Psychotherapists' Interoception and Autonomic Nervous System Activations During Significant Moments of Psychotherapy Sessions

Background This exploratory case study combines two branches of psychotherapy research, that is, multimodal study of therapeutic interaction and the paradigm of significant events. Aims We explored therapists' autonomic nervous system responses during significant moments in therapy sessions and the role of interoception in this context. Materials & Methods Multimodal data were collected from four therapist–client dyads. The sessions were video‐recorded, and all participants completed self‐assessment questionnaires during each session. Skin conductance and heart rate were also recorded during the second and sixth sessions. Furthermore, the therapists' interoceptive accuracy and interoceptive awareness were assessed at the start of the study. Data were analysed using mixed methods and the results compiled using an integrative cross‐case approach. Results Visual inspection suggested a downward trend in heart rate variability during significant moments, consistent with reduced parasympathetic modulation relative to comparison periods. Given the very small, clustered sample, this pattern should be considered preliminary. Discussion & Conclusion Moreover, our qualitative findings suggest that therapists with higher interoceptive awareness may describe their bodily experiences in a manner that resonates with their concurrent physiological patterns, indicating greater alignment between subjective reports and measurable physiological reactions.