RD Laing's model of ontological insecurity (1959) is extended to one of ontological dominance: which exists more the self or the world? Psychopathology is characterized as the cognitive and behavioral consequences of unstable boundaries between self and world (or others) as a result of inadequate resolution to this tension. All resolutions are placed along an autistic-normal-catatonic continuum, where reward (social, physiological) modulates position on this continuum. Left and right hemisphere processing is presented as ontological dominance of self, and world, respectively. Mental health is thus a balance of this tension; i.e., the healthiest individual has no hemispheric dominance in his or her self-concept or worldview. Particular emphasis will be placed on the autistic spectrum disorders.