Summary of Research
Hammersley, D.E. (2002) ‘An exploration of how therapists view therapeutic process in relation to clients who are taking benzodiazepines.’ Unpublished PhD Thesis, School of Psychotherapy and Counselling, Regent’s College and City University, London.
This qualitative inquiry explores how therapists view therapeutic process in relation to clients who are taking benzodiazepines. Benzodiazepines are drugs prescribed for the short-term relief of the symptoms of anxiety and for insomnia. There are estimated to be over one million people dependent on benzodiazepines in the United Kingdom at present.
I conducted a survey of a sample of NHS psychotherapy services in England to ask what their policies were towards clients in therapy who also took benzodiazepines. I then conducted semi-structured interviews and audio-recorded 26 therapists from different therapeutic orientations, with experience of working with clients taking benzodiazepines in a variety of settings. I analysed these interviews using grounded theory, deriving 44 propositions from the data.
I was specifically interested in the process of grieving and I propose that benzodiazepines suppress emotional processing and affect narrative competence in relation to grieving, which is thereby inhibited, prolonged or unresolved. I also identified that clients seemed to suffer a loss of lived experience for the time they were taking this medication. When comparing clients taking benzodiazepines with other clients, therapists needed to make adjustments to the therapeutic process because these clients were less able to respond to therapy.
Psychodynamically, I propose that there might be a series of triangular relationships between client, therapist, drug and doctor, involving dependency, power, seduction and ingratiation. Because the client’s defences seem to be increased by benzodiazepine use, I suggest that their use may be incompatible with psychotherapy.
Therapists confirmed the survey’s findings that the implications of benzodiazepine prescribing for clients in therapy are largely ignored and we make recommendations that psychotropic medication issues be given greater prominence in the training and supervision of therapists.
British Medical Association and The Royal Pharmaceutical Society (2015) British National Formulary. London: The Pharmaceutical Press.
Ghodse, H. (1995) Drugs and Addictive Behaviour (2nd edn). Oxford: Blackwell Science.
Goldhamer, P.M. (1993) ‘The challenge of integration’, in M. Schachter (ed.), Psychotherapy and Medication. Northvale, NJ: Jason Aronson.
Hausner, R. (1993) ‘Medication and transitional phenomena’, in M. Schachter (ed.), Psychotherapy and Medication. Northvale, NJ: Jason Aronson.
Hayward, P., Wardle, J. and Higgitt, A. (1989) ‘Benzodiazepine research: Current findings and practical consequences’, British Journal of Clinical Psychology, 28: 307–27.
Kahn, D.A. (1993) ‘Medication consultation and split treatment during psychotherapy’, in M. Schachter (ed.), Psychotherapy and Medication. Northvale, NJ: Jason Aronson.
Kaufman, K. (1994) Psychotherapy of Addictive Persons. New York: Guilford Press.
Kohut, H. (1977) The Analysis of the Self. Connecticut: Int.U.P.
Levy, S.T. (1993) ‘Countertransference aspects in the treatment of schizophrenia’, in M. Schachter (ed.), Psychotherapy and Medication. Northvale, NJ: Jason Aronson.
Montague, M. (1988) ‘The metaphorical nature of drugs and drug taking’, Journal of Drug Issues, 26: 417–24.
Nevins, D.B. (1993) ‘Psychoanalytic perspectives on medication for mentaliIllness’, in M. Schachter (ed.), Psychotherapy and Medication. Northvale, NJ: Jason Aronson.
Winnicott, D.W. (1971) Playing and Reality. London: Routledge.