Psychosomatic disease (Ubhayatmaka)
Ayurvedic understanding and treatment of psychosomatic disease
by Randy Rasmusson
Ayurveda means the science of life in Sanskrit. It is the oldest healing system we have, coming to us from the “Vedas”, the most ancient texts in existence. The exact age of these are lost in history but can be traced back to the oral tradition of wisdom passed down by sages (gurus or rishis) at the end of the last ice age some 10000 years ago
Ayurveda essentially sees every disease as a psychosomatic manifestation. The sage Vagabhata made it clear when he said, “The mind (psychic component) is like ghee (clarified butter) in an earthen pot (the body or somatic component). The warmth or chill of either necessarily affect the state of the other.” So Ayurveda views the mind and body as two aspects of one unity. Over thousands of years Ayurveda and Yoga have been interrelated as the physical and psychological healing modalities, often described as two wings of the same bird.
The Basis of Ayurveda is an understanding of the energies that exist in the body and mind of man. These energies exist also in the world around us and in time and space. These Root energies are called Doshas: Vata, Pitta and Kapha in our body and in the physical universe. They are further divided into five types. In the mind they have more subtle forms and are called Prana, Tejas and Ojas. Understanding the link between these energy forms is the key to understanding how physical disease can be caused by the mind (psychosomatic illness) and how the conditions of the body can disturb the mind such as all of the stress related disorders we encounter today.
Ubhayatmaka or psychosomatic disease is real physical disease that is related to a psychological process. This should not be confused with a somatic form disorder such as conversion hysteria that is a mental disorder that results in what appears to be physical disease but really is not. Conversion hysteria is a kind of neurosis because there is no organic cause for the symptoms. A psychosomatic disease is a physical disorder with two major aspects: 1.) It is caused or made worse by stress and 2.) It is characterized by on organic structural change in the body.
Several Popular theories try to explain psychosomatic disease. While each has merits for some patients there is no universal explanation in modern western therapy. Ayurveda on the other hand has a completely different view. There are three mental/ spiritual dispositions or qualities called Gunas that determine how an individual responds to ‘Stress”. These are Satva, Rajas and Tamas, and are inherent in all aspects of life. Satva is responsible for mental equipoise and clarity. It is a quality of food, plants (medicines), environmental locations, and impressions that influence the lifestyle of everyone… Unfortunately it is often neglected and not emphasized in our western culture just as wisdom is not considered a priority. The other two: Rajas, the force of distraction and instability and Tamas, the force of confusion, darkness and ignorance and fear are the direct causes of disease both physical and psychological. Each type of physical (Vata, Pitta and Kapha) and mental (Prana, Tejas and Ojas) energy can change the quality of health of the person by increasing Satva and reducing Rajas and Tamas. This works from both the physical and psychological side.
The somatic diseases where psychological factors are involved (in disease causation) constitute a long list in ancient Ayurvedic texts in Sanskrit such as the “Charaka Samhita". Ayurvedic treatment of these diseases of course begins with reliving the symptoms of suffering but does not stop there. The source of the problem must be diagnosed and treated as well.
The basic therapeutic approach in Ayurveda is to detoxify and then rejuvenate the person, thereby restoring homeostasis. From the Ayurvedic point of view there are many kinds of toxins…physical toxins such as agro toxins, pollution, and medical poisons, energy toxins such as excessive or deficient states of the three root energies Vata, pitta and Kapha, emotional toxins such as suppressed or repressed emotions and stress, Spiritual toxins like negative karma, samskaras (stored body memory of unresolved impressions), and vasansas (subtle body memories of unresolved past life impressions). To work with these one needs an understanding of Ayurvedic physiology which is only beginning to be recognized in the occidental world.
The three bodies in Ayurveda are: The physical or gross body (sthula sharira) it has sixteen components; the five sense organs, the five organs of action, the five elements and the mind (that part of it connected to the senses). Within it is a subtle body of like form called the subtle or astral body (sukshma sharira). It includes not only mind but also ego, intelligence and consciousness (Ahankara, Buddhi and Chitta), which are do not exist directly on a physical level. In it dwell the seven chakras or astral centers. Within the subtle body is a subtler or causal body (karana sharira) shaped like an egg around the other two bodies. It is composed of the three gunas or causal elements, along with special causal forms of seeing and hearing (drishti/shruti). Through the gunas it can create the experience of either of the other two bodies. It is built up by the three gunas and fed by the gunas we take in. The three gunas are the spiritual dispositions mentioned above.
An easier way to understand this is to imagine an orange. The skin is the physical body. The juice and pulp is the subtle body and the seed is the causal or karmic body. Normally we are only aware of the physical body. We employ the astral body in dreams, strong emotions and inspiration but are not usually conscious of it. It is called the subconscious mind in western psychology. The causal we only touch upon in deep sleep, profound perception or the deep silence of mind called meditation. This is similar to the unconscious mind.
