Developmental co-calibration and therapeutic recalibration: a neurobiopsychosocial model of regulatory path dependence in psychosomatic care.

Psychotherapy and psychosomatic medicine require accounts that connect developmental context, embodied regulation, bodily symptoms, and treatment processes without collapsing them into a single causal story. This Hypothesis and Theory article presents developmental co-calibration as an integrative, testable specification rather than a set of novel component mechanisms. It proposes a staged chain in which biological dispositions and current affordances shape regulatory states; states and candidate interoceptive inference processes influence strategy selection; immediate consequences and environmental responses feed back into later states and contexts; and repeated episodes may alter transition probabilities over development. Its model-specific claim is regulatory path dependence: a prespecified distal regulatory history should improve prediction of current state or strategy transitions after accounting for current context, state, stable person characteristics, measurement opportunity, and immediate inertia. This claim differs from current regulatory inflexibility, variability, avoidance, and habit. The cited literatures inform individual links involving developmental plasticity, adversity, allostasis, interoception, regulatory flexibility, camouflaging, and psychotherapy processes; none tests the complete sequence. The framework therefore remains a staged, falsifiable research program. Health implications are separated into disease onset, exacerbation or course, persistent physical symptoms, functional somatic disorders, and multimorbidity; psychogenic causation is not inferred. Therapeutic recalibration is defined primarily as an intervention- or accommodation-associated change in the prespecified distal-history effect when baseline history predicted poorer fit, functional cost, or delayed recovery. Context-strategy-outcome fit and recovery are separate secondary process outcomes; symptom improvement alone does not qualify. State-matched psychotherapy and environmental accommodation are complementary candidate routes. The article specifies competing frameworks, measurable signatures, falsification criteria, and safeguards of medical humility and epistemic dignity.