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The Architecture of Living Coherence (PPT) (PDF)

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Deep Dive | Mental illness as a living process

Debate | The Living Coherence Model of Psychiatry

Critique | Applying the Seven Primitives Clinical Grammar

Video Explainer | Living Coherence Paradigm

Cinematic Explainer | Living Coherence: Deriving Psychiatry from First Principles

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Executive Summary

This expanded white paper proposes a life-coherence framework for neuropsychiatric disease. Its central claim is that mental disorder cannot be adequately understood through any single lens: not solely as brain disease, chemical imbalance, cognitive distortion, trauma response, social stress, or diagnostic category. These are all partial truths. The missing integrative layer is the living process itself: the organism as a self-producing, structurally coupled, emotionally oriented, interoceptively felt, meaning-making unity.

The framework begins from first principles. A living system must conserve its organization despite continuous material turnover. This is the autopoietic requirement. Because no living system exists in isolation, it must remain viable through recurrent relation with a medium. This is structural coupling. Because not all perturbations are equal, living systems must be oriented toward what supports their viability and away from what threatens it. This is valence. In animals, valence becomes emotioning: bodily dispositions that open and close domains of possible action. In sentient organisms, bodily regulation is not merely performed; it is lived from within as felt sense. Katherine Peil Kauffman’s notion of emotional sentience then becomes intelligible as the felt-evaluative self-regulatory dimension of life (Kauffman, 2015, 2020; Maturana & Varela, 1980; Maturana, 1988).

The current scientific moment makes this synthesis timely. The National Institute of Mental Health’s Research Domain Criteria (RDoC) framework attempts to investigate mental disorders through dimensions of basic biological and behavioral functioning rather than starting from diagnostic categories alone. The Hierarchical Taxonomy of Psychopathology (HiTOP) offers a dimensional taxonomy intended to improve classification, measurement, and clinical application. Enactive psychiatry understands cognition and mental disorder as embodied, embedded, and constituted through active engagement with the world. Interoceptive neuroscience and allostatic-interoceptive overload frameworks increasingly show that psychiatric and neurological conditions involve disruptions in body regulation, brain-body prediction, heart-brain and respiratory-brain dynamics, immune processes, and gut-brain-microbiota pathways. WHO’s contemporary mental-health framing emphasizes that mental health is shaped by individual, family, community, social, environmental, and structural determinants (Barrett & Simmons, 2015; Cicero et al., 2024; Feng et al., 2025; HiTOP Consortium, n.d.; Khalsa et al., 2018; Morris et al., 2022; National Institute of Mental Health, n.d.; Nielsen, 2025; Santamaría-García et al., 2025; World Health Organization, 2025).

This paper does not claim to replace diagnosis, medication, psychotherapy, neurology, or public-health psychiatry. Instead, it proposes a foundational grammar beneath them. Neuropsychiatric disease is interpreted as disturbed viability across organismic regulation, structural coupling, emotioning, felt interiority, and meaning-making. Healing, therefore, cannot be reduced to symptom reduction. It must also restore viable self-regulation, truthful feeling, legitimate relation, expanded options, and renewed participation in a livable world.

The original contribution of the paper is the Seven-Primitives Clinical Grammar: Constraint, Margin, State, Disturbance, Perception, Regulation, and Options. These primitives allow clinicians, researchers, and policy designers to ask: What is blocked? Where has reserve capacity been depleted? What is the present bodily-affective-relational state? What disturbances are acting? What is being made salient? What regulatory strategies are being used? What viable paths can be reopened? This grammar provides a transdiagnostic formulation method that complements existing systems while restoring life-process coherence to the center of psychiatric understanding.

