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Year : 2013  |  Volume : 55  |  Issue : 6  |  Page : 310-314
Ayurvedic concepts related to psychotherapy


1 Department of Psychiatry, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India
2 Resident Department of Psychiatry, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India
3 Department of Psychiatry, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India
4 Department of Psychiatry, American Board of Psychiatry and Neurology Adult Board Certified and Senior Child Psychiatry, Fellow South Illinois University, USA

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Date of Web Publication7-Jan-2013
 

   Abstract 

The perfect balance of mind, body and soul is considered as complete health in Ayurveda. Ayurveda has its own identity as most ancient and traditional System of Medicine in India. Even Ayurveda emphasizes its treatment modalities into three parts viz. Satwawajay Chikitsa, Yuktivyapashray and Daivyapashray Chikitsa. Sattvavajaya therapy mentioned in Charakasamhita and it used as new concept of psychotherapy in Ayurveda. The effectiveness of "traditional mental health promoting practices" was identified as health regimens (swasthvrtt), correct behavior (sadvrtt), and yoga. Sattvavajaya as psychotherapy, is the mental restraint, or a "mind control" as referred by Caraka, is achieved through "spiritual knowledge, philosophy, fortitude, remembrance and concentration. Ayurvedic psychotherapy would play a dual role: First, as a revival of authentic medical culture, the exercise of a practice with an assumed primordial dimension, and second as a discovery of authentic subjectivity, the revelation of a self with an assumed interior depth. When we integrate the contemporary art of psychotherapy with the ancient science of Ayurveda, it becomes a powerful combination that is called Psycho Veda. The integration of Psycho and Veda is motivated by the complete integration of the immense but fairly contemporary view of the mind, emotions and psyche and how this performs in our lives. Integrating Psychotherapy and Vedic principles teaches us how to rediscover critical knowledge and awareness of the natural forces and rhythms that compliment and strengthen our human experience, through the understanding of the psyche and what our inner experiences are and also involving practical daily activities with thorough attention to our total environment to bring about radical changes in our mental outlook and in physical health.

Keywords: Achar rasayana, Ayurveda, psychotherapy, psychoveda, sattvavajaya

How to cite this article:
Behere PB, Das A, Yadav R, Behere AP. Ayurvedic concepts related to psychotherapy. Indian J Psychiatry 2013;55, Suppl S2:310-4

How to cite this URL:
Behere PB, Das A, Yadav R, Behere AP. Ayurvedic concepts related to psychotherapy. Indian J Psychiatry [serial online] 2013 [cited 2019 Aug 24];55, Suppl S2:310-4. Available from: http://www.indianjpsychiatry.org/text.asp?2013/55/6/310/105556



   Introduction Top


Ayurveda has its own identity as most ancient and Traditional System of Medicine in India. It deals with the whole life of human being starting from birth to end of life because Ayurveda describe the art of living and it is a science of life that reveals what is appropriate as well as auspicious for a happy and long life. The term Ayurveda is formed by the combination of two words- "Ayu" meaning life, and "Veda" meaning knowledge. Ayurveda is regarded as "The Science of Life" and the practice involve the care of physical, mental and spiritual health of human being. Life according to Ayurveda is a combination of senses, mind, body and soul. Ayurveda is not only limited to body or physical symptoms but also give comprehensive knowledge about spiritual, mental and social health. Thus, Ayurveda is a qualitative, holistic science of health and longevity, a philosophy and system of healing the whole person, body and mind. [1]

The perfect balance of mind, body and soul is considered as complete health in Ayurveda. The concept of mind in ancient India had been since pre-vedic period. Mind has been conceived to be functional element of ATMAN (soul) which described in Vedas - earliest written script of human race. It has been mentioned in Vedas that thoughts determine the facial appearance, thoughts influence facial expression. Even Ayurveda emphasizes its treatment modalities into three parts viz. Satwawajay Chikitsa, Yuktivyapashray and Daivyapashray Chikitsa. Sattvavajaya therapy mentioned in Charakasamhita and it used as new concept of psychotherapy in Ayurveda. Whereas Yuktivyapashraya is rational therapy and Daivyapashray is faith therapy. [1]


