Tiniest Muscle with Real Pull (Part 1)

Greenhouse or Conservatory?

It was a wonderful surprise experiencing a major improvement in my short term memory after two hours of  Listening Therapy. I started the Listening Therapy five years after my injury. Why not earlier? Mainly because I hadn’t known about the treatment.

My short term memory challenges impact several areas of my daily functioning. it effected my executive functioning, planning, keeping things organized and maintaining focus. There are probably other related elements but those are the elements that come to mind.

How It Happened

I was about 3 days into a minor building project, building a small greenhouse from repurposed materials, when I started my Listening Therapy. In working on the building project I was struggling with the daily frustrations of having to remeasure the same things time and again. I take a measurement, walk ten steps and then question my recall of the measurement. Eventually I got the first part of my project figured out.

I was two days into a 7 day Listening Therapy when I realized something had changed. I found myself remembering measurements up to 10 minutes later. I was no longer misplacing tools. Hard to believe what happened. Over the past five years misplacing tools had become all too familiar.

The progress on my project started going much smoother because I wasn’t wasting time looking for tools and getting sidetracked. It had become quite common for me to walk to the garage or my lumber storage to pick up something and then find myself reorganizing things or doing some work on an unrelated partially finished project. That wasn’t happening. I would remember what I was looking for. I would know where to find what I needed. I would stay focused on what I set out to do. I would make a mental note of things I should attend to later.

The view from within

This change was the most exciting improvement in my five years of recovery. The dramatic change after two days of Listening Therapy was far beyond what I expected. So let me give you some background.

Safe and Sound Protocol ™

The SSP (Safe and Sound Protocol) is a research-based therapy showing significant results in just five days in the following areas:
  • Social and emotional difficulties
  • Auditory sensitivities
  • Anxiety and trauma related challenges
  • Inattention
  • Stressors that impact social engagement

The above checklist taken from the SSP website succinctly summarizes and matches the areas of challenge I continue to struggle with. This is the information and treatment I would have welcomed a few years back. I had heard inklings of information related to SSP.

Not long after my brain injury I had heard comments that the daily challenges following a brain injury often had to do with the ear. My problem was not knowing where to pick up the trail of finding further information or for that matter how to go about making the healing happen.

It’s common knowledge that the ear is the receptor for sound, one of the five senses understood by children and adults alike. It’s also common knowledge that the ear is the balance center of the body, the role being done by the semi-circular canals. With a head injury it is not unusual that either or both of these two areas are damaged. The intent of the therapy is to get the ears functioning properly again.

For me the issue of balance resolved itself in the first couple of years following my injury. Some people suggested that my unicycling experience makes my balance better. I care to disagree. I don’t think having better balance before the injury would prevent an injury in that area or necessarily shorten the recovery time.

My challenges relate to cognitive overload, inability to focus, functioning in larger social settings, and emotional overload in specific types of settings.

The consultation before starting my Safe and Sound Protocol ™ Listening Therapy explained how most of my challenges arise from the way I perceive sound and how it affects my autonomic system.

The autonomic system is the part of the body that functions without us being intentional or conscious. This system includes breathing, heart beat, digestion and all the other organs. The only part of the autonomic system that we have direct control of is our breathing. Through our breathing we can affect change in other parts of the autonomic system.

One purpose of the autonomic system is to alert us to potential danger. When our body perceives danger we move out of our social functioning mode and into a ‘fight and flight’ mode. This is not a conscious action. Our body recognizes danger signals and reacts. High frequency sounds or low frequency sounds are recognized by the body as warnings. An animal’s growl or an animal’s screech causes a spontaneous reflex suggesting imminent danger.

The challenges that I listed above are related to how my ears perceive sound and how it is sent to the brain. With the injury the middle ear muscle, the stapedius muscle which by the way is the smallest muscle in our body, which is attached to the stirrup has been damaged. The intent of the therapy is to exercise that muscle so that sounds are heard and interpreted within the proper frequency range.

With the loss of muscle tone of the stapedius muscle, my ear perceives sounds which are within the social engagement mode as being in the danger frequency range. With the loss of muscle tone of this small muscle distorts the perceived sounds enough that the autonomic system goes into a ‘fight or flight’ response mode many times in the day.

