When our physiology becomes our psychology

This article presents the Domain Loop Model, a framework developed through clinical work with elite athletes, proposing that anxiety arises from misalignment between three interconnected domains of consciousness: interoceptive (internal body signals), exteroceptive (external sensory input), and narrator (meaning-making). The model is integrated and multi-directional: actions in any domain can impact across the whole system. Drawing on research linking joint hypermobility to anxiety disorders, we demonstrate how physiological conditions—particularly excessive gut permeability and resulting inflammatory responses—can create persistent fight-or-flight states independent of environmental threats. When interoceptive and exteroceptive domains become discordant, the narrator constructs narratives to reconcile the mismatch, potentially leading to catastrophic thinking and a self-reinforcing "locked-in loop." While hypermobility serves as an illustrative case (affecting over 20% of the population and showing up to 16 times higher anxiety rates), the model applies broadly: any source of domain discordance—physiological, environmental, or narrative-driven—can generate persistent anxiety. The framework suggests effective intervention requires addressing all three domains, enabling interdisciplinary collaboration. Beyond clinical applications, the model offers insights into polarised thinking and fear-based decision-making in contemporary society, where media-driven narratives can activate threat responses independent of real environmental danger.