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PRESIDENTIAL COLUMN |
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Mental health concepts in India: Providing valuable insights |
p. 133 |
Roy Abraham Kallivayalil DOI:10.4103/0019-5545.105505 PMID:23858242 |
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EDITORIAL |
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Indian mental concepts: Looking forward |
p. 134 |
TS Sathyanarayana Rao, L. Sam S Manickam, Roy Abraham Kallivayalil DOI:10.4103/0019-5545.105506 PMID:23858243 |
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REVIEW ARTICLES |
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Indianization of psychiatry utilizing Indian mental concepts |
p. 136 |
Ajit Avasthi, Natasha Kate, Sandeep Grover DOI:10.4103/0019-5545.105508 PMID:23858244Most of the psychiatry practice in India is guided by the western concepts of mental health and illness, which have largely ignored the role of religion, family, eastern philosophy, and medicine in understanding and managing the psychiatric disorders. India comprises of diverse cultures, languages, ethnicities, and religious affiliations. However, besides these diversities, there are certain commonalities, which include Hinduism as a religion which is spread across the country, the traditional family system, ancient Indian system of medicine and emphasis on use of traditional methods like Yoga and Meditation for controlling mind. This article discusses as to how mind and mental health are understood from the point of view of Hinduism, Indian traditions and Indian systems of medicine. Further, the article focuses on as to how these Indian concepts can be incorporated in the practice of contemporary psychiatry. |
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Yoga school of thought and psychiatry: Therapeutic potential |
p. 145 |
Naren P Rao, Shivarama Varambally, Bangalore N Gangadhar DOI:10.4103/0019-5545.105510 PMID:23858245Yoga is a traditional life-style practice used for spiritual reasons. However, the physical components like the asanas and pranayaamas have demonstrated physiological and therapeutic effects. There is evidence for Yoga as being a potent antidepressant that matches with drugs. In depressive disorder, yoga 'corrects' an underlying cognitive physiology. In schizophrenia patients, yoga has benefits as an add-on intervention in pharmacologically stabilized subjects. The effects are particularly notable on negative symptoms. Yoga also helps to correct social cognition. Yoga can be introduced early in the treatment of psychosis with some benefits. Elevation of oxytocin may be a mechanism of yoga effects in schizophrenia. Certain components of yoga have demonstrated neurobiological effects similar to those of vagal stimulation, indicating this (indirect or autogenous vagal stimulation) as a possible mechanism of its action. It is time, psychiatrists exploited the benefits if yoga for a comprehensive care in their patients. |
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Karma yoga: A path towards work in positive psychology |
p. 150 |
Arun Kumar, Sanjay Kumar DOI:10.4103/0019-5545.105511 PMID:23858246Karma yoga is the path that leads to salvation through action. Salvation is the ultimate state of consciousness. Work is the central and defining characteristic of life. It may have intrinsic value, instrumental value, or both. Instrumental value includes incentive, dignity and power, etc., which is the result expected from the work. The Gita teaches us to do work without thinking of result (work with intrinsic value). Attachment with the result leads to stress, competition and aggression. Stress further gives rise to heart ailments, depression and suicide. Positive psychology studies the factors and conditions leading to pleasurable and satisfying life. Understanding Karma yoga and its practice has a similar role that lead an individual towards work and leading to a satisfied life. This may play a unique role towards practical aspects of positive psychology to improve one's lifestyle and aid in the treatment of stress disorders. |
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Emotions: An Indian perspective |
p. 153 |
Dharitri Ramaprasad DOI:10.4103/0019-5545.105514 PMID:23858247The present paper is an attempt to understand emotions and the affect from Indian traditional point of view. In the Indian philosophical texts' detailed descriptions of emotions are not available nor are dealt with as a separate concept. This view of emotions lays emphasis on desires as the root cause of emotional upheavals. They are seen as modification of desire and attachment. The desires are seen as arising from the contact and attachment of the ego or ahamkara with the external world and are caused by a sense of imperfection, incompleteness or non-fulfillment. Ego or ahamkara is differentiated from the true Self or atman. Emotions are viewed as springs of action and are bipolar in nature. According to Patanjali's Yoga Shastra, suffering is due to ignorance about one's true "self" (avidya). Hence, suffering or dukha arises from within and not from the outside world. Bhagvadgita traces all emotional experiences to the gunas, i.e., sattva, rajas, and tamas. Works of Bharathmuni have contributed to the understanding of emotional experiences. Concept of rasa or aesthetic relish is central to this approach to understanding affective experiences as dealt with in the Natyashastra of Bharathamuni. These views underline the recommended path for self-transformation. Regulating emotions, both emotional experience and emotional expression, is an integral part of the recommended "principles of living." |
