The Ten · Temperance
Temperance is the right amount of the right things.
It is one of the most misunderstood ideas in health. People hear it as a grim list of things to give up. What it means is the wisdom of measure: leaving aside what harms, and keeping even good things short of the point where they start to hurt you.
Book a Consultation →What This Is
Two simple movements. The first is letting go of what damages the body. The second is finding the right measure in everything else. The first is familiar. The second is where most of us struggle, because what catches us is rarely the obviously bad things. It is too much of the good ones.
What the research shows
The dose makes the difference.
Work. Work is good, and overwork is now one of the deadliest patterns in modern life. The World Health Organization and the International Labour Organization pooled dozens of studies covering more than 1.5 million people. Working 55 or more hours a week, compared with 35 to 40, carried about a 35% higher risk of stroke and a 17% higher risk of dying from heart disease. By their estimate, long hours caused about 745,000 deaths in a single year, most of them in men over 60 who had worked that way for decades (WHO/ILO, Environment International 2021). The same principle runs through eating, exercise, and busyness.
Alcohol. For years the advice was that a little is good for the heart. The largest analysis to date pooled 83 studies and 600,000 drinkers in high-income countries. The lowest death rate was at or below 100 grams of alcohol a week, roughly five or six drinks, and every 100 grams above that cut life expectancy at 40 by months, then years. For stroke, heart failure, and high blood pressure there was no level below which drinking less stopped helping (Wood, Lancet 2018). For women there is a second cost. The Million Women Study followed 1.3 million British women and found that each regular daily drink added about 15 cancers per 1,000 women by age 75, eleven of them breast cancer, and wine was no different from anything else (Allen, J Natl Cancer Inst 2009). These are observational studies, large and consistent. The simplest course is not to drink, and that is the one I recommend.
Caffeine. Stimulants borrow energy you pay back later. Researchers at Henry Ford Hospital gave healthy sleepers 400 mg of caffeine, about two or three cups of coffee, at bedtime, three hours before, or six hours before. Even six hours out, it cut measured sleep by about an hour, and the sleepers did not notice (Drake, J Clin Sleep Med 2013). The study had 12 people, and the finding has since been repeated. For people with anxiety, poor sleep, or high blood pressure, cutting back often helps more than they expect.
Food. The body takes about twenty minutes to register fullness, so it is easy to eat past what you need before you notice. Eating slowly, and stopping when satisfied, before you are full, is one of the oldest health practices there is. What it asks for is attention.
Tobacco and other drugs. The harm here is well documented and most people already know it. If any of them has a hold on you, that becomes the next thing we work on, together and without judgment.
From the medical literature
Cases doctors have written up.
Behind every trial are real people. Here are a few whose doctors wrote up what happened.
A man with a long history of heavy drinking was admitted to a Toronto hospital in severe heart failure. His heart was dilated and pumping out only 15% of its volume with each beat, two features that usually mean a poor outlook. He stopped drinking. After one year of abstinence his heart function had returned to normal on repeat testing, and at eighteen months he was free of symptoms and taking no medication.
Schwartz et al., American Journal of Cardiology, 1975 · Read the reportA 46-year-old man with severe heart failure from alcohol was studied in a French cardiology unit, then again after a year and a half of near-complete abstinence. On the second study the left ventricle was working normally, and his heart responded normally to exercise. When last seen, 29 months after his first admission, he had no symptoms and was on no treatment.
Baudet et al., Cardiology, 1979 · Read the reportA more recent report describes a patient whose heart muscle was thickened and whose contraction was impaired on detailed imaging, although the overall pumping figure still looked acceptable. Heavy long-term drinking was the likely cause. He stopped completely. At seven months the imaging had returned to normal, and the diagnosis of early alcohol-related heart disease was made only in hindsight, from the recovery.
European Heart Journal Case Reports, 2023 · Read the reportHow I use it
There is no list of prohibitions. We look at where excess is quietly costing you, whether that is overwork, too little rest, the evening drink, the fourth coffee, or simply never stopping, and we work on it at a pace you can keep. Letting go of what harms, and finding the right measure in the rest.
Where something has real hold, we address it with support and without shame. If a medication is involved, any change is a decision you make with the doctor who prescribes it.
What is possible
Temperance asks something of everyone, because nearly all of us overdo something. The goal is a life you can enjoy for a long time, and right measure is what makes that possible. You will not get it perfect, and you do not have to. If you overshoot, you reset and carry on.
Where This Leads
Temperance touches how you work, eat, rest, and unwind. It pairs closely with rest, because much of it is knowing when to stop. See also Sleep & Rest and Stress Management.