Ayurveda and PsychiatryEverything that Exists is a Mirage of the Mind
Ayurveda is the Meeting of Metaphysics and Medicine• Good Health – Dharma (virtue) – Not just based on the three humors – Constituents of a Person • Connection with Environment • Connection with psyche and soul • Polis of the cosmos in determining health – Understands that illness may not always be at the conscious level
Ayurveda Cultural Scope• Has dominated the medical traditions of all of India, South Asia and to some extent South East Asia.• Western Medicine often views Ayurvedic methods as on the edge of “lunatic fringe” or an “ occult science “. – Can see the high amount of emotional investment to the body similar to a mother doting care for her newborn, or as Bodily Narcissism.
The Body• Gross Physical Body• Subtle Body – Core of Person adhere to Soul – Personal identity • Buddhi – intellegence, Ahamkara – I-ness, Manas – Mind(includes heart), Indriyas – 5 sensory organs, Tanmantas- subtle matter or potential energy. – Rebirth Cycles – Body and Mind are Two Different aspects of Subtle Body• Casual Body – Metaphysical Pure Self
The Psyche & Ayurveda• Greek term Psyche – comes closest to the subtle body minus tanmantas.• The psyche is the source of all vital activities and psychic process (rational and irrational) and capable of existing in disembodied state after death.• Its based upon a predetermined lifespan, individuation, understanding, emotional behavioral predispositions, which reflect a psychic constellation reached at a previous life.
Subtle Body is more than the Psyche• The subtle body is the locus of identity - Mind (mental events - psychological) and Body (brain nervous system - physiological) and are identical.
Mind - Psyche Soma Identity• Mind is located in the heart• The heart is the center network of channels within the body which carry flow of vital fluids.• Any disturbance, physical or mental, manifests in both somatic and psychic spheres.
Umada – Mental Disorders• All mental disorders in which individual looses power and conduct in society.• Includes all psychotic disorders, neurosis, and obsessions.• Umada therapy is a blend of psychological & physiological.• When a persons thoughts, speech, and actions have become unnecessary or harmful to society.
Manas – True Nature of Reality• Atomic energy made of subtle matter that becomes conscious and capable of performing it’s assigned tasks through power of atman.• Functions of Manas – Activation – sensory and motor organs – Self Regulation – Reasoning – Deliberation Mental Illness is an impairment of these functions. Root - Humoral Imbalance that disturbs the gross body.
Different original types of insanity• Originally defined as Wind, Bile, and Phlegm.• Rajas and Tamas are two humors affected.• Twin Causes are Desire (need) and Repulsion (anxiety, fear, envy). – Desire/ Repulsion – prenatal stage 3rd and 4th month. Unfullfilled longing of mother, unrelieved fears transmitted to newborn child – Previous Existence “memory trace” unfullfilled longings at end of previous life.
Tibetan Ayurvedic Medicine• Although there is no system in treating mental illness in Vedic texts, Tibetan medicine, which comes from Ayurveda, affirmed metaphysical and cosmic aspects of mental illness. – Dreams – Nadi – Three Mental Qualities – Diet, character, conduct (deviance from social ideal)
Ayurveda Atharva Texts• Roots in Atharva Veda – Ritual, magical elements, mantras, precious stones, penances, atonements, charms, amulets, sacred pilgrimages. – Treatment – purify, pacify, and remove root cause • Purification –enemas, bleeding – Enemas are main methods of purification – Purge to head – nasal & Eye drops – (purges and emetics were not used because of violence) • Rejuvenation - oil massages, oils, rice bowls • Pacification – tranquilizers, antidepressants, strengthen nerves. • Diet and Conduct Therapy – Rules of proper conduct
Ayurveda Dream Theory• Vedic healers maintain that we are in the waking state (consciousness) during the daytime is delusionary (shamanistic roots) even when awake dream is predominant psychic activity, we continually dream.• Dreams connect us not only with psychic life, but with physiological events in the body.