   Psychotherapy Top


In modern, mental-health, psychotherapy is defined as the treatment by psychological means, of problems of an emotional nature in which a trained person deliberately establishes a professional relationship with the patient with the object of (1) removing and modifying or retarding existing symptoms (2) of mediating disturbed pattern of behavior (3) of promoting positive personality growth and development. This is perhaps the most widely accepted definition given by Wolberg in 1967. [2]

Psychotherapy is the utilization of psychological measures in treatment of sick people. It is planned and systematic application of psychological facts and theories to alleviate large varieties of human ailments, which are psychogenic in origin. Psychotherapy is the art of combating disease and promoting health by mental influences. Psychotherapy is use of psychological technique in the treatment of mental of mental disorder or maladjustment. This technique should be strictly reserved for treatment by a professional trained person, i.e., clinical psychologist, psychiatrist and a psychiatric social worker. It has three main varieties viz supportive, re-educative and reconstructive.

The essence of psychotherapy has been present in all traditional societies all along. In India, it has existed in a submerged form, interwoven with social structures, social norms, in religious practices, in customs, myths and rituals. It has been included in mysticism, in yoga, in Buddhism, in Ayurveda, in Unani tradition and in allopathic tradition. Mahabharata is a great textbook of psychopathology and Gita a great treatise in psychotherapy. Bhagavad Gita describes various aspects of psychotherapeutic techniques through 18 chapters of self-knowledge. [2] Gita frees a person from guilt sense in its own frame work, resolves repression, supplies energy and morale by making a person dig deeper still in his own self and develop insight into its working. Model of psychotherapy which will widely be accepted in Indian patients could be found in traditional concept of relationship between a Guru and Chela. The word guru has twin connotations in Indian tradition, of being a teacher and a spiritual preceptor. The guru acts as a physician of mind and soul with objectivity and competence. The guru takes Chela (his disciple) through an experiential journey of self-exploration with an aim to liberate the disciple from all sufferings. The Guru - Chela relationship as a therapeutic paradigm was suggested by Neki in 1973 [3] and appears to be tenable where self-discipline, rather than self-expression is to be inculcated in patients and where creative harmony is sought between patient and society. More activity and direct guidance and advice by therapist are adopted as form of psychotherapy. The Guru - Chela relationship is polyvalent, polyvibrant and multidimensional and therefore, much wider than the transference relationship of western psychotherapy. [3]

Hanuman complex

Hanuman was always considered wise and brave, but he did not fully realize his potential to fly and do other great deeds till much later when he was on a mission to search for Queen Sita, who was kidnapped by Ravana and was taken to Lanka. Hanuman did not know his full power until he was reminded by Jambavan. N.N.Wig named this part of Ramayana as Hanuman Complex. He has used this idea many times as a psychiatrist in treating patients, basically in psychotherapy. He uses this mythological tale to make two points: (1) To a patient who has lost confidence and who feels unable to meet life's challenges, I relate this story. Most of the patients have already known it. I point out that the power to change his life rests within him. He has temporarily lost the knowledge of his own powers due to his illness, due to this veil of ignorance. Like Hanuman he has to shake off this diffidence and realize his true potential. The golden Lanka lies across the sea and he has the power to reach there. (2) To the doctors in training I narrate this story to emphasize that "when you do psychotherapy, do not assume that power to change the life of the patient lies with you. In fact, the potential to change rests with the patient who has temporarily like Hanuman, lost it. It is your job as a therapist (like Jambavan) to restore this power back to the patient. [4]

