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Side effects of the Safe and Sound Protocol

Why does SSP sometimes cause such extreme “adverse reactions”? Why is it so transformational for other people?

Emma Ashfield of Move2Connect and Carol Ann Rowland of Halton Therapy & Neurofeedback in Georgetown, Ontario explain…

This post contains vital information for remote clients of the Safe and Sound Protocol as well as for those researching the programme, and explains why it is essential to be SUPPORTED through the SSP, and to understand that this is not a “plug and play” music programme that you can do by yourself, having read a couple of books on Polyvagal Theory and trauma.

If you are looking for information on what the SSP is, please refer to this post –

As you probably already know, the Safe and Sound Protocol is a five-hour listening programme, based on Dr Stephen Porges’ Polyvagal Theory.

Brief overview of the polyvagal theory

When we work with the nervous system, less is always more. “More” is like stretching a perished rubber band to breaking point – you’re bound to see side effects as a person grows into their “more”, whereas with less, a person can still grow into a more settled system, but gradually.

The Safe and Sound Protocol is designed to help a person process trauma as well as improve social engagement, language and cognition. The protocol was originally intended for children with developmental trauma as well as to improve social communication for children with autism, but it is in widespread use by psychotherapists and other trauma therapists globally for complex trauma in adults, as a powerful non-talking intervention that helps people to process trauma effectively.

Your practitioner NEEDS to be trauma-informed and it is essential that they also that they understand how to work with the nervous system. This means they need to be trained in trauma and understand both trauma and the polyvagal theory in depth. This doesn’t mean simply banding the word “trauma” around or citing a couple of books they’ve read. A practitioner MUST have a thorough knowledge of how the SSP works and they must work with you to ensure that they understand exactly how much listening you need every day as well as the volume you should use, whether to complete in clinic or digitally and so-on.

A thorough administration of SSP involves a lot of preparation and support on the part of both you and your practitioner, and success is equally dependent on you fully engaging with what you are doing as it is on your practitioner working ethically and knowledgeably with you.

Carol Ann Rowland of Halton Therapy & Neurofeedback in Georgetown, Ontario is an esteemed colleague and valuable member of the SSP practitioner community. I asked her to encapsulate why it is so important to find the right practitioner with the right level of experience and sensitivity – rather than focussing on price:

People looking for an SSP practitioner are often tempted to go with whoever has the lowest rate. Unfortunately, practitioners who strive to offer the lowest price are often cutting corners in how much time they are investing in their clients’ processes. At best this may lead to the process being much more difficult than it needs to be.  At worst, there is the potential that, if dysregulation gets big enough, that improvements may either be reduced or sabotaged completely.  In some cases the process will end up costing even more when intially taking a budget approach as it may become necessary to then find another practitioner who is able to help repair where things went wrong.  Worst of all, someone who has a difficult experience with SSP may never be willing to repeat it again, which is heartbreaking given that SSP can be life changing for many. With SSP I often see shifts that usually would have taken decades of hard work before showing up.  It is well worth investing in a quality practitioner who will ensure that you have the best and gentlest possible experience, while maximizing the potential for signficant improvements.

Carol-Ann Rowland

We also need to make it crystal clear that experiencing side effects are not a BAD thing when going through the Safe and Sound Protocol. However, lingering negative side effects are what we want to avoid, and that is where understanding how to work with nervous systems is all important. What we need to do is find the “biting point”, to use manual car terminology – the point at which one starts to react and is able to soothe the reaction using somatic work. The body needs time to process, so rushing or “pushing through” should not be an option.

Let me give you a couple of case studies – one positive, one negative, in order to illustrate my point further about the importance of being trauma-informed.

Adverse reaction to SSP in a 6 year old

William, aged 6 did SSP last year at home with his parents. He had a history of lengthy hospital stays and trauma. It is worth mentioning that our health and social care system in the UK had not identified the link between invasive early childhood hospital stays and behaviour, and hence William had been placed on a diagnostic pathway for autism and ADHD.

His practitioner advised starting with 15 minutes of listening, but unfortunately his mother decided that because he was looking relaxed and happy while listening, she would leave him to listen and play with Lego while she went to do the dinner. She forgot he was listening, and he did a full hour. She admitted this to the practitioner, who took a deep breath re ignoring instructions, and said it would be wise to give it a break the following day. Unfortunately, this advice was not heeded, and so William did a second hour-long session the following day… after which he threw a cat down the stairs, kicked a hole in a shed door and threw his mother’s mobile phone in a fish pond. When his mother asked the practitioner whether this was a normal reaction, the answer had to be very measured considering the fact that all instructions had been completely ignored.

