‘Best of luck on your journey to healing’

A corpus-based discourse analysis of an online forum for withdrawing benzodiazepine users

Authors

  • Melissa Ceuterick Ghent University
  • Jana Declercq University of Groningen

DOI:

https://doi.org/10.1558/cam.22677

Keywords:

Corpus-based discourse analysis, Expertise, Online discussion forum, Benzodiazepines, Tapering, Withdrawal

Abstract

In many countries, including Belgium and the Netherlands, dependence on benzodiazepines (BZDs) is a medical and social issue, and, for long-term users who want to taper off, doing so remains a personal challenge. For these users, online contexts such as forums can be a place to discuss this experience and look for practical and moral support among former users and fellow users trying to reduce or stop BZD use. This paper aims to shed light on the discourses of a Dutch-language benzodiazepine withdrawal forum, examining 133 forum threads (41,516 words). We take a corpus-based approach that combines frequency analyses with qualitative discourse analysis. We explore how the users extensively share lived, experiential knowledge of using and reducing medication and, in doing so, engage with domain-specific biomedical jargon. As such they discursively construct specialised expertise and a medical(ised), health professional-like expert identity, both in relation to their own situation, but also in interaction with other forum members, as advisors to each other. The forum thus not only serves as a site for emotional peer support, but also as a site for detailed informational support on tapering, which is traditionally offered by health professionals. This is especially pervasive, as many forum users also express
indignation about the medical establishment and its lack of institutional knowledge support in the process of tapering off.

Author Biographies

  • Melissa Ceuterick, Ghent University

    Melissa Ceuterick is a medical anthropologist who received her PhD in Medical Biosciences from Bradford University (UK) and is currently a postdoctoral researcher at Hedera (Health and Demographic Research), Ghent University, Belgium. Her research interests include health and identity, medication narratives and discourses of health and illness.

  • Jana Declercq, University of Groningen

    Jana Declerq received her PhD in Linguistics from Ghent University (Belgium) and is currently an Assistant Professor in Linguistics and Communication Studies at the University of Groningen (The Netherlands). She is primarily interested in health and language, and more specifically in health and the media, food and health, and the body in health discourses.

References

Ashton, Heather (2002) Benzodiazepines: How They Work and How to Withdraw. Online: http://www.benzo.org.uk/manual

Ashton, Heather (2005) The diagnosis and management of benzodiazepine dependence. Current Opinion in Psychiatry 18 (3): 249–255. https://doi.org/10.1097/01.yco.0000165594.60434.84

Baker, Paul (2006) Using Corpora in Discourse Analysis. London: Continuum. https://doi.org/10.5040/9781350933996

Baker, Paul (2010) Sociolinguistics and Corpus Linguistics. Edinburgh: Edinburgh University Press.

Baker, Paul and Erez Levon (2015) Picking the right cherries? A comparison of corpus-based and qualitative analyses of news articles about masculinity. Discourse & Communication 9 (2): 221–236. https://doi.org/10.1177/1750481314568542

Barker, Melinda, Kenneth Greenwood, Martin Jackson and Simon F. Crowe (2005) An evaluation of persisting cognitive effects after withdrawal from long-term benzodiazepine use. Journal of the International Neuropsychological Society 11 (3): 281–289. https://doi.org/10.1017/S1355617705050332

Barton, Ellen (1996) Negotiating expertise in discourses of disability. Text & Talk 16 (3): 299–322. https://doi.org/10.1515/text.1.1996.16.3.299

Britten, Nicky and Kath Maguire (2016) Lay knowledge, social movements and the use of medicines: Personal reflections. Health 20 (2): 77–93. https://doi.org/10.1177/1363459315619021

Candlin, Christopher N. and Sally Candlin (2002) Discourse, expertise, and the management of risk in health care settings. Research on Language and Social Interaction 35 (2): 115–137. https://doi.org/10.1207/S15327973RLSI3502_1

Canham, Sarah L., Joseph Gallo and Linda Simoni-Wastila (2014) Perceptions of benzodiazepine dependence among women age 65 and older. Journal of Gerontological Social Work 57 (8): 872–888. https://doi.org/10.1080/01634372.2014.901470

Carr, Summerson (2010) Enactments of expertise. Annual Review of Anthropology 39: 17–32. https://doi.org/10.1146/annurev.anthro.012809.104948

Collins, Harry and Robert Evans (2007) Rethinking Expertise. Chicago: University of Chicago Press. https://doi.org/10.7208/chicago/9780226113623.001.0001

Davison, Kathryn, James Pennebaker and Sally Dickerson (2000) Who talks? The social psychology of illness support groups. American Psychologist 55 (2): 205–217. https://doi.org/10.1037/0003-066X.55.2.205

Declercq, Jana, Tessa van Charldorp and Mike Huiskes (2021) Diversiteit en complexiteit van kennis in zorginteracties. Tijdschrift Voor

Taalbeheersing 43 (2): 83–94. https://doi.org/10.5117/TVT2021.2.001.DECL

Dell’osso, Bernardo and Michael Lader (2013) Do benzodiazepines still deserve a major role in the treatment of psychiatric disorders? A critical reappraisal. European Psychiatry 28 (1): 7–20. https://doi.org/10.1016/j.eurpsy.2011.11.003

Ekström, Mat (2016) Medical authority and ordinary expertise. Discourse, Context and Media 13 (A): 20–28. https://doi.org/10.1016/j.dcm.2016.05.002

Eyal, Gil (2013) For a sociology of expertise: The social origins of the autism epidemic. American Journal of Sociology 118 (4): 863–907. https://doi.org/10.1086/668448

Fage-Butler, Antoinette and Patrizia Anesa (2016) Discursive construction and negotiation of laity on an online health forum. Pragmatics and Society 7 (2): 196–216. https://doi.org/10.1075/ps.7.2.02fag

Fixsen, Allison (2016) ‘I’m not waving, i’m drowning’: An autoethnographical exploration of biographical disruption and reconstruction during recovery from prescribed benzodiazepine use. Qualitative Health Research 26 (4): 466–481. https://doi.org/10.1177/1049732315576496

Fixsen, Allison and Damian Ridge (2017) Stories of hell and healing: Internet users’ construction of benzodiazepine distress and withdrawal. Qualitative Health Research 27 (13): 2030–2041. https://doi.org/10.1177/1049732317728053

Haider, Ahmad (2019) Syrian-Lebanese relations: A corpus-based critical discourse analysis of Bashar Al-Assad’s speeches and interviews. Human and Social Sciences 46 (4): 551–570. https://doi.org/10.35516/0103-046-004-040

Harvey, Kevin James, Brian Brown, Paul Crawford, Aidan Macfarlane and Ann McPherson (2007) ‘Am I normal?’ Teenagers, sexual health and the internet. Social Science & Medicine 65 (4): 771–781. https://doi.org/10.1016/j.socscimed.2007.04.005

Hartzler, Andrea and Wanda Pratt (2011) Managing the personal side of health: How patient expertise differs from the expertise of clinicians. Journal of Medical Internet Research 13 (3): Article e62. https://doi.org/10.2196/jmir.1728

Henwood, Flis, Sally Wyatt, Angie Hart and Julie Smith (2003) ‘Ignorance is bliss sometimes’: Constraints on the emergence of the ‘informed patient’ in the changing landscapes of health information. Sociology of Health & Illness 25 (6): 589–607. https://doi.org/10.1111/1467-9566.00360

Hunt, Daniel and Kevin James Harvey (2015) Health communication and corpus linguistics: Using corpus tools to analyse eating disorder discourse online. In Anthony McEnery and Paul Baker (eds) Corpora and Discourse Studies, 134–154. London: Palgrave. https://doi.org/10.1057/9781137431738_7

Jaspers, Jürgen (2014) From unwanted to so-called expertise: Ideologizing sociolinguistics in mainstream media. Science Communication 36 (5): 570–592. https://doi.org/10.1177/1075547014547160

Kingod, Natasja, Bryan Cleal, Ayo Wahlberg and Gitte Husted (2017) Online peer-to-peer communities in the daily lives of people with

chronic illness: A qualitative systematic review. Qualitative Health Research 27 (1): 89–99. https://doi.org/10.1177/1049732316680203