Ayurveda Dream Examinations• Dreams that repeat things in waking life.• Dreams that enact whats been heard.• Dreams that foretell the future.• Dreams that occur in conjunction with disturbance of particular body humor.• Dreams that satisfy desires that could not be in waking life.• Dreams of drama of individual fantasy “mask of desire”.
Loss in textsPsychological Content of Ayurveda is limited. It’sskeletal. It became scattered and was more oratory.Ayurveda could not pursue detailed investigationsof mental illness because it has to bring within itsframework social and metaphysical aspects dilutingclinical thrust dissipating force of psychologicalinsight.Mental Illness became the Provence of manyhealers, shamans, exorcists, mystics, andastrologers.
The Sacred in India• Brahman of mystics• Krishna devotees of gods• Spirits of ancestors and forests• Beings that live in enchanted groves• Specters that haunt cremation grounds• Demons who wait for the next crossing• Gurus (malaise of spirit) Shaman (treat illness)
India views on Western Culture• Scientific Naturalism has forced the priest into exile.• Western culture is a Christian product• Cultural Relativity – madness often reflects the general social and logical preoccupations of the time.• Atmanamvidhi – Know Thyself – Means a self uncontaminated by space and time without historical dimension
Demonology (Balas)• Devils, Demons, Goulies, Ghosts, Balas, Negative Energies, Manifested Stumbling blocks within ones own mind.• Hindus, Chinese, Arabs, Greeks, Hebrews all hold the universal belief in possession.• Western Anthropologists see demonology as valid as Freud.• Psychological – Unconscious wishes and fears, roles demons play in etiology of patients illness
Islamic Healers in India• 3 classes of living beings higher than man – Angels – Satanic Beings – Bala – Demon or spirits – made of fire – darkness (our unconscious impulses) Demons do not only possess sinners – They possess someone due to sorcery – They possess someone the demon fancies The Islamic Healers first question to patient is always – “What do you see in your dreams ?”
Islam in India (cont.)• In India Balas prefer young unmarried girls, demons enter person through milk, curd, or cream, and they suck humans blood• Types of Balas can be compared to unconscious fantasies • Sirkota - Headless man, Bhuta – Form of fire, Churel – Beautiful women – bells around ankles seduces men – slits mans penis and sucks his blood (Freudian mother anxieties).• Western Psychoanalysis and this Indian Exorcism can be seen as two different languages of psychic disturbances, though Bala is not a simple reflex of Id.• There is also a admittance in India that sometimes it is peoples over-imaginations and the nerves in brain that have been stretched and need medicines.
Hindu Healers in India• Calling Higher Power or Divine Force to rid person of Bala (evil spirit) to deposes him or protect him.• They can only knock on door of higher power. Up to him if he listens.• Communicate with Diety to intervene on behalf of afflicted soul• Divine force is transmitted through healer.
Hindu Healers• The reputation of the healer with spirits is more important than technique (purity of mind, truthfulness, detachment)• Boundary Man – Lives at the margins of his society, he is in the world but not of it.• Soul Face – He needs to pass through an inner transformation that connects him and makes him receptive.
Hindu Deposession• Bala Possession Problems ( anxiety, neurosis, hysteria, accident prone )• Those who seek Hindu Healers – Those who are possessed by Bala – Those who are in threat of being possessed by Bala – Those who seek spiritual offices• Most important question for Hindus – “What do you see in your dreams… what do your daydreams look like ?”
Hindu Malignant Spirits• Bhuta Preta – exists in halfway house between human world of ancestral spirits. – Bhuta – Souls of people who meet untimely death – Preta – spirit of a child died in infancy – Pishacha – ghost of man who was mad, dissolute or ill-tempered – Churel – ghost of unhappy widow, or childless woman• Atripta Spirits – ghosts of unsatisfied desires. People who could not live out their full life potential.• They remain Atripta Spirits until they have been judged and have paid their karmatic debt and are allowed into the world of ancestral spirits• Bhuta Preta – Occupy lowest rungs of hindu hierchy of supernatural beings and are closest to human state.• People go to temple for healing.
