8. What is a Mindbody Model of Protracted Withdrawal? Expanding on Mad in America Panel
MIA Panel presents ideas on resolving "protracted withdrawal" from psychiatric drugs
Last month I participated in a Mad in America panel on different ways to resolve “protracted withdrawal syndrome” from psychiatric drugs. The panel was hosted by Robert Whitaker and featured three panellists. Two of them, Ben and Kay, shared their stories using brain re-training and I shared my story using a mindbody approach from John Sarno and Howard Schubiner to resolve both protracted withdrawal and chronic pain. So you can check that out if you want.
Now I very reluctantly joined this panel. I’m introverted and reticent to share my story which suggests that, based on my experience and some others I’ve been in touch with, protracted withdrawal sensations are not necessarily an ongoing drug injury requiring time to heal but a learned brain phenomenon that can be unlearned through specific mindbody approaches. This idea goes against the grain and it’s commonly misunderstood by people who haven’t looked at Sarnos or Schubiner’s work. I was the same way as well. I didn’t take Sarno’s ideas seriously for years. But there’s now a lot of research supporting his work. Here’s a great introductory video called Breakthrough with Healing Chronic Pain with Howard Schubiner. This presentation opened my mind to the possibility of the brain learning physical and strange sensations and that they could have an emotional basis.
Shubiner also did an interview with millions of views and I think it’s very insightful.
Now despite my reservations I chose to participate on the panel because I thought my story might resonate with someone who then starts exploring the mindbody world that all began with this concept of The Mindbody Syndrome (TMS) from John Sarno and now has several spin-offs, particularly in a scientific direction and there are even clinical trials now show this approach is effective for non-structural chronic pain and Long Covid without organ damage. I think these studies are relevant for protracted withdrawal and I’ll get into that. But before I go further I’ll just repeat what I said on the panel that TMS is a non-pathologizing term: it’s not a disease or illness but its opposite; it’s getting away from concepts of disease, of something being “wrong” with somebody, whether it’s “mental illness” or even “protracted withdrawal syndrome.” That’s a crucial thing that makes this approach different, especially from the biomedical model of protracted withdrawal syndrome. I’d actually like to briefly talk about this biomedical model first and then I’ll go into the mindbody model of protracted withdrawal sensations.
The Biomedical Model of Protracted Withdrawal Syndrome
The biomedical / drug sickness model of protracted withdrawal, which is what’s found all over the internet and in some academic literature as well usually written by psychiatrists, this model states that psychiatric drugs induce a unique neurobiological injury that causes “symptoms” that can last for months or years. It’s claimed that the only healer is time itself. This seems to be universally applied to everyone in “withdrawal.” People are told this and so this is what people tend to believe. Now that may well be the situation including for those in acute withdrawal or with specific iatrogenic injuries or anyone else who says time healed them. I would never dispute someone else’s experience. But this doesn’t work for everyone, like time wasn’t working for me. Too much time had gone by. I’d been experiencing these sensations for five years so I needed something else, you know? So for those who are just kind of waiting around and suffering because the only approach in this biomedical model is waiting around, and if you’re interested in considering something else, I can now talk about an emerging mindbody model and the one that helped me to resolve five years of protracted withdrawal sensations and chronic pain.
A Mindbody Model of Protracted Withdrawal Sensations
A mindbody model of “protracted withdrawal” proposes that yes we’ve been injured by psychiatric drugs but we’ve sufficiently healed by now to feel healthy again even if we presently feel terrible. Or beyond terrible. And this is because the reason the withdrawal sensations can continue is that they’ve become learned by the brain due to an overwhelming amount of stress. I can expand on that by taking a working mindbody pain model and adapting it to protracted withdrawal. So according to this model acute withdrawal sets off a danger-alarm signal in the brain. Brain pathways form to process the withdrawal reaction, what we should feel, how intense, and what can happen is even after the drug injury sufficiently heals these brain pathways processing the withdrawal sensations, they can remain behind, they can remain active. And what seems to keep this processing going is if the brain’s alarm system stays on, if there’s an ongoing threat. So if a person’s really stressed out or upset about something this danger-alarm signal keeps going and it feeds into this withdrawal brain processing. When this happens again and again they can get wired together and the brain can basically learn to produce “withdrawal” on its own due to ongoing stress. Then it becomes “protracted withdrawal.”