Indian psychologist like Balhodi and Sinha has discussed traditional holistic definition of health and illness according to Ayurvedic system of medicine. Balhodi finds western therapeutic intervention is incongruent with the Ayurvedic holistic worldwide. These holistic worldwide influences definitions of individual and of psychological health and illness. Instead of western concept of health based on separate individual, there seems to be a concept of health based on individual as a personality, sociocultural and cosmic whole. [5] He discusses how the Hindu society is a world of sharing. Illness is seen as a integral part of the whole community and as a fault of the whole community. Health is based on holistic worldview of no separation from mind, body and society. Holistic Ayurvedic intervention involves diet, massage and performance of rituals that often include family members. Therefore, patients expect more from treatment than western style therapy. Balhodi recommends psychiatrist to work with local Ayurvedic practitioners and try to familiarize themselves with Ayurvedic and folk concepts of mental ailments. [5]


   Approach of Ayurveda to Psychiatry Top


Ayurveda describes three guna of Mind and named as Satwa (Balance), Raja (Arrogance) and Tama (Indolence). Mind is called 'Manas'. Ayurveda describes that a possibility for disease is due to imbalance of the 'tamas' or 'rajas' in the mind which are the reactive tendencies which vitiate the mind and leading to emotional imbalance, also results in psychological disturbances, hence Rajas and Tamas are termed as 'Doshas of mind'. Tridosha are Vata, Pitta and Kapha. These terms literally mean the darkness and brightness of the mind or negative thoughts in the mind or the clearness of mind. These impurities or imbalances are called 'doshas'. The reason for any unhealthy condition is the toxins create by the accumulated 'dosha'. These negative feelings are emotional toxins accumulate in the mind. If they are not driven out of the body in a stipulated period of time, they give rise to or may lead into various chronic mental disorders like anxiety, neurosis, depression, insomnia, etc., If this is further ignored, it turns into permanent disorders like Unmad; unreasonable and irrational state of mind like hysteria, Apasmara (epilepsy) is also categorized as a mental disorder, Atatwaabhinivesh and other Manas roga under the Manovaha srotas or psyche centre. In Ayurveda, there are some different types of sets of behavioral alteration such as Kama, Krodha, Lobha, Bhrama, Tandra, Murchha, Sanyans, Maddattaya etc. [1]

Ayurvedic science more concentrated on the aspect of mind, body and soul and thus molded the system of Ayurveda as treating process combining both mind and body. It also declares that health is the result of pure body, happy soul and selfless mind. Happiness and unhappiness are the final consequence of health and disease respectively and these affect the person wholly and not partly. Tridosha as well as psyche pervade the whole body, therefore, in health and disease one will have to consider the person as a whole who is known as 'Purusha' in Ayurveda. Along with the 'Yuktivyapashraya' treatment, Sattvavajaya (psychotherapy) has also been given due place in individual. Man is not a machine and as such can't be operated equally with a uniform law. Every person has got his own individuality and to normal variations. This forms his constitution, which distinguishes him from other individuals. This is termed as 'Prakruti' of that individual according to doshas. Every regimen or therapy has to be applied keeping in view the constitution of the concerned person and his suitability (satmya). The modern concept of idiosyncrasy, allergy and anaphylaxis may he interpreted on the basis of this old idea of Prakruti according to Ayurveda. There are specific mental treatments described in Ayurveda to cure physical problems as well mental disorders. The mental attitude, mental status of a person has a great role in the curing process of every disease and it directly affect on its. Even the modern medical science admits that without the proper consent and mental co-operation, no patient could be cured perfectly. Charaksamhita (ancient Indian literature) describes the disorders of Dhatus viz. Shukrameha (Spermaturia) in which patient passes semen resembling urine or urine mixed with semen, Sitameha (Phosphaturia) in which patient gets frequent micturition, which is exceedingly sweet and cold, and Suklameha, where the patient passes urine having white colour like that of pasted floor. The Dhatu has been given so much importance in Indian culture that it becomes synonyms with semen. The origin of 'Dhat' has come from the Sanskrit word 'Dhatu', meaning the elixir which constitutes the body (Sushruta Samhita, 1938). In ages known ancient Indian literature, seven types of Dhatus are described. Semen is considered as the most important Dhatu among all. Indian Dhat syndrome is a clinical condition in which patient is preoccupied with excessive loss of semen by nocturnal emissions and this leads to severe anxiety, hypochondriasis, lack of concentration, bodily weakness and is often associated with sexual impotency. [6]