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Clinical hypnosis and Patanjali yoga sutras |
p. 157 |
Shitika Chowdhary, Jini K Gopinath DOI:10.4103/0019-5545.105516 PMID:23858248The trance states in yoga and hypnosis are associated with similar phenomena like relaxation, disinclination to talk, unreality, misrepresentation, alterations in perception, increased concentration, suspension of normal reality testing, and the temporary nature of the phenomena. While some researchers consider yoga to be a form of hypnosis, others note that there are many similarities between the trance in yoga and the hypnotic trance. The present study aimed to find similarities between the trance states of hypnosis and Patanjali's yoga sutras. The trance states were compared with the understanding of the phenomena of trance, and the therapeutic techniques and benefits of both. An understanding of the concept of trance in Patanjali's yoga sutras was gained through a thematic analysis of the book Four Chapters on Freedom by Swami Satyananda Saraswati. This led to an understanding of the concept of trance in the yoga sutras. The obtained concepts were compared to the concepts of trance in hypnosis (obtained through the literature on hypnosis) to investigate whether or not there exist similarities. The findings of the study show that there are similarities between the trance in hypnosis and the trance in Patanjali's yoga sutras in the induction and deepening of the trance states in hypnosis and that of Samadhi, the phenomena present in hypnosis and the kinds of siddhis that are obtained through Samadhi, and the therapeutic techniques and the therapeutic process in Patanjali's yoga sutra and hypnosis. |
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Buddha philosophy and western psychology |
p. 165 |
Tapas Kumar Aich DOI:10.4103/0019-5545.105517 PMID:23858249Four noble truths as preached by Buddha are that the life is full of suffering (Duhkha), that there is a cause of this suffering (Duhkha-samudaya), it is possible to stop suffering (Duhkha-nirodha), and there is a way to extinguish suffering (Duhkha-nirodha-marga). Eight fold Path (astangika-marga) as advocated by Buddha as a way to extinguish the sufferings are right views, right resolve/aspiration, right speech, right action/conduct, right livelihood, right effort right mindfulness and right concentration.
Mid-twentieth century saw the collaborations between many psychoanalysts and Buddhist scholars as a meeting between "two of the most powerful forces" operating in the Western mind. Buddhism and Western Psychology overlap in theory and in practice. Over the last century, experts have written on many commonalities between Buddhism and various branches of modern western psychology like phenomenological psychology, psychoanalytical psychotherapy, humanistic psychology, cognitive psychology and existential psychology. Orientalist Alan Watts wrote 'if we look deeply into such ways of life as Buddhism, we do not find either philosophy or religion as these are understood in the West. We find something more nearly resembling psychotherapy'.
Buddha was a unique psychotherapist. His therapeutic methods helped millions of people throughout the centuries. This essay is just an expression of what little the current author has understood on Buddha philosophy and an opportunity to offer his deep tribute to one of the greatest psychotherapists the world has ever produced! |
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The mystery of reincarnation |
p. 171 |
Anil Kumar Mysore Nagaraj, Raveesh Bevinahalli Nanjegowda, SM Purushothama DOI:10.4103/0019-5545.105519 PMID:23858250 |
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Indian legal system and mental health |
p. 177 |
Choudhary Laxmi Narayan, Deep Shikha DOI:10.4103/0019-5545.105521 PMID:23858251Although there was a rich tradition of legal system in Ancient India, the present judicial system of the country derives largely from the British system and is based on English Common Law, a system of law based on recorded judicial precedents. Earlier legislations in respect of mental health were primarily concerned with custodial aspects of persons with mental illness and protection of the society. Indian laws are also concerned with determination of competency, diminished responsibility and/or welfare of the society. United Nations Convention for Rights of Persons with Disabilities (UNCRPD) was adopted in 2006, which marks a paradigm shift in respect of disabilities (including disability due to mental illness) from a social welfare concern to a human right issue. The new paradigm is based on presumption of legal capacity, equality and dignity. Following ratification of the convention by India in 2008, it became obligatory to revise all the disability laws to bring them in harmony with the UNCRPD. Therefore, the Mental Health Act - 1987 and Persons with Disability Act - 1995 are under process of revision and draft bills have been prepared. Human right activists groups are pressing for provisions for legal capacity for persons with mental illness in absolute terms, whereas the psychiatrists are in favor of retaining provisions for involuntary hospitalization in special circumstances. |
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Mind and consciousness in yoga - Vedanta: A comparative analysis with western psychological concepts |
p. 182 |
HR Aravinda Prabhu, PS Bhat DOI:10.4103/0019-5545.105524 PMID:23858252Study of mind and consciousness through established scientific methods is often difficult due to the observed-observer dichotomy. Cartesian approach of dualism considering the mind and matter as two diverse and unconnected entities has been questioned by oriental schools of Yoga and Vedanta as well as the recent quantum theories of modern physics. Freudian and Neo-freudian schools based on the Cartesian model have been criticized by the humanistic schools which come much closer to the vedantic approach of unitariness. A comparative analysis of the two approaches is discussed. |
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Religion and mental health |
p. 187 |
Prakash B Behere, Anweshak Das, Richa Yadav, Aniruddh P Behere DOI:10.4103/0019-5545.105526 PMID:23858253In this chapter, the relation between religion and mental health and vice versa has been described. From primitive times different religions have different beliefs and systems of worshipping. Every religion with their belief system has implications on mental health and illness. We described how Hindu system of beliefs and rituals may have an effect in causation of various mental illnesses. It is also described how religion can help an individual to sustain one's life in various domains. The relationship between different religion and symptomatology is described. The impact and outcome of religion on mental health have been highlighted. |
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Does Guru Granth Sahib describe depression? |
p. 195 |
Gurvinder Kalra, Kamaldeep Bhui, Dinesh Bhugra DOI:10.4103/0019-5545.105531 PMID:23858254Sikhism is a relatively young religion, with Guru Granth Sahib as its key religious text. This text describes emotions in everyday life, such as happiness, sadness, anger, hatred, and also more serious mental health issues such as depression and psychosis. There are references to the causation of these emotional disturbances and also ways to get out of them. We studied both the Gurumukhi version and the English translation of the Guru Granth Sahib to understand what it had to say about depression, its henomenology, and religious prescriptions for recovery. We discuss these descriptions in this paper and understand its meaning within the context of clinical depression. Such knowledge is important as explicit descriptions about depression and sadness can help encourage culturally appropriate assessment and treatment, as well as promote public health through education. |
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Judeo-Christian concepts related to psychiatry |
p. 201 |
R Ponnudurai DOI:10.4103/0019-5545.105533 PMID:23858255The behavioral manifestations of psychotic disorders that are attributed to evil spirits in the Judeo-Christian scriptures as demonstrated by Jesus Christ have been narrated. The descriptions of false beliefs and the perceptual experiences that are consistent with the psychiatric terminologies "delusions and hallucinations" are briefly discussed. Attempt has been made to analyze the patterns of suicidal behaviors, guilt feelings, and, expressions of depressive symptoms in the Jewish culture. Of interest is the mass suicide by the Jews in the 1st century AD at the Fort Masada, perhaps the first of its kind recorded in the history. Noteworthy are alcohol and related mental health problems prevalent in the Jewish culture. While highlighting the descriptions of dreams and their revelations recorded in the Bible, it is suggested that such concepts about dreams might have influenced Sigmund Freud's classical works on dreams. The biblical messages and teachings that could be applied for psychotherapy and behavior modification strategies have been outlined. The mental concepts of Jewish culture and their relevance to Indian culture have also been discussed from a cross-cultural perspective. |
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Role of Islam in the management of Psychiatric disorders |
p. 205 |
Walaa M Sabry, Adarsh Vohra DOI:10.4103/0019-5545.105534 PMID:23858256With the significant growth of the Muslim population all over the world, there exists a corresponding increase in the need for mental health services that suit this group of patients. Research demonstrates the effectiveness of the integration of spirituality and religiosity into psychotherapy and how religious beliefs could affect the management plans. This article discusses the impact of various beliefs in the Islamic faith on the bio-psychosocial model for the management of different psychiatric disorders including focusing on the modification of psychotherapeutic techniques as cognitive restructuring. It also shows other types of therapies such as music therapy, meditation therapy, and aromatherapy. The main emphasis remains to ensure that Muslim psychiatric patients get ethical, acceptable, and effective treatment. |
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Sufism and mental health |
p. 215 |
S Haque Nizamie, Mohammad Zia Ul Haq Katshu, NA Uvais DOI:10.4103/0019-5545.105535 PMID:23858257Human experience in, health and disease, always has a spiritual dimension. pirituality is accepted as one of the defining determinants of health and it no more remains a sole preserve of religion and mysticism. In recent years, pirituality has been an area of research in neurosciences and both in the nderstanding of psychiatric morbidity and extending therapeutic interventions it seems to be full of promises. Sufism has been a prominent spiritual tradition in Islam deriving influences from major world religions, such as, Christianity and Hinduism and contributing substantially toward spiritual well‑being of a large number of people within and outside Muslim world. Though Sufism started in early days of Islam and had many prominent Sufis, it is in the medieval period it achieved great height culminating in many Sufi orders and their major proponents. The Sufism aims communion with God through spiritual realization; soul being the agency of this communion, and propounding the God to be not only the cause of all existence but the only real existence. It may provide a vital link to understand the source of religious experience and its impact on mental health. |
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The Islamic prayer (Salah/Namaaz) and yoga togetherness in mental health |
p. 224 |
Shabbir Ahmed Sayeed, Anand Prakash DOI:10.4103/0019-5545.105537 PMID:23858258Religion and its practices have been duly implicated in treating not only problems related to medical health, rather, intervening and preventing such problems as well. In the present article, the authors have reviewed significance of the Islamic prayers (Salah/Namaaz) in healthcare in general and mental health in particular. The nature, procedures, practices and the benefits of Salah have been comprehensively described and discussed. In addition, an attempt to combine yoga and its practices with Salah has been made for intervening and preventing the problems of mental health as an expeditious tool. In upshot, the clinicians in the field of mental health care have been suggested to incorporate these two viewpoints in their intervention program, at least, for the Muslim patients for a more desirable outcome. |
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Impact of Mahatma Gandhi's concepts on mental health: Reflections
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p. 231 |
Abhinav Tandon, VK Singh DOI:10.4103/0019-5545.105540 PMID:23858259Mahatma Gandhi can be looked upon as one of the greatest visionaries born. His life tells us about the varied emotions he went through as a boy and young adult during difficult times, and the experiments he did to cope up with these problems. It was his perseverance and dedication to an unrelenting pursuit of his goal that finally led to his transformation. His concepts like nonviolence, satyagraha, brahmcharya and the concepts related to 'Truth' and 'God' can give psychological strength and mental resilience to any individual trying to cope up with the demands of life. |
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Applications of Gandhian concepts in psychology and allied disciplines |
p. 235 |
Vinod K Kool DOI:10.4103/0019-5545.105541 PMID:23858260The paper highlights the significance of Gandhian concepts in research in psychology and its related fields. To illustrate the application of Gandhian ideology, a test of non-violence is described here with its psychometric properties. Further, two unexplored research issues having a bearing on clinical psychology and psychiatry have been delineated. Firstly, a call for addressing the mental health problems of non-violent protesters numbering over one billion spread all over the world has been made. And secondly, there is a need for understanding the neurological basis of non-violent form of behavior, for example, the role of oxytocin, to increase the legitimacy of non-violence as adaptive behavior. |
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Marriage as a perceived panacea to mental illness in India: Reality check
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p. 239 |
Ashish Srivastava DOI:10.4103/0019-5545.105542 PMID:23858261Marriage is a consensual and contractual relationship recognized by law. In India, there is a tremendous social and cultural pressure to marry. It is of paramount importance to discuss the relationship between marriage and mental illness in Indian scenario as marriage is perceived to be a panacea to mental illness by many. This review aims to explore whether marriage contributes to mental-health problems; whether it has a protective role; what effect it has on pre-existing mental illnesses and its outcome in major mental illnesses. |
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Hinduism, marriage and mental illness |
p. 243 |
Indira Sharma, Balram Pandit, Abhishek Pathak, Reet Sharma DOI:10.4103/0019-5545.105544 PMID:23858262For Hindus, marriage is a sacrosanct union. It is also an important social institution. Marriages in India are between two families, rather two individuals, arranged marriages and dowry are customary. The society as well as the Indian legislation attempt to protect marriage. Indian society is predominantly patriarchal. There are stringent gender roles, with women having a passive role and husband an active dominating role. Marriage and motherhood are the primary status roles for women. When afflicted mental illness married women are discriminated against married men. In the setting of mental illness many of the social values take their ugly forms in the form of domestic violence, dowry harassment, abuse of dowry law, dowry death, separation, and divorce. Societal norms are powerful and often override the legislative provisions in real life situations. |
