The information presented in this case study was submitted by the identified provider and reviewed by the Unyte Clinical Team. Modifications to the text have been made solely for the purpose of enhancing comprehension and clarity for the reader’s benefit, and were carefully applied while ensuring the accuracy and integrity of the original submission. Unyte Health makes every effort to use updated terms and inclusive language, this case study retains the author’s original descriptions to be most sensitive to the client’s identity and preferences.
About the Provider
Name: Noémi A. Sullivan
Disciplines/credentials: Certified IFS Practitioner (Level 3 Trained), National Board Certified Health and Wellness Coach, ADAPT Certified Functional Health Coach, ICF Associate Certified Coach
Modalities: Safe and Sound Protocol (SSP), Rest and Restore Protocol (RRP), Internal Family Systems (IFS)
Client Background
Name: Stephen (pseudonym)
Age and Gender: Adult man, he/him/his
Program Delivered: IFS in combination with SSP Core (Classical Flow, Hours 1-5, twice) and Balance (Classical Flow, Hours 1-5; Freely, Hours 1-2)
Stephen is a creative and spiritually oriented retired school teacher who has been in recovery from substance and process addictions for more than four decades. Two years before beginning work with his provider, he experienced the sudden death of his adult son and the collapse of a romantic relationship. In an impulsive attempt to escape the associated pain, his “inner teen” protector led him to relocate from a busy urban neighborhood to an isolated home in a rural area. The solitude initially felt helpful but soon became dysregulating: “The deep silence in the woods can be daunting.”
When he began sessions, Stephen described himself as fatigued, stressed, anxious and disconnected from both himself and others. The world felt unsafe — “a blanket of dread” — and he oscillated between social discomfort and complete avoidance. He had historically engaged with various mental health professionals and, despite maintaining regular care, mistrusted his medical team, including his primary care provider and specialists. He experienced a “loss of patience” and reactivity issues that led to strained relationships, difficulty engaging in recovery groups and impaired social functioning. Years of isolation compounded his fears about continued withdrawal and the risks of reconnecting.
Stephen maintained sobriety yet continued struggling with meaning and self-efficacy. He sought a deeper sense of vitality, greater autonomy, freedom from reactivity, and better strategies for managing stress (“Stress puts me in panic mode”). First encountered in his recovery program, the welcoming and non-pathologizing IFS approach appealed to him as “gentle, refreshing and worth a try.”
The youngest of five siblings, Stephen grew up in a chaotic household where, despite their best intentions, an overwhelmed mother and emotionally detached father were unable to provide consistent safety, nurturing or co-regulation due to their own unresolved intergenerational pain. At the same time, they held high expectations for achievement in school and extracurricular activities and penalized shortcomings. Addictive processes began in his preteen years and were compounded by a near-fatal motor vehicle accident around age 10.
Inner System and Key Parts
Revealed gradually, Stephen’s internal system reflected multiple layers of protective adaptations developed across a lifetime of hardship.
- “Curmudgeon”: A harsh critic and judge committed to maintaining the status quo through self-criticism, hostility, contempt and negative forecasting, keeping Stephen in a persistently pessimistic outlook on life.
- “Tough Guy”/“BS Guy”: A “fight protector” strategically employing sympathetic activation — bravado, anger and rage — to keep others at bay and shield against vulnerability and shame. This part took on its protective role around age 10 or 11, following repeated bullying experiences (“I was a mouse among wolves”).
- “Withdrawal”/“Inner Nihilist”: A “freeze protector” strategically using dorsal vagal shutdown to avoid risk, disappointment or exposure. Its motto was “trying and failing is worse than not trying at all” and operated within a cluster of protectors that formed alliances that would activate sequentially to prevent access to vulnerable parts.
- Grief Constellation: A collection of parts holding profound grief and guilt connected to multiple losses.
- “Little Kid”/“Inner Child”: Revealed later, Stephen’s vulnerable parts included a frightened, tender one who felt unseen and unloved, carrying the burdens of worthlessness and shame.
These and other parts often blended rapidly — grabbing the metaphorical microphone, competing for attention, and jumping from one thought or feeling to the next, often in contradictory directions. Despite the inner turbulence and limited early access to clarity and confidence, Self energy flickered through: a wish for inner peace, a desire to “explore relationships and how to be a loving, caring, compassionate human being,” and occasional contact with a wise, benevolent inner voice encountered in nature (“God is everything and I am that”). Such moments were regularly interrupted and silenced by the harsh critic: “Coming back to myself is a letdown.”
