About the provider
Name: Susanna Harkonen
Discipline/Credentials: Registered Counselor
Modalities: Safe and Sound Protocol (SSP), EMDR, CBT, ASDCS, CCTP, sensory processing/integration, mindfulness
Customer background
Name: Bob (pseudonym)Age and gender: 22-year-old man
Program delivered: Safe and Sound Protocol (SSP) (SSP Core and Balance, hours 1 through 5)
Bob is a young, socially flexible and bright university student, but could not concentrate and focus on his studies because of intrusive thoughts.
His mother's side is Asian and has a history of unprocessed trauma. After his parents divorced several years ago, Bob and his two brothers stayed with their mother, with whom he has a close relationship.
Bob's relationship with his father, however, is distant. His father is Caucasian and exhibits some autistic tendencies, although he has not been diagnosed. He was often unpredictable and angry, directing his anger at Bob. He created corporal punishment and rules that constantly changed without Bob's knowledge, making them difficult to follow. Bob's father used physical violence and allegedly made Bob beat himself as punishment.
All his family members drank significantly when they got together "to support each other," and Bob drank half to a full bottle of wine daily to calm his anxiety.
Bob went to therapy several times in his home country and received medication for his disorders. He experienced intrusive thoughts, generalized anxiety and dissociation. He was unable to relax, had cognitive problems and could not focus on talk therapy during the first sessions because of his intrusive thoughts. Bob wanted help with these thoughts that kept him from studying and connecting with other students, and worried about his drinking.
After trying many forms of therapy and medication, Bob admitted that he was somewhat skeptical of the results of therapy, as his previous experiences had not produced lasting results. (His previous therapist had also dropped him just before he began working with Susanna.) Their treatment goal was primarily to provide regular support during his university exchange program, which lasted a semester, before he could return to his country and find a regular therapist.
Implementation of the SSP
Bob started directly with the SSP Core because he had no specific sensitivities. Due to COVID-19 restrictions, the program was delivered remotely via independent listening followed online (but not listening together) for 30 minutes a day, with regular check-ins weekly or biweekly online via Zoom and daily follow-ups via WhatsApp (text message) for the first 10 days.
Bob took a short break from the program after the first five hours, but asked to continue listening daily because it had such a positive and significant effect on him. He used the SSP Core for another month and a half and then switched to the SSP Balance program. He has now been listening daily or several times a week since early October 2022 and continues to use both programs.
His SSP delivery was supported by psychoeducation on trauma, polyvagal theory and attachment trauma, as well as co-regulation during the online sessions and three in-person sessions at the beginning and end of therapy.
He was eager to learn more about the topics discussed and became quite knowledgeable about polyvagal theory and the neuroscience behind trauma, which helped their joint work and further increased his confidence in the SSP. Within one to two weeks of starting the SSP, Bob increased sports and social activities on his own and limited his drinking to social occasions.
Response to the SSP treatment
Provider Susanna Harkonen shared the following testimony from Bob:
The Safe and Sound Protocol surprised me and greatly improved my overall well-being. I had been dealing with a persistent episode of problems with depression, anxiety, intrusive thoughts and dissociation for months when I started the protocol. After the first session, I didn't feel much of anything. After session three, I felt subtle calmness that I had not felt for months. My symptoms gradually improved until I completed the protocol - and even after that, it continued.
What I find interesting about the SSP is that it is so subtle - there is no magic moment of remission. Instead, I just finished the sessions and went on with my normal business. Slowly I realized that I felt much better than I had in months. I was able to enjoy peace and reconnect with the world. The motivation and optimism these first moments of reduced symptoms gave me enabled me to completely change my daily habits - further leading to healing. After a few sessions of SSP, for example, I began to exercise more, read more and drink less.
Overall, I am extremely grateful for the SSP and the reduction in depression, anxiety and intrusive thoughts it has given me. I can enjoy life again and experience peace. I have motivation to change my lifestyle and I am even optimistic about the future.
Discussion
"I was delighted to see the tremendous physical, mental and emotional shifts in the client," Susanna said. "This intervention worked particularly well because we formed a good therapeutic alliance from the beginning, [he] is young and really wanted to get better, he was open minded and enthusiastic about trying new approaches, and he immediately absorbed and applied most of the parts he learned through psychoeducation."
Susanna noted that at first she was careful not to go too fast because the workout emphasized so much that less is more and was a little hesitant to do a second set of SSP Core immediately after the first.
"I was very concerned about the client's condition, and even safety, when we started therapy because he was clearly upset and overwhelmed. I wasn't sure how much I could do for him, if anything," said she. However, because Bob was improving so much and so quickly, she followed him closely and made sure the impact was positive rather than overwhelming.
"I think the SSP is a great tool for Gen Zs and especially anxious students because it can be delivered remotely, easily and discreetly, and the cost of delivery can be kept reasonable because the SSP requires less [one-on-one] face-time required than talk therapy."
"It was so beautiful to watch the client improve session after session, become more communicative and social, and begin to report positive elements about his life, including dating and other social activities," Susanna added added. "He continues to keep me informed and recently reported getting along better with his mother."