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Indian concepts on sexuality |
p. 250 |
Kaustav Chakraborty, Rajarshi Guha Thakurata DOI:10.4103/0019-5545.105546 PMID:23858263India is a vast country depicting wide social, cultural and sexual variations. Indian concept of sexuality has evolved over time and has been immensely influenced by various rulers and religions. Indian sexuality is manifested in our attire, behavior, recreation, literature, sculptures, scriptures, religion and sports. It has influenced the way we perceive our health, disease and device remedies for the same. In modern era, with rapid globalization the unique Indian sexuality is getting diffused. The time has come to rediscover ourselves in terms of sexuality to attain individual freedom and to reinvest our energy to social issues related to sexuality. |
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Indian religious concepts on sexuality and marriage |
p. 256 |
Priyanka Thukral Mahajan, Priya Pimple, Delnaz Palsetia, Nahid Dave, Avinash De Sousa DOI:10.4103/0019-5545.105547 PMID:23858264Indian religions and cultures are diverse and have always influenced the way people live in this part of the world. Religion has been a very dominant influence in marriage, choice of marital partner and cohabitation. The present paper looks at various religions in India and their influence on sexual attitudes and the institution of marriage. Sikhism, Jainism and the Parsi faith with its influence on sexuality and marriage are reviewed. Christian values and the role they play in shaping sexual notions as well Christian marriage traditions are explored. The paper also looks at the influences Islam has had on marriage and sexuality and ends with a feminist perspective on women and sexual attitudes towards women. |
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Ardhanareeshwara concept: Brain and psychiatry |
p. 263 |
BN Raveesh DOI:10.4103/0019-5545.105548 PMID:23858265Ardhanareeshvara is a combination of three words "Ardha," "Nari," and "Ishwara" means "half," "woman," and "lord," respectively, which when combined means the lord whose half is a woman. It is believed that the God is Lord Shiva and the woman part is his consort Goddess Parvati or Shakti. The Ardhanareeshvara represents a constructive and generative power. Ardhanareeshvara symbolizes male and female principles cannot be separated. It conveys the unity of opposites in the universe. The male half stands for Purusha and female half is Prakriti. Ardhanareeshvara harmonizes the two conflicting ways of life: The spiritual way of the ascetic as represented by Shiva, and the materialistic way of the householder symbolized by Parvati. It conveys that Shiva and Shakti are one and the same. A human being is not a pure unisexual organism. Each human organism bears the potentiality of both male and female sex. Neurohormonal mechanisms have been found to be greatly influencing the sexual behavior. The modern world has come to understand the concept of "Ardhanareeshwara" as it aspires to resolve the paradox of opposites into a unity, not by negation, but through positive experiences of life. The matching of opposites produces the true rhythm of life. |
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Osho - Insights on sex |
p. 268 |
Anil Kumar Mysore Nagaraj DOI:10.4103/0019-5545.105549 PMID:23858266Sex is a mysterious phenomenon, which has puzzled even great sages. Human beings have researched and mastered the biology of sex. But that is not all. Sex needs to be understood from the spiritual perspective too. The vision of Osho is an enlightening experience in this regard. Out of the thousands of lectures, five lectures on sex made Osho most notorious. Born into a Jain family of Madhya Pradesh, Rajneesh, who later wanted himself to be called Osho, is a great master. He has spoken volumes on a wide range of topics ranging from sex to super-consciousness. His contributions in the area of sex are based on the principles of "Tantra" which has its origin from Buddhism. This article focuses on his life and insights on sex, which if understood properly, can be a stepping stone for enlightenment. |
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Vajikarana: Treatment of sexual dysfunctions based on Indian concepts
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p. 273 |
PK Dalal, Adarsh Tripathi, SK Gupta DOI:10.4103/0019-5545.105550 PMID:23858267Vajikarana or Vrishya chikitsa is a one of eight major specialty of the Ashtanga Ayurveda. This subject is concerned with aphrodisiacs, virility and improving health of progeny. As per Charak Samhita, by proper use of these formulations, one becomes endowed with good physique, potency, strength, and complexion and sexually exhilarated and sexually potent. This in turn is helpful in many common sexual dysfunctions, including Infertility, Premature Ejaculation and Erectile dysfunction. The therapy is preceded by living in strict compliance with the directions mentioned in Ayurvedic classics, various methods of body cleansing and other non-medicinal strategies like sexual health promoting conduct, behavior and diet. Certain individualized herbal and herbo-mineral combinations are administered as per the nature of a person according to the Ayurveda. Many limitations need to be considered before considering the use of theses therapy like lack of scientific studies, possibilities of adulteration in the herbal and herbo-mineral combinations available in market and possibilities of unexpected side-effects etc., The article calls upon initiating research in this area so that claims of ancient Ayurvedic texts could be substantiated and vajikaran therapy may be utilized by modern medicine. |
