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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10643
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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I have stuttered since I was seven years old. It varies from

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I have stuttered since I was seven years old. It varies from hardly noticeable to very severe. I recently completed a Masters degree and was able to speak quite well during presentations and classes when taking 2mg or more of Lorazepam. I feel it's necessary to give a brief history of my stuttering situations before getting to the main questions.

I personally believe that my stuttering is purely psychological. I say this because I am fluent in some situations and with certain people as opposed to other people and more stressful situations. I have no problem talking to myself, to children or to pets. From my own experience with stuttering I have found that not every stutterer has the same type of problem. For some it is physical, others psychological.

I am part of a costal breathing therapy program for the last ten years. Whenever I talk to or meet other people from this program, I can speak perfectly fluently. What's even more amazing is that I can speak quite well in any situation with any person as long as I am with someone from that program or if I know they are listening to me speak. It is as if a switch it is turned on in my mind that allows me to become more fluent when I'm with other people from this costal breathing course. When I am alone again, my stuttering gradually gets worse and the whole cycle starts again. When I tell strangers that I am on this course, it improves my fluency in some situations.

Anyway, what I am wondering is whether this behavior is atypical of any other psychotic condition or illness? I don't want to go down the medication route if I can help it but lorazepam has been of great benefit to me in the past. I am very familiar with the drug and tried many different drugs with the guidance of my doctor while in grad school. Lorazepam was the only one that helped to a noticeable degree. Can lorazepam be taXXXXX XXXXX term? I am aware of the dependency issues associated with it, however I have not taken the drug for over two weeks now with no withdrawal symptoms apart from my speech getting worse.

Finally, would it be a good idea to go see a psychiatrist in person about my stuttering behaviors? I have tried to treat the problem from a physical point of view...ie breathing therapy and medication but have never really dealt with associated psychological issues which may well be rooted in childhood (While I had a lot of good friends in childhood, I was extremely shy as a child and avoided social interactions if possible).

DoctorZ :

Hello I believe I can help you with your concern

DoctorZ :

I am sorry that you have been dealing with this issue of stuttering for so long, but congratulations on recently completing your Master's degree, that is quite the accomplishment.

DoctorZ :

Since it sounds like your stuttering is not caused by a physical defect or an auditory processing issue because it occurs at different times that are usually more stressful, it appears to be the result of a Social Anxiety Disorder.

DoctorZ :

This would also explain why the Lorazepam is effective for you, why it occurs when you are more stressed (anxiety and stress both have the same the physiological symptoms, such as stuttering) and why you were shy as a child and avoided social situations.

DoctorZ :

The good news is that Social Anxiety is treatable with a high success rate through the use of Cognitive Behavioral Therapy (CBT). This is most beneficial and evidence based treatment for social anxiety disorders.

DoctorZ :

What is going on in your subconscious and consciousness is that you are having negative thoughts, most likely about social situations, that causes you to increase your anxiety and thus causes you to stutter. So the goal of CBT is to change that negative thought process into a more positive and plausible one to lessen the symptoms that you have been having.

DoctorZ :

So this link may help you, it contains a technique I use with patients called a thought record. It will help you keep track of any negative thoughts you have. You put the negative thought on paper, the emotion accompanying, the evidence to support it, and the evidence against it. Then I want you to come up with an alternative thought for the situation (more positive and plausible). This will help you change your way of thinking to be able to think more positive and not automatically go to a negative type of thinking.

DoctorZ :

In addition this de-catastrophising worksheet is also helpful to use before any event or occurrence that you feel will be very stressful for you.

DoctorZ :

Now if you choose to see a CBT therapist, they will use worksheets like this as well as something called exposure therapy, which will expose you to anxiety provoking situations in a controlled environment to allow you to process it slowly and adapt. Gradually the level of stress and anxiety that provokes your stuttering will be increased until you develop a tolerance and are no longer anxious or stressed from these situations.

DoctorZ :

By the way stuttering is not an uncommon symptom of social anxiety disorders. So no need to feel that this is atypical behavior at all.

Customer:

Thanks. CBT would be something that interests me. Ideally I would like to not have to take lorazepam but since it has worked well for me in the past without any side effects, I think it may help. I just get wary of all the talk I read on forums about addictive and dependency issues. Would it be possible to try CBT with medication or is CBT a therapy that is used without any meds?

Dr. Z and other Mental Health Specialists are ready to help you
Sorry you rated me before I could answer your question. You can definitely try CBT with the Lorazepam, in fact it happens very often. And after awhile of using the CBT techniques, you may feel that you do not need the Lorazepam anymore and you can try to wean off it and see if your stuttering comes back or not. I understand the issues with Lorazepam and other benzodiazepines, but the long term issues with this medication are minimal if you use it correctly and under the guise of a physician. And if you wean off of it correctly under a physician's supervision then the withdrawal effects will be minimal at most. Thank you for the positive rating and if you need anything else, please feel free to contact me at anytime. Best of luck to you.
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