Standing on a Teeter Totter

Balance is a word we hear a lot. We’re encouraged to find balance between our work and our life; between what we eat, drink, and do; within the realms of our relationships, emotions and even our physical bodies. Chinese medicine also emphasizes the importance of balance, but what does the term actually mean, and how can we make it a useful concept in our lives? There are two main realms where we can examine the idea of balance: the microcosm and the macrocosm.


The Microcosm

At the cellular and even the molecular level there are many systems within the body where balance is important. Blood sugar, for example, needs to be maintained between 80 to 140 Mg/DL. If blood sugar levels fall too low one will begin to feel tired and hungry as the body calls out for more energy. You might also feel shaky or experience spontaneous sweating. But if blood sugar levels rise too high this is also dangerous since excess sugar can bind to and denature proteins in the blood. Uncontrolled hyperglycemia can cause blurred vision, headaches, and, in severe cases, even coma and death. This example is likely familiar to many people, but it represents just one of many variables that need to be balanced within certain limits in order for the body to function well. Other examples include the pH level (acidity) of the blood, the blood pressure and the levels of minerals such as calcium, potassium and sodium.

Zooming out to the level of the organs, we can see that each organ needs to be functioning at the correct level to do its job within the body, but at the same time not over-working itself. For example, when the stomach receives food it needs to release stomach acid and perform what are called mixing movements and peristaltic movements to combine the food with the stomach acid and move it on into the small intestine. If these functions are impaired then there will be slow gastric emptying which can lead to acid reflux and indigestion. Once the food has been passed on, however, the stomach muscles need to relax and the secretion of stomach acid needs to stop. If the stomach is overproducing acid and does not take the time to rest and heal then ulcers and other gastric disorders could result. Chinese Medicine would consider the first example Stomach Qi Xu. Xu means deficiency or lack and Qi means energy—so the stomach does not have enough energy to do its job properly. The second example would be diagnosed at Stomach Heat or Stomach Fire—the engine is running too hot and damaging itself in the process!


The Macrocosm

Zooming out again, we reach the scale of the human body as a whole. This is the realm where we have the most direct control. After all, we cannot consciously alter our blood pH or our blood sugar levels, but we can direct what we do with our bodies throughout the day. The Huang Di Nei Jing (Medical Classic of the Yellow Emperor) is one of the foundational texts of Traditional Chinese Medicine. It was written somewhere between 475 BC and 220 AD and much of the text is devoted to how one attains and maintains good health. On the topic of daily activities, it notes that too much sitting damages the bones, too much standing damages the muscles, too much walking damages the tendons and too much lying down damages the lungs. The key words here are, “too much”. None of these activities are harmful in and of themselves, but these days many of us sit in a car to go to work, sit in front of a computer for seven or eight hours at our jobs, sit in the car on the way home, and then sit on the couch again watching television in the evening. Conversely, I see many patients who work jobs where they are constantly walking and standing and, just as the Huang Di Nei Jing observes, they present with muscle pain or tendonitis. In both of these cases, you do not have to be a medical expert to see that there is not a good balance between different activities.

Sadly, our culture tends to promote excess and so even people who have been walking or standing all day feel like they must go for a walk or a run or push their bodies even more at a gym if they want to be “healthy”. The question people often ask themselves is, “What do I need MORE of in order to be healthy?” I find that a much more useful question is: “What have I been doing recently, and what can I do NOW to balance that out?” If I’ve been working hard or engaging in a lot of exercise, I might need to balance that out with some extra rest. If I’ve been going out to eat with friends and having heavier meals, my body would probably enjoy some lighter fare for a couple days. Framing the question in this way keeps the focus on what our bodies are feeling and what they actually need rather than just mindlessly checking off boxes on a “be healthy checklist” that we’ve constructed.


The Harmony

The wonderful thing about giving your body a balance of different foods and different activities is that this will promote balance at every level of your body down to your very cells and molecules. As I said, you cannot consciously control many of the physiological functions that your body performs, but with your actions and decisions throughout each day you can make it much easier for your body to maintain those systems in balance. I often tell my patients to imagine standing on the middle of a teeter totter. With such an unstable footing, you have to spend a lot of energy and focus just to keep your balance. But, if you start to make that pivot point wider and wider it gets easier and easier to keep your balance and before long you barely have to spend any extra energy at all to stay upright.

This is very much how it works with our bodies. If what we do each day is not in balance, our bodies will compensate for that, but it will take much more energy than it should. As we give our bodies more balance at the macro level, which we can control, then it will become easier and easier for the body to keep that balance, that homeostasis, that it wants at the micro level. And the beautiful thing is that this is not a one-way street. If our bodies are in a state where they can easily maintain balance then we will feel more energetic, we will get sick less often and recover from injuries more quickly.

Yin and Yang: The Dynamic Balance

The Yin-Yang symbol is perhaps one of the most recognizable symbols in the world. Though some people here in the West think of it as a religious symbol that is not completely accurate. It was originally a statement of how the natural world functions. The Chinese character for “yang” literally translates as “the sunny side of the hill.” Conversely, the character for “yin” translates as “the shady side of the hill.” Chinese philosophers observed that as the sun moved across the sky the shady side of the hill would gradually grow brighter and the sunny side would darken until finally the two changed places. Similarly, day gradually changes to night and the seasons change from warm to cold in a similar pattern. This state of dynamic balance was thought to govern all natural phenomenon and this way of looking at the world came to influence many areas of thought: government, art, martial arts, medicine and even interior decorating.

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Yin and Yang

Fire and Water are two common examples of Yin and Yang in nature.

When applied to Chinese Medicine, the theory of Yin and Yang divides the body's functions into two main types. Functions that are active, moving and energetic and considered Yang. The intestines moving food along their length, the beating of the heart and the actions of the muscles moving the body through space are all good examples of Yang functions. Paired with these Yang functions the body also has Yin functions. Yin functions are all involved with nourishing and repairing the body. The stomach has to contract to help break down the food we eat—a Yang function—but it also has to renew its lining—a Yin function.

Yin and Yang functions are mutually dependent and support each other. If an organ's Yin functions are impaired it will eventually accumulate damage and be unable to perform its Yang function either. Take a muscle for example. If it is worked too hard with no time to rest and repair itself eventually it will be torn or strained. When that happens it cannot move at all without difficulty or pain. But Yang functions are equally important to the Yin. Think what would happen if the muscle never moved at all. It would quickly atrophy and become unhealthy. Or think how poorly your digestive system would work if it couldn't perform its Yang function of moving food through the intestines.

Both Yin and Yang functions are necessary for the body to stay healthy. Many times people recovering from an injury find it difficult to take the time and rest their body needs to heal completely. They want to get back to doing all the things they want to do and feel as though they can heal themselves through sheer effort. This is called “Fighting Fire with a Fan.” The more energy you put into waving the fan back and forth the worse the flames become. Other people become very inactive following an injury. They are afraid of causing themselves pain or perhaps injuring themselves further. Because of this they often heal from injuries weaker than before and with decreased range of motion in their joints. They are at increased risk for injuring themselves again.

In the above example, the first approach is too Yang, the second too Yin. But ignore one aspect of the body's needs to the detriment their overall health. By helping us to keep both sides of the equation in mind, Yin-Yang theory gives us a useful lens through which to examine many different aspects of our lives and plot a true course towards greater health and well-being.