Variability in behavioral, emotional, and cognitive functioning across different contexts remains insufficiently explained by models that rely solely on environmental contingencies, cognitive processes, or static trait-based interpretations in isolation. Individuals frequently exhibit pronounced fluctuations in executive functioning, emotional regulation, learning accessibility, behavioral flexibility, and adaptive responses, despite maintaining intact knowledge, insight, or previously acquired skills. These inconsistencies are commonly observed in trauma-related conditions, chronic stress, autism, psychiatric disorders, rehabilitation settings, and educational environments—suggesting that access to behavioral and cognitive capacities is dynamically shaped by underlying physiological organization. Emerging evidence from interoception research, affective neuroscience, stress physiology, and autonomic regulation indicates that adaptive functioning fluctuates according to ongoing physiological state organization, rather than remaining uniformly accessible across conditions (Barrett Craig, 2009; Porges, 2011). This paper introduces the Interoceptive Communication Model (ICM 2.0), a conceptual, state-dependent neurophysiological framework that elucidates how autonomic regulation, interoceptive processing, affective signaling, sensory integration, and higher-order regulatory modulation interact to influence adaptive accessibility in real time. Within this framework, accessibility refers to the moment-to-moment functional availability of behavioral, emotional, cognitive, and regulatory capacities under shifting physiological conditions. The model features a dual-pathway organizational structure: Route 1—the Limbic–Autonomic Pathway (“Survival”)—associated with defensive physiological responses and limited adaptive accessibility; and Route 2—the Insular–Prefrontal Conscious Pathway (“Modulation”)—linked to interoceptive integration, flexible regulation, conscious evaluation, and expanded adaptive functioning. This paper positions ICM 2.0 as a conceptual and integrative framework rather than a definitive neuroanatomical model. It aims to support interdisciplinary interpretations of state-dependent variability across clinical, educational, psychological, and behavioral contexts, while generating testable hypotheses regarding the relations between physiological state organization and human functioning. This study also discusses implications for trauma, executive functioning, emotional regulation, behavioral intervention, learning accessibility, and physiological regulation.
Uncu et al. (Mon,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: