Coupled mode theory (CMT) is a powerful framework for decomposing interactions between electromagnetic waves and scattering bodies into resonances and their couplings with power-carrying channels. It has widespread use in few-resonance, weakly coupled resonator systems across nanophotonics, but cannot be applied to the complex scatterers of emerging importance. We use quasinormal modes to develop an exact, ab initio generalized coupled mode theory from Maxwell's equations. This quasinormal coupled mode theory, which we denote "QCMT", enables a direct, mode-based construction of scattering matrices without resorting to external solvers or data. We consider canonical scattering bodies, for which we show that a CMT model will necessarily be highly inaccurate, whereas QCMT exhibits near-perfect accuracy.