The Safe and Sound Protocol (SSP): Exploring Research and Applications
The Safe and Sound Protocol (SSP) is a practical application of Polyvagal Theory, created by Dr. Stephen Porges. SSP can make, and has made, a big difference for patients.
But that doesn’t mean we can’t get there. When we first begin our recovery journey, we may not be ready to make the most of treatment from day one. Wanting to feel better doesn’t necessarily mean we are in the right place to be able to do so. Safe and Sound Protocol (SSP) is one way to support your early recovery. So what is Safe and Sound Protocol? It’s a relatively new treatment supplement created by Dr.
How SSP Works
During SSP, you listen to specifically filtered music designed to signal safety. The SSP uses a wide variety of music, including some that you may already be familiar with. All the music in the SSP playlists are thoughtfully sequenced and filtered through the patented, evidence-based algorithm backed by decades of scientific research.
By sending cues of safety through specially filtered music, the SSP engages a system of muscles and nerves that support social engagement, stimulating the vagus nerve. The Safe and Sound Protocol explains that when we have faced trauma, mental health issues, addiction, or other life challenges, we can get stuck in a loop of autonomic nervous system dysregulation. What this means is that our brains, bodies, and external triggers tell us we aren’t safe. And when we’re having trouble with any of these areas of our life and health, we experience even more feelings of unsafety. This loop of unsafe gets in the way of us moving forward.
The SSP contains several vocal and non-vocal music playlists and levels of filtration to help you support client engagement and participation in the listening process. Yes - at-home carry over is very important for SSP and it can be accessed through a user- friendly app compatible with iOS and Android devices.
Clinical Evidence and Research Findings
Clinical studies and observations show that SSP is very effective; patient experiences and successes help prove this. Our case study, “Integrating SSP group delivery in an inpatient Level One psychiatric facility,” confirms that SSP makes it easier to approach and address all forms of trauma and even creates more “coherent and organized” brainwaves. Patients participating in SSP felt calmer, were less likely to get overwhelmed in treatment, and were better able to manage their emotions and behaviors.
In a new article published in the peer-reviewed academic journal Music and Medicine, a group of researchers explores the connection between voice and throat symptoms and autonomic dysregulation, anxiety, and depression, and the potential of the Safe and Sound Protocol (SSP) as a part of treatment. This publication offers valuable insights into understanding these complex symptoms through a bottom-up, neurophysiological approach informed by Dr.
The researchers conducted two studies. First, they examined the connection between voice and throat problems and autonomic dysregulation. Through clinical assessments, they found that people with these symptoms reacted more strongly to stress in parts of the body influenced by the vagus nerve above the diaphragm.
“Prior to this study, I shared with Dr. Porges my experiences in my work as an SLP, [and] voice and trauma therapist. I saw that many clients who, despite the fact that the ENT physician did not detect any abnormalities, experienced a strong complaint experience,” said Heleen Grooten-Bresser, a speech therapist specializing in voice therapy for 40 years and the article’s lead author.
Additionally, the study found a positive correlation between voice handicaps and anxiety and depression. This suggests that not only do these symptoms affect a person physically, but they also cause an emotional impact. Grooten-Bresser, H., Heilman, K. J., Kooijman, P. G. C., Monti, E., Chenault, M. N., Holmes, L. G., & Resto, O. (2024). Speech therapy clients with voice, throat and respiratory complaints: Self-reported autonomic reactivity, anxiety and depression and effects of Safe and Sound Protocol.
“This research, conducted at the request of Dr. Porges, confirmed my suspicion that emotional dysregulation also plays a role in the background of voice, throat, and breathing complaints: many of the clients with these complaints have high anxiety-depression scores, among other things,” said Grooten-Bresser. Jack, 69, presents with spasmodic dysphonia, a neurological disorder affecting the voice, with stress on his vocal cords.
These results demonstrate the SSP’s potential to shift the autonomic nervous system out of a sympathetic “fight-or-flight” state.
| Study Finding | Description |
|---|---|
| Autonomic Dysregulation | Individuals with voice and throat issues exhibited heightened stress responses in areas influenced by the vagus nerve. |
| Correlation with Anxiety and Depression | A positive correlation was found between voice handicaps and symptoms of anxiety and depression. |
| SSP Effectiveness | The Safe and Sound Protocol (SSP) demonstrated potential in shifting the autonomic nervous system out of a "fight-or-flight" state. |
Voice and throat disorders can significantly impair a person’s quality of life and manifest as symptoms such as voice handicaps, pharyngeal globus (the persistent sensation of a lump in the throat), and breathing problems. Treatment of these conditions can be challenging, especially when there is no clear diagnosis. Addressing nervous system dysregulation may be an effective approach rather than targeting individual symptoms.
Vice President of Trauma Resolution Services Deirdre Stewart explains how when you enter treatment, you’ve been living in this fear, in flight, fight, or frozen mode. Whether you’re aware of it or not, this mode continues. SSP shifts this fear, which Stewart says helps your nervous system become more available “so that all other modalities can be received and integrated.” This enables you to notice your anxiety, fear, or anger at a distance.
SSP doesn’t treat mental health or addiction on its own, but it gives you the mental space you need to do so. You can’t get the greatest value out of therapy when you are distracted, out of touch with yourself, or experience great distress when accessing the memories and feelings you need to process to move forward.
Integrating SSP into Treatment
When you choose to participate in SSP with The Meadows, you will meet with a group for 90 minutes a day. SSP is a group practice because, as Stewart explains, ”Healing happens in community, neuroscience tells us this.” SSP is usually part of your early treatment so that you can make the most of both SSP and your other treatment modalities.
That is how SSP may fit into your treatment schedule, but now you may be wondering, What activities can I do while safe and sound protocol is in place? Do I just sit there and listen? The answer is you have choices! You and your treatment team will talk about the best activities for you to take part in during SSP. Some options can include creative pursuits like drawing, painting, movement, or poetry. Or you may get the most out of simply sitting with your sensations and focusing on your physical and mental feelings. Or you may practice several of these to find the ones that work best for you.
If you’re looking for this in-depth, comprehensive, and personalized care, reach out to us at The Meadows. SSP is now available at the Brain Center at The Meadows, a resource you have full access to as part of our program. Our expert team can also answer any further questions you have about what is Safe and Sound Protocol. This protocol can make a big difference when it comes to your or your loved one’s recovery success.