of the rapid tapering process.

   After stopping benzos, Steven’s  symptoms forced him to withdraw from medical school. He and his wife searched  for explanations from their doctor, but encountered denial. They soon found  information on the Web, and made contact with support people through the Yahoo  group, including me. 

   Steven emphasizes that for him, it was  imperative to hear of positive outcomes from people who had gone through the  withdrawal syndrome and had eventually regained their health. Part of Steven’s  syndrome was extreme sensitivity to negative stories about withdrawal. For this  reason he found that reading the posts on the support group was often more  frightening than helpful, and he decided to limit his contact with the group.

   Working as a volunteer in the Yahoo  group, I met Steven and became his central support person (outside of his  family) throughout his thirteen-month ordeal of benzo withdrawal syndrome. We  at first communicated through e-mail, but quickly switched to telephone  sessions. We set up appointed times for Steven to call, but I accepted  spontaneous calls from him after a certain point in the relationship. In  addition, I agreed to allow brief e-mails five days a week. I talked often with  Steven’s wife Francis as well, and our relationship became an important part of  the process, both for Francis and for me. The major benefit for me was that through  my conversations with her, I was able to gain a fuller grasp of Steven’s  personality and of his history, and was able to draw a clear picture of what he  was like prior to benzodiazepines.

   Over the many months of Steven’s  healing process, both he and Francis were terrified that he had lost his mind,  and that the situation was hopeless. Therefore it was essential that I remain  steadfast in my conviction when talking with either of them. Steven needed  reassurance frequently, and Francis was better able to provide it along with  me, because of her trust in my experience, and in the information I provided. 

   Throughout the relationship, the most  central therapeutic element was my steadfast conviction that time would heal  Steven’s symptoms. Early on I noticed that he reacted negatively to any sliver  of doubt that he would get well. I realized that he needed absolute and  consistent certainty, and this is what I worked at providing. I knew that he  had only to hold on for a sufficient amount of time and that faith in this,  both my own, that of Steven and that of Francis, was crucial to his ability to  endure the many symptomatic months. 

   Another therapeutic device Steven  responded well too was listening to my accounts of my own experience. He  responded positively to hearing how ill I had been and the timeline of my  healing. Elements of this are reminiscent of the way children gain reassurance  from hearing the same story over and over again, and in many ways, Steven was  like a frightened child. I wanted to help him cling to whatever slender thread  of hope he had, and hearing about my healing journey seemed to help him do  this. I was aware of his basic intelligence in knowing he needed to hear  positive outcomes of benzo withdrawal, that sensing my credibility, Steven  seemed to know instinctively that he should grasp onto the relationship.  Working with Steven, I used a certain amount of counseling skill gained through  my formal education, but the central theme in the relationship was constant  reassurance from a person he and his wife trusted. 

   My knowledge of benzo withdrawal was  important for several reasons. As mentioned, my credibility to was vital in  order for Steven to allow himself to believe me when I assured him he would get  well. For me, in order to feel as certain as I needed to be, it was important  to know the histories of many others who had also gone through a too-rapid  taper, and whose timelines of healing I could reference. Even more important,  however, was my personal experience. There were nuances of Steven’s description  of his mind-states that I recognized, and I could talk with him about my  experience of the same symptoms. This went far in gaining his trust, because he  could see that I truly had been as “bad” as he was, and that I had gotten well.

   Steven tried many times to argue and  convince me that he was a hopeless case. This was his way of pleading, I was  sure, for me to convince him it was not true. I worked at doing that by  standing very firm in the belief he would get well. This again was often like  talking to a child. At times Steven cried, and in those instances I repeated  the message of hope over and over, often simply repeating the words that I knew  reassured him, always without doubt or hesitation. 

