Pressure, Hysteresis, and Experience: A Friction-Theoretic Framework for Clinical Intervention

Paper 8 in the Friction Theory paper-series. Psychiatric clinical intervention through the lens of Friction Theory (FT; Pødenphant Lund 2026b, Paper 1) and Behavioural Friction Theory (BFT; Pødenphant Lund 2026a, Paper 0). Abstract. Psychiatric intervention selection is currently guided by diagnosis-indexed taxonomies (DSM, ICD), which cluster patients on observable outcomes rather than on the substrate-route configuration that produces the outcomes. The Friction Theory framework specifies psychiatric pathology as the output-cluster of multi-scale race-resolution under elevated commit-pressure plus accumulated hysteretic trace, and re-organises intervention-selection along five matching dimensions: substrate level, direction (above/within/below productive band), layer-access, temporal-aggregation regime, and intervention-mechanism-type. We develop a six-row intervention-mechanism taxonomy distinguishing add-direct / add-phased / reduce-friction-direct / reduce-friction-baseline / dilution-based / race-opening prevention. Trust is treated as a structurally defined meta-variable for any intervention involving an external actor. A new §5.0.4 synthesis identifies stipulation and pre-mortem as the two framework-distinct techniques that bypass reactance at the race-resolution level, unifying ACT, MCT, SFBT, MI, CBT-IU, psilocybin set/setting preparation, and relapse-prevention pre-mortem under a single RACE-architectural mechanism (substrate signal-budget conserved for alternative-route deposition when intervention-framing does not trigger defended-route recruitment). A new §5.0.5 classification develops pharmacology as forward-modelling-modulator — a seventh classification dimension organising psychedelics + MDMA (translation-amplifiers), alcohol + benzodiazepines (translation-suppressors), amphetamines + SSRIs (translation-function-shifters), and anaesthetics + stimulants (layer-pressure modulators) under a single substrate-mechanical principle developed in coordination with the Forward-Modelling paper (Pødenphant Lund 2026x, Paper 7). Twenty-eight pre-registered empirical predictions plus five negative-prediction R-conditions specify what would force framework-revision. Framework contributions. The paper makes (a) the substrate-computational re-formulation of psychiatric pathology as race-resolution-under-pressure with hysteretic trace; (b) the pressure-column model where biological-base friction propagates upward and column-lowering at the base reduces downstream pressure across all layers; (c) the six-row intervention-mechanism taxonomy with reduce-friction (not remove-friction) as the structurally honest label given the additive-only intervention asymmetry; (d) the three-category hysteresis-fighting taxonomy A (durable substrate-replacement) / B (substrate-modification with consolidation) / C (state-perturbation requiring maintenance), anchored on Wilkinson 2017 ketamine + CBT and Carhart-Harris 2021 psilocybin-vs-escitalopram; (e) the outcome-cluster-versus-route-identity diagnostic-imprecision pattern that motivates substrate-vector stratification beyond diagnostic-cluster classification; (f) trust as structural precondition, with explicit clinical warning regarding AI-coach deployment on RLHF-compressed substrates. Author position and invitation. The author is an independent researcher without clinical credentials. The framework is positioned as hypothesis-and-invitation: the paper specifies what should be tested; clinical translation requires domain-expert collaboration. We make no patient-level recommendations and prescribe no doses. Companion papers in the Friction Theory series: Paper 8b (Compound Race Pathology): 10.5281/zenodo.20059870 (reserved) Paper 8c (Translational Research-Programme): 10.5281/zenodo.20059872 (reserved) Paper 8d (Sub-threshold Cofactor Support): 10.5281/zenodo.20277291 (reserved) Paper 0 (Behavioural Friction Theory): 10.5281/zenodo.19462499 Paper 1 (Friction Theory substrate): 10.5281/zenodo.20012654 Paper 7 (Forward-Modelling in Bounded Race Substrates): 10.5281/zenodo.20449155 Series project page: frictiontheory.org. ORCID: 0009-0000-4724-2427.