Now I think there are a few ways that explain what keeps this danger signal going and causes these withdrawal sensations to persist. The first way this alarm keeps going is a sense of physical danger. I mean I was totally preoccupied with these sensations because I thought I was probably brain-damaged. So these sensations were the first thing I’d think about when I woke up, the last thing I thought about when I went to bed, I’d scan for them, talk about them constantly, research them on forums. And all my fear sent the message to my mind that something really important and scary was going on, that I was damaged, and it reinforced the danger-alarm signal that was processing these sensations. And ultimately what happened is my stress response got wired together with these withdrawal sensations. So I’d have stress, get withdrawal or I’d start to feel withdrawal and freak out; it was a vicious cycle. But oftentimes I’d get waves that came out of nowhere. And I thought how’s this possible?
So I think the second thing that kept this danger signal going was a sense of emotional danger from deeper emotions. And there’s now fascinating neuroscientific research that shows as pain or perhaps other unwanted sensations as they become chronic the active areas of the brain shift away from acute physical injury processing to emotional processing; so in a way persistent pain is actually an “emotional injury” or becomes an emotional injury. This is not “mental illness.” We need to get away from the idea that emotions equal illness. There’s nothing wrong with having emotions.
I think the relevant idea here is that beneath conscious awareness, beneath all these horrible often physical sensations like what I felt, there was deeper emotional processing taking place outside my awareness that kept them going. Now part of that came from my fear of my ongoing situation but it appears to be more than just that. Because there’s now a connection between mysterious syndromes that go on and on and “trauma.” I think my own trauma especially from my childhood, sensitized this danger-alarm system to go off more easily. And when this alarm went off again in withdrawal and my life stress at that time it triggered old emotions about feeling unsafe in my life and it’s my history of feeling unsafe that helped keep this danger alarm system activated. I also think my immense fear and rage toward psychiatry contributed to my sense emotional danger. I was so, so, so angry.
To be clear this isn’t a medicalizing concept like “PTSD.” John Sarno had a non-pathologizing concept called The Mindbody Syndrome (TMS), which says that emotional stress can induce or maintain physical syndromes and there’s lots of research now that shows this is real brain processing. So this is not all in one’s head—and that’s obvious to anyone who’s ever experienced this.
Now the way to resolve this is to work toward feeling physically safe again and emotionally safe again. And you know you don’t have to feel safe right away. It’s a process. But it’s through this process that the danger signal can calm down and the sensations can go away. So time is not the healer in this case, it’s just understanding. So if time is involved at all it’s the time needed to deeply understand and integrate these mindbody concepts, how they apply to us, so that the sensations can resolve. There are several successful clinical trials for chronic pain and long-Covid that show how this is possible so let’s take a look at those now.
Clinical Trials
The first clinical trial I want to look at is on Pain Reprocessing Therapy (PRT) which basically took a mindbody educational approach and delivered it as one-on-one psychotherapy, which is not always necessary but that’s the way they did it. The participants in this study had non-structural pain, which is the vast majority of chronic pain, and really emphasized feeling physically safe again for the participants. That there’s nothing fundamentally wrong with them. This was done by the participants’ coming to understand that the pain is not from an injury or nervous system damage but a learned brain state driven by fear and preoccupation with the pain. And what this means is that the pain can be unlearned by reframing one’s relationship to it. So one tool they used called somatic tracking which is being with the pain and actively reprocessing it as simply learned sensations turning on due to a danger-alarm signal. Then they investigate why this alarm goes off for themselves and start to view the pain through a lens of safety, and the pain could then go away. And that’s what usually happened by the end of this trial. About two-thirds of participants essentially resolved the pain they experienced in this trial. It’s a landmark study, I can link to it in the description below, and it has the best results for chronic pain in any clinical trial, except maybe for this next one. Here is a “treatment outline” for PRT.
