Episode Details

Ask David: Getting Off Benzos How Does Music Stir Our Emotions? Combatting Negative Thoughts about the World Treating Schizophrenia with TEAM The Four Feared Fantasy Techniques and more!

Questions for today:

1. Mamunur asks: What's the best way to withdraw from benzodiazepines?
2. Gray asks: How does music evoke such powerful emotional reactions?
3. Josh thanks David for techniques that have helped in his personal and professional life.
4. Harold asks: How do you respond to negative thoughts about the world, as opposed to self-criticisms? For example, "The world is filled with so little joy and so much suffering."
5. Moritz asks: How do you help people with bipolar, schizophrenia, etc.?
6. John expresses gratitude for our answer to his question on Positive Reframing, which triggered an "ah ha moment."
7. Rhonda asks: What are the four Feared Fantasy Techniques?

The answers below were written prior to the podcast. Listen to the podcast for the dialogue among Rhonda, Matt, and David, as much more emerges from the discussions!

1. Mamunur asks: What's the best way to withdraw from benzodiazepines?

Ask David, Bangladesh question

Dear Sir,

I am writing to you from Bangladesh. Your book Feeling Good is a phenomenal work, and it has greatly helped in promoting the development of a healthy mind through logic and reason.

Sir, I have a question regarding benzodiazepine withdrawal, which is often prescribed for mental health disorders. Is there a specific CBT (Cognitive Behavioral Therapy) approach that can help in withdrawing from benzodiazepines? Your guidance on this would be invaluable, as many people have been taking it for years, either knowingly or unknowingly, without being fully aware of its severe withdrawal effects.

Thank you, sir, for your kind contributions to humanity.

Sincerely,

Mamunur Rahman Senior Lecturer

David's reply

Dear Mamunur,

Thank you for your important question! I am so glad you like my book, Feeling Good, and appreciate your kind comments!

As a general rule, slow taper off of benzodiazepines is recommended. This might involve slowly decreasing the dose over a period of several weeks.

When I was younger I used to take 0.25 mg of Xanax for sleep, because it was initially promoted as being non-addictive, which was wrong. It is highly addictive. The dose I used was the smallest dose.

When I realized that I was "hooked," I tapered off of it over about a week, and simply put up with the side effects of withdrawal, primarily an increase of anxiety and difficulty sleeping. These disappeared after several weeks.

Abrupt withdrawal from high doses of any benzodiazepine can trigger seizures, as I'm sure you know. That is the biggest danger, perhaps.

I do recall a published study from years ago conducted at Harvard, I believe at McClean Hospital. The divided two groups of people hooked on Xanax into two groups. Both groups were switched to Klonopin which has a longer "half-life" in the blood and is supposedly a bit easier to withdraw from than Xanax, which goes out of the blood rapidly, causing more sudden and intense withdrawal effects.

After this initial phase, both groups continued with slowly tapering off the Klonopin under the guidance of medical experts. However, one of the groups also attended weekly cognitive therapy groups, learning about how to combat the distorted thoughts that trigger negative feelings like anxiety and depression.

My memory of the study is that the group receiving cognitive therapy plus drug management did