Thursday, September 6, 2012


We worry about this. 
So, we diet (episodically and in the long run, never quite successfully enough), we run (rarely), we do yoga and pilates, drink green (or  preferably white) tea, learn to play golf, eat less bacon, forego that second scoop of ice cream, buy organic tomatoes, and yearn for more sleep. Yet, all of these many and noble endeavors remain fragmented and directionless without an overarching principle on how to lead one's life.

Among the splendid and life-affirming philosophies that were birthed by the ancient Greeks during their Golden Age between the 6th through 4th centuries B.C.E., there is one that is foundational. It is the concept of Sophrosyne (σωφροσύνη).
Sophrosyne was one of the
"Eudaimonia" or "Good Spirits," who
escaped Pandora'"s box, as seen in this
pre-Raphaelite style painting
J.W. Waterhouse (1849-1917)
In Greek myth, Sophrosyne was one of the "Eudaimonia," or "Good Spirits," who, along with Pistis (Trust), escaped from Pandora's box when she opened it. Aristotle, in his Nichomachean Ethics, commented on the notion of eudaimonia, defining it as "living well and doing well." A better definition for the present-day would be "fulfillment" or  "purpose." 

The goddess Themis, (one of the original Greek Titans birthed through the union of Ouranos (Uranus, or Sky) and Gaia (Earth)), also manifests  the qualities of Sophrosyne in the aspect of   "divine order."

Divine Order

I have long enjoyed going to the Online Etymology Dictionary (that other O.E.D.), to find the sources of words, back to their P-I-E (Proto-Indo-European) roots. 
The P-I-E sources for Sophrosyne:

Sophrosyne Greek, “prudence, moderation,” from sophron “of sound mind, prudent” (see Sophronia):

Sophronia Greek, feminine, proper name, from sophronia, from sophron, sophronos, "discreet, prudent," prop. "of sound mind," from sos, "safe, sound, whole" + phren, " heart, mind, midriff."

The Egyptian
foundational goddess
Ma-at, embodying
Restraint, Justice,Balance
Inherent in the notion of Sophrosyne is the concept of moderation, integrity and humility, that everything that the individual does should be done in perfect balance. These ideas are so essential that all great civilizations have thought about them and grappled with their meaning and import. Before the Greeks, the Egyptians recognized the relationship of balance and integrity, and anthropo-morphized it in the goddess Ma-at, which they also rote about as the principle of Ma-at. To the Egyptians, Ma-at was a central tenet of an individual leading the "good life," the life of balance, restraint and self-awareness. Ma-at was represented by a young woman with an ostrich feather on her head, which was used on a balance scale as a weight against the "lightness" of a person's heart before they entered the after-life.

As Helen North discusses in her eponymous book on the subject, Sophrosyne contains all of these many and disparate principles of self-knowledge, self-awareness and self-restraint. Sophrosyne thus becomes a moral belief system which, if intuited and practiced, can lead to a healthier and more wholesome life.

The Greek philosopher Socrates equated Sophrosyne with temperance, "everything in moderation," and that those who practiced this belief system, "would not need medication except in the most extreme of cases." Socrates believed that the pursuit of self-development was more noble than the achievement of material wealth, and that virtue was the most valuable of all of one's possessions.

Socrates' pupil, Plato, wrote about Sophrosyne in his Republic, as one of the four cardinal virtues, along with prudence, justice and fortitude.  Plato stated that physical exercise should be done in combination with "cultivating the mind" and "exercising the intellect" which would accrue to the betterment of one's memory. This concept of mind-body synergy was the personification of Sophrosyne

One of the virtues of Sophrosyne is self-control. For the Stoics, Sophrosyne was one of the cardinal virtues, along with courage, prudence and justice. Plato, in the Charmides, discusses this attribute of Sophrosyne.

The Romans conceptualized several ideas akin to Sophrosyne: in Juvenal's maxim, mens sana in corpore sano, which captured the balance and mutual necessity of "the sound mind in a sound body," and in their constructs of constantia (fidelity), sobrietas (restraint), temperantia (temperance) and dignitas. The term dignitas  does not translate to "dignity" as one might intuitively expect; it is more complex and nuanced than that. In the Roman context, dignitas was defined as an aspect of social standing, wherein a person's integrity was seen as a manifestation of the idealized life, much as the Egyptians understood a life under the rubric of Maat. 

Sophrosyne is also rooted in the notions of balance and health-mindedness.  The concepts of balance and integrity are embedded in the teachings of Hinduism, Buddhism, Taoism, and the analects of Confucianism.

The universality of these ideas can be found, for example, in Hinduism, where parallels to Sophrosyne are seen in the concept of dharma (the law supporting the order of the universe),  in the hathayoga (the balancing of opposite forces), and in the tenet of artha  The artha is one of the four puruṣārthas (Sanskrit पुरुषार्थ : "goals of life")  within Vedic belief, which concern themselves with the concept of "proper living" as espoused in its great epics, the Ramayana and the Mahabharata. Thus, Egyptian, Greek, Roman and Hindu philosophies each contain similar concepts embedded within Sophrosyne.