Implementation of the Safe and Sound Protocol (SSP)
Early work focused on exploring the vision Stephen held for himself, anchored in the establishment of safety, trust and rapport. This included following the system, welcoming every part as it appeared, honoring each role or story, and consistently conveying the message, “I am on your parts’ side.” Over time, “mini-unblends” (pause–breathe–notice) as taught by Cece Sykes, author and IFS educator, were introduced. These brief co-regulatory moments soon became a ritual that Stephen requested at the beginning of each session.
Given Stephen’s affinity for music and his interest in developing a home-based practice for internal connection, his provider proposed the SSP as a way to support this process, facilitate relaxation and expand neuroceptive safety. The SSP was presented as a way to help remember and connect with what had always been there, rather than as an intervention “to be done to” him.
Before listening began, consent was obtained from Stephen and all relevant parts of his system. Preparatory IFS sessions explored the hopes, intentions and concerns surrounding participation. Enthusiastic parts intrigued by the novelty of filtered music shared the stage with skeptical, vigilant protectors expressing fears about hypnosis, subliminal messages or a potential loss of self. Remaining careful not to take sides, the provider engaged in patient dialogue and validation, addressing concerns and highlighting pacing, titration and client autonomy until consensus was reached. Stephen became ready to engage with the SSP from a place of inner alignment.
Since the provider’s scope of practice excluded formal clinical assessment, her own questionnaires centered around strengths, functioning and lifestyle factors were used. Stephen also completed Unyte’s intake form. Consistent with parts revealed during earlier stages of ongoing system mapping, he described a predominant pattern of sympathetic hyperarousal with a “low current” of dorsal hypoarousal in the background, along with occasional glimpses of ventral regulation. His scores (11 on Client Experience and 10 on Client Resources) and narrative answers, combined with his provider’s observations, suggested that the SSP Core pathway would be an appropriate starting point.
Stephen’s available resources included proximity to nature, a beloved companion animal and peers in recovery who could provide co-regulation, along with movement and breathwork practices. He expressed a clear preference for independent listening. These factors informed the collaborative decision to deliver the SSP Core independently following an initial remote listening session.
Regular check-ins were incorporated into weekly sessions, and the provider remained available for support via text, email or phone between meetings. The frequent communication allowed for ongoing titration of listening length and frequency while maintaining Stephen’s sense of choice and agency throughout the process. Session duration was gradually adjusted — from 10 to 15 minutes, then back to 10, and eventually to five minutes for the entire Hour 4 — before returning to longer sessions of 10-15 minutes for Hour 5 as his capacity and comfort increased.
Stephen preferred listening to the SSP outdoors during the day whenever possible. He enjoyed being surrounded by nature, often pausing to marvel at the birds and other wildlife. A brief tai chi or stretching practice beforehand helped him settle and prepare. During his listening sessions, his intention was to connect internally. When feeling inspired afterward, he would engage his creative talents, such as drawing and eventually return to a former passion, playing his guitar.
Additional supportive practices included co-regulation, parts check-ins, education on the autonomic nervous system and its potential relationship with the intrapsychic system, PVT-based exercises (such as autonomic mapping and noticing glimmers), reflective writing, poetry reading, and mindful silence.
Following the completion of SSP Core, and based on his positive experiences and the internal shifts that were unfolding, Stephen continued with the SSP Balance pathway (Hours 1-5 of one playlist, then Hours 1-2 of another) before choosing to repeat the SSP Core pathway once more.
Stephen completed the following sequence:
- SSP Core (Classical Flow): May–July 2024 (Hours 1-5)
- SSP Balance (Classical Flow): July–August 2024 (Hours 1-5)
- SSP Balance (Freely): September 2024 (Hours 1-2), followed by a brief return to Classical Flow
- SSP Core (Second Round of Classical Flow): October 2024–January 2025 (Hours 1-5)
Note: A brief trial of the RRP, including the Introduction and Level 1 tracks, was conducted in the spring and summer of 2025, but was discontinued due to effects the client preferred to avoid at that time. As of October 2025, at the time of this submission, the client is preparing to repeat the SSP Core pathway once again, with the hope of deepening the benefits already experienced while maintaining a stance of openness and non-attachment to specific outcomes.
Response
First Round of Core, Hours 1-3: Early Glimmers
- By Hour 3, Stephen began reporting “glimmers of hope” (“Maybe I’m on the right track,” “Maybe I can do this”) alongside moments of self-compassion. (“The choices I made weren’t my fault.”)
- Moments of peace were present, formerly tormenting triggers “lost their power” (“Thoughts about my ex don’t torture me”), and the inner critic naturally softened (“I don’t beat myself up as much.”)
First Round of Core, Hour 4: A Pivotal Moment of Emerging Self Energy Toward a Fierce Protector
During Hour 4, the provider began to observe a deepening in Stephen’s process, recalling a pivotal moment when she witnessed him embodying Self energy and extending genuine compassion toward a fierce protector that appeared as a vicious dog locked in a cage. “I want to help him,” he said softly.
