From bodily signals to safe action: an interoceptive self-regulation loop for whole-person health

Health systems increasingly measure physiological and behavioral outputs, yet the transition from a bodily signal to a safe, feasible decision remains difficult to specify. We propose the Interoceptive Self-Regulation Loop (ISRL), a provisional framework linking context and exposure, bodily state, interoceptive sampling, appraisal, action, and feedback. Four measurement strata distinguish contextual inputs, functional changes, subjective signals, and clinical indicators. A safety gate operates throughout the loop through condition-specific rules, named clinical responsibility, and documented escalation and follow-up. Its purpose is to support decisions without transferring diagnosis or risk assessment to individuals. The proposed contribution is an explicit, testable account of cross-stratum discordance and evidence-responsive appraisal, rather than the invention of interoception, triage, or behavior-change support. We specify independent candidate measures of appraisal flexibility and action proportionality, illustrate the safety gate using recent-onset chest pain, and compare ISRL with a simpler combination of the common-sense model, COM-B, and identical triage guidance. Six propositions distinguish supporting predictions from the more discriminating tests of discordance, flexibility, and timely care. A bounded initial research program concerns adults in primary care, daily observations, and episode-level decisions, with prospective validation before interventional use. Repeated failure to improve prediction or decisions over the active comparator, despite adequate measurement and precision, would count against retaining ISRL as a distinct framework in that setting. Clinical safety, monitoring burden, cultural adaptation, and unequal access are explicit evaluation outcomes. ISRL remains a theory for investigation, not a validated diagnostic tool or treatment.