Reclaiming Identity After Captivity: How SSP and RRP Supported a Survivor’s Trauma Recovery

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.

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About the Provider

Name: Sharon Stultz
Disciplines/credentials: MA, MS, LMHC, EdSp – Pathways of Learning
Modalities: Rest and Restore Protocol (RRP), Safe and Sound Protocol (SSP), Tension & Trauma Releasing Exercises, EMDR

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Client Background

Name: Anderson (pseudonym)
Age and Gender: 57-year-old man
Program Delivered:

• Safe and Sound Protocol (SSP)
  • SSP Core: Hours 1-5
  • SSP Balance: Hours 1-5
• Rest and Restore Protocol (RRP)
  • Introduction
  • Level 1

Back in his home country, Anderson had been captured and taken as a political prisoner. While he was held hostage, he experienced significant traumatic experiences that completely reshaped his daily life and greatly impacted his ability to function.

Anderson suffered from total memory loss of his life prior to imprisonment, his memories limited to debilitating flashbacks that he experienced multiple times a day. The frequency and intensity of these flashbacks sometimes translated into erratic actions and unstable behaviors. Anderson also exhibited several PTSD symptoms, including chronic headaches, rigidity that led to using a cane for support, suicidal ideation, and more. Anderson’s cognitive symptoms made it difficult for him to communicate, and he often repeated words and phrases.

After his release, Anderson was moved to the U.S. for his safety, but the severity of his symptoms made it difficult for him to integrate into a new society. Anderson became unhoused and lived on the streets of Seattle, Washington, until a local church community provided him with shelter. He turned to a local health agency for support, but it was unable to properly address his specific needs, particularly his PTSD.

Anderson’s primary goals for treatment were to regain functioning and the ability to take control of his life. His trauma and the resulting symptoms felt debilitating, and he hoped to regain personal agency. He did not want to live a life defined by the horrific situation he had endured any longer.

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Implementation of the Safe and Sound Protocol (SSP) and Rest and Restore Protocol (RRP)

When provider Sharon Stultz first met with Anderson, she knew that an effective treatment plan had to properly accommodate the scale of his trauma. Her treatment plan for him featured a phased, body-first approach that took place over two and a half years, delivered weekly in Anderson’s home.

Anderson began listening to the SSP Core pathway in short, two- to three-minute intervals to gradually attune his nervous system to the treatment. After each listening session, Anderson completed a 20-minute Tension & Trauma Releasing Exercises (TRE) regimen. These exercises included tremors, playing cards, creating art and more calming activities. Over the course of six months, Anderson increased his listening tolerance to 20 to 30 minutes weekly.

After Anderson developed enough comfort with the SSP, he began listening at home without Sharon. His partner also played the familiar playlists to stabilize his mood and interrupt flashbacks, particularly when they occurred while he was sleeping. This technique dramatically reduced the duration and severity of his flashbacks.

Once Anderson felt confident with the SSP, Sharon introduced RRP to their listening sessions. She noted that he “tolerated it well and I saw a much lighter mood.” 

Throughout both SSP and RRP, Sharon titrated Anderon’s listening durations carefully, strictly adhering to his window of tolerance. For this reason, Sharon chose not to administer assessments, fearing that the questionnaires could induce flashbacks.

Response 

Over two and a half years, Anderson’s level of functioning gradually improved. He felt a reduction in suicidal ideation, and his desire to self-harm became less frequent. He woke up less frequently throughout the night and experienced fewer nighttime flashbacks. As he progressed with the listening treatments, the flashbacks he did experience changed: when he started treatment, these visions repeated one specific event over and over; as he progressed, his flashbacks began to vary, uncovering more memories from his capture.

Sharon also integrated EMDR into their treatments. Anderson began drawing and painting like a trained artist, which was a drastic change from when they initially introduced art into his sessions. Previously, Sharon described his drawings as simplistic and child-like. Only recently did he remember that he went to university to train in the visual arts.

Anderson’s partner noticed significant results. When asked about his progress, they stated:

“Your SSP music app has helped in the stabilization and healing [of] Anderson. In the beginning, when he would have a flashback from his torture, there was nothing we could do but ride it out. Sometimes, it would take hours for him to come out of these episodes. When an episode would end, he would be very withdrawn and suicidal. Since working with his therapist and utilizing the SSP, along with tremoring, he has reduced some medication. We use the music to help him stabilize his mood when he is feeling withdrawn and suicidal, and it lessens the severity or length of his flashbacks.

“It has been two and a half to three years since he started this treatment with his therapist, and it has been a lifesaving tool. He needs it to continue to thrive. When he had to stop working last year, we were no longer able to afford to pay Sharon for her services. Since receiving the grant, he was able to resume, and his stability and growth returned. His progress has been extensive; even if he does not see it, everyone else can. When we started, he could barely draw or focus on things without getting severe headaches and/or flashbacks. Now, he can focus, and his drawing and painting talent has returned, and he has started writing more. Writing was his job before his torture. What happened to him happened over a matter of days. His healing will be a lifetime. I really don’t know what we would do if we lost access to SSP as part of his healing.”

Anderson’s ability to socialize in his day-to-day life strengthened. Before treatment, Anderson often felt paranoid around strangers, worried that his captors would return. Now, he has been able to attend social events and enjoy meeting new people. Anderson shared a story about holding a conversation and joking with a police officer when, in the past, the mere presence of an officer would trigger a flashback.

For Sharon, the most notable developments manifested in Anderson’s demeanor. When they first met, Anderson was “so extremely fragile,” and Sharon feared that she would “only add to the devastation if his trauma was re-experienced during our sessions.” Now, he is often conversational and smiling when he enters a session. He no longer shuts down entirely when experiencing a flashback, and “while he might get dissociative during a session, he is always present and able to return to the present.”

Physically, he relies less on his cane for stability and moves more agilely than he did when they first met. His memory and conversational abilities both continue to improve, indicating that “protective processes in his brain are releasing aspects of the event that thoroughly overwhelmed him before. There were times he believed he was about to die, but did not. Slowly, the story of survival is making itself into his system.”

Discussion

Sharon’s key takeaway from working with Anderson emphasized the adaptability of combining treatment plans for individual clients. By combining SSP, RRP, TRE and EMDR, Anderson began to unravel a complex web of trauma that could not be addressed by one modality alone.

Sharon believed that offering only one intervention would have provided temporary relief for Anderson, while creating a routine and expanding his window of tolerance helped offer more processing. 

While Anderson still experiences confusion and overwhelm, he expressed that he would not be here today without this work, reflecting the profound impact of listening therapies within a multi-modality therapeutic approach.