   Thirteen months after going off of  benzos, Steven awoke one morning and the torment had ceased. He told me that he  knew immediately that he was finally well, and as it turned out, he was right.  He never again experienced the withdrawal syndrome symptoms to any significant  degree, and has gone on to continue to rebuild his life. He is presently in the  process of overhauling his chiropractic practice, and will begin medical  residency in July of 2006. 
    Matt
    
Matt is 34-years old, and at the time of  this writing has been off of benzos for four months. He has been on and off of  benzos since first being introduced to Ativan in 1993 for panic attacks. Matt  has a Master’s degree in creative writing, and has been working as a magazine  editor for the last four years. He is a rock-climbing enthusiast and was in a  serious long-term relationship, which recently ended. Matt’s history since 1993  is one of going on and off of benzos, each time reinstating before his system  had time to fully recover. During that time he was unaware that he needed to  wait more than a few months, and misinterpreted his symptoms as a range of  problems, including low blood sugar, increased original anxiety disorder,  depression, and bipolar disorder. 

       Information and misinformation have  played major roles in Matt’s experience. Misinformation has contributed to his  becoming addicted to benzos, and to his remaining in a cycle of painful  withdrawal and reinstatement for years. He says he wishes he had started doing  his research a long time ago, when he began a series of cold turkey  withdrawals. During that time, Matt’s doctors gave him misguided or no  information about benzo withdrawal, seriously underestimating the intensity and  duration of the syndrome, thus adding to his distress and confusion. The  symptoms, unrecognized as such by his doctors, led to misdiagnoses,  reinstatement of benzos (switched from Ativan to Klonopin), plus a cocktail of  other pills for his alleged bipolar disorder.

       Matt  telephoned me six weeks after a rapid withdrawal from 3 mgs per day of  Klonopin. The withdrawal had been done at Johns Hopkins University Hospital in  three weeks, after which Matt stayed another three weeks with his parents  before returning to his apartment in Boulder. He called me looking for support,  and we agreed to meet once or twice a week. I was aware from our telephone  conversation that he was highly symptomatic. Matt told be that he was  experiencing a great deal of fear, sensory distortions, breathing problems,  tremors, and more. I told him this was no surprise, at six weeks following a  rapid withdrawal from 3 mg per day of Klonopin. 

      I sensed a very strong determination in  Matt, along with a high pain tolerance, and an ability to sound better than he  felt. I began working with Matt at that time, and am working with him as of  this writing. Our first and second visits were at my home office in Boulder,  after which Matt moved to Carbondale, CO.   We have continued the relationship by e-mail, writing approximately  every other day.  At this time Matt is  four months off Klonopin, and we have been working together for  approximately three months.

      In addition to working with me, Matt is  an active member of the Yahoo support group. He checks in several times each  week and has spent time reading the numerous success stories published on the  group website. Matt frequently asks the group for feedback about certain  symptoms he is experiencing and receives confirmation from other members that  these are withdrawal symptoms and that they will pass. He also corroborates  symptoms for others and offers reassurance and hope to members who are  experiencing their own pain and/or fear. 

      For our first meeting I wanted to create  a therapeutic environment that I hoped would feel non-threatening to Matt. In  benzo withdrawal, especially abrupt withdrawal, everything can feel  frightening, and I was aware of Matt’s courage in coming out to meet a new  person. I was aware that my presence should be calm, compassionate, assured,  and gentle. I made sure to prepare myself by doing grounding exercises and  eating a small meal before the appointment. 

      At our first meeting, Matt was visibly  trembling. His shoulders were held high and tight, and he spoke in a low  monotone through a clenched jaw.  I  sensed his relief when I told him this was all normal after an abrupt  withdrawal from benzos, and that I was certain it would pass in time. At the  same time, I was careful to convey that I knew that he was in a great deal of  very real distress. I shared some of my own experiences of withdrawal, and this  exchange seemed to further the developing trust in our relationship. I believe  it meant to Matt that not only did I not judge him, but that I am living proof  that people recover from benzo withdrawal syndrome. I believe this helped Matt  feel less alone, and that it gave him hope. 

