The Safe and Sound Protocol (SSP) supports positive shifts in fibromyalgia symptoms and uncovers untreated trauma

About the Provider

Name: Janey Cutting
Discipline/Credentials: Integrative Arts Psychotherapist MA, UKCP,  HCPC
Modalities: Safe and Sound Protocol (SSP), Arts Psychotherapies (specializing in trauma)

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Client Background

Name: Rachel (pseudonym)
Age and Gender: 53-year-old woman
Program Delivered: Safe and Sound Protocol (SSP) (Core, Hours 1-5)

Rachel presents with C-PTSD, anxiety, fibromyalgia and MUS (medically unexplained symptoms). Janey first visited Rachel for an in-person assessment in her home, which she was sharing with friends. Although Rachel had reported that the living environment was calm, Janey experienced the opposite, noticing that Rachel was emotionally dysregulated. Rachel scored highly on the intake form, indicating that her sympathetic nervous system was activated. She had recently started sessions with a bodywork therapist but had found it difficult to engage. 

Rachel was experiencing a lot of pain throughout her body, with increasing sensitivity to both the pain and to sound. Over the past 18 months she was experiencing muscle stiffness and sometimes excruciating pain, especially in her back and legs, coupled with fatigue, sleep and digestive problems. She had also noticed that her memory and concentration was getting worse. Treatment began with the goal of calming her anxiety and helping her to get more rest. Then, Janey began titrating exercises for grounding and connection with her body with the hope that Rachel would eventually gain more mobility and experience less pain overall.

Halfway through the SSP, Rachel had a biopsy to remove five saliva glands, which she had not mentioned upon intake. She was diagnosed with suspected Sjogren’s Syndrome, an autoimmune disorder with common symptoms of dry eyes and dry mouth. Janey wondered if this might be connected to the social engagement system somehow.

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Implementation of the Safe and Sound Protocol (SSP) 

Following the first in-person assessment, sessions were done remotely two times per week, supported by 10-20 minutes of independent listening a day, with days off. The listening took four weeks in total, and Janey shares that “in hindsight [it] would have been more beneficial if [done] slower. I had to keep an eye on my [MyUnyte] dashboard to make sure she wasn’t ‘powering through’, which was a tendency she had.” 

Janey provided Rachel with an appropriate amount of psychoeducation and attunement to not overwhelm her system. She encouraged movement, breathing and humming exercises, mindfulness and self-compassion. Janey reports “this resulted in lots of sighing and yawning as the system had an opportunity for regulation.”

Response

After the first session Rachel was able to access the deepest rest she had experienced in years. She noticed a positive change in her ability to connect with her breath, which is something she had struggled with in the past. After session two, the pain in her back and legs eased and she began to feel more flexibility in her movements.

When independently listening to hour two, she was in a dysregulated state due to an argument and went overboard with the listening in the middle of the night. Janey reports “she said this ‘felt naughty’, and we discussed her responses and how ‘less is more’. As is her tendency, she tried to ‘run before she could walk’, and towards the end of hour five, we needed to put the brakes on.” 

She was able to tell her bodywork therapist that she was frustrated with the treatment, after which she was able to engage more deeply.  And in turn this must have fed back into the SSP treatment as a reinforcement.

During listening, Rachel experienced memories of unresolved relationships from her past and recognized that she hadn’t been able to grieve the deaths of her parents. These unresolved feelings caused a downward spiral over the past four years. As listening progressed she reported a shift in her anxious thinking loops and felt she was hanging onto thoughts less and was more grounded in her body. 

Janey shared “I feel that the work with Rachel was beneficial in helping her to know what a more regulated system feels like. A foundation of safety and trust was achieved, followed by a deeper connection with her body.” The SSP provided a solid foundation for success in further therapeutic interventions in the future. Janey came across layered complexities, both physical and emotional, that are interdependent and would need further therapeutic work to unravel.

Discussion

Rachel is a musician which made her keen to engage in the listening and she enjoyed the selection of music. Janey shared the importance of establishing the safe before sound ethos so that Rachel could relax deeply and trust the process. She reports “She became more aware of her own regulating resources, walking in nature, singing, and dancing, and was able to engage in these more often as the listening progressed and she felt stronger.  Approaching her biopsy she had felt the onset of a panic attack but was able to calm herself down very quickly.” 

Rachel’s anxiety, pain due to fibromyalgia, and untreated trauma have all been positively addressed through the SSP.