Now the other study I want to talk about is a Harvard pilot clinical trial on Psychophysiologic Symptom Relief Therapy (PSRT) that used Sarno’s work directly, reading one of his books and a Howard Schubiner book, and almost 75% of people finished the study pain-free or almost pain-free compared to 18% in the “usual care” group. So massive difference. This approach also focused on feeling physically safe but emphasized feeling emotionally safe even more. They looked at the role of “trauma”, repressed emotions, and personality traits as the main factors causing this danger signal (i.e. pain) to persist. The techniques employed here were related to emotional expression such as journaling and stress-reduction such as meditation but ultimately the aim here was learning to connect stressors and powerful emotions as the drivers of the sensations themselves. And by learning that we’re now emotionally safe, despite all that’s happened to them in life and it doesn’t have to be some big trauma, that’s the thing that resolved the pain for them, again in 75% of them. The largest number ever for a pain trial. A massive thing is happening here. Here’s its protocol.
Now while I’m at it I’ll also just mention another Harvard study on Psychophysiologic Symptom Relief Therapy for long COVID without organ damage and participants saw highly significant benefits across the board and there’s even several YouTube channels dedicated to resolving Long COVID using this or a very similar manner. There is also lots of related research and anecdotal evidence and success stories that this approach can work for chronic fatigue, fibromyalgia, IBS, various skin problems and more and this is easily found online when searching them in connection to The Mindbody Syndrome.
How is this Related to Protracted Withdrawal?
So protracted withdrawal sensations, like chronic pain and all these other mindbody phenomena, they all feature a catalogue of weird neurological things going on that are unexplainable by traditional biomedical perspectives. There is a lot of “symptom” overlap between protracted withdrawal and chronic pain, Long COVID, and so on. And like people in “protracted withdrawal” all the people in these studies I listed believed that they were damaged. People who were in car accidents who believe they broke their bodies (and have MRIs suggesting that) or that the COVID virus had damaged them, and of course, there are us people in “protracted withdrawal” who believe that drugs have damaged us. This idea of damage or injury is so important in maintaining this syndrome. It’s by stopping believing that we’re damaged or that time is the healer, again for people who this resonates with, that we can begin to reprocess the experience, acknowledge the emotional aspects and begin to resolve it through the acquisition of this new knowledge.
I’d also just say that the people who develop “protracted withdrawal” probably had other medically unexplainable stuff going on previously in their lives as well, I certainly did. Also the people who tend to develop this mindbody phenomena tend to be as well people who are hard on themselves, perhaps compassionate, really driven people. This can sometimes result in negative stress and that’s another common element between these things as it helps maintain the danger alarm signal.
Not All Mindbody Approaches Are the Same
Somtimes mindbody approaches are conflated as if they’re all the same or equally effective or whatever. This is like saying all physical approaches are the same, as if physical therapy is the same as chiropractic or osteopathy. Yes, they’re all physical but they’re very different and yield different results. So there are also different mindbody approaches like CBT vs meditation. A Sarno-inspired approach is also very different not only in its techniques but also in its superior efficacy for pain and other mindbody phenomena.
For instance the Psychophysiologic Symptom Relief Therapy study for chronic pain also included a Mindfulness-Based Stress Reduction component. So one group just got the mindfulness program and the other group got the mindfulness program and a Sarno-based education. So what were the results? Well of those who only got mindfulness 25% of them were pain-free. But for those who entered the mindfulness program armed with Sarno-based mindbody knowledge 75% of them were pain-free or mostly pain-free. A 50% difference. Massive.
And this mindfulness stuff, which can be useful, but it’s what people in withdrawal are more likely to gravitate towards because of its popularity, but there’s far more powerful mindbody techniques out here and they are clearly not the same, not even close. It could be the difference between someone managing protracted withdrawal sensations to actually resolving them. People with protracted withdrawal sensations are generally not doing this sort of thing; in fact if you even mention this stuff you can get attacked or banned from certain withdrawal groups.
So what does this all mean?
It means time is not necessarily the healer. Some people will basically heal themselves with their own mindset and others, like myself, may benefit from an education-based mindbody approach. In that case the only time needed is the time required to understand and integrate this approach into our lives. So that’s the healer: understanding. It takes work to deepen one’s understanding but it can be done. Some are offended by this idea and will criticize it the usual ways; that’s okay. Because some people will actually dig into TMS materials and find the resolution they’re seeking.
For those interested in exploring The Mindbody Syndrome, this is something that can be done for free by finding library books or downloading books, YouTube videos, podcasts, so on. I have a resource page. Feel free to reach out if you have any comments or questions. I wish all of you the absolute best and hope you find the best path for yourselves.