      During the first visit with me Matt  talked about his history, and about his present symptoms. I continued to  carefully corroborate for him that what he was feeling were definitely  withdrawal symptoms, and emphasized repeatedly that it was normal, that others,  including me, had felt that way, and that we had all recovered. Matt told me  that he had not been believed at Johns Hopkins when he described what he was  going through. It was important that I, as a professional, countered the  non-belief and made it very clear that I absolutely believed him. We talked  about specific symptoms and shared some ideas of what might help. 

      I was careful to support Matt’s statement  that in benzo withdrawal syndrome, very little one does has much effect on  symptoms, except to wait it out. Because I know that this is basically true,  that we are not dealing with normal anxiety in benzo withdrawal syndrome, and  all of the conventional methods of working with anxiety are like throwing  teaspoons of water onto a bonfire, it was important to my credibility that I  not give Matt trite recommendations. With the above understanding, we talked  about those things that could help him endure by bringing even a moment of  peace, and I advised Matt to watch for clues by being aware when he felt a bit  of relief, and building on whatever he was doing at the time. I encouraged Matt  to do activities that required concentration, because this can distract the  mind briefly from itself. I also encouraged blatant distraction techniques  including anything, even television shows, that help us escape our minds for a  time.  Matt added one of his own  concentration techniques: bouldering, which I thought was a wonderful idea for  him, as long as he did so in safe conditions, such as a climbing gym.

       During month two and three following  Matt’s withdrawal from Klonopin, my greatest emphasis in therapy was continued  assurance that the symptoms were due to benzo withdrawal syndrome. Information  was of the greatest use in order to assure Matt that others had felt all of the  symptoms he was experiencing, and had recovered. It was helpful to talk about  the timelines according to which most people heal form benzos, but at the same  time I was careful to not set up too specific a timeline, because doing so  could bring about fear in the event that his healing took a little longer than  average. The fact that I had found my way out of the syndrome was a constant  benefit in the relationship. I was careful to convey certainty to Matt, never  wavering in my belief that he was experiencing a specific syndrome, which had a  beginning and, most importantly, an end. 

       Matt’s fourth benzo-free month is  proving to be particularly difficult. The symptoms are beginning to wane, but  Matt’s patience is beginning to wear thin. Four months is a long time to be in  distress, and one begins to lose hope. In addition, Matt’s friends and  co-workers are losing patience. At this point, Matt is occasionally questioning  whether he will ever feel any different from how he feels now. It is critical  that I continue to reassure Matt by reminding him of the usual timeframes in  which others, including me, have gotten well, and by reinforcing belief in his  intrinsic health. It also seems to help to remind him that it was at four  months that I too gave up and reinstated, only to repeat the same cycle four  times. This is helping him understand his present frustration and see it as  normal in withdrawal. Support group members are also reinforcing the length of  time needed to heal by sharing their own stories of healing with Matt. I tell  him that by six months I believe he will have a significant breakthrough, and  Matt says that this, combined with the windows of relief he is experiencing,  give him enough hope to continue.

 

Part II of Allison's thesis concludes in the following post.

If you have not done so already, please first read Part I.

 

Alison Kellagher's Master's Thesis. Part II, below.

 

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  Toward a Model of Psychological Support  for People Withdrawing From Benzodiazepine Tranquilizers
  
    A  Master’s Paper Submitted
      In  partial fulfillment of the requirements for the Degree of
      Master  of Arts
      Transpersonal  Counseling Psychology Department
      Counseling  Concentration
      Naropa  University
    Alison  Kellagher
      April  2006

    