   Sattvavajaya Top


The effectiveness of "traditional mental health promoting practices" was identified as health regimens (swasthvrtt), correct behavior (sadvrtt), and yoga. Sattvavajaya as psychotherapy, is the mental restraint, or a "mind control" as referred by Caraka, is achieved through "spiritual knowledge, philosophy, fortitude, remembrance and concentration". According to Ayurveda, "volitional transgression (prajnaparadha)" is "the main etiopathological factor" in mental illness, and can be corrected through psychotherapy or sattavavajaya. Sattvavajaya is that method of treatment through which one tries to bring the intellect (dhi), fortitude (dhrti) and memory (smrti) of the patient into a proper condition. Two methods of sattvavajaya: (1) Assurance to the patient of the return of lost objects or persons. (2) Inducement of emotions opposite to those associated with patient's distress. [7]

The technique of replacement of emotion is compared to shuttling in Gestalt therapy, while refraining of ideas is compared to Ericksonian hypnosis. Since sattvavajaya literally means "winning the mind" the single reference to sattvavajaya from which Ayurvedic therapy has been (re) constituted could easily be interpreted to mean not a relationship between doctor and patient, but rather a mental discipline. It is therapy that can be administered by oneself or by one's family or community or by a practitioner who specializes in mediations with unseen realms. Caraka speaks of "objective" mind control involving the doctor's "interference", thus saying that in sattvavajaya "a physician wins the mind of the patient". [7]

There is no fundamental difference between sattvavajaya and modern psychotherapy. Both involve the removal of the mind from harmful sense-objects. In sattvavajaya there is no reference to the meaning of the mind to reveal a true interior self. Yet genealogies of modern selfhood suggest that psychotherapy is an institution in which authentic interior selves are constructed, at the same time as and by means of the epiphany of their repression and the move toward their recovery. Ayurvedic psychotherapy would play a dual role: First, as a revival of authentic medical culture, the exercise of a practice with an assumed primordial dimension, and second as a discovery of authentic subjectivity, the revelation of a self with an assumed interior depth. [7]

When we integrate the contemporary art of psychotherapy with the ancient science of Ayurveda, it becomes a powerful combination that is called Psycho Veda. The integration of Psycho and Veda is motivated by the complete integration of the immense but fairly contemporary view of the mind, emotions and psyche and how this performs in our lives. Integrating Psychotherapy and Vedic principles teaches us how to rediscover critical knowledge and awareness of the natural forces and rhythms that compliment and strengthen our human experience, through delicious nutrition using natural herbs and spices, through enhanced levels of self-awareness, through the understanding of the psyche and what our inner experiences are and also involving practical daily activities with through attention to our total environment to bring about radical changes in our mental outlook and in physical health. [8] Sattvavajaya warrants physician's interference with patient's mind control. This can be achieved by various ways. (1) By regulating the thought process (Cintya), (2) By replacing the ideas (Vicarya), (3) By channelling the presumptions (Uhya), (4) By polishing the objectives (Dhyeya), (5) By proper guidance and advice (Samkalpa) for taking right decisions. [9] Sattvavajaya is that typical Ayurvedic approach which is not only prevents the impairment of intellect, patience of memory, but also brings them back to a normal state, whenever they are impaired. Thus, Sattvavajaya plays a significant role in the maintenance of a harmonious state between these three important factors - intellect, memory and patience, ultimately leading to a happy healthy state of the individual.


