About the Provider
Name: Lori Tussey
Discipline/Credentials: Speech-language pathologist, MA, CCC-SLP
Modalities: Speech and language therapy, Safe and Sound Protocol (SSP)
Client Background
Name: BJ (pseudonym)
Age and Gender: 55-year-old woman
Program Delivered: Safe and Sound Protocol (SSP) Core (Hours 1-5); Balance (Hours 1-5)
BJ presents with Ehlers-Danlos syndrome, past trauma and frequent autonomic nervous system difficulties, such as rapidly dropping blood pressure that causes her to “flop.” BJ lives with her husband and used to be a truck driver, but no longer is as it required heavy lifting. She enjoys live music and goes to many shows but in recent years has had to sit in a wheelchair in case her blood pressure drops and she faints.
As BJ was completing the initial assessment prior to starting the Safe and Sound Protocol (SSP), BJ told Lori that she could not remember the last time she was in ventral vagal, as she spends most of her days either being overwhelmed by her environment or physically shut down.
Lori knew BJ socially noticed that many of the features described in SSP clients seemed to match BJ’s symptoms. The treatment goals were for BJ to feel better physically and help her recover from a bout more quickly. Lori shared, “We were interested in seeing if the SSP would keep her from having her frequent dorsal responses.”
Implementation of the Safe and Sound Protocol (SSP)
Lori and BJ began the SSP in person and shifted to remote delivery after the first session, with a visual check-in before and after each listening session. Because of BJ’s medical history, she has equipment to monitor her blood pressure and heart rate that she would also check before and after her sessions.
Because of BJ’s excitement around the Safe and Sound Protocol (SSP), she wanted to “just power through and complete all five hours quickly.” Lori advised against speeding through the sessions after seeing the physical responses BJ was having. They both agreed that doing a maximum of 30 minutes per listening session, and abandoning the session if she felt distress, was the best approach.
Lori shares how discussing BJ’s response to the SSP with her was incredibly helpful. BJ “began to be able to just sit and meditate or be calm on her own when she had not been able to do so for many years.”
Response
After the first Safe and Sound Protocol (SSP) listening session, BJ was able to notice physical changes that were different but not stressful to her. For example, she got goosebumps on her left arm, and her neurologist had told her on other occasions that a one-sided reflex was indicative of nervous system issues. She also had a strong sensation to some of the music and could feel it right at the top of her sternum. After the first session, when she stood up, her blood pressure increased drastically but then leveled out fairly quickly. She reported that her usual response when standing was a drop in blood pressure instead of a rise.
After hour two of listening, she had to immediately pass a bowel movement and experienced this after each subsequent listening session. This is notable because she did not have regular bowel movements. After hour four, she awoke in the middle of the night and had to urinate. This is notable because she would often go for several hours without the need to urinate and will sometimes have to use a catheter.
Since completing the SSP, BJ has reported that when at some concerts, a musical note will trigger that same sensation previously mentioned at the top of her sternum. In addition to the physical changes to her autonomic nervous system, BJ reported having memories of traumatic situations but felt at ease after they passed.
Discussion
Lori was quite surprised by the drastic changes in BJ’s physical health in such a short period of time. BJ has said that this is the first technique in years that has given her hope and made her feel better, even if the benefits have not been maintained.
Lori shares, “I feel that the intervention worked for BJ because she was totally committed to it. She learned the terminology quickly and I was able to talk to her about the stages and [her] goals easily. Her access to monitoring equipment made it very easy to document the physical changes she experienced.”
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