AFFECT TOLERANCE UNDER ACTIVATION: A COMPARATIVE REGULATORY MODEL OF TRAUMA-FOCUSED THERAPIES

Abstract

According to comparative efficacy studies and despite the numerous different trauma-focused psychotherapies currently in existence, the difference in efficacy between them is minimal. This paper argues that instead of focusing on comparing outcomes, a structural question is worth exploring. Namely, how exactly do these different treatments organize the emotional regulation work that patients must perform during trauma processing?
This article develops a Comparative Regulatory Model, understanding diverse trauma-focused therapies as different variants of the same structural sequence, Activation → Dysregulation → Modulation → Integration, and establishing affect tolerance under activation as the central assessment variable.
This model does not classify the superiority or inferiority of various treatment modalities. Its analytical purpose is to establish a common theoretical language for comparing the structures of different trauma treatments.