    Discussion
    
The themes of information, belief in  intrinsic health, and encouragement run through each of the case studies. They  appear in different combinations and we see that one element may be more  important to one person than another. We see how information and belief in  intrinsic health are closely related, one informing the other and that both  together make sustained encouragement possible. 
      We also see the often-devastating effects  of the absence of information, absence of belief in intrinsic health, and lack  of simple encouragement. Surrounded by health professionals who did not believe  in their intrinsic health, the people in the case studies, in most instances,  were given drugs instead of encouragement. We also need to consider the  symbiosis in the psychiatrist-patient relationship. The pain of withdrawal is  often so acute that we may want to believe it is some other, curable condition,  and having been habituated to taking pills, seek more of the same from the  doctors who are only too happy to oblige.   It is testimony to their courage and belief in themselves that each of  the individuals in the case studies has fought his/her way out from under the  effects of psychotropic drugs.  
      Poor information has nearly cost several  of these people their lives, causing thoughts of suicide as the only way out,  and/or causing the person to become lost in a haze of psychotropic drugs  prescribed when withdrawal symptoms were misdiagnosed as mental illness.  Dr Ashton has warned: “Lack of explanation of  the symptoms has often added to their distress and has introduced fears (“Am I  going mad?”) which themselves magnify the symptoms” (Ashton, 2006, Ch.  P.26). Poor information led to doctors being  unable to distinguish between withdrawal symptoms and mental illness. This is a  far cry from knowledge, belief in intrinsic heath, and encouragement.
      Information has been the point of  departure for each of the people in the case studies. The central most  important piece of information was the truth about the existence of  benzodiazepine withdrawal syndrome, which told the person that they were  basically sane, and that they were experiencing a known syndrome, and that this  syndrome has a cure (time). All of the experts have emphasized this central  point, that understanding the syndrome is the most important aspect of getting  through benzo withdrawal. For the people in the case studies, information came  through the Web, through books, a support group, and through me.
      For Genie and Debra, the information from  books and the Internet helped them understand what to expect during withdrawal.  They found and used the extensive research of Dr. Ashton, Dr. Peart, and other  experts. Their symptoms were lessened because they knew how to do a gradual  tapering process. They had the advantage, as Dr Ashton describes, of knowing  that the strange symptoms were benzo withdrawal and not the signs of mental  illness. Genie and Debra had the sustained encouragement of the support group,  which the experts agree is another key factor in successful withdrawal.
      For Matt, the combination of private  talks and e-mails with me and the stories he is reading in the group about  other people’s successful journeys through benzo withdrawal is giving him the  necessary hope to endure his own process. This is the ideal combination  mentioned by Elin Ree (2000). Information has been combined with encouragement  in Matt’s case, to help him this far through his withdrawal, and to give him  hope that he will heal. Personal encouragement from me, perhaps especially  because I am both a professional and a benzo survivor, is helping reinforce  Matt’s belief in his own ability to heal, as it encourages his belief in his  own intrinsic wellness. Reading that people who had symptoms even worse than  his own have recovered is also helpful. As the months go by, it has become  increasingly important for Matt to continually check in with me to be reminded  of the normal duration of the syndrome. As time goes by his family and friends  are becoming doubtful that he is still in a healing process, and it is  especially important for me to encourage Matt to sustain his conviction that he  is in fact healing, and that he needs only a little more time to get well.
      Encouragement and information were the  most important factors during Steven’s healing process. He was able to hold on  for over a year of misery because of the effects of talking with others, and  with me in particular, who had endured what he had, and who had eventually  healed. In addition, information helped Steven’s wife provide sustained  encouragement because of the hope that other people’s successes instilled in  her. Due to the combination of information, belief in intrinsic health (at  least, Steven’s wife’s belief in such) and sustained encouragement, Steven was  ultimately not overwhelmed by the terrible fears of benzo withdrawal syndrome  and endured long enough to return to health.
    Group Support
    
