Psychotherapy (Sattvavajaya Chikitsa) in Ayurveda

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The book “Psychotherapy (Sattvavajaya Chikitsa) in Ayurveda” written by the well known author Professor Ajay Kumar Sharma & Associates is a complete and comprehensive treatise on the subject. This is the first book in English which deals with the subject in all completeness and clarity covering all aspects of “Psychotherapy” as described in various modern medical texts and various treatise of Ayurveda. The entire text is richly supported with original reference from Ayurvedic classics. Latest information regarding Psychotherapy has been incorporated with the objective of providing basic knowledge to readers. The book is meant especially for Ayurvedic students, physicians and teachers for creating awareness among masses about the dependable holistic approach of Ayurveda in the management and prevention “Mental Diseases.”

Ayurveda has always laid a special emphasis on the maintenance and promotion of health and prevention of disease rather than on the curative aspects. In modern science of medicine continuous and prolonged use of sedatives, tranquilizers, anxiolytics and hypnotics for treating various mental ailments has resulted in rebound phenomenon and drug dependence causing further frustration and decline in mental health status. Ayurveda propounds many methods to boost up mental health. The available literature in Ayurvedic texts regarding mental health and mental disorders is very little and in a scattered form. Although pharmacological management for certain mental disorders has been described elaborately but description of non-pharmacological management is very brief. Therefore, there is a dire need to develop an alternate non-pharmacological approach equivalent to psychotherapy of modern medicine for the management of mental diseases. On the basis of description and similarities in the approaches of both systems of medicine, Sattvavajaya Chikitsa of Ayurveda can be developed as an Ayurvedic substitute for modem psychotherapy. The principles of psychotherapeutic management of various mental disorders as described in Ayurvedic classics and allied literature can be modulated in a form, which can serve the purpose of psychotherapy.

Professor Ajay Kumar Sharma, one of the main authors of the book was born on May 31St 1954, graduated in Ayurveda with Medicine and Surgery from A. & U. Tibbia college, New Delhi in 1976 with throughout top rank career. He completed his M.D. (Ay.) and Ph.D. from B.H.U. Varanasi under the guidance of his illustrious mentor Prof. R.H.Singh, presently Professor Emeritus, Faculty of Ayurveda, I.M.S., B.H.U., Varanasi — U. P. and Ex-Vice Chancellor, Rajasthan Ayurveda University, Jodhpur.

Prof. Sharma is now the Director, Professor and Head of P. C. Department of Kayacikitsa at National Institute of Ayurveda, Jaipur. In the capacity of a reputed Ayurvedic physician, a capable teacher and outstanding researcher, Professor Sharma has published 11 standard books on Ayurveda and over 216 research papers in various journals of National and International reputation. He is recipient of Rashtriya Ekta Samman in memory of Late Shri Rajiv Gandhi, 2007 and many more awards and prizes for out standing services, achievements and contributions in the field of Ayurveda. He has contributed a chapters to the prestigious volumes on Ayurveda — Kayachikitsa — Panchakarma published by CRC Press, Boca Reton-London-New York-Washington, and Argentina Prof. Sharma has produced 47 M.D.(Ay.) and 11 Ph. D. under his guidance. He is the expert member of several important national level committees. Prof. Sharma has visited Serbia, South Korea and Malaysia for propagation of Ayurveda.

