Across the modern world, a balanced lifestyle has been presumed to ensure a healthy, happy and productive life.  During the twentieth and early twenty-first centuries, the concepts of balance and imbalance have been mobilised to explain and enhance physical health and fitness, to shape approaches to the treatment and prevention of mental illness, to inform advice relating to diet and work, and to promote exercise in natural environments.

The aim of this multi-stranded, interdisciplinary research project is to explore the manner in which preoccupations with balance have been incorporated into medical advice and shaped lifestyle choices aimed at improving physical health, addressing work-life imbalances and restoring the ecological balance of nature.  Employing a number of disciplinary perspectives, it will analyse the clinical, scientific, political and cultural authority of the concept of balance within modern medicine by addressing a number of inter-related questions:

• How has the notion of `a balanced lifestyle’ been variably defined and reconceptualised?
• How have modern lifestyles been shaped by the notion of balance?
• To what extent have understandings of the body and mind been informed by the concept of balance?
• To what extent have clinical commitments to balance been determined by socio-political and cultural contexts?
• Have scientific accounts of physiological and biochemical balance reinforced or challenged contemporary commitments to leading balanced lives?
• Why has the notion of balance remained a critical component of both Eastern and Western approaches to the prevention and treatment of disease?
• Why do we believe that maintaining balance is essential to mental and physical health?
• How have modern populations attempted to achieve balanced lifestyles?
• Do patients explain and experience health and illness in terms of balance and stability?

Drawing on archival and published scientific and clinical documents, on oral testimony and life histories, and on media, literary and visual sources, the project comprises three major strands:

a) Bodies in balance

In the early twentieth century, physiological function was often explained in terms of balance.  Biochemical and biological stability were understood either in terms of hormonal balance or in terms of the balanced integration of the antagonistic branches of the autonomic nervous system.  Imbalances in these physiological systems were thought to be responsible for a variety of clinical conditions, including diabetes, asthma, obesity, epilepsy, and sexual dysfunction.

The concept of balance also informed the development of physical treatments designed to reduce pain, improve posture and mobility and restore emotional equilibrium.  Some therapies, such as yoga and meditation, originated in Asia.  Others, such as Pilates, the Alexander technique, physiotherapy, osteopathy, chiropractic, the use of balance boards and `zero balancing’ (a technique introduced by Dr Fritz Smith in 1973), were rooted in Western interest in the health benefits of remedial gymnastics, massage therapy and outdoor exercise.  In conjunction with balanced diets and exercise, such techniques were increasingly advocated as part of a healthy lifestyle: improving balance through movement and manipulation was thought to release energy, enhance resilience, promote endurance and productivity, combat obesity, and increase a sense of well-being.

This strand of the project will explore the social, political and cultural contexts within which scientific theories of neuro-hormonal balance and various balance therapies were adopted and adapted by clinicians and their patients.

b) Balancing minds

Mental illness is recognised as a major threat to health across the world.  In Britain, depression costs the NHS £11 billion per year, largely as a result of the rising consumption of antidepressants.  Reducing the personal and financial burden of mental illness has become a key target for national health services and international organisations such as the WHO.

Balance has constituted a pivotal concept within modern scientific and clinical accounts of mental illness.  After the Second World War, psychiatrists and pharmaceutical companies promoted a medical model of mental illness according to which depression was primarily caused by `chemical imbalances’ in the brain.  Treatment with antidepressants or `mood stabilisers’, they argued, served to improve symptoms by restoring the balance of neurotransmitters.  Psychiatrists interested in the psychosocial determinants of mental illness also embraced the concept of balance: mental illness was caused not by chemical disequilibria but by unbalanced lifestyles or the failure to effectively manage work-life balance.  From this perspective, treatment was aimed at helping patients re-establish a sense of balance in their lives through CBT, relaxation techniques, mindfulness meditation, and outdoor exercise in the `green gym’ or `blue gym’.

This strand of research will explore scientific and clinical models of mental illness, alongside oral histories and patient narratives, in order to reveal the manner in which notions of balance have shaped perceptions of mental illness and impacted on the identities and experiences of patients and their families.

c) The balance of nature

In a speech to the Royal Society in 1988, Margaret Thatcher claimed that `Protecting the balance of nature is . . . one of the great challenges of the late twentieth century.’  Thatcher’s comments testify to growing scientific, public and political interest in preserving ecological balance and ensuring the sustainability of the cosmos.  Although `the balance of nature’ was often dismissed as a myth, the notion served to support political arguments for greater regulation of environmental hazards, mobilise economic resources, and shape approaches to health and illness.

Late twentieth-century concerns about the impact of human consumption on environmental sustainability and anxieties about the health impact of climate change deepened in the light of evidence that global variations in population growth and density were also adversely affecting ecological balance and human well-being.  Attempts to control social and ecological systems in order to improve human health were often predicated upon biological accounts of balance, leading to specific attempts to promote individual lifestyle choices and welfare policies in order to reduce the burden of obesity and mental illness.  Environmental scientists, clinicians, policy-makers and international health organisations increasingly advocated exercise, outdoor recreation in the green or blue gym, and balanced diets to combat chronic disease and increase awareness of the importance of environmental protection.

This element of the research will explore the manner in which modern practitioners, like many of their historical predecessors, have attempted to convince patients to incorporate exercise and leisure in natural environments into hectic, and potentially toxic, lifestyles.  Historically informed, the research will link with the work of environmental and behavioural scientists, clinicians and policy-makers.