Autonomic regulation constrains psychotherapeutic workability: a state-dependent translational model for psychotherapy and psychosomatics (opens in new tab)

Psychotherapy does not fail only because techniques are poorly chosen or alliances are weak; it may also fail because the patient’s momentary state does not support productive use of the task. This matters especially in psychotherapy and psychosomatic care, where bodily distress, interoceptive threat, shame, and autonomic dysregulation can narrow affective, mnemonic, and reflective workability. In this hypothesis-and-theory paper, I propose a state-dependent translational model of psychothera...