Ayurveda having its origin from Vedas is an eternal medical science covering all the aspects of life, health, disease and treatment. It has philosophic, holistic and humanistic approach. Which is life and health oriented. It treasures physical, psychological and spiritual well being of an individual and represents total health of a human being in a holistic way. The spirit of Darshana is the fundamental basis of Ayurvedic principles. Dharma, Artha, Kama and Moksha are the prime goals of life constituting the root cause of health. To achieve all these things, the human life has been considered as the invaluable opportunity and one needs a healthy and peaceful life. The aim of our ancient society was to achieve these goals by having a smooth, sound, calm, steady and healthy life style. On the other hand, in today’s modem era life has become so sophisticated that changes in life style and dietary habits along with over ambitiousness lead to increased mental stress, which acts as a predisposing factor to cause various psychological disturbances and mental disorders. Therefore, today’s metaphysical society has been facing stressful situations and every day changing life style. As a result anxiety, depression, insomnia, stress related disorders and other mental illnesses are coming into existence like forest fire and the present era has become the era of psychiatric problems. Statistical data shows that one out of ten; in the population suffers from psychosocial disturbances. Ayurveda has always laid a special emphasis on the maintenance and promotion of health and prevention of disease rather than on the curative aspects. In modem science of medicine continuous and prolonged use of sedatives, tranquilizers, anxiolytics and hypnotics for treating various mental ailments has resulted in rebound phenomenon and drug dependence causing further frustration and decline in mental health status. Ayurveda propounds many methods to boost up mental health. The available literature in Ayurvedic texts regarding mental health and mental disorders is very little and in a scattered form. Even then, the line of treatment for the management of mental diseases has been mentioned. Although pharmacological management for certain mental disorders has been described elaborately but description of non- pharmacological management is very brief. Therefore, there is a direct/urgent/specific need to develop an alternate non- pharmacological approach equivalent to psychotherapy of modem medicine for the management of mental diseases. Keeping this in view Sattvavajaya Chikitsa mentioned in Ayurvedic classics can be developed as a new concept of Ayurvedic psychotherapy.

In Ayurvedic system of medicine, Chikitsa has been categorized under three dimensions as follows:

1. Daivavyapashraya (Divine Therapy) to combat Daivakrit diseases.
2. Yuktivyapashraya (Rational Therapy) a planned treatment based on fundamental principles of Ayurveda.
3. Sattvavajaya (Psychotherapy) to control the mind by withdrawing it from undesired objects.

As there is a detailed description of rational therapy for somatic diseases in Ayurvedic classics, similarly Sattvavajaya implies the remedies for psychic disturbances. Acharya Charaka was the first person to mention the word Sattvavajaya but only once. The concept of Sattvavajaya has been described in a brief and concise form but its applied aspects have not been mentioned anywhere. An elaborate description of other psychotherapeutic procedures is available not only in Ayurvedic literature but also in spiritual philosophical texts like Shrimad Bhagwad Gita, Vedas and Upnishadas. Lord Krishna was the first counsellor who delivered the message of Gita to Arjuna in the battlefield of Mahabharta when Arjuna got depressed. This is a beautiful example of counseling which is a sort of psychotherapy.

In the definition of Sattvavajaya given by Acharya Charaka “Sattvavajaya punar ahitebhyo arthebhyo manonigraha”, there are three words Arhta, Artha and Manonigraha. The word Arhta means something unwholesome to the other, Artha meaning object of a sense faculty and Manonigraha refers to control of mind. Thus, Sattvavajaya is a technique controlling or restraining the mind from desires for unwholesome objects, which can be achieved by increasing Sattva.

However, whatever available regarding Sattvavajaya is very concrete and fundamental based on which the whole concept of psychotherapy can be explored.

Pragyapradha (intellectual blasphemy) one of the basic three fold aetiological factors causing a disease is mainly responsible for causation of mental disorders. All the ailments are the direct consequences of impairment of Dhee (intellect). Dhriti (patience) and Smriti (memory) which constitute Pragyapradha. Sattvavajaya or control of mind is a typical approach, which not only prevents the impairment of Dhee, Dhriti and Smriti but also brings them to normalcy resulting in the maintenance of harmony between these factors. In another reference quoted in Charaka-Samhita, regarding the control of mind one should keep oneself established in one’s own self after knowing the real nature of soul and attaining the height of spiritual wisdom, which can be achieved by development of Gyana i.e. true knowledge of self and soul.

The psycho supportive techniques like assurance, consoling the patient by proper guidance and suggestions, replacement of emotions, giving sudden shock, provision of favourable environment and psycho-shock therapy are also deemed a part of Sattvavajaya as they come very much within the limits of its definition. A critical analysis of the definition brings to light the hidden treasure of the concept of Sattvavajaya.

Conventional psychotherapy in modem medicine plays a significant role in the management of mental illnesses and other medical conditions associated with psychological components. It aims at supporting the patient and changing his disturbed personality, attitude, thinking and behaviour towards the present circumstances. In Ayurveda, no such type of therapy has been described in detail. Therefore, it was thought to develop an approach that may be equivalent to the conventional psychotherapy of western modem medicine. Hence, efforts have been made to develop the concept of Ayurvedic psychotherapy on scientific lines.