The role of the support group is  underscored throughout the case studies. For every person except Steven, the  group offered constant encouragement and information. Belief in the intrinsic  health of the individual is evident, even while not explicitly stated, in the  support group. Individuals were always available to assure the person that it  is possible to move through withdrawal and feel well again. Members who have  been through the process offered hope and faith to Debra, Genie, and Matt. The  group members believed in others because they had personally experienced moving  from sickness to health. Just as important, members shared research and  experience, providing comprehensive understanding of benzo withdrawal. 
      The case studies demonstrate the manner  in which the Internet group format helps solve the issue that Dr. Ashton (1994)  has raised regarding the difficulty participating in public groups during  withdrawal. All of the people in the case studies were are able to type at a  computer, regardless of their condition. In addition, the group is always  available, provided the person has computer access, which, as Lennane (1986)  had mentioned, is important to the withdrawing person who needs more support  than an individual therapist is able to provide. It is perhaps the subject of  another paper to explore the role the Internet plays in allowing people to  become less dependent on “experts,” their doctors in this case, and begin  communicating with others throughout the world who share their experience. The  case studies prove the power of communication among fellow benzo survivors,  because all of the people in the case studies were successful getting off of  benzos.
      However, sometimes when just one or two  people believe in our intrinsic health, it is enough support. We see in  Steven’s case that the belief of just two people, his wife and his therapist,  me, was enough to keep ignited his own buried inner belief in himself. The role  of spouse or partner has been especially important for Steven. They are often  the only person who has known the benzo person before the ordeal began. They  are often in a position to have seen the changes brought on by the drug and the  withdrawal syndrome and are often most likely to continue to recognize the  core person, underneath all of the symptoms. It is important that partners have  a good understanding of benzo withdrawal, especially because of the long-term  aspect of the healing process. Even the most loving partner is apt to be  challenged at times and information will help support their own belief in the  imminent healing of their loved-one. Sadly, partners often give up before the  person has had time to recover. Matt’s long-term girlfriend gave up in fact,  exhausted from his suffering. Information will help the partner believe the  person, and will help sustain their belief as months go by, often with little  apparent change.
    Conclusion
    
