My journey has always been the balance between chaos and order. — Philippe Petit

Koyannisqatsi is a Native American word meaning “life out of balance.” The Hopi tribe may have been among the original behaviorists when insisting that some ways of being suggest looking into a better way of being. Whatever we’ve tried before, it behooves us to shift our cognition or behavior until relative stability can be achieved. However, finding the source of our instability requires vigilance coupled with the posthumous voice of Richard Feynman reminding us that the easiest person to fool is ourselves.

Maintaining balance in life is often an a posteriori experience that’s only understood after one has repeatedly landed on their posterior. Establishing homeostasis while being mindful of the circadian clock is crucial, but calibrating personal equilibrium depends on gaining knowledge from previous mistakes and experiments. A modicum of trial and error early in life allows for exploring the world while acknowledging the limitations of embodiment, but high frequency derailment will eventually open a trap door of harrowing consequences—especially as we get older.

IPSRT (Interpersonal and Social Rhythm Therapy) is an intervention for establishing mood stability that focuses on developing daily routines and social interactions with improvements in sleep hygiene, diet, medication management, and exercise. The concept behind IPSRT is that harm reduction and mood regulation is much easier when one is engaged in prearranged activities with adherence to “rhythmic” schedules. Understanding how consequences emerge from imbalances in biological and social realms necessitates preventive care and maintenance to accompany activities of daily living.

On a more personal level, I once worked with a co-occurring client who suffered from Bipolar Disorder with an extensive history of interpersonal and occupational instability. After a period of many sessions, we focused on his most recent goal of smoking cessation and explored why his previous attempts to quit smoking had failed (e.g., antagonists, behavior therapy, nicotine patches). Suddenly, an epiphany occurred. Cigarettes were symbolic of the only reliable experience in his life. His upbringing had been unstable; his relationships had been volatile; his occupational history had been turbulent; and his mood cycles were frighteningly unpredictable. In fact, cigarettes represented a reliable anchor of experience while offering comfort, privacy, and relaxation. In addition, the perceptual illusion of stress reduction and the power of ritual had solidified smoking as a source of welcome predictability. It wasn’t the biochemical effects of nicotine alone that perpetuated his habit as much as his endless yearning for equanimity.

Regarding allegories on the importance of maintaining balance, the story of Dr. Herbert Otto Penzhorn may be more convincing than any personal observations or appeal to medical advice.* Penzhorn was a highly regarded and accomplished surgeon who worked in the town of Pretoria located in South Africa. In addition to being a renown physician, the sixty-six year old reserved an avocational affinity for the commercial farming of crocodiles on his private farm in the nearby town of Kroondal. During an early morning visit to the farm on February 23, 2011, Penzhorn attempted to fix a broken water pipe leading to one of the holding dams. Despite being alone without the assistance of his employees, Penzhorn climbed to the top of the holding dam and positioned himself directly in front of the water pipe as he worked. When the water pipe resumed full flow, the build up of pressure apparently knocked Penzhorn backwards and directly into the crocodile pit below. As the indifference of nature would have it, the crocodiles were already anticipating breakfast and didn’t seem to mind culinary substitutes. Needless to say, there wasn’t much left of the unfortunate doctor by the time his employees arrived at the farm. Sometimes maintaining balance is a high-priority endeavor.

Whenever asked how I’m doing these days, I amusingly tell people that I’m in the preventive and maintenance stage of my life. Let’s be honest, if we’re not periodically adjusting our physiological and psychological alignment, or if we rely on the wrong set of crutches for support, we may become vulnerable to the symbolic crocodiles lurking beneath our most significant mistakes.

* the descriptive event is a true story