This moment marked a turning point. In the weeks and months that followed, Stephen’s system displayed a subtly increasing sense of spaciousness, coherence and self-awareness. In-sight work became more regular, accompanied by growing capacity for embodied awareness of parts’ emergent expressions. As Self energy became more available, additional protectors began forming direct connections with Self. Building on these initial positive shifts, the Balance pathway was introduced to further support systemic realignment.
Balance: Holding Complexity and Polarizations, Golden Essence, Calm Presence, and Safe Connection with Vulnerable Parts
Highlights include:
- Greater capacity to notice and name parts, unblend, and widen the window for ambivalence.
- Recognition and befriending of a significant internal polarization dynamic — the longing for closeness versus the fear of connection and anticipated rejection — experienced as and playfully named the “Pushme-Pullyu” after the two-headed creature from the Doctor Dolittle books from Stephen’s childhood. From this awareness, he developed the ability to pause and identify the parts involved in the polarization whenever they activated. The provider observed an increase in holding both sides with curiosity rather than over-identifying with either.
- More frequent experiences of emergent imagery and embodied Self energy, such as: “There’s a throne inside with a goddess sitting on it,” and “The flow of golden essence.” These moments were accompanied by a new sense of calm and a greater ability to remain present to inner experience.
- A longstanding “Lid Keeper” protector relaxed (“All my ghosts are visible now”), allowing Stephen increased ability to connect with and witness vulnerable parts in their somatic storytelling without experiencing overwhelm.
- The subjective experience of the external world shifted as a growing felt sense of safety and regulation emerged (“The world seems less threatening”).
Second Round of Core: Expanding Self Qualities and Pro-Social Shifts, Compassionate Witnessing, Grief
Highlights include:
- Humor and playfulness re-emerged, indicating ventral activation and Self energy.
- The “Fight Protectors” gradually relaxed, allowing space for managerial parts to identify and name feelings and needs (e.g., “I feel hurt” or “I feel rejected”), rather than defaulting to fight-or-flight reactions. This shift created more pauses between stimulus and response, resulting in greater choice (sometimes referred to as “the ninth C of Self”) and reduced emotional reactivity.
- Additional Self qualities emerged:
- Calm: “Effervescent champagne bubbles popping against my head.”
- Compassion: “I can feel my heart … I’m not a terrible person!”; “I can feel people deeply”; “I’m like the Grinch with a growing heart.”
- Connectedness: “Starting to feel less lonely.”
- Clarity: “Hurt people hurt people.”
- Memory fragments of safe connection surfaced, including being comforted by his grandmother, suggesting renewed access to previously implicit memories of co-regulation.
- Connecting with and compassionate witnessing the pain and fear of vulnerable parts deepened further as protectors began handing over “the keys to the cage of [his] desperation.” Awareness of legacy burdens also entered the field (“The heaviness of the blanket goes back several generations” and “My mother was caught up in her own cycles of hell”).
- The grief process intensified and softened simultaneously: parts holding disbelief, anger, remorse and memories of his son’s final hours were witnessed and bathed in Self’s loving care. As their needs, including forgiveness, were honored, they experienced relief and expressed themselves through creative and sometimes cathartic forms, such as songwriting (“Goodbye to the Morning Dew”).
- The provider noted an evident softening in Stephen’s facial tone and voice prosody, reflecting increased autonomic balance.
Functional Outcomes
Stephen continues meeting with his provider biweekly or as needed. He reports greater autonomy in relation to his physical and mental health, and in his life overall. Hope is no longer experienced as a trigger: “I’m open to possibility.” He describes a growing sense of safety and connection to a higher power — “Maybe God really loves me” — and views himself and his past actions through a more compassionate lens: “I did the best with what I had.”
Although his process continues to unfold, several notable shifts have been observed and reported:
Autonomy, Health Engagement and Well-being
- Renewed trust and re-engagement with medical providers; psychopharmacologic regimen successfully adjusted.
- Decreased exhaustion and shutdown, allowing a consistent return to strength training and yoga.
- Regular participation in revitalizing, nature-based activities that support joy and regulation.
- Increased creativity and motivation in preparing healthier, more nourishing meals.
- Reignited artistic expression through painting, songwriting and learning to play new instruments.
Emotional Regulation and Relationships
- Markedly improved self-regulation in historically activating contexts (e.g., recovery rooms); increased impulse control and compassionate boundary setting; greater ability to articulate needs and remain present rather than withdrawing or abruptly leaving: “There’s a joy in being present to people.”