An ideal support for the withdrawing  person would combine the support of a benzo-wise therapist who values the  intrinsic health of the person, with that of a carefully chosen benzodiazepine  support group. Where possible, a family member or members can also play a  crucial role. Held in such a web of hope, of belief in intrinsic health and  sustained encouragement, combined with accurate information and a proper  tapering schedule, the person stands the best chance of getting through  withdrawal, and moving forward toward a time of addressing the reasons for  taking the medication initially.
      The people in the case studies often  encountered health-care professionals who did not believe in their intrinsic  health. When a person explicitly tells a therapist that they believe they are  experiencing the aftermath of benzos, then it is especially wrong to dismiss  that as a real possibility, without investigating the person’s exact  circumstances. It is better to think first, here is a fundamentally sane person  feeling insane, rather than thinking here is an insane person, or a chronic  malingerer. In the first approach, there is a chance to explore and uncover the  reasons for the person’s distress. In the case of benzo withdrawal the healthy  person underneath is always there. If the person is under-informed, they are  likely to feel a great deal of self-doubt, and will be vulnerable to the  attitudes of their caregivers. 
      It is up to mental health professionals  to have enough belief in intrinsic health, and enough knowledge of benzo  withdrawal to refute the person’s doubts in their intrinsic health, and not, as  with those in the case studies, to increase the person’s self-doubt and  dependence on a drug. This self-doubt is exactly what Breggin and Cohen refer  to when they talk about the importance of a therapist’s firm grounding in a  non-pharmaceutical approach (1999). Because as we have seen in the case  studies, it was the drugs themselves that eventually became the main cause of  the person’s problem. In every case, the original problem for going on the benzos  became a minor one when compared to the compounded problems brought about  through chronic benzo use, followed by the withdrawal syndrome.
   A person who has experienced benzo  withdrawal is specially equipped to support others through the process, but it  is possible to provide quality support without personal experience, as long as  the therapist embodies the three essential elements: knowledge, belief in  intrinsic health, and the ability to provide sustained encouragement. Benzo  knowledge supports belief in intrinsic health, and these together will help the  therapist provide sustained encouragement.
      It may require a certain leap of faith  for many therapists to trust that they and their client, as Breggin and Cohen  (1999) have said, are enough to solve the problem. In particular, therapists  who have no first-hand experience with benzo withdrawal will need to have a  great deal of courage and faith in themselves and in the person, in order to  believe the client is ultimately well in the face of strong, unusual, and  protracted symptoms. These therapists will need to combine good information  with a strong belief in intrinsic health in order to stand against the gaining  tide of pharmacological psychotherapy.
      If a therapist wavers in this belief, the  impact on the withdrawing person can be devastating, as we have seen. This can  lead to demoralization and despair, and can also contribute to keeping the  person trapped in a medication nightmare, as I have described in my own case,  and as we saw in several of the case studies. This point is especially  significant in regards to the case of benzo withdrawal because of the very slow  rate of healing. A therapist’s belief in the client is apt to be challenged at  times during the long weeks and months when often only minute improvement is  evident. Trungpa’s (1979) attitude of staying with the person, whether or not  things are going well, applies to the challenge of continuing to believe in and  support the person in withdrawal.
      As a person goes through benzo  withdrawal, there may be months with little visible improvement, and sometimes  there will be setbacks. This requires a great deal of acceptance, and an  ability to let go of any attachment to certain therapeutic goals. Those who  have been advised by psychiatrists to reinstate the benzo when little  improvement is seen following months of tapering were under the care of a  person who did not believe in intrinsic health, and whose knowledge of benzo  withdrawal was insufficient. It is up to health-care providers to encourage our  health, not to bury the person under ever-increasing layers of drugs. It is a  therapist’s job to help the person dig out, not to bury them deeper.
      Ideally, physicians should be listening  and learning from the millions of people who have endured benzodiazepine  withdrawal syndrome. They should be studying the work of Ashton, Curran, Lader,  Peart, and others who have studied the syndrome in depth, and who have  developed sound protocols for withdrawal. Ideally too, the prescribing  guidelines of no more than one month of chronic administration (Roche, 1990)  will be adhered to by physicians, but that is not likely to happen. Doctors,  especially psychiatrists, seem to have a deeply ingrained belief that drug  therapy is the best solution to people’s problems. It seems to be especially  difficult for psychiatrists to recognize the potential destructiveness of their  own prescriptions, and I believe many are threatened by the truth about  benzodiazepines. Therapists, hopefully having a belief in intrinsic health, and  having nothing to lose by learning about benzo withdrawal syndrome, are among  the health care professionals who can offer real hope and help to people  wishing to withdraw from benzodiazepines.
      Perhaps transpersonal psychology is the  branch of the profession best situated to taking a stand for intrinsic health.  John Davis has stated the responsibility of the profession to aspire to a  socially engaged spirituality (Davis, 2002). The balance has tipped too far in  favor of pharmacological solutions for emotional and spiritual challenges, and  transpersonal psychology could seek to restore balance. This does not mean  that it is a stand against medication, but it is a stand that questions the  automatic over-prescribing of drugs, many with devastating effects, and which  the doctors are under-equipped to help free the person from, as we have seen  with benzodiazepines.
    Further Study
    
Because of the paucity of literature that  concerns itself with psychological support for people in benzodiazepine  withdrawal, new ideas for how to help are greatly needed.  Dr. Ashton has recognized this need, stating  in The Ashton Manual: “It may well be possible to develop better methods than  those described in this monograph for drug withdrawal in people who have become  dependent on benzodiazepines” (Ashton, 2002, Ch.3, p. 24).
      The information we already know should be  made mandatory reading for health professionals and medical students, to help  prevent people from becoming dependent on benzos in the first place, and to  increase the chances of successful and humane withdrawal for those already  addicted.
      Further study will build upon the three  basic elements of support that are the topic of this paper. We have described  the container in which successful withdrawal can be experienced. Next we need  to look at the precise nature of therapies to be carried out within that  container. These therapies will seek to help ease the experience of  benzodiazepine withdrawal syndrome. Because the mind is temporarily altered  during withdrawal, successful therapies may be those that attempt to reach the  person via physical and spiritual pathways. They will support the need for  distraction from the mind during the withdrawal process, introducing work with  the person’s original challenge at the time when sufficient healing from the  effects of benzodiazepines has taken place.
    