It took William FOUR months for anyone to see any benefits. By this time, he was on a final warning at school for violent outbursts. However, once he had settled, his progress was fantastic: he was able to vocalise his anger so much better, and in the meantime, sleep settled right down too.

Since the initial round of SSP, William’s mother has also done SSP for herself and he has had a repeat of days 3-5.

In fact, the above is still a positive result, despite appearing to be an adverse reaction. In fact, William was merely responding to his environment after being overwhelmed by too much challenge to his nervous system in one hit. It is also worth mentioning that the reason why an experienced practitioner may suggest that a parent also completes SSP themselves is that it is essential for parents to connect deeply with their children during this process. Leaving them to play Lego by themselves while they listen is not going to provide the magic bullet they think they are paying for, and neither is completely disregarding carefully given instructions.

A client rescued from a bad experience with a cut-price SSP experience with a practitioner, who did not offer any support during the programme

A mum contacted Move2Connect, desperate for help with her teenage son, who had got to day 4 of a third round of SSP and was suffering from extreme sensory overwhelm.

When Move2Connect asked when the previous rounds had been, we were alarmed to find that this parent was sharing physical SSP equipment with another 5 families – and using SSP once every 6 weeks! Given that SSP continues to take effect for up to 8 weeks post SSP, repeating quite so often is ill-advised.

We decided to complete day 5 of SSP, but VERY slowly (5 minutes every day or two, depending on reactions), and incorporating external (bodywork) support for the vagus and facial nerves.

The mother then followed up with a course of cranial osteopathy.

The teen went from being totally shut down (eyes tightly closed, hands clasped over ears, non-verbal, distressed, sleeping all the time), to smiling, relaxed facial muscles, laughter and expressing desires in language. A fantastic transformation!

Please beware of cut-price SSP practitioners, lack of supervision and lack of titration knowledge.

A wonderful experience for an adult with PTSD

A 40 year-old with PTSD (and a psychology student who had studied polyvagal theory as part of their degree) went through SSP in clinic, following many years of talking therapies.

They completed the SSP in a number of half hour sessions on a Monday and Friday over a number of weeks. Each session involved a few minutes listening and followed by a few minutes of co-regulation, followed by another few minutes of listening and then more co-regulation. Even after the first half hour, they noticed an incredible ability to connect with strangers that seemed to come out of the blue. After completion of hour 3, they had a job interview and got the job, where they remain happy to date.

They completed the five-hour SSP Core and reported a fantastic shift in terms of anxiety. However, they decided to undertake a “booster” of hours 3-5 remotely using the Digital SSP in April 2020 due to stress over the Covid-19 situation, which they report to have made them feel noticeably calmer and better able to sleep through the night without 3am wake-up-and-worry sessions.

What has happened, and why was this so successful? This client fully engaged in the process. They researched SSP and the Polyvagal theory thoroughly in advance and engaged with the practitioner every single day to give the required feedback so the programme could be tweaked if necessary.

So, how do we avoid having a William situation, and ensure a peaceful and effective situation?

  1. Research your provider.
  2. How long have they been qualified to deliver SSP?
  3. What is their background?
  4. Don’t be scared to ask how many clients they have worked with.
  5. What kind of client they specialise in?
  6. Do they specialise in SSP or are they a jack of all trades?
  7. Are they trauma-certified? Do they work with nervous systems as part of their discipline?
  8. Ask them to explain how SSP works – can they do this clearly in their own words? Or do they use recycled materials and waffle?
  9. Ask what sort of side-effects they have seen and how they deal with them.
  10. Do they ever refuse clients? (you want them to say yes, and explain why – you would also want them to explain that they cannot deal with those stuck in a “freeze” state, and will ideally need to see them face-to-face in clinic).
  11. How do they work out how to work with clients?
  12. How will communication take place during the protocol? Does this feel safe to you?
  13. What will happen post-SSP? What is their go-to follow up? Do they insist on you following their programme or do they have a network of other therapists they refer to?
  14. How will they prepare you for SSP? How do they use the SSP Connect Programme?
  15. In addition, are they strikingly cheap or strikingly expensive?
  16. Do they have a website? Have a really good look around it to get a feel.

I have been providing SSP since 2018, and have worked with hundreds of clients to date, with a variety of presentations and different nervous systems.

I run 1:1 workshops for anyone recently trained in the Safe and Sound Protocol, and regularly advise and collaborate with Unyte-iLs on training/clinical practice.

For any questions about the Safe and Sound Protocol, either as a client or a practitioner, please contact me.

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