Schismogenesis in anxiety spectrum disorders: a biopsychosocial perspective

Anxiety spectrum disorders (ASDs) often have an unsatisfactory prognosis, suggesting the opportunity for complementary explanatory frameworks to advance their therapeutics. This text advocates for a framework rooted in cybernetics and complex systems theory, which views the mind, brain, and social networks as deeply interdependent systems. A characteristic feature of such systems is the operation of similar organizational principles and laws across different levels of analysis, a phenomenon termed isomorphism. Thus, the mind, brain, and social systems operate under isomorphic principles, requiring a critical balance between stability (homeostasis) and the capacity for change (homeodynamics) to successfully adapt to environmental perturbations. From this perspective, the central challenge under stress is to prevent excessive fragmentation and functional dissociation, a process termed schismogenesis in cybernetics. ASDs are, therefore, reconceptualized as biopsychosocial dissociations stemming from a schismogenic mechanism. This framework posits that mental health is contingent upon maintaining a dynamic equilibrium between connectedness and independence across social, mental, and neural levels. It also suggests that any intervention promoting reintegration can be therapeutic when dissociation occurs. While single-component psychosocial approaches may suffice for mild cases of ASDs, the ideal therapeutic plan for severe or refractory cases should be rapidly implemented, personalized, multicomponent and synchronous.