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| PERSPECTIVE/VIEWPOINT |
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| Year : 2021 | Volume
: 3
| Issue : 3 | Page : 150-153 |
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Learnings from Ancient India: Relevance to Contemporary Psychiatry
Rakesh Kumar Chadda1, Pallavi Rajhans2
1 Professor and Head, Department of Psychiatry & National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi - 110 029, India
2 Senior Resident, Department of Psychiatry & National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi - 110 029, India
| Date of Submission | 14-Nov-2021 |
| Date of Decision