Ayurveda sees the mind existing in four levels:
CHITTA: or Consciousness. It functions independently of the senses. It is also where all the memories of our past lives are stored. It exists in all three bodies. It functions even in sleep. In hypnosis our mind can be brought to the level of Chitta. It represents the totality of our mental field. It contains deep-seated emotions, habits, impressions and attachments.
MANAS: It is that part of our mind that is connected to the senses coordinates our activities (motor and sensory) & is dominated by our emotions and opinions. It includes the outer sensory awareness or “desire mind”, including our personal subconsciouses and personal unconsciousness. It is generally our capacity for thought, consideration, and imagination (samkalpavikalpa), primary emotion or capacity to react to impressions.. Manas does not exist in the causal body, because it depends on sensory input.
AHANKARA: Literally the “I-fabrication” is really a process not an intrinsic reality. It is a necessary power of differentiation inherent in nature, a stage of evolution, but does not represent the underlying truth or identity of creatures. It is the ‘I-thought” behind the other thoughts of the mind. Its action is a series of identifications of the self or subjective aspect of our being with some objective form or quality, like the body or various mental states. Manas or outgoing mind is a series of internalized emotional reactions. The ego appropriates these as “I like this”or“I do not like that” etc. Hence the ego gives energy to the reactions of the mind. On the positive side the ego allows for a greater focus of the mind. It helps consciousness differentiate itself form external nature. It is one of the main causes of physical and psychological imbalance and disease.
BUDDHI: This is our discerning facility that allows us to distinguish truth from false imagining. It allows us to establish values and give principles to our lives, the basis of conscience. It is our conscious mind and intelligence (from the root “bud” to awaken or perceive). When directed outwardly it becomes the intellect and makes us discriminating of name and form in the external world. When directed inwardly it becomes intelligence that allows us to discriminate between the inner and outer, between appearance and reality. When directed outwardly its function is through Manas and Ahankara and is not independent. It is detached from the senses and exists in all three bodies (physical, subtle, and causal).
Ayurveda uses different metaphors to describe these subtle physiologies just as one would
try to describe the taste of an orange to someone who had only seen it. The person is like an onion with layers that are called koshas. The Purusha or inner Self is encased in five sheaths or densities of matter 1.) The Food Sheath (Annamaya Kosha), 2.) The Breath Sheath (Pranamaya Kosha), 3.) The Emotional Sheath (Manomaya Kosha), 4.) The Intelligence Sheath (Vijnanamaya Kosha), 5.) The Bliss Sheath (Anandamaya Kosha)
The Food Sheath makes up the physical body; the mental sheath the astral body; and the Bliss Sheath the causal body. The Breath Sheath mediates between the physical and astral bodies; the Intelligence Sheath mediates between the astral and causal bodies.
Between each of these bodies and within them are channels or nadis of varying degrees of subtly. Understanding the flow of Prana or energy in these channels is the key to diagnosing the relationship between the body and mind with respect to disease. There is one principal channel that connects the three bodies called the Chitta nadi. Through it passes the information stored in the causal body to the subtle body (dreams and the subconscious mind) and eventually to the physical body creating the manifestations of cellular memory called karmic (genetic) disease.
The body and mind are hinged together like a bellows. Or like the classic example the wings of a bird. Each responds to the other dynamically. When either of the two main types of Vata: Prana Vayu (the upward momentum) and Apana Vayu (the downward momentum) becomes unbalanced then the other goes out of balance also. For example; Constipation leads to insomnia and anxiety, OR fear leads to digestive discomfort. Chronic situations produce disease. The Ayurvedic therapist must determine if the mind (Prana Vayu) is causing the bodily symptoms or is the body (Apana Vayu) disturbing the mind. An obvious example of a 45 year old woman who was traumatized by being trapped between floors in an elevator for an hour . She could not enter an elevator for two years after without diarrhea. This is an obvious example of the power of the mind over the body…particularly the effect of stress on the digestive system. When she was instructed in a Yogic breathing method to control Prana the problem was controlled. Other therapies had proven unsuccessful. The guiding principle in Ayurveda with regard to psychosomatic illness is “If the mind can create the problem then it certainly can solve it.”
The Psychological therapy side of Ayurveda is called Yoga. Here in the west most people are only familiar with the “Flow and Glow” physical aspects of Yoga. We can consider the Yoga Sutras of Pantajali to be the basic manual of this science. Three percent of the Yoga Sutras is devoted to the Asanas or Physical exercises. Ninety seven present of the Yoga Sutras is devoted to the understanding of the Nadis (The channels of energy), Gunas and Mediation. It is the science of the mind. In Ayurveda we call this the Science of Prana, Tejas and Ojas, the energies of the mind.