• Healing Direct attack on possession Series of Rituals in Temple – at Hindu Temple – Patient must attend with family members – pilgrimage to temple. – Darkwast – application – patient makes offering of rice and dhal and gives temple attendent laddos – Priest touches laddos and gives it back to patient to eat. – Eating laddos power of Balaji goes into patient and makes Bhuta appear in court. – If unsuccessful they make more offerings (maybe sweets, ect) – Family members chant mantras over water. Impart Divine energy into water. Patient drinks water. – These application and Petition rituals incorporate authority of gods and patient will eventually go into trancelike state of Peshi. – Peshi is altered trancelike state of conciousness where the focus of the patients awareness of the environment I radically narrowed but not erased. (Disassociation is Western Term). – Start of Peshi (trance) rhythmic swaying of upper body, violent shaking of head, beating fists on floor, ect… are evidence of Bhutas appearance. – Struggle between patient bhuta and one of temples deites. Spirit might challenge god. – People around might try to provoke spirit to say slogans in praise of god. – Bhuta might become angry and yell obscenities at god, mocking the onlookers. – Audience shouts “baba give it a good thrashing otherwise villain will not listen. – Finally patient tires and submits. Spirit will beg for forgiveness urging crowd to leave and throw itself at the mercy of god. – Patient Must take bath in holy water after depossesion so they don’t affect anyone else.
Comments on Hindu Temple Approach• Could be culturally unacceptable behavior.• It change a persons feelings of themselves, patient overcomes his feelings of isolation and moral unworthiness. True Wall between sickness and health. All is one.• Healing rituals seek to connect or reconnect the individual with sources of psychological strength, counter act unconscious feelings of despair, shame, guilt, inferiority, confusion, and isolation.• Patient usually has exhausted all local resources before he makes decision to Pilgrimage to Temple (home remedies, doctors, exorcisms)• Sometimes Bhuta (knowing of pilgrimage) will raise obstacles which patient has to overcome before he can arrive to Temple.• Before Pilgrimage the dreams of the patient typically involve a personal summons from the divine healer.• Malignant spirits are unfortunate pitris or ancestral spirits deservingn compassion rather than anxious reaction.• Sometime rituals are done hundreds of times. Sometimes Patient has to live in temple for a year.• Sometimes temple is not successful, just like western medicine
Shamans• Western View: Medicine Man, Witch Doctor, Native Healer, Voodoo Sorcerer, the quack. Mentally ill person. Veritable idiot, trickster, neurotic- epileptoid type. They are seen as suffering from severe maladjustments, hysteria, mental abnormalities, outright psychotic, personality disorder with impulsive hysterical traits... but a religious specialist who connects his community with everything that is sacred and the mediator between the supernatural and community. They heal the sick and divine the future....they typically have poor reality testing.• Term S’aman comes from Tungusic tribe of northeast Asia: means “one who is excited, moved, raised”.• Shamans specialize in spiritual illness. They have the ability to go into voluntary and controlled trances during their diagnostic and healing efforts.• Shamans are psychoanalysts sliding in between both the collective and individual. Both shamans and psychoanalysts establish a relationship with a patience conscious and indirectly with their unconscious. Shamans speak for the patient.• In India and China Shamans are as common as the dentist.
Shamans in East India• Oraon Shamans of East India (agricultural tribe)• Uses gods, goddesses, deities to send him into trance like states when he is divining or treating illness.• They tend to take on a supermarket full of divine spirits and deities from everywhere. The shadow is joined to their patient and is the other side of his power.• They undergo shamanic training, ritual workshop, periodic fasting and have been chosen by their father or they were chosen by god via instructions in dreams.• 2 kinds of madness – Endogenous Madness - They tell you to stop worrying – Shaitani Disorders – Work of Demonic Spirits• They see a separation between spiritual and physical illness. If the illness is physical they will tell you to go see a doctor.• Sometimes they do mantra.• God IS the Shaitan – Who else reminds us there is a higher power than us?• They read leaves and sugar.• They put themselves and sometimes their patients into disassociated states.
