Neuromodulation using digitally filtered and edited music to treat a ten-year-old child unresponsive to standard interventions for Functional Neurological Disorder.
Case study published in Harvard review of Psychiatry
Clinical case studies play an important role in building a strong evidence base for therapeutic interventions. They tell a holistic story about a client's experience and allow space to observe change observe across a wide range of possibilities in the context of an individual's real-world experience. As the evidence for the Safe and Sound Protocol (SSP) grows, case studies shed light on who, how, and under what circumstances the SSP can be most effective. This helps both program planning and future research areas.
A recent Harvard Review of Psychiatry publication does just that, telling the story of MT, a 10-year-old girl with Functional Neurological Disorder (FND) (Rajabalee et al., 2022). Together with an expert medical and research team, co-author Dr. Stephen Porges provides insight into the mechanism and impact of the SSP.
LFND is a neurological-somatic disorder with an unknown cause. There is a disconnection between the brain and the body due to disturbances in sending and receiving signals related to memory concentration, emotions, cognition and motor functions. FND is often triggered by bio-psycho-social factors, including childhood trauma, interpersonal stress or illness.
When MT was diagnosed, she presented with a cluster of somatic symptoms that included unsteady gait, blurred vision, periods of confusion, persistent headaches, back pain, nausea and swallowing problems. This seemed to be caused by a viral disease. After a formal diagnosis of FND, she was admitted to the hospital's intensive Mind-Body Program, which included physical, psychological, pharmacological and family therapy.
However, because of the severity of MT's condition, she had difficulty participating in the program, and MT's brooding about her pain grew into catastrophic and suicidal thoughts. MT had particular difficulty with cognitive or "top-down" therapies. The team therefore turned to physiological "bottom-up" and passive regulatory therapies - including the Safe and Sound Protocol (SSP).
The SSP was delivered in nine listening sessions over six weeks, starting with 15-minute sessions and building up to 30 minutes. While participating in the SSP, her ability to communicate, social behaviors and physical movement significantly. Her breathing slowed and catastrophic thoughts disappeared. Her scores on anxiety, depression, stress and the Body Perception Questionnaire (BPQ) returned to "normal" levels. At follow-ups two months later and a year and a half later, MT had maintained these benefits and her sense of well-being.
While the program plan and results of this important case study may not apply to every client with FND, it does provide a clear picture of how the SSP can help support health and well-being of clients with similar presentations. By affecting the autonomic nervous system, the SSP helps clients better access their social engagement system. Improved regulation of the nervous system has important secondary effects on breathing, heart rate, cognition and other essential neurophysiological functions that contribute to overall recovery.
Read more about the Safe and Sound Protocol
References
National Institute of Neurological Disorders and Stroke (NINDS), (2022). Functional Neurological Disorder. Retrieved from https://www.ninds.nih.gov/functional-neurologic-disorder
Rajabalee, N., Kozlowska, K., Lee, S. Y., Savage, B., Hawkes, C., Siciliano, D., Porges, S. W., Pick, S., & Torbey, S. (2022). Neuromodulation using computer-modified music to treat a ten-year-old child who was not responding to standard interventions for Functional Neurological Disorder. Harvard Review of Psychiatry, 30(5), 303-316. https://doi.org/10.1097/HRP.0000000000000341
