Survivors of sexual trauma may develop coherent insight and improved affect regulation in therapy yet find that these capacities do not reliably remain portable in intimate contexts. Objective: This paper proposes a clinical formulation lens for this non-transfer pattern by conceptualising it as state-dependent access to meaning rather than as resistance, incomplete processing, or loss of therapeutic gain.

It offers a narrative conceptual synthesis that brings together trauma and dissociation frameworks with context-dependent learning accounts, sexual trauma and bodily response literature, and work on interpretive safety and social responses to disclosure.

A triadic heuristic is proposed: narrative access, embodied tolerance, and interpretive safety. The originality of the heuristic lies not in treating these as separate new constructs, but in organising them around the clinical question of when therapeutic meaning remains portable in intimacy-linked states. Used dynamically, the domains help clinicians locate where meaning becomes inaccessible, pace treatment more carefully, and identify internal, interactional, and post-event portability markers beyond the consulting room.

The framework is pre-empirical and is offered as a formulation tool rather than a validated model. It is most applicable where therapeutic meaning is demonstrably available under protected conditions but repeatedly becomes inaccessible under intimacy-linked state shifts. It aims to make apparently inconsistent progress intelligible as state- and context-dependent, reduce therapy-induced shame, and generate testable clinical predictions for future work.