Integrative Psychotherapy of Emotional and Psychosomatic Regulation: Promoting Transformational Processes 1

Abstract This article outlines an integrative, trauma‐oriented, polyvagal‐informed framework for psychodynamic psychotherapy. In this approach, patients are inherently motivated to overcome entrenched, repetitive patterns, seeking to restore a sense of safety that was lost during developmental phases. Grounded in the belief that psychic transformation occurs through a maturational process within the therapist‐patient relationship, this approach views psychopathology as a rigid adaptation to early relational environments, shaped by trauma, dissociation, and autonomic dysregulation. This rigidity is linked to dissociative defenses, where unresolved trauma disrupts intimacy, preventing individuals from experiencing connection and relatedness. Dissociative patterns manifest as repetitive relational schemas within interpersonal relationships, where early traumatic experiences hindered integration during development. This leads patients to detach from their bodily experiences and lose authenticity in their relationships, distancing themselves from intimacy and deep bonds. Consequently, they struggle to experience safety and pleasure in themselves and in their connection to or with others. In this approach, therapist and patient work collaboratively to recognize and regulate traumatic patterns of autonomic dysregulation within the therapeutic relationship, so that old relational wounds can be reprocessed in conditions of greater safety and reflective capacity.