{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T05:18:59Z","timestamp":1787548739408,"version":"build-2736575974"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Autonomic dysregulation is increasingly recognized as a central mechanism complicating psychotherapeutic work across anxiety, trauma-related, and mood disorders. Persistent hyperarousal (sympathetic activation) or hypoarousal (persistent parasympathetic activation or shutdown\/ dissociation) may put clients out of their \u201cwindow of tolerance,\u201d thus limiting access to cognitive, emotional, and interpersonal processes that are essential to the effectiveness of psychotherapy. Swara yoga, a traditional Indian system, assigns functional significance to nasal dominance and unilateral nostril breathing (UNB). According to this system, right nostril breathing is said to be activating, while left nostril breathing is calming. Contemporary psychophysiological studies on UNB and related breathing techniques have shown that nostril-specific breathing can alter autonomic indicators, such as heart rate variability. In contrast, slow-paced breathing tends to increase vagal tone and enhance autonomic flexibility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This conceptual analysis integrates Swara yoga's principles with current knowledge of autonomic physiology to propose a \u201cSwara-informed autonomic synchrony model\u201d for psychotherapy. The proposed model aims to provide state-contingent use of unilateral nostril breathing as an adjunct to evidence-based psychological interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Based on empirical investigations of UNB, alternate nostril breathing, heart rate variability, and trauma-related autonomic dysregulation, we developed a state-based clinical framework. Rather than assigning a fixed autonomic profile to each diagnostic category, we distinguished two broad psychophysiological states: hyperarousal (autonomic surge) and hypoarousal (shutdown), and mapped these states to nostril selection based upon Swara yoga.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Model<\/jats:title>\n                    <jats:p>We propose that slow left nostril breathing should be used as a parasympathetic biasing, down-regulatory adjunct to psychotherapy when the client presents with hyperarousal-dominant states such as panic, hyperarousal-dominant PTSD, or agitated anxiety. When hypoarousal-dominant states such as psychomotor-retarded depression, dissociative PTSD, and negative symptom presentations are evident, we propose that slow right nostril breathing should be used as a sympathetic biasing, up-regulatory adjunct to psychotherapy. In both cases, UNB would be used as a short-term, inexpensive preparatory regulatory technique embedded in standard psychotherapeutic procedures (e.g., exposure, behavioral activation, trauma processing).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The Swara-informed autonomic matching model provides a culturally grounded framework that hypothesizes how nostril-specific breathing may be integrated into psychotherapy and provides a basis for future empirical investigation. We formulated testable hypotheses and study designs to investigate whether state-matched UNB yields greater benefits than slow-paced breathing. Finally, we discuss several potential limitations, safety issues, and ethical considerations relevant to this research area.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2026.1853837","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T04:23:11Z","timestamp":1787545391000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The Swara-Informed model of autonomic synchrony in psychotherapy: theoretical foundations and hypotheses"],"prefix":"10.3389","volume":"17","author":[{"given":"Aarsh Ojas Parasar","family":"Pandey","sequence":"first","affiliation":[{"name":"Department of Psychology, Indira Gandhi National Tribal University","place":["Amarkantak, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"B1","unstructured":"Ethical principles of psychologists and code of conduct\n          \n          2017"},{"key":"B2","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1111\/j.1469-8986.1997.tb02140.x","article-title":"Heart rate variability: origins, methods, and interpretive caveats","volume":"34","author":"Berntson","year":"1997","journal-title":"Psychophysiology"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2119909","DOI":"10.1080\/20008066.2022.2132599","volume":"13","author":"Beutler","year":"2022"},{"key":"B4","doi-asserted-by":"publisher","first-page":"104788","DOI":"10.1016\/j.ajp.2025.104788","article-title":"Breathing and the brain: pranayama, an ancient self-directed approach to neuromodulation","volume":"115","author":"Bhargav","year":"2026","journal-title":"Asian J. 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