It is of course necessary to be able to diagnose if the illness that we can observe in the body has its origin in the mind or the Doshas (body energies). This problem was solved five thousand years ago with the understanding of the seven levels of pulse diagnosis. An experienced therapist can read in the pulse if it is Prana or Apana that is out of balance originally. He or she can also know if it is Prana in the mind (stress) or the nadis that is disturbing the body. The status of the nadis can be addressed and correct therapy can be used. This may be at odds with western technology but if it did not work it would have been discarded thousands of years ago.
Stress management is becoming a popular term for adapted forms of meditation. Not only is this for health, but for productivity, and creativity in other aspects of life especially business. Stress has become a common reality in our culture but the truth is that Rajas has overwhelmed our culture and societies…Technology naturally creates more distraction and Rajas. Rather than trying to cope with distraction we should cultivate Satvaic qualities and the stress will disapate by itself. This is exactly how an Ayurvedic Therapist treats a patient with psychosomatic illness.
Essentially we are immature in our approach to the problem on an individual level and cultural level. Five hundred Years in the western hemisphere may seem like a long time but not compared to 5000 years of recorded wisdom. It is like a five year old trying to run a corporation or a country. Our medical system is not much better when dealing with stress. Telling people to slow down is a good idea but what do they really do…? Sit in front of the TV or computer for relaxation (Rajasic activities).
We must learn to develop Satva and apply it to our lives if we want to really manage stress. Satvic diet, Satvic Colors, Satvic environments, and Satvic Activities are the long term cure for Stress. Satvic Diet is explained in many popular books of Ayurveda today…It is the most pure and healthy diet. Satvic Colors can be used in many forms. Most vibrational remedies like Floral Essences, Gem Elixirs, Aroma Therapy, Crystal therapy, are based on understanding the meaning and nature of colors of flowers, minerals etc. Color is vibration after all. I have personally helped many patients reduce psychiatric drug dependency by substituting these forms of vibrational remedies that eventually cured the person so they did not need any remedies. The original vibrational remedy is sound in the form of mantra (special sounds in the Sanskrit language that have the ability to change the architecture if the mind). This is one of the principle supports or adjuncts of meditation. Satvic Environments are usually in nature and in isolation. Waterfalls are highly satvic and the beach at sunrise when the ozone is fresh in the air is very satvic, These qualities have been used for centuries to create artificial spaces that are highly satvic…Ashrams, temples, parks, nature preserves etc…this can be done in ones home and is very effective if it is used in healing environments like clinics, offices, detoxification centers, and rest spaces in work environments. Rather than focusing on a coffee pot (a Rajasic substance) there can be a quiet natural space with fountains and refreshing colors
Satvic activities can be the most healing treatment. Meditation is the most satvic activity possible. Meditation can be adapted for countless conditions. Visualization is a part of meditation that is easily taught to patients that leads to healing. Positive thinking is a natural side effect of meditation. It has been proven that laughter increases immunity.
Both chronic and acute pain can be controlled with meditation. The placebo effect is only possible because the mind makes it real. Breathing methods of Yoga are incorporated into most forms of meditation. Anxiety and Panic can be managed by Pranayama alone. Respiratory problems like asthma and allergies are often treated with hypnosis which is a form of induced meditation. Anger management with meditation techniques can decrease emotionally precipated angina, and heart disease. Sexual dysfunction and infertility can also be addressed with satvic methods.
Yet all this falls under the guise of symptomatic relief. Ayurveda goes much further in treatment though. Complete detoxification is possible with exceptional improvements and sometimes miraculous cures. Pancha Karma (Five Actions) is a complete Ayurvedic detoxification. Not just the body and its energies but the suppressed emotions, and subtle body are detoxified. In some instances the samskaras (karmas) are released also. Many patients have life changing dreams, revelations, and cathartic experiences. The original objective was longevity because the sages wanted to live long healthy lives to continue their karmic purification practices. Most patients who make Pancha karma treatment feel five or more years younger and have the energy to live that way. This detoxification is always followed by Rasayna (rejuvenation) therapy and cellular memory can be rewritten. Adapting to stress then becomes just observing the interesting movements of life with humor, health and wisdom. We are, after all is said and done, just teaching ourselves what we are capable of learning in this life..
I met a 68 year old Swami (spiritual teacher) who had undergone this therapy and I asked him how he detoxified his mind. He said the memories still exist but he no longer had any attachment to them. His memory was perfect. All his many physical illness had disappeared (Heart disease, diabetes, arthritis, many age related disorders). He was active like a man 45 years old and he looked like it to, shining, teaching, meditating and living a satvic life filled with wisdom. He told me that we can all do this. There is nothing stopping us…were all just oranges. By combining ancient wisdom with the preconscious energy of our western culture, we can find that none of this is alternative but really just complementary.