      As Professor Ashton has said there  may be better ways of withdrawing. 
      Each person must find their own best  way to get through the withdrawal 
      process, remembering that every  person  is an individual and will have 
      individual  protocols during  withdrawal.
    References
    
Armstrong, P. (1987). Carrying the Fight  to Stop Tranquillizer Addiction. (On-line WWW site) http://liv.ac.uk/csunit/community/cita.htm
    

      Ashton, C.H. (1984). Benzodiazepine  Withdrawal: An Unfinished Story. British Medical Journal, 288.
    

      Ashton, C.H. (1994). The Treatment of  Benzodiazepine Dependence. Addiction, 89, 1535-41.
    

      Ashton, C.H. (1995). Protracted Withdrawal  From Benzodiazepines: The Post-Withdrawal Syndrome. Psychiatric Annals,  25, 174-9.
    

      Ashton, C.H. (2002). Benzodiazepines: How  They Work And How To Withdraw. University of   Newcastle.
    

      Ashton, C.H. (2005). The Diagnosis and  Management of benzodiazepine Withdrawal. Curr. Opin. Psychiatry,  18, 249-255.
    

      Breggin,  P. & Cohen, D. (1999). Your Drug May Be Your Problem. Cambridge, MA:  Da Capo Press.
    

      Coleman,  V. (1989). Life Without Tranquillizers. Bath: Chivers Press.
    

      Cortright,  B. (1997). Psychotherapy and Spirit. Albany: State University of New  York Press.
    

      Curran,  H.V. (1991). Benzodiazepines, Memory and Mood: a Review. Psychopharmacology, 105, 1-8.
    

      Davis,  J. (2002). An Overview of Transpersonal Psychology. The Humanistic  Psychologist.
    

      Drummond,  E. (1997). Benzo Blues. New York: Plume.
    

      Lader, M. & Morton, S. (1991).  Benzodiazepine problems. The British Journal of Addiction, 86, 823-828.
    

      Lennane, K. (1986). Treatment of  Benzodiazepine Dependence. The Medical Journal of Australia, Vol.144.
    

      Packer, C. (2005). Anxiety/Fight and Flight  in Withdrawal.
    

      Peart, R. (2000). The Benzodiazepines.  (On-line WWW site) http://www.benzo.org.uk
    

      Ree, E. (2000). Beyond Benzodiazepines.  Richmond, Victoria: Education Image Pty, Ltd.
    

      Roche Products Ltd., (1990).  Benzodiazepines and Your Patients: A Management Programme.
    

      Sahley, B.J. & Birkner, K. (2004). Break  Your Prescribed Addiction. San Antonio, Texas: Pain & Stress Publications.
    

Stevie Nicks and Klonopin. (n.d.) Retrieved June, 05, from http://www.benzo.org.uk/nicks.htm.
    

      Trungpa, C. (1979). Intrinsic Heath: A  conversation With Health Professionals. The Journal of Transpersonal  Psychology, 11, 2.
    

      Tyrer, P. (1984). Benzodiazepines on Trial. British Medical Journal, 288, 1101-1102.

Thank you so much for finding this, Colin. I really doubt that Allison would have minded having her work shared. Reading about her situation and how she was helping others is what helped me so much during some very depressing times.

Thanks for posting, I have read this thesis before but not recently.

 

The author frequently references faith in intrinsic health & transpersonal psychology.

 

Transpersonal Psychology:

 

https://en.wikipedia.org/wiki/Transpersonal_psychology#Criticism,_skepticism_and_response 

 

Some find great comfort in this kind of faith but, I personally do not advocate for adherence to undevoted faith in intrinsic health & transpersonal psychology as a panacea for symptoms associated with neurological damages of indeterminate duration, including symptoms associated with w/d'g from benzodiazepines. 

Thank you so much for posting Allison's thesis.  It helped me greatly.  Reinforced my own ideas and thoughts.

 

Was so very saddened to read of her death. 

 

Here's to our intrinsic health. 

 

Dee

 

 

 

Wow, 16 years on Benzos and only 2 years to recover from a cold turkey withdrwawal. I was 2-3 years on Benzos and still have issues. Makes me think that it's not all Benzo withdrawal at some point....