   Psychotherapy According to Ayurveda Top


According to Charaksamhita, systematic line of mental diseases includes - Nidana Parivarjana, i.e., elimination of basic cause, Daivavyapasraya chikitsa, Yukti vyapasraya chikitsa. In above the word 'Vyapasraya' refers to depending on, trusting to. Daivavyapasraya is literally translated to mean any therapy that depend on the 'Daivya' (Devine) or linked to it and it is concerned to unknown circumstances, which are beyond the purview of reasoning or can't establish on scientific basis, and hence it is just remain as spiritual therapy. As it is Magicoreligious Practice it include Mantrah (Incantations), Manidharan (Precious Stones), Oushadam (Amulets), Mangalam (Propitiatory Rites), Balih (Oblations), Homah (Sacrifice), Upavasah (Fasting), Japah (Prayer), Vratam (Vows). Yuktivyapasraya, yukti means union, connection and it is much rational in its approach to treating the diseases of psychological and somatic origin. Yukti refers to reasoning and Yuktivyapasraya is based on a rational and scientific outlook. In this, the treatment of mental disorders given by specific procedures known as Panchakarma and presiding suitable palliative measures as a drugs (Aushadha) and diet regimen. [1]

Sattvavajaya literally translated refers to conquest of mind. This therapy appears to be more rational and conclusive Ayurvedic Psychotherapy known as Sattvavajaya Chikitsa (Mind Control Therapy) is composed special status is the incorporation of Sadvrittam (ideal behavior) or moral code. Sattvavajaya therapy, i.e., psychological method of Ayurveda includes - mind control method replacement of emotions, psychophysical shocks, moral and behavioral code, mental equanimity, inhibiting some psychophysical, environmental, psychological, volitional stressors. By adopting some temporal vagaries like over manifestation, under manifestation, perverted manifestation of five senses of human body regulation of mind, promotion of intellectual level, by following seasonal regimen, discrimination. [1]

In this therapy, there are some methods, which also include like gradual withdrawal bad habits, addiction, by adopting some good things in behaviors. Replacement of emotions such as malice by love, anger by composure, greed by content, ignorance by knowledge, jealousy by affection, fear by valor, etc., by keeping Mental equanimity such as fortitude, patience, cognizance, remembrance, true knowledge etc., In this method, only advices are given on right conduct Ayurvedic approach to psychic healing can be termed positive in as much as it does not only try to negate a negative emotion like hatred, but endeavors to replace it with a positive emotion like love. This is what makes sattvavajaya therapy unique in its own right. [1]


   Basic Principles of Ayurvedic Psychotherapy Top


'Satvavajaya' or Psychotherapy is one of the three principal categories of the approach to the patients care as described in Ayurvedic classics. In principle, Satvavajaya is applicable in varying forms in all kinds of diseases, but it is essentially indicated in mental diseases. The classical Satvavajaya is based on three principles viz., (1) Replacement of emotions, (2) Assurances and (3) Psycho-Shock Therapy. Ayurveda conceives a set of emotions like Kama (Lust), Krodha (Anger), Lobha (Greed), Moha, Irsya, Dwesa, Harsa (Happiness), Visada (Grief), Mana (Pride), Cittodveqa (Anxiety) etc., These are considered as basic components of psychopathology. Some of them are contradictory to certain others viz., Kama is contradictory to Krodha and Harsa is contradictory to Visada and vice versa and so on. In Satvavajaya, the psychotherapist attempts to know the state of these emotions casually associated to the illness in his patient and then develop strategies to replace the pathogenic emotions with the opposite ones. Simultaneously, he also uses assurance therapy and in case of severe manifestations the psychoshock therapy is indicated. Although in current times comprehensive Satvavajaya is not practiced by many Ayurvedic physicians but there is a potential scope of its revival and development into a suitable psychotherapeutic model. [10]


   Achar Rasayana (Ideal Behavior of Human Being) As Psychotherapy Approach Top


According to Charaksamhita, there are certain things that should be followed for better psychological health.