The difference in the sound is not something that I’m conscious of. I have dealt with challenges related to sounds; loud sounds, sounds of a particular timbre, unusual acoustics in certain environments. I was not able to connect these different experiences to the difference in the sound frequencies or the autonomic system’s response to it.

Fatigue has been my nearly constant companion over the past 5 years. It’s because one can only handle so much ‘fight and flight’ responses before the adrenal gland becomes depleted. Every time we get an adrenaline rush the body needs recovery time to replace the adrenaline. I have taken daily doses of kelp and iodine to replenish my adrenal gland. However, the supplements replace the adrenaline that is lost but doesn’t stop the over use of adrenaline. Real healing won’t happen if I don’t get beyond masking the symptoms with my daily supplements. Masking symptoms is at best a stop gap measure. To make real progress one needs to stop the body from depleting the adrenaline gland.

Preparation and Testing

Prior to starting the Safe and Sound Protocol (TM) intervention I went through the Measure of Foundational Ability Assessment. The assessment was to determine the main areas of concern and the extent of the problem. Issues relate to balance were minor. Issues related to focus, attention and cognition were most pronounced.

One of the factors in restoring proper sound transmission to the brain is having the ear hear a clear or properly tuned sound. Sound travels to the middle ear through air and through our bones. Bone conduction of sound moves ten times faster than air conduction. For our autonomic system to interpret sound properly it needs to receive properly balanced sound. With the loss of muscle tone in the Stapedious muscle the balance between bone conduction and air conduction is skewed.


The SSP (Safe and Sound Protocol) is based on listening to the music. The intent is to restore the muscle tone of the stapedius muscle. To accomplish this, songs are selected based on the frequency range in the song. Some songs have been modified to achieve the most effective sound frequencies. By controlling the frequencies the stapedius muscle is being exercised to improve the muscle tone. The protocol is designed to work through the therapy in half hour blocks of listening.

The possible side effects of the protocol are various. There is the possibility of reliving past trauma. Or one can become agitated or emotional. It can create anxiety. Or there can be intervals of increased level of fatigue.

There are several remedial exercises recommended to minimize the side effects. If the side effects are too severe the pacing of the therapy is slowed down, such as taking a one day break between listening sessions.

The Listening Therapy was done in the comfort of my home. My initial consultation was done via video conferencing. During the listening process I sent my therapist daily updates on how the therapy was progressing and how my body was responding. The daily monitoring was in important part of achieving an effective outcome.

In Short

I never expected this initial step in the music therapy protocol to bring about such a profound change. The next step in my Listening Therapy is to provide maintenance to support the improvements that have been made. It’s like having a fitness program. There needs to be followup to not lose the the gains that have been made.

It’s the research that went into Dr. Stephen Porges Polyvagal Theory that gives me confidence in the potential effectiveness of this program. His theory makes some very convincing connections between the vagus nerve of the autonomic nervous system, the middle ear, the amygdala and the prefrontal cortex. I won’t pretend to do justice to his ideas in a short paragraph or two. I will defer to Dr. Stephen’s son Seth Porges who has a wonderful introduction on You Tube.

I did hear from one person through a brain injury support group who had used the SSP therapy but noticed no changes. There needs to be an assessment prior to starting since the therapy needs to be tailored to individual needs. No two brain injuries are the same. So no two programs are identical.

I hope to share the next steps and my progress as my Listening Therapy continues.

If you think this has potential for you or someone you know and would like to learn more I would be pleased to provide contact information.

Author: Jasper Hoogendam

After 36 years as an educator my career ended due to a TBI. Renewable energy as part of 'walking lightly on this earth' has been and continues to be my interest since my teen years. Since early 2015 I have been learning to live with ABI (Acquire Brain Injury). I don't want to let my ABI limit the goals I set for myself. I'm living with a different brain, not a lesser brain. In sharing my day to day successes and struggles, I am better able to understand how my life had changed and begin to accept the change. In sharing my experiences I'm hearing from caregivers and fellow ABI's. I'm encouraged when my experiences are helping others understand some of the complexity of living with ABI.

21 thoughts on “Tiniest Muscle with Real Pull (Part 1)”

    1. I’m realizing that my vestibular ocular challenges are related to the loss of muscle tone in the strapedius muscle and the vestibular area of the ear. So hopefully my use of wrap around sunglasses for when I’m taking a long road trip can be phased out.

      Liked by 1 person

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