A few years ago, I enrolled in the course in Mindfulness at the University of Massachusetts Medical Center. Mindfulness, viewed through the lens of Sophrosyne, becomes its modern-day avatar, a philosophy which also incorporates balance, thoughtful (which is to say, mindful) quietude, self-observation, meditation and basic hathayoga. It was at the U. Mass Medical Center in 1979 that Dr. Jon-Kabat Zin first defined and then developed the Mindfulness-Based Stress Reduction (MBSR) program, articulating it as a methodology for reducing life stress and anxiety, and increasing life balance. Over the last thirty-five years, a rich and robust series of controlled trials published in the peer-reviewed literature, at different medical centers, has corroborated both the validity and efficacy of Mindfulness.

What struck me as I got to know some of my fellow students in the Mindfulness course was that many were health care professionals as myself - there were physicians, nurses, medical technicians in our group. What also became abundantly evident as the course unfolded was how necessary this type of strategy is in the lives of us all.

One of several tools one learns in Mindfulness practice is to internalize, and then actualize in daily practice, the acronym S.T.O.P. - Stop, Think, Observe, Proceed. The S.T.O.P. acronym has utility as a response to life stressors. Even as this S.T.O.P. mnemonic may appear to be yet one more self-evident and "throw-away" concept, it is also a much ignored aspect of modern-day life. There seems to be no time to stop and observe anymore. Today, society moves at warp speed, with multi-tasking being largely rewarded, and only rarely punished (for example, if one gets caught texting while driving). There is no time to actually listen, to smell the flowers, as it were. Yet the Mindfulness practitioner actually takes the time to think and observe before responding. Responding,  instead of Reacting Reflexively.

Andrew Weill M.D. has coined the term "news fast." Avoid TV, radio and internet news for, say, a week. Read books.  Yes, a physical book. Look at nature. Play music, or an instrument, if you do. See what happens to your stress and blood pressure.

Chade-Meng Tan, one of the original engineers at Google, founded a course at the company that he named "S.I.Y." for "Search Inside Yourself." He developed S.I.Y. with nine instructors in mindfulness in the workplace. One of the mantras in the S.I.Y. course is a notion similar to S.T.O.P. and has its own acronym - S.N.B.R.R. for "Stop, Notice, Breathe, Reflect, Respond." (Given that this is Google, that acronym also has an affectionate technological nickname - "Siberian North RailRoad"). Both of these mantras - The Mindfulness S.T.O.P. and the S.I.Y. term S.N.B.R.R.- remind us to reflect and respond, and NOT simply react, to stress.

In the workplace, this concept of reflection and response leads to more mindful interactions with colleagues, mindful e-mailing (meaning not just firing off endless reactive e-mails, but taking the time pre-emptively to think about the recipients of those myriad zingers), and less anger, envy and resentment among coworkers.

A common response one gets when telling peers and colleagues about the Mindfulness course is that, to them, it sounds and feels way too "touchy-feely" or "new age." 
Yet many of the principles intrinsic to Mindfulness are the very things that we already do in our daily routines, whether individually or in groups. Yoga, for example, is quite popular as a stand-alone activity, even rising to the level of cult sport-like status in some circles. Blending some of the more straightforward tenets of yoga's basic postures and salutations (asanas) with mindful meditation can become a potent resource in achieving life balance. Others of us meditate, engage in breathing exercises, or spend time in quiet reflection, all of which are aspects of Mindfulness, during our increasingly busy and disrupted days.

Within the quiet place that Mindfulness resides, one does not judge, one does not react, one is never defensive. Instead, Mindfulness teaches the concept of being "in the present moment," of acceptance and letting be, and that beyond a certain point, no one is truly in control.

I believe that aspects of Sophrosyne should populate medical school education, as part of what I have termed and collated as  "A Curriculum in Compassion." This curriculum of  "High Touch" should include narrative and reflective writing, mindfulness and yoga, art and aesthetic appreciation, basic music performance and appreciation, dance and movement, and a deeper understanding of nutrition and exercise. The skills that comprise the curriculum would be transferred to the medical students, throughout their four years of medical school, thus informing them as physicians. This curriculum should also be extended back into college and university in the education of "pre-meds", and extended forward into the internship and residency years, and into clinical practice when physician burn-out and disengagement is greatest.

Sophrosyne is no longer a long-forgotten  Greek word; it has been reborn in our own time. Sophrosyne has become a vital and relevant concept today, spawning modern
-day correlates like S.T.O.P. and S.N.B.R.R., and being a part of a humanistic medical school  education, indeed a roadmap for everyone, that when practiced, will be enduring and life-enhancing.

copyright 2012 Vincent P. de Luise M.D. A Musical Vision.


  1. Simply a brilliant article. I especially liked those mnemonic tips that you have mentioned. thanks for sharing.

    1. Thank you so much, Sridhar, for your comment. Indeed, the concept of Sophrosyne and its modern correlates of Mindfulness, S.T.O.P. and S.N.B.R.R., are epicentric. If we can become informed by these wondrous concepts, we will live better and more balanced lives.

  2. Excellent blogpost. Everyone should learn about Sophrosyne in school. Self-control is about mastering one's excesses (aka addictions and obsessions) and choosing the best possible course of action according to one's circumstances. Persons without an education in self-control will easily fall prey to addictions and bad habits. Without reflection and mindfulness (thoughtfulness) we are merely like beasts.

    In terms of health, a properly controlled mind and body by one's choices is important in reducing one's bodily stress or illness. Canadian doctor Gabor Mate has talked about how stress can cause disease in the link below.

    1. Thank you for these thoughtful, and mindful, comments. Indeed, self-control is in a sense the real balancer of free will. Choosing the best possible course, usually in medias res, is the answer. Everything in moderation. Sophrosyne.