Friday, February 23, 2018

Brief case study: Asian Bodywork Therapy supporting client in withdrawal from Benzodiazepine

One day, about a year ago, I was manning my chair massage post at a natural food store, when a lady in her mid- to late-forties approached me with wild eyes and the statement "I'm going through withdrawal!" I invited her to sign-in for her session, pre-pay for the time (as is the protocol at this location) and then began to listen to her symptoms as we adjusted the massage chair for her.

She told me that a psychiatrist has been working with her manic depressive disorder for multiple decades. Eight years ago she was given a prescription for a benzodiazepine drug which was supposed to be a ramp down from previous medications. The administering doctor said there were no addictive side effects. For her own reasons my client decided to stop taking the drug and immediately found that her detoxification was quite intense. She had done some online research and found that 3 weeks was the expected duration of the intense withdrawal.
I asked if there was any particular area that she would like me to focus my work on. She replied, "I just need touch." I began working on her shoulders and neck and quickly found that direct and sustained pressure helped her relax. Knowing from my studies that the Fire Organ Networks are the most affected by manic/depressive fluctuations, I inquired of her body if this was a correct assumption. Her Triple Heater meridian (the most peripheral of the Fire Organs) was energetically quivering. The entire Triple Heater meridian is accessible in the massage chair, so once I confirmed that my focus of work felt good to her I treated this meridian thoroughly, including the Zen extension on her legs. I finished with sustained pressure on her Bladder meridian from head to base of spine. 
After the time was over she sat up with a completely different countenance. Her breathing was deep, she seemed to be comfortable in her body and expressed feeling relieved. She set up an appointment for later that week to receive a full Shiatsu session. We had two full-length sessions total. 

For any readers unfamiliar with Shiatsu bodywork, a widely taught method is for the practitioner to listen to the client for clues as to the direction of treatment, but to confirm all clues with a touching assessment of the abdomen (referred to as the "hara"). The Organ Networks are all represented in this area of the body. Gentle and inquisitive touch around the specific assessment areas of the hara will provide the practitioner with a clear comparison of which networks need attention and which are holding extra energy. Listening to the body in this way takes the guessing out of Shiatsu bodywork so the practitioner can focus on being present with the client throughout the session. Re-checking the hara during a session is a common technique used to help stay on track with a body as it balances itself.

The first session was a continuation of the chair massage session. She arrived looking a bit frazzled, but was more emotionally calm than my first meeting with her at the natural food store. The session was focused on the Fire Element vessels, specifically the Pericardium. She relaxed physically as soon as I touched the meridian, and began to process her experience of finding comfort with the nurturing pressure. During the session she asked for suggestions on how to support herself through the detoxification process. Aside from drinking several liters of water per day, which I recommend for anyone working through toxicity, I gave her two pieces of advice. The first was a "homework" assignment given by my Chinese Medicine teacher, to practice belly breathing, 50 breaths per day. This is a simple and accessible form of chi gong and a natural pain management technique. The second was from my own experience with detoxifying, to drink a tablespoon of liquid chlorophyll in water whenever physical discomfort began to creep in. Liquid chlorophyll is nutrient-dense and available at most health food stores. It provides the blood stream with magnesium which supports an alkaline pH environment. I believe we agreed that epsom salt baths would help her on multiple levels, specifically for the full-body feeling of warm support.
She left the session feeling physically comfortable and hopeful that she would be able to get through the full detox with the minor intervention of medical marijuana. Being a resident of Colorado she had been given a medical marijuana permit by her doctors, which had been part of her self-medication for mania. 

When she arrived for her second session, about 10 days later, she looked happy and calm, almost like a different person. She told me that she was in a manic phase. The session was focussed more on the Wood and Water Elements, which I took to be progress toward deeper organ healing. She was indeed full of thoughts about how to move forward without pharmaceuticals. She was pleased that she had made it almost to the end of her three weeks of withdrawal and had no intentions of looking back. Because she had been diagnosed with this disorder at a young age she knew there would always be swings of mania and depression but was committed to coping with them in a natural way. She said that during the manic episodes she was productive, social and able to accomplish tasks. Her bigger problem and fear was that she didn't know when the tide would turn. Once she went down to depression she could not motivate or think well enough to help herself. My suggestion to her, based on my own experiences and personal study, was to supply herself with tools before she needed them. Specifically forms of aromatherapy and mood-supportive flavors. 
Aromas stimulate a response from the limbic part of our brains and if used intentionally can be highly productive in stabilizing moods. Inhaling aromas with "high notes" such as citrus or floral fragrances have historically alleviated the deeper troughs of depression. Asian medical models have always made use of food as medicine. The bitter taste tonifies the Fire Organ Networks, the networks in need of support during depression. In my experience smelling freshly ground coffee is as effective as drinking it, and chewing a cacao bean has a marvelously anti-depressant effect.
At the end of the second session she was satisfied that she had a plan to finish the detoxification from benzodiazepine. She did not reschedule, and was comfortable that she would be able to find me if future need should arise. Anecdotally, she was still in her manic phase when she walked out, but seemed more centered in her resolve.

I have not seen this client since, but feel confident that she has achieved her goal to get clear of pharmaceuticals for manic depressive disorder. My observation is that she was an exceptionally resourced person to begin with, and had been living with this diagnosis for her entire life. It was my honor to be part of the support that helped her through the deep difficulties of withdrawal.