Psychological Safety, Medical Trauma and Adaptive Functioning in Long‐Term Conditions: A Multidisciplinary Integrative Approach

ABSTRACT

Living with a chronic health condition (CHC) can involve sustained exposure to uncertainty, bodily threat and disruption to identity, relationships and anticipated life trajectories. Although a substantial evidence base exists for psychological interventions in long‐term illness, theoretical accounts remain fragmented across modalities and disciplines, often prioritising symptom reduction and health behaviour change over prevention, adaptation and meaning‐making. This paper presents a conceptual integrative framework synthesising theoretical and empirical literature alongside the author's lived experience to advance psychological safety as a unifying, embodied regulatory construct linking medical trauma, emotional regulation, social connection, meaning making and self‐management in CHCs. Drawing on trauma science, it is argued that chronic illness disrupts psychological safety. Difficulties in adaptation are understood as disruptions in the capacity to regulate, engage and remain meaningfully connected in the context of ongoing challenge. The Neuroception of Psychological Safety Scale (NPSS) is presented as a theoretically grounded tool for assessing psychological safety and supporting prevention and positive adaptation. Implications for psychotherapy, healthcare systems and interdisciplinary research are discussed, positioning psychological safety as a transdiagnostic mechanism central to psychologically informed healthcare. The R.E.S.P.E.C.T. framework is introduced as an applied lens for embedding psychological safety across healthcare systems.