Balanced Dimension

This ‘Balanced dimension’ was created in 2016 by Dr Antonia Wrigley, BHMA Vice Chair

Your hand opens and closes, opens and closes. If it were always a fist or always stretched open, you would be paralysed.

Your deepest presence is in every small contracting and expanding, the two as beautifully balanced and coordinated as birds’ wings.

Rumi, The Essential Rumi

Balance and Health

The essence of health is inner balance

Dr Andrew Weil

The Autonomic Nervous System

We can look at balance in many systems of our bodies, indeed at medical school budding doctors today learn all about ‘homeostasis’, however the balance of the autonomic nervous system deserves special attention.
We are talking about the 2 opposing systems of the (sympathetic) ‘Fight & Flight’ vs the (parasympathetic) ’Rest & Restore’.
In our modern busy lives we have become out of balance. Our sympathetic drive has become dominant and eventually the stress associated with this leads to exhaustion and burnout, physically and emotionally.

It is also worth noting that there is a growing interest in the role of the vagus nerve in health and disease, and in practices & therapies that help to stimulate this nerve. E.g:

• Slow belly breathing with longer exhale
• Gargling
• Chanting, humming & singing
• Cold showers
• Implanted electrical device

For more info read this blog: How to Stimulate Your Vagus Nerve for Better Mental Health

We can also look at the balance of certain brain chemicals which relate to different mental states.

Another way to look at balance is between the mind and the body or the left and right sides of our brain.

What we experience as mind is primarily our experience of the left side of the brain, which has shaped our Western world. Though it has brought great advances in technology it has also tended to take us away from our intuitive, feeling and imaginative side.
Our right brain is connected to our emotions and our body and focussing more on these can lead us back to balance.

An Ancient View

The concept of balance is integral to many ancient medical systems. Perhaps the best known today is Traditional Chinese Medicine which recognises 5 elements that need to be in a dynamic balance for there to be health of the body, mind and spirit
The elements can be equated with the seasons, each bringing new challenges and opportunities for balance. In TCM the earth element relates to late Summer – the time of harvest.

Hippocrates (The ‘Father of Modern Medicine’) used a four element system -the 4 ‘Humours’ or ‘Temperaments’.

In India however where they have three seasons (Summer, Winter and Monsoon), they have a 3 element system.

Balance in Life and Work – Life Balance

Our pace of life has changed enormously in the last century with increasing demands to juggle different responsibilities. Perhaps many of us yearn for a simpler or more spacious life. Rest and leisure time are essential for health as are activity, exercise and fulfilling ‘work’. Finding the right balance is a dynamic and ongoing process which we all need to work out for ourselves.

“To be without leisure – to do everything for the sake of something else – is to be only half alive” writes Edward Skidelsky in Resurgence article Genuine Leisure

Burnout

Healthcare practitioners have a high rate of burnout and mental health issues. This is in part due to a lack of balance between their work and life. There will be more about this elsewhere.

Balance in Medicine

One problem facing healthcare today is ‘over-diagnosis’. This has become an umbrella term for over-investigating, over-diagnosing and over-treating people. Knowing when to turn someone into a ‘patient’ is complex. It requires of the doctor many skills and qualities along with knowledge and experience. It is an art that is being lost with our modern culture of litigation.
GP’s in particular need to be not only knowledgeable about risk but also comfortable with uncertainty. Indeed in their role as gatekeepers GP’s

need to be courageous enough to reassert the border’ so that people only make the journey when ‘medical care is appropriate and will produce more benefit than harm.

Iona Heath From her Key Note speech, Preventing Overdiagnosis Conference, Oxford, 2014

One technique that is important to grasp is ‘satisficing’. Applied to medicine it has been defined as “gathering the minimum amount of information sufficient to reduce risk to an acceptable level”. This is not only important for the patient but also for the doctor to prevent burnout. And with the pressures of time and money it is also pragmatic.

Resources

• RADIO INTERVIEW: Dr Iona Heath: Too much medicine is making us sick
• Role of fear in overdiagnosis and overtreatment—an essay by Iona Heath
• If you are interested in the differences in the right and the left brain and how these have shaped our world then this book by psychiatrist Iain McGilchrist is a fascinating read.