Autonomic Charge Modulation in Attachment Therapy: A Multiple-Case Analysis of the Somatic Attachment Protocol
Attachment-related difficulties present in diverse ways, including relational instability, emotional flattening, and cognitive-emotional disconnection, and may arise from shared underlying mechanisms rather than distinct symptom categories. A proposed mechanism is emotional memory reconsolidation, in which previously encoded emotional learning can be updated when reactivated under specific conditions.
This study examines whether these presentations can be understood and treated through a shared process involving the modulation of autonomic activation, conceptualized here as autonomic charge. A multiple-case analysis (N = 3) was conducted using the Somatic Attachment Protocol (SAP), a process-based framework integrating somatic observation, neural interruption, and relational co-regulation, with cases selected to represent relational instability, emotional flattening, and cognitive-emotional disconnection. Across all cases, therapeutic change followed a similar sequence of activation, sustained somatic observation, reduction in autonomic activation, and subsequent reorganization of emotional and behavioural responses (AORR). Despite differences in presentation, all cases converged toward increased emotional regulation and adaptive relational functioning.
These findings support a process-based view of psychotherapy, in which diverse attachment difficulties may reflect variations in a shared underlying mechanism. SAP is presented as a flexible clinical framework for engaging this process, with limitations and implications for future research discussed.
© The Author(s) 2025. Published by RITHA Publishing. This article is distributed under the terms of the license CC-BY 4.0., which permits any further distribution in any medium, provided the original work is properly cited maintaining attribution to the author(s) and the title of the work, journal citation and DOI.
Article’s history: Received 1st November, 2025; Revised 9th of December, 2025; Accepted: 27th of December, 2025; Available online: 30th of December, 2025; Published as research article in Volume III, Issue 3, 2025.
Tang, S. Y. N. (2025). Autonomic Charge Modulation in Attachment Therapy: A Multiple-Case Analysis of the Somatic Attachment Protocol. Journal of Contemporary Approaches in Psychology and Psychotherapy, Volume III, Issue 3, 141 – 161. https://doi.org/10.57017/jcapp.v3.i3.08
CRediT Authorship Contribution Statement: Nicole S. Y. Tang: Conceptualisation, Methodology, Investigation, Formal Analysis, Writing – Original Draft, Writing – Review & Editing.
Conflict of Interest Statement: The author declares that there are no conflicts of interest regarding the publication of this paper.
Acknowledgments: Not applicable.
Funding: Not applicable.
Data Availability Statement: The clinical data supporting the findings of this study are not publicly available due to confidentiality and privacy considerations associated with clinical case material. The analysis is based on anonymised clinical observations, therapist process notes, client-reported experiences, and, where applicable, subjective units of distress (SUDS) recorded during therapy sessions. A de-identified summary may be made available by the corresponding author upon reasonable request, subject to applicable confidentiality and ethical restrictions.
Ethical Approval Statement: This study is based on anonymised clinical case material derived from routine therapeutic practice. All identifying information was removed or modified to protect client confidentiality, and all clients provided informed consent for the use of their anonymised clinical material for research and publication purposes. No experimental intervention was conducted specifically for the purposes of this study.
AI Use Disclosure Statement: The author used ChatGPT, Claude (Anthropic) and Gemini (Google), which are AI language models, to assist with structural editing, academic language refinement, and the identification of coherence issues during the preparation of this manuscript. All theoretical content, clinical material, case formulations, and intellectual contributions are the original work of the author. The process figure (Figure 1) was created by the author with the help of AI tools. The author takes full responsibility for the integrity, accuracy, and originality of all content presented in this manuscript.