Tibetian Healers and Shamans• Foothills of Himalayans – Came to India after the Dalai Lama.• Buddhist Monks “LAMAS”.• Mystics and Doctors practicing the ancient art of Tibetan medicine and shamanism.• Mix of northeast Asian shamanism, and Mahayana Buddhism, and tantric ideas from India and Nepal.• They believe in the softness of reality. All that exists is a “ mirage of mind “. – Everything in the universe has meaning other than apparent – The world is full of oracles and signs – Imagination reigns supreme. All that is imagined is as real as all exists. – There is no supernatural. Everything is a miracle.• Existence is created by mind. Reality can be controlled by mental efforts. – Concentrating meditation – Elaborate rituals – Transforming power of mantra• Blurring distinction between physical and mental sickness – both ignite from fault of mind. – Anger, desire, mental darkness (3 poisons of mind) – These three poisons disturb 3 bodily humors – Wind, Bile, Plegm• Cleansing of the entire mental and emotional world to cure sickness. Absoluter reality has only limited practical value.• Ignorance is cause for illness
Tibetan Healers (cont.)• 4 immediate causes of illness - Seasons of year, Food, Habit, Behavior (If wind bile or phlegm get disturbed)• They also believe one of 360 spirits some cause illness. – only 18 can afflict human beings with illness or insanity – Some spirits beneficial, some wrathful – Spirits have same rules as humans (promoted or demoted on karmatic behavior) in constant flux• Nagpalla – specialists in spirits (Tibetan shamanism) – Iha : Gods of Upper Region – Klu : Serpent Spirits – Sabday : of the netherworld(share cosmos with humans) – Earth Lords• Law of Karma Governs all beings, gods, serpents – beings in constant flux (promoted or demoted)
Tibetan Mental Disorders• Causes of Mental Disorders – Evil spirits – Sudden Loss – Prolonged wind disease – Power of mantra (enemy against victim – sorcery) – Mild insanity caused by reciting bad mantras (black magic)• Sudden Loss Cure – Focus on the deprived instead of loss – Be thankful for having and experienced – Freedom of earthly attachments – Path of enlightenment
Tibetan Mental Disorder Diagnoses• They establish whether the mental illness is due to spirit attack or other – spirit attacks announce through dreams, omens, dizziness, nightmares. – A man becomes a child of his dreams. The child is reborn in the insane man.• They Diagnose spirit attack via eye movements – Possessed by Bhuta – eyes move down towards left – Posessed by Dakinini – female spirit – eyes move upward towards right• A spirit attack depends on state of ones karma (dangers in life, to the body, the dignity, to luck) - If these factors are off then spirit will attack him.• Mantra prevents evil spirit from entering him. Mantra is power to Tibetans and Indians. Magic of mantra.• Spirits are more apt to possess believers than non-believers as a teaching.
