Case Study: Transgender boy experiences less social anxiety and fatigue after SSP

About the Provider

Name: Michael Krause
Discipline/Credentials: Heilpraktiker (Psychotherapy)
Modalities: Hypnosis, Hakomi Method

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Client Background

Name: Paul (pseudonym)
Age and Gender: 17 years old, transgender boy
Program Delivered: Safe and Sound Protocol (SSP) (SSP Core, Hours 1 through 5)

Paul is a 17-year-old transgender boy, who was diagnosed with an anxiety disorder at three years old and depression at eight years old, in addition to gender dysphoria and complex post-traumatic stress disorder (PTSD). Four weeks prior to the start of treatment with his provider, a mastectomy took place. A three-year stay at a youth welfare institution was also recorded.

At the beginning of the treatment, he experienced symptoms including sensitivity to sound, dissociative fugue, anxiety, rapid fatigability, shallow chest breathing (at about 16 breaths per minute), sensitivity to external stimuli, problems in social behavior, strong emotional vulnerability, marked inner turmoil, and flashbacks.

His mother, who is a nurse, heard about the SSP and specifically sought it through a certified SSP provider. Their treatment goals were emotion regulation, better handling of external stimuli, and stress regulation.

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Implementation of the SSP

A total of six 90-minute therapeutic sessions were conducted, the first of which served as an opportunity for the provider and client to get to know each other to establish a relationship, as well as to test the SSP Core for five minutes. This was followed by five SSP sessions over five consecutive days. Before and after each listening session, there was a short exchange about the current state of health and a heart rate variability (HRV) measurement.

During the listening, Paul lay down in a hypnosis chair. To further increase the feeling of safety, he was wrapped in a cozy blanket and softly bedded with an additional pillow. The therapist was present and emotionally involved during the entire time.

Response

Following treatment, Paul reports significantly lower social anxiety: he is now able to be in the middle of a room and not just against the wall. His sleep disturbances have decreased significantly and he reports significantly better performance, as well as decreased fatigability.

At the beginning of the fourth session, he reported a stressful situation that had occurred following the previous session. While working at the public library, he had been insulted by an elderly woman. In the past, such events had always led to a shift in state toward dorsal vagal, with pronounced numbness and dissociation. This time, however, he was able to emotionally distance himself and successfully disconnect from the situation.

In the course of the sessions, his average HRV short-time measurement showed an increase in coherence values from 3.5 to 5.1 (measured with Emwave by HeartMath).

Paul’s parents confirmed his positive reports and, for their part, reported an improvement in symptoms that were also clearly evident to them. A significant calming of the general condition could also be observed during the sessions. Paul reported a feeling of “being cradled” while listening, which visibly calmed and relaxed him.

SSP Core Session (Hour)	HRV Before	HRV After
1	3.5	3.5
2	3.5	5.0
3	3.0	4.1
4	3.9	4.2
5	4.5	5.1

Discussion

In the first session prior to starting the SSP, a very intensive relationship could already be established. This led to a fundamental feeling of security for Paul, as the sessions were characterized by a high degree of trust. Particularly important in this case was the unconditional acceptance of his person and the verbal and nonverbal message: “You are OK the way you are!”