One should not deviate from generally approved principles no one should break any code of conduct; one should not walk during the night or in an inappropriate place. One should not indulge in taking food, studies, sexual relation or sleep during the dawn or dusk. One should not make friends, with children, the old, the greedy, the fools, persons under afflictions. One should not have any inclination towards wine, gambling or prostitutes. One should not expose secret parts of our body. One should not insult anybody. One should not be conceited, unfriendly no one should backbite. One should not insult the Brahma, ancestor, mentor or one should not beat the cows. One should not use harsh words towards the old persons, teachers, persons grouped together or kings. One should not speak too much no one should oust kings folk. [1]

One should not be in the habit of postponing things nor should one indulge in any activity without proper examination. One should not inflict too much burden over the intellect or the senses. One should avoid over-dilatory practices. One should not do things in a fit of anger or rejoice. One should always remember his own nature. One should have faith in the correlation of the cause and effect (that is good and bad action sand their corresponding results) and should always act on it. One should not be complacent about his own action. One should not lose sprit no one should remember his insult too. [1]

Persons who are truthful and free from anger, who are devoid of alcohol and sex indulgence, who do not indulge in violence (himsa) or exhaustion, who are peaceful and pleasing in their speech, who practice japah (incarnation etc.) and plea, who are stable and steady, who regularly practice charity and tapas (penance); who regularly offer prayers to the gods, cows, Brahmins, teachers, preceptors and old people, such people who can be given psychotherapy. [18]

 
   References Top

1.Charak Samhita. In: Yadav S. editor. Mumbai: SBP Nirnay Sagar.   Back to cited text no. 1
    
2.Avasthi A, Anthony R. Psychotherapy in Indian context. J clin psychiatry 1998-99;3:26-8.  Back to cited text no. 2
    
3.Integrating Traditional Healing Practices Into Counseling and Psychotherapy. In: Roy Moodley, editor. William West. p. 118.  Back to cited text no. 3
    
4.Wig NN. Hanuman Complex And its Resolution: An Illustration of Psychotherapy from Indian mythology. Indian J Psychiatry 2004;46:25-8.  Back to cited text no. 4
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5.Handbook of Culture, Therapy, and Healing. In: Gielen UP, Fish JM, Draguns JG.  Back to cited text no. 5
    
6.Behere PB, Natraj GS. Dhat syndrome: The phenomenology of a culture bound sex neurosis of the orient. Indian J Psychiatry 1984;26:76-8.  Back to cited text no. 6
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7.Jean M. Ayurvedic Psychotherapy: Transposed Signs. Langford: Parodied Selves.  Back to cited text no. 7
    
8.Integrating Psychotherapy With Ayurveda By: Linda Bretherton.  Back to cited text no. 8
    
9.Murthy AR, Singh RH. The concept of psychotherapy in ayurveda with special reference to satvavajaya. Anc Sci Life 1987;6:255-61.  Back to cited text no. 9
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10.Nespor K, Singh RH. The experiences with ayurvedic psychotherapy 'satvavajaya' in europe. Anc Sci Life 1986;5:154-5.  Back to cited text no. 10
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11.Charaksamhita. In: Shukla TV, editor. Varanasi: Choukhamba Prakashan.  Back to cited text no. 11
    
12.Sushrutsamhita. In: Vidyadhar Dwevedi, editor. Varanasi: Choukhamba Prakashan.  Back to cited text no. 12
    
13.Rational of Ayurvedic Psychiatry Dr. A. R. V. Murthy Jaikrishnadas Ayurveda Series, No.157, 2009.  Back to cited text no. 13
    
14.SushrutSamhita. In: Shukla V, editor: Choukhamba Prakshan.  Back to cited text no. 14
    
15.Dr.Laxmipathy A. Textbook of Ayurveda. Jamnagar: Jain Bhaskarodaya Press.  Back to cited text no. 15
    
16.Ashtang Sangraha Translated by A.Gupta, Choukhmba Prakashan, Varanasi,1962.  Back to cited text no. 16
    
17.Dwarkanath C. The Fundamental Principle of Ayurveda. Mysore: The Hindustan Press; 1953.  Back to cited text no. 17
    
18.Dwarkanath C. Introduction to Kayachikitsa. Varanasi: Choukhamba Pratishtan.  Back to cited text no. 18
    

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Correspondence Address:
Prakash B Behere
Professor and Head, Department of Psychiatry, Mahatma Gandhi Institute of Medical Sciences Sewagram, Wardha, Maharashtra - 442 102
India
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DOI: 10.4103/0019-5545.105556

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