From Dysregulation to Co-Regulation: A Mixed-Methods Exploratory Case Series of Remote ReAttach for Functional Neurological Disorder

Abstract

Functional Neurological Disorder (FND) is characterized by pervasive dysregulation across autonomic, sensory, cognitive, and affective domains. Individuals frequently experience difficulty accessing self-regulation independently, particularly during periods of hyperarousal, dissociation, motor intensification, or cognitive overload. Remote, brief, and individualized interventions that support both self-regulation and co-regulation may therefore be clinically relevant. This mixed-methods exploratory case series describes practice-based remote ReAttach interventions delivered to adults with FND and Functional Movement Disorder (FMD) between 2025 and 2026.

Participants received individualized remote sessions incorporating W.A.R.A. (Wiring Affect with ReAttach), Forgive & Forget Hood, ConFusion, Identifications, and an emerging hypervigilance-focused procedure termed the Safety Override Technique (SOT). Data sources included participant narratives, written reflections, practice-based clinical observations, and available naturalistic Neurolog symptom logs. One participant provided a longitudinal set of time-stamped transcripts enabling embedded qualitative language analysis.

Across cases, participants described meaningful benefits, including reduced overwhelm, improved affect regulation, increased cognitive clarity, decreased dissociation or motor intensity, and greater agency. Co-regulation emerged as a central therapeutic mechanism enabling participants to access regulatory states that were otherwise difficult to reach independently. These exploratory findings suggest that remote ReAttach may represent a low-threshold, state-sensitive intervention for individuals with FND/FMD whose needs are often insufficiently met by existing care pathways. The results provide groundwork for future structured Neurolog Symptom Amplification Module (SAM)-based research.