Knight, Rachel (2021) Peer support for substance use disorders. In Jonathan Avery (ed.) Peer Support in Medicine: A Quick Guide, 1–30. New York: Springer. https://doi.org/10.1007/978-3-030-58660-7_1

Kotthoff, Helga and Ruth Wodak (1997) Communicating Gender in Context. Amsterdam: John Benjamins. https://doi.org/10.1075/pbns.42

Liebrenz, Michael, Marcel Schneider, Anna Buadze, Marie-Therese Gehring, Anish Dube and Carlo Caflisch (2015) High-dose benzodiazepine dependence: A qualitative study of patients’ perceptions on initiation, reasons for use, and obtainment. PLoS One 10 (11): Article e0142057. https://doi.org/10.1371/journal.pone.0142057

Lupton, Deborah (2012) Medicine as Culture: Illness, Disease and the Body. Los Angeles: Sage. https://doi.org/10.4135/9781446254530

Lupton, Deborah (2016) Towards critical digital health studies: Reflections on two decades of research in health and the way forward. Health 20 (1): 49–61. https://doi.org/10.1177/1363459315611940

Lupton, Deborah (2017) Digital Health: Critical and Cross-Disciplinary Perspectives. London: Routledge. https://doi.org/10.4324/9781315648835

Macken, Lieve, Orphée De Clercq and Hans Paulussen (2011) Dutch parallel corpus: A balanced copyright-cleared parallel corpus. Meta 56 (2): 374–390. https://doi.org/10.7202/1006182ar

MacLean, Diana, Sonal Gupta, Anna Lembke, Christopher Manning and Jeffrey Heer (2015) Forum77: An analysis of an online health forum dedicated to addiction recovery. Proceedings of the 18th ACM Conference on Computer Supported Cooperative Work & Social Computing, 1511–1526. New York: Association for Computing Machinery. https://doi.org/10.1145/2675133.2675146

McDonald, Daniel and Robyn Woodward-Kron (2016) Member roles and identities in online support groups: Perspectives from corpus and systemic functional linguistics. Discourse & Communication 10 (2): 157–175. https://doi.org/10.1177/1750481315615985

Milani, Tommaso (2007) Voices of authority in conflict: The making of the expert in a language debate in Sweden. Linguistics and Education 18 (2): 99–120. https://doi.org/10.1016/j.linged.2007.07.002

Morrow, Phillip (2006) Telling about problems and giving advice in an Internet discussion forum: Some discourse features. Discourse Studies 8 (4): 531–548. https://doi.org/10.1177/1461445606061876

Mudry, Tanya and Tom Strong (2013) Doing recovery online. Qualitative Health Research 23 (3): 313–325. https://doi.org/10.1177/1049732312468296

Nambisan, Priya (2011) Information seeking and social support in online health communities: Impact on patients’ perceived empathy. Journal of the American Medical Informatics Association, 18 (3): 298–304. https://doi.org/10.1136/amiajnl-2010-000058

Nettleton, Sarah (2021) The Sociology of Health and Illness. Cambridge: Polity Press.

Oborn, Eivor, Michael Barrett, Sarah Gibson and Steve Gillard (2019) Knowledge and expertise in care practices: The role of the peer worker in mental health teams. Sociology of Health & Illness 41 (7): 1305–1322. https://doi.org/10.1111/1467-9566.12944

Orton-Johnson, Kate and Nick Prior (2013) Digital Sociology: Critical Perspectives. New York: Palgrave-MacMillan. https://doi.org/10.1057/9781137297792

Parr, Jannette, David J. Kavanagh, Ross McYoung and Kelly McCafferty (2006) Views of general practitioners and benzodiazepine users on benzodiazepines: A qualitative analysis. Social Science & Medicine 62 (5): 1237–1249. https://doi.org/10.1016/j.socscimed.2005.07.016

Partington, Alan, Alison Duguid and Charlotte Taylor (2013) Patterns and Meanings in Discourse: Theory and Practice in Corpus-Assisted Discourse Studies (CADS). Amsterdam: John Benjamins. https://doi.org/10.1075/scl.55