Clinical Interpretations of Disorder Families through Living Coherence

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Disorder Family	Living Coherence Interpretation	Autopoietic/Biological Disruptions	Structural/Relational Coupling	Locked Emotioning Domain	Felt Sense/Interoceptive Quality	Primary Repair Emphasis
Anxiety and Panic	Threat-saturated coupling; threat-readiness mismatched to present conditions.	Overactive alarm system; disrupted sleep; autonomic arousal (heart rate, breathlessness).	World brought forth as unsafe, uncertain, or uncontrollable.	Persistent, overgeneralized threat-readiness.	Bodily sensations (dizziness, heat, trembling) interpreted as imminent catastrophe.	Interoceptive exposure, grounding, sleep repair, and restoration of trust.
Depression	Collapse of viable possibility; contraction of the field of life-serving action.	Disrupted sleep, appetite, energy, movement, endocrine rhythm, and immune-inflammatory tone.	Marked by isolation, loss, humiliation, poverty, chronic demand, or grief.	Locked in collapse, withdrawal, defeat, or numbness.	Heavy, deadened, painful, or absent; loss of felt vitality.	Restoring margins and possibility; sleep repair, social reconnection, and movement.
Post-Traumatic Stress Disorder (PTSD)	Danger-worlds after danger has passed; persistent coupling with the traumatic past.	Altered startle response, nightmares, and persistent survival-mode body-states.	World scanned for threat; reorganization of organism-world relation around danger.	Organized around survival (vigilance, freezing, escape).	Ordinary activation feels like danger returning; altered sense of time.	Safe recoupling; body-based regulation; reduction of ongoing threat and restoration of agency.
Psychosis	Altered salience, self-world boundary, and consensual reality.	Sleep loss; altered neurotransmission; unstable self-world boundary.	Social reality reorganized around persecution, revelation, or control; social threat.	Altered salience; actions organized around hallucinations or delusions.	Overmeaningful signals; externalized agencies (voices); terrifying or compelling interiority.	Restoring safety and shared reality; sleep repair; non-shaming social recoupling.
Addiction	Narrowed regulation around relief and reward; life-regulation strategy that becomes life-disorganizing.	Hijacked regulatory loops; erosion of biological margins.	Option-field collapses around the addictive loop; erosion of relational/occupational margins.	Relief-seeking, reward, numbness, or escape.	Narrowed field of reward; physical withdrawal or craving.	Restoring alternative regulation, belonging, rhythm, and dignity.
Obsessive-Compulsive Disorder (OCD)	Uncertainty and ritualized regulation; regulatory loops that narrow life.	Repetitive behavioral loops; altered salience of threat or contamination.	Relational patterns often involve family accommodation of rituals.	Threat, uncertainty, and disgust leading to ritualized action.	Intolerable distress/uncertainty relieved temporarily by ritual.	Inhibiting rituals; tolerating uncertainty; reopening action outside the compulsion.
Mania and Bipolar States	Expansion without sufficient constraint.	Severe sleep stabilization issues; weakened biological constraints on energy/pacing.	Relational cost of risk-taking; radiant affordance in the world.	Expansion of action possibility; weakened consequence-evaluation.	Radiant vitality; intense confidence, sexuality, or irritability.	Restoring constraint; sleep stabilization; reduction of stimulation and risk safeguards.
Eating Disorders	Disrupted body-world meaning and interoceptive control.	Entanglement of nutrition, metabolism, and endocrine status with control.	Social comparison, stigma, and identity-driven coupling.	Control, mastery, and avoidance of shame/disgust.	Physiological signals (hunger/fullness) charged with safety or worth; body as enemy.	Restoring nutrition; repairing body-world meaning; trusting bodily signals.
Neurodevelopmental Differences	Coupling mismatch rather than simple deficit (e.g., Autism, ADHD).	Sensory processing differences; atypical attention/movement regulation.	Mismatch between individual organization and rigid institutional/social environments.	Distress from chronic masking, exclusion, or sensory overload.	Sensory burden; exhaustion from social performance requirements.	Environmental redesign; accommodation; sensory ecology; legitimate recognition.