Craig, A. D. (2009). How do you feel - now? The anterior insula and human awareness. Nature Reviews Neuroscience, 10(1), 59–70. https://doi.org/10.1038/nrn2555
Damasio, A. (1999). The Feeling of What Happens: Body and Emotion in the Making of Consciousness. Harcourt Brace. https://www.academia.edu/49720364/The_feeling_of_what_happens_Body _and_emotion_in_the_making_of_consciousness
Deninger, M. (2021). Multichannel Eye Movement Integration: The Brain Science Path to PTSD Treatment, 396 pages. Gracie Publications. ISBN-10: 1735151505. https://www.amazon.com/Multichannel-Eye-Movement-Integration-Effective/dp/1735151505
Ecker, B. (2015). Memory reconsolidation understood and misunderstood. International Journal of Neuropsychotherapy, 3(1), 2–46. https://doi.org/10.12744/ijnpt.2015.0002-0046
Ecker, B., Bridges, S. K. (2020). How the science of memory reconsolidation advances the effectiveness and unification of psychotherapy. Clinical Social Work Journal, 48(3), 287–300. https://doi.org/10.1007/s10615-020-00754-z
Ecker, B., Ticic, R., & Hulley, L. (2012). Unlocking the Emotional Brain: Eliminating Symptoms at their Roots Using Memory Reconsolidation. 244 pages. Routledge. ISBN: 978-1000540321. https://www.routledge.com/Unlocking-the-Emotional-Brain-Eliminating-Symptoms-at-Their-Roots-Using-Memory-Reconsolidation/Ecker-Ticic-Hulley/p/book/9781032117539
Gendlin, E. T. (1996). Focusing-Oriented Psychotherapy: A Manual of the Experiential Method. 317 pages. Guilford Press. ISBN: ISBN 9781572303768. https://www.guilford.com/books/Focusing-Oriented-Psychotherapy/Eugene-Gendlin/9781572303768?srsltid=AfmBOoqw7zRjeul6kYQ0 BKJc7IdKCAVONigNWZx6aKOgMt-DHqo70jQc
Greenberg, L. S. (2011). Emotion-Focused Therapy. American Psychological Association. https://www.apa.org/pubs/books/4317237
Kindt, M., Soeter, M., & Vervliet, B. (2009). Beyond extinction: Erasing human fear responses and preventing the return of fear. Nature Neuroscience, 12(3), 256–258. https://doi.org/10.1038/nn.2271
Lane, R. D., Ryan, L., Nadel, L., & Greenberg, L. S. (2015). Memory reconsolidation, emotional arousal, and the process of change in psychotherapy: New insights from brain science. Behavioural and Brain Sciences, 38, e1. https://doi.org/10.1017/S0140525X14000041
LeDoux, J. E. (2000). Emotion circuits in the brain. Annual Review of Neuroscience, 23, 155–184. https://doi.org/10.1146/annurev.neuro.23.1.155
Levine, P. A. (2010). In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness. North Atlantic Books. https://archive.org/details/inunspokenvoiceh0000levi
Nader, K., Schafe, G. E., & LeDoux, J. E. (2000). Fear memories require protein synthesis in the amygdala for reconsolidation after retrieval. Nature, 406(6797), 722–726. https://doi.org/10.1038/35021052
Norcross, J. C., & Lambert, M. J. (2018). Psychotherapy relationships that work III. Psychotherapy, 55(4), 303–315. https://doi.org/10.1037/pst0000193
Ogden, P., & Minton, K. (2000). Sensorimotor psychotherapy: One method for processing traumatic memory. Traumatology, 6(3), 149–173. https://doi.org/10.1177/153476560000600302
Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation. Norton. https://wwnorton.com/books/The-Polyvagal-Theory/
Schiller, D., Monfils, M. H., Raio, C. M., Johnson, D. C., LeDoux, J. E., & Phelps, E. A. (2010). Preventing the return of fear in humans using reconsolidation update mechanisms. Nature, 463(7277), 49–53. https://doi.org/10.1038/nature08637
Hinz, L. D. (2015). The Science of the Art of Psychotherapy: by Allan N. Shore New York, NY: Norton, 2012 480 pp., ISBN: 978-0-393-70664-2. Art Therapy, 32(3), 152–153. https://doi.org/10.1080/07421656.2015.1060564
Siegel, D. J. (2012). The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are (2nd ed.). Guilford Press. https://www.academia.edu/9043874/The_developing_mind_ how_relationships_and_the_brain_interact_to_shape_who_we_are
Stake, R. E. (1995). The Art of Case Study Research. Sage. https://www.academia.edu/3251093/ The_Art_of_Case_Study_Research
Wampold, B. E., & Imel, Z. E. (2015). The great psychotherapy debate: The evidence for what makes psychotherapy work (2nd ed.). Routledge/Taylor & Francis Group. https://www.routledge.com/The-Great-Psychotherapy-Debate-The-Evidence-for-What-Makes-Psychotherapy-Work/Wampold-Imel/p/book/9780805857092
Yin, R. K. (2018). Case Study Research and Applications: Design and Methods (6th ed.). Thousand Oaks, CA: Sage. https://uk.sagepub.com/en-gb/eur/case-study-research-and-applications/book250150