Pickersgill, Martyn (2012) What is psychiatry? Co-producing complexity in mental health. Social Theory & Health 10 (4): 328–347. https://doi.org/10.1057/sth.2012.9

Pols, Jeanette (2014) Knowing patients: Turning patient knowledge into science. Science, Technology & Human Values 39 (1): 73–97. https://doi.org/10.1177/0162243913504306

Prior, Lindsay (2003) Belief, knowledge and expertise: The emergence of the lay expert in medical sociology. Sociology of Health and Illness 25 (3): 41–57. https://doi.org/10.1111/1467-9566.00339

Rayson, Paul, Damon Berridge and Brian Francis (2004) Extending the Cochran rule for the comparison of word frequencies between corpora. In Le poids des mots (JADT vol. 1): Actes des 7es Journées internationales d’analyse statistique des données textuelles, 926–936. Louvain: Presses universitaires de Louvain.

Romeyer, Helene (2021) The expert patient in the digital age: Between myth and reality. In Benoit Cordelier and Galibert Olivier (eds) Digital Health Communications, 120–143. London: Wiley. https://doi.org/10.1002/9781119842651.ch6

Rueger, Jasmina, Wilfred Dolfsma and Rick Aalbers (2021) Perception of peer advice in online health communities: Access to lay expertise. Social Science & Medicine 277: Article 113117. https://doi.org/ 10.1016/j.socscimed.2020.113117

Sarangi, Srikant (2001) On demarcating the space between ‘lay expertise’ and ‘expert laity’. Text & Talk 21 (1–2): 3–11. https://doi.org/10.1515/text.1.21.1-2.3

Sarangi, Srikant and Angus Clarke (2002) Zones of expertise and the management of uncertainty in genetics risk communication. Research on Language and Social Interaction 35 (2): 139–171. https://doi.org/10.1207/S15327973RLSI3502_2

Scott, Mike (2020) WordSmith Tools Version 8. Stroud, UK: Lexical Analysis Software.

Shaw, Eric (2020) The use of online discussion forums and communities for health research. Family Practice 37 (4): 574–577. https://doi.org/10.1093/fampra/cmaa008

Smedley, Richard M. and Neil S. Coulson (2018) A practical guide to analysing online support forums. Qualitative Research in Psychology 18 (1): 76–103. https://doi.org/10.1080/14780887.2018.1475532

Soyka, Michael (2017) Treatment of benzodiazepine dependence. New England Journal of Medicine 376 (12): 1147–1157. https://doi.org/10.1056/NEJMra1611832

Vampini, Claudio and Luca Gallelli (2014) Anxiety and benzodiazepines: A Delphi method-based survey of knowledge on their pharmacology and clinical use. Journal of Psychopathology 20: 322–340. Online: https://www.jpsychopathol.it/issues/2014/vol20-3/08-Vampini.pdf

Wall, Marianne, Sharon Lambert and Aidan Horan (2018) An evaluation of practitioner’s experience of service users seeking community detoxification from benzodiazepines. Journal of Psychoactive Drugs 50 (3): 224–230. https://doi.org/10.1080/02791072.2017.1401184

Weiste, Elina, Melisa Stevanovic and Lise-Lotte Uusitalo (2022) Experiential expertise in the co-development of social and health-care services: Self-promotion and self-dismissal as interactional strategies. Sociology of Health and Illness 44 (4–5): 764–780. https://doi.org/10.1111/1467-9566.13457

Weiste, Elina, Liisa Voutilainen and Anssi Peräkylä (2016) Epistemic asymmetries in psychotherapy interaction: Therapists’ practices for displaying access to clients’ inner experiences. Sociology of Health and Illness 38 (4): 645–661. https://doi.org/10.1111/1467-9566.12384

Published

2022-12-31

Issue

Section

Articles

How to Cite

Ceuterick, M., & Declercq, J. (2022). ‘Best of luck on your journey to healing’: A corpus-based discourse analysis of an online forum for withdrawing benzodiazepine users. Communication and Medicine, 18(1), 37–50. https://doi.org/10.1558/cam.22677