- Found a more value-aligned recovery fellowship and joined an in-person mindfulness and meditation group.
- Renewed service orientation: “The fruit of spiritual development is service.”
- Repaired and deepened family connections. Reconnection with his adult son’s family led to regular visits and extended stays in his home, bringing new experiences of joyful grandparenting. The family delights as his young granddaughter affectionately calls him “Comfy Bear,” in the safety of his embrace. Stephen treasures these moments as “the best weeks of [his] life” and is committed to “being there for them, no matter what.”
Discussion
This case illustrates the potential benefits of combining IFS and SSP within a trauma-informed framework. The provider observed that IFS-based preparation was invaluable prior to introducing the SSP, as familiarity with the client’s internal system and obtaining protector consent fostered collaboration and established safety.
Throughout the listening process, IFS offered both a language and ways for relating to physiological responses. When imagery or bodily sensations, such as tremors, warmth, yawns or tears surfaced, they were understood as signals from parts rather than symptoms to eliminate. This compassionate turning toward inner experiences allowed what emerged to be met with genuine curiosity and care.
Concurrently, the SSP supported the neurophysiological conditions necessary for deeper, more layered inner work. As the client’s autonomic flexibility increased, blended parts softened and Self energy became more available. In turn, as Self-to-part relationships deepened, periods of dorsal collapse gave way to mobilization and, eventually, to social engagement.
The provider noted the bidirectional relationship inherent in the interpersonal field. Maintaining a Self-led, attuned presence invited the client’s nervous system to entrain toward safety. While the provider felt compassionate and connected to Stephen from the beginning, occasional activation of her own parts — such as a caretaker part or those reacting to systemic injustices the client had endured — was addressed through IFS consultation and personal use of the SSP pathways. This served as a reminder that clients and providers benefit when the work is held as an experience of mutual growth and possibility.
Over approximately 18 months, the client’s engagement reflected a clear, though non-linear, progression from defensive isolation to increased relational participation. He moved from neuroceptive threat toward neuroceptive safety, from protector dominance toward Self leadership, and from a sense of hopelessness toward agency. The interplay of IFS and SSP supported gradual re-alignment across physiological and intrapsychic dimensions — demonstrating how listening programs can enhance parts-based work and how systemic awareness can, in turn, deepen the impact of sound-based protocols.
As a single-case report in a combined delivery context, these outcomes are not generalizable. No standardized clinical measures were used, as this falls outside the provider’s scope of practice. Findings are based on the client’s narrative, reported behavioral changes and provider observation.
While the combined delivery of IFS and SSP appears to have paved the way for re-engagement with supportive networks and tools, multiple concurrent influences — such as recovery groups, medical care, lifestyle practices, the passage of time and maturational processes — also likely contributed to the client’s progress.
Over the course of a year and a half, through the integrated application of the SSP and IFS, Stephen experienced meaningful shifts in autonomic regulation and flexibility, emotional balance, and interpersonal engagement. As he opened up to trusting his embodied experience of safety and Self energy, he began translating these inner shifts into daily life, practicing internal co-regulation*, cultivating a kinder inner dialogue, establishing purposeful routines, reconnecting with community, and repairing family bonds.
Stephen now holds and honors his grief without being consumed by it. Hope, once a trigger, has become a string of possibilities. It warms his provider’s heart to hear him reflect: “Perhaps I’m here to take the peace I find in the woods and share it with those who may benefit.”
*The term “internal co-regulation” was coined by IFS educator and author Alexia Rothman, Ph.D., and has become widely used in the IFS community.
Provider’s Note
This case example was written with the specific intention of inclusion in the IFS and Listening Therapies Combined Delivery Guidelines. Its length is representative of the 18-month engagement it captures, encompassing multiple deliveries of the SSP Core and Balance pathways for a client with a complex intrapsychic system. The intention was to translate theory into practice, offering a tangible illustration of the combined delivery process, along with its perceived benefits and potential.
References
Sykes, C., Sweezy, M., & Schwartz, R. C. (2023). Internal family systems therapy for addictions: Trauma-informed, compassion-based interventions for substance use, eating, gambling, and more. PESI Publishing.
Rothman, A. (2023). IFS and Polyvagal Theory: Healing through compassionate connection. In J. Riemersma & R. C. Schwartz (Eds.), Altogether US: Integrating the IFS model with key modalities, communities, and trends. Pivotal Press.
Delivery Notes
This case study represents a year and a half of engagement. Throughout that time, SSP Core (Hours 1-5) was delivered twice, with SSP Balance (Hours 1-5 of Classical Flow, and Hours 1-2 of Freely) being delivered in between each round. RRP was attempted, but the client decided to discontinue due to effects he didn’t wish to experience at that time.
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