Mainstream Indian Religious Culture• There is an urge to transcend a self-conscious selfhood, self-development and self integration in Indian mysticism.• 4 Levels of knowledge of Man (Transformation) – Shrewd Level – common sense – Rational Level – Scientist – Imaginative Level – Artist – Spiritual – Mystic
Kundalini Healing in India• Works on the Collective Subconscious• It is the home of various orders of demonic beings (Bhuta- Preta)• Training where to place the mind - Heaven and Hell are both unattractive. Both paths are evolutionary dead ends that only lead to reincarnation on earth. – Too much attention on left side of body( Hindu Hell ) is in danger of spirit entering his psyche and we tend to become self absorbed in affects and mood realms of feelings and past events. – Too much attention to the right side of his body (Hindu Heaven) he dwells in the realm of the lesser gods (spirits of yogis) “monsters of egotism” who sought mastery over themselves.• Universal Consciousness shows mans true potential
Umanda in Ayurveda Today• Ayurvedic medicine views mental disorders as the imbalance of energies on an inner level, thinking that behind the gross physical body is a subtle or astral body composed of the life-force, emotions and thoughts.• Causes are unhealthy spoiled food, improper eating, dejected people due to worry, grief, emaciated persons indulging in activities in improper ways, mistakes in the method of worship, doing sinful acts, effects of strong poisons, karma, ancestry, sexual abuse, perversion, and taking drugs, excessive thinking, occult practices.• It is an excess rajas and tamas turbulence and darkness in the mind. Too much rajas involves excess of anger, hatred and fear, excessive nervousness, worry, and anxiety. Too much tamas involves excess sleep, dullness, apathy, inertia and the inability to perceive things as they are.• Overall the dosha’s get increased in the mind in persons and invade the channels of the mind and cause insanity – Wind insanity: (vayu) – Choleric Insanity: (pitta) – Phlegmatic Insanity: (kapha) – Conjunctive Insanity: (trisdosha)
Wind insanity: (vata)Emaciated body; inappropriate lamenting, shouting, laughing, and smiling, as well as dancing, singing, playing music, talking, posturing, bursting out; repeatedly and tunelessly imitating the sound of a flute, veena, or other instrument; frothing at the mouth; constantly wandering about; ceaseless talking; using things which are not ornaments as decoration; trying to travel on things which are not vehicles; being greedy for food, but spurning it once it has beenobtained; bulging, Bloodshot eyes, and illness after foods had been digested.
Choleric Insanity: (pitta)Threatening behavior, fury, and charging atpeople with fists stones. He goes naked, and hasa yellow color. He sees thing which are notthere, such as ire, flames, stars, and lamps. Mindis narrowed and contentious, fighting eitherwith others or with themselves. Agitation,irritation, anger, and possible violence.Domineering, authoritarian or fanatical. Somehave paranoid delusions, delusion of grandeuror can become psychotic.
Phlegmatic Insanity: (kapha)• Lose desire for food, vomiting, and a reduction in motivation, appetite, and conversation. Lust for women. solitude. dribbles mucus and snot, and is very frightening. He hates being clean. He sleeps, and has puffy face. This insanity is stronger at night. Attachment and lack of motivation lading to depression, sorrow, and clinging. The mind may be incapable of abstract, objective or impersonal thinking. There is lack of drive and motivation along with passivity and dependency.
Conjunctive Insanity: (tridosha)• Tridoshic Insanity - Described as dreadful and incurable.• Two other types of insanity – insanity due to loss (depressed, swoons, pale) – insanity due to poison (dark complexion, bloodshot eyes, senses are all ruined)
Modern Ayurveda Treatment• Balance the biological humors through diet, herbs, and exercise.• Panchakarma is a great treatment.• Healing the energetic psychological problems in the mind-body complex.
Vata Disturbance• nourishing and sedating herbs – Ashwagandha. Sarpagandha, rauwolfia serpentine, Valerian, guggul, jatamansi and calamus.• Other therapies most recommended for vata are oil and ghee therapies – Oil enemas – Oiling the body – Put laxatives with the oils and ghee to remove any blocks
Pitta Disturbance• Purgation is recommended.• Good herbs - rhubarb root, senna, aloe, Gotu kola bhringaraj, sandalwood , passion flower, Shatavari .• Oleation and fomentation therapies• Purgatives• Emetics• Medicated enemas with jatamashi and Gotu kola.
Kapha Disturbance• Spicy brain-stimulating herbs to clear phlegm. – calamus, basil, bayberry, sage, myrrh, and guggul, which have good expectorant action. – Other formulas include trikatu with ghee or calamus ghee.
Other Therapies all types• Abhyangai, Shirodhara, shirobasti, & ghee• nasal medicines, head and face massage mixed with mustard and oil• bloodletting and shock treatment• cultivation lifestyle through all five senses• spending time in nature• Mediation, pranayama, mantra, prayer, and visualizations.• Yoga, aromatherapy, and color therapy.• satvic diet• Avoid Modern Media• Increase ojas and balance prana, tejas