This article introduces the Tetractys of Philosophical Health, a structured visual exercise inspired by the Pythagorean tetractys that facilitates alignment between an individual’s cosmological worldview, sense of purpose, and practical engagement with the world. This heuristic exercise is methodologically grounded through multi-layered convergent indications from cognitive load theory, affective neuroscience, neuroplasticity research, ancient wisdom traditions, and sustained philosophical counselling practice. Employed as a core component within the SMILE_PH method (Sense-Making Interviews Looking at Elements of Philosophical Health), the exercise serves as both exploratory tool and intervention, bridging abstract philosophical reflection and concrete action while training compossibility thinking—the capacity to create mutually reinforcing relationships between different dimensions of possibility. The article presents this four-layer theoretical foundation, describes implementations within philosophical counselling sessions with case examples, and discusses theoretical and practical implications for educational, organizational, and personal development contexts. The Tetractys, a tested innovation presented here for the first time in print, contributes to philosophical practice and possibility studies by offering a consolidating—compossibilizing—approach that helps individuals create integration between personal cosmology, cognitive coherence and practical mission while developing systemic thinking.