Disrupting overactive survival reactions with the Safe and Sound Protocol (SSP)

About the Provider

Name: Jessica Holton
Discipline/Credentials: MSW, LCSW, LCAS
Modalities: Safe and Sound Protocol (SSP), CBT, TF-CBT, solution-focused, strengths-based, experiential

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Client Background

Name: Evelyn (pseudonym)
Age and Gender: 29-year-old woman
Program Delivered: Safe and Sound Protocol (SSP) Core (Hours 1-5)

Evelyn first began therapy several years ago to address interpersonal challenges secondary to post-traumatic stress disorder (PTSD) signs and symptoms, but stopped therapy when she moved out of state. Evelyn returned about a year ago, primarily to live closer to family, and resumed therapy biweekly to address past traumas, attachment injuries and nervous system dysregulation.  

Upon her move back, she began a new job and applied to graduate school. She lives in a safe neighborhood with her partner and two companion animals. Jessica reports that Evelyn seems internally motivated for therapy and appears to apply recommended extra-therapeutic techniques between sessions. 

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Implementation of the Safe and Sound Protocol (SSP)

The SSP was delivered remotely in July 2022. Evelyn listened independently for 30 minutes at a time and completed the full five hours of SSP Core. 

Jessica used psychoeducation to inform Evelyn that she might feel sensations in her ears, mouth, face and body, but that they’d likely be manageable with her current coping strategies. If needed, Evelyn was encouraged to implement self-regulation skills and co-regulation with her partner or companion animals during the SSP. She was told she could pause if the sensations became too overwhelming, but did not report needing to implement her coping strategies during the SSP.

Response

Jessica shares that after completing the Safe and Sound Protocol (SSP), Evelyn’s hands hardly ever sweat when experiencing mild stressors or triggers and, if they do, it is mild and short-lived. She feels less immobilization and stays in ventral vagal more often, accessing her adaptive coping strategies more easily and having clearer thoughts. Her sleep has also improved during the SSP.   

After the SSP, Evelyn seemed to have a brighter demeanor. She has reported less nervous system dysregulation and seems to manage stressors more easily. She stated that if her nervous system edges into immobilization, she can move into ventral vagal more easily and efficiently. In the past, it could’ve taken hours or days to move out of immobilization. Now, it takes only minutes.

Discussion

Jessica has found that the Safe and Sound Protocol (SSP) is especially helpful for clients that become immobilized easily and become stuck in that state. Her clients have reported improved access to thoughts, allowing them to implement their suggested adaptive coping skills more easily. Similarly, her clients who tend to stay in mobilization report that their thoughts are not as rapid, allowing them to remember to implement their coping skills. Almost immediately after completing the SSP, her clients become more responsive, their tone of voice becomes more prosodic, and they notice more cues of safety. 

Jessica shared the following: “After the thorough assessment is completed, I provide psychoeducation to all of my clients about their diagnostic criteria (usually PTSD since that is one of my specialties), the neuroscience of PTSD, Polyvagal Theory, and the suggested coping skills (based on neuroscience). All of my clients with PTSD have completed the SSP without difficulty, whether [the sessions are] one hour for five days or 30 minutes for 10 days.”