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Indian mental concepts on children and adolescents |
p. 277 |
Prabhat Sitholey, Vivek Agarwal, Satya Vrat DOI:10.4103/0019-5545.105551 PMID:23858268Ancient Indian mental concepts of children and adolescents are very similar to the contemporary modern concepts. The ancient concepts were based on a very positive regard for the children's development, education and future independence, adult role and contribution to society. Children were wanted and considered precious. The children were categorized in to 4 different varnas based on their intelligence, abilities, merit and aptitude and educated accordingly, away from their home, at Gurukuls. They had universal right to education. Girls received attention equal to boys. The boys were expected to earn their livelihood, while the girls were expected to be homemakers. Graduation of the young person at the end of education and return to home marked the emancipation from adolescence. Children's physical and mental health and its disorders were given due attention. Aetiology and treatment of physical and mental disorders was in accordance with the overall scientific development of those times. |
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Morality and moral development: Traditional Hindu concepts |
p. 283 |
Chhitij Srivastava, Vishal Dhingra, Anupam Bhardwaj, Alka Srivastava DOI:10.4103/0019-5545.105552 PMID:23858269Morality (from the Latin word moralitas that means "manner, character, proper behavior") is the differentiation of intentions, decisions, and actions between those that are good (or right) and those that are bad (or wrong). It is determined by how one's genetic makeup interacts with the environment. The development of morality has been a subject of investigation for a number of decades, and our understanding of neuro-biological and psychological mechanisms has increased manifolds in the last few decades. Development of morality has been of particular significance to psychiatric literature because of its significant contribution to the development of one's personality and it's aberration in various disorders. Cultures that have been just, equal and moral have been widely accepted and appreciated. In this review, we shall summarize the modern theories of moral development and then look into a part of our past and cultural heritage and review the traditional Hindu concepts of morality and their contribution to development of one's personality and their relevance in the current times. |
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The Indian concepts of lifestyle and mental health in old age |
p. 288 |
SC Tiwari, Nisha M Pandey DOI:10.4103/0019-5545.105553 PMID:23858270Lifestyle is the perception of a particular person or entire society towards life and it is the way people live, think and behave. In Indian lifestyle, principles of Karma (action) and dharma (the righteous way to perform the work) are given significant value. In India, earlier, the life of an individual was being regulated harmoniously according to the stages (Ashrams) of life, i.e., studentship (Brahmcharya); householder (Grihstha); forest dweller (Vanprasth); ascetic (Sanyas) and was meant to maintain the discipline, peace and harmony in the family and society. However, revolution in the social milieu and political scenario changed the patterns of religious beliefs and lifestyle of individuals. And thus, the Indian lifestyle got colored with shadows of cults and cultures. The lifestyle affects the longevity and health in old age. Lifestyles also have role in developing cognitive disorders like Alzheimer's disease (AD). AD found to be more common in socially isolated older adults. Deteriorations in health (especially mental health) are often the results of faulty lifestyles like smoking, alcohol intake, improper diet and lack of exercise as well as an adverse psycho-social milieu. Adopting the advocated principles of Indian concepts of lifestyle and paying proper attention to mental illnesses of older adults and recognizing their problems may preserve mental health in old age. |
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End-of-life care: Indian perspective
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p. 293 |
Himanshu Sharma, Vankar Jagdish, Prabhakaran Anusha, Sharma Bharti DOI:10.4103/0019-5545.105554 PMID:23858271According to Hinduism, the main religion of India, the end-of-life (EOL) deals with good and bad death. The WHO definition of palliative care stresses on improving not only the quality of life of patients facing incurable diseases but also their families by providing relief from the pain and suffering that includes the psychosocial and spiritual needs as well. The Indian Society of Palliative Care has been doing a commendable work and appreciable efforts are being done by the Kerala model of delivering the EOL care. The spiritual, ethical issues and ethical challenges raised when the patients are in terminal phase are also reviewed keeping in mind the socio-cultural norms. The Indian Penal Code (IPC) has lacunae, which hamper the physicians from taking proper decision in the EOL care. Some of the sections like IPC 309 are defunct and need to be changed. The Indian Society for Critical Care Medicine has developed a position statement on the patient management of the terminally ill patient in the Intensive Care Unit (ICU) which states that the society should move from the paternalistic model to the share based decision model of the West when deciding the fate of such patients. The literature review on the Indian research on palliative care shows very little emphatic results and the medical under graduates show illiteracy. To strengthen it Medical Council of India has included the palliative care in its curriculum by starting a PG course. Literature review revealed that more research from Indian perspective should be done in this area. This article studies the core issues of developing palliative care in Indian setting keeping in mind the ethical, spiritual and legal issues. |
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Indian family systems, collectivistic society and psychotherapy  |
p. 299 |
Rakesh K Chadda, Koushik Sinha Deb DOI:10.4103/0019-5545.105555 PMID:23858272Indian society is collectivistic and promotes social cohesion and interdependence. The traditional Indian joint family, which follows the same principles of collectivism, has proved itself to be an excellent resource for the care of the mentally ill. However, the society is changing with one of the most significant alterations being the disintegration of the joint family and the rise of nuclear and extended family system. Although even in today's changed scenario, the family forms a resource for mental health that the country cannot neglect, yet utilization of family in management of mental disorders is minimal. Family focused psychotherapeutic interventions might be the right tool for greater involvement of families in management of their mentally ill and it may pave the path for a deeper community focused treatment in mental disorders. This paper elaborates the features of Indian family systems in the light of the Asian collectivistic culture that are pertinent in psychotherapy. Authors evaluate the scope and effectiveness of family focused psychotherapy for mental disorders in India, and debate the issues and concerns faced in the practice of family therapy in India. |
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Ayurvedic concepts related to psychotherapy |
p. 310 |
Prakash B Behere, Anweshak Das, Richa Yadav, Aniruddh P Behere DOI:10.4103/0019-5545.105556 PMID:23858273The 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. |
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The Bhagavad Gita and contemporary psychotherapies |
p. 315 |
Subhash C Bhatia, Jayakrishna Madabushi, Venkata Kolli, Shashi K Bhatia, Vishal Madaan DOI:10.4103/0019-5545.105557 PMID:23858274The Bhagavad Gita is based on a discourse between Lord Krishna and Arjuna at the inception of the Kurukshetra war and elucidates many psychotherapeutic principles. In this article, we discuss some of the parallels between the Gita and contemporary psychotherapies. We initially discuss similarities between psychodynamic theories of drives and psychic structures, and the concept of three gunas. Arjuna under duress exhibits elements of distorted thinking. Lord Krishna helps remedy this through a process akin to Cognitive Behavioral Therapy (CBT). We ascertain the analogies between the principles of Gita and CBT, grief emancipation, role transition, self-esteem, and motivation enhancement, as well as interpersonal and supportive psychotherapies. We advocate the pragmatic application of age old wisdom of the Gita to enhance the efficacy of psychotherapeutic interventions for patients from Indian subcontinent and to add value to the art of western psychotherapies. |
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Integrative change model in psychotherapy: Perspectives from Indian thought |
p. 322 |
L. S. S Manickam DOI:10.4103/0019-5545.105558 PMID:23858275Different psychotherapeutic approaches claim positive changes in patients as a result of therapy. Explanations related to the change process led to different change models. Some of the change models are experimentally oriented whereas some are theoretical. Apart from the core models of behavioral, psychodynamic, humanistic, cognitive and spiritually oriented models there are specific models, within psychotherapy that explains the change process. Integrative theory of a person as depicted in Indian thought provides a common ground for the integration of various therapies. Integrative model of change based on Indian thought, with specific reference to psychological concepts in Upanishads, Ayurveda, Bhagavad Gita and Yoga are presented. Appropriate psychological tools may be developed in order to help the clinicians to choose the techniques that match the problem and the origin of the dimension. Explorations have to be conducted to develop more techniques that are culturally appropriate and clinically useful. Research has to be initiated to validate the identified concepts. |
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