A ritual central to science is the PhD defence. At Leiden University, the oldest university in the Netherlands, this ceremony unfolds in an ornate auditorium where stained glass windows cast coloured light onto centuries-old wood panels. Then picture a procession of senior scholars, each adorned in black robes and peculiar hats as if plucked from a medieval painting.

Recently, I witnessed my friend Ahnjili ZhuParris's defence, an AI engineer with a flair for the artistic. I'd first encountered Ahnjili at the "AI and Experience Design" conference in Amsterdam, where she showcased her provocative AI artworks. Her "fashion police" drones, using computer vision to identify "fashion crimes," were particularly unsettling.

But at Leiden, Ahnjili inhabited a different world. Her PhD work uses machine learning to create digital biomarkers of mental health—a proposition as controversial as her art. Can we really predict clinical depression or Parkinson's disease from smartphone usage patterns?

The defence was intense. Each scholar would offer a gentle compliment before leaning in for the intellectual attack. Ahnjili parried their questions about statistical robustness and generalizability with calm curiosity and a humble yet confident smile. Then came the final question from the most senior panellist:

"What is health?"

Ahnjili paused. It was a long pause. This was clearly not a question she'd prepared for. As her pause awkwardly continued, I felt my own head swirling in academic vertigo, imagining how I'd even begin my answer in her position. Then, after a few tense moments, she started exploring the question with curiosity. She broke health down into the specifics of diagnostic criteria and various measurable phenomena. Soon after, the defence came to a successful conclusion and everyone enjoyed a glass of champagne with “Dr ZhuParris.”

Yet, I couldn’t stop thinking about this "what is health" question. After all, the way we answer that question has major implications for the entire field of design for health and well-being. Traditionally, health has been defined in the negative - the absence of disease or infirmity. But this definition falls short. The World Health Organization offers a more holistic view, describing health as "a state of complete physical, mental and social well-being." This well-being approach is central to the Delft Institute of Positive Design, which focuses on design for well-being. Yet even the WHO’s definition raises questions. Is complete well-being truly achievable? What is well-being, anyway? 

The answer may lie in an ancient perspective: understanding health through the philosophical concept of harmony.

In a recent review across disciplines and cultures, my colleague Haian Xue and I found that for millennia, harmony has been a central concept in philosophy. Contrary to popular belief, harmony isn't about sameness or avoiding conflict; it's a dynamic process of integrating diverse elements into a whole (Lomas & Xue, 2022).

What does harmony have to do with health? The word 'health' originates from the Old English 'hal,' meaning whole, which suggests that health intrinsically relates to wholeness. And harmony, broadly speaking, is the integration of diverse parts into a whole. Furthermore, harmony seems to manifest as a qualitative feeling of wholeness—something that we can feel and sense across physical, mental, social, and even spiritual aspects of our being. 

Recently, well-being researchers surveyed thousands of people across multiple countries about their “lay person” perceptions of well-being. The most common response was to understand well-being as inner harmony and harmony with others (Delle Fave et al., 2016). If health is based on well-being and well-being is rooted in harmony, it may be worth digging deeper into the potential for the philosophy of harmony to inform design.

What might a philosophy of harmony mean for designers? First, it doesn't negate traditional medical approaches. Instead, harmony often emerges from integrating seemingly opposite ideas. Consider a cancer patient benefiting from both cutting-edge immunotherapy and holistic practices like meditation. The harmony lies in finding ways for these diverse approaches to complement each other. 

This concept of the "harmony of opposites" extends beyond health. In another article, we explored how conflicts, when approached constructively, can lead to greater harmony. It's about learning from tensions and using them as stepping stones to more integrated solutions.

A perfect example of designing for harmony in healthcare is the work of Elif Ozcan Vieira on sound design in hospitals. Traditional hospitals are filled with disruptive noises—alarms, machinery, and chatter—which can create a stressful environment. Elif's work focuses on creating informative but pleasant soundscapes that reduce stress and promote healing. It's a beautiful illustration of finding the right balance between opposing elements: the need for clear communication and alerts, and the desire for a calm, healing environment.

As health and wellbeing designers, we face similar efforts to integrate opposing needs. How do we integrate measurable data with human subjective experiences? How do we blend AI capabilities with a human touch?

One approach is to consider harmony in our design process. We can create more wholeness in our teams by integrating diverse and even conflicting perspectives—bringing together data scientists, clinicians, designers, and patients to co-create solutions. We can use mixed methods, combining quantitative analysis with a qualitative, empathetic understanding of user experiences.

Reflecting on Ahnjili's defence, I'm struck by how her work embodies this idea of harmony. Her machine-learning research might seem at odds with her AI art pursuits. Yet, it's this integration of seemingly opposite interests that creates a rich, harmonious whole.

After all, isn't this what we all seek—not just freedom from illness, but a sense of wholeness, integrating different parts of ourselves, in tune with our world? As designers, we have the privilege and responsibility to create tools and environments that support this harmony and wholeness in people's lives.

Designing for health and well-being won't be easy; we'll face conflicts, tensions, and opposing forces. But if we approach these challenges like Ahnjili did at her defence—with intellectual curiosity and a humble yet confident smile—we can turn the tension of conflict into opportunities for greater harmony. And wouldn’t that be healthy?

References

Delle Fave, A., Brdar, I., Wissing, M. P., Araujo, U., Castro Solano, A., Freire, T., . . . Soosai-Nathan, L. (2016). Lay Definitions of Happiness across Nations: The Primacy of Inner Harmony and Relational Connectedness. Frontiers in Psychology, 7(30). https://doi.org/10.3389/fpsyg.2016.00030

Lomas, J. D., & Xue, H. (2022). Harmony in design: A synthesis of literature from classical philosophy, the sciences, economics, and design. She Ji: The Journal of Design, Economics, and Innovation, 8(1), 5-64. https://doi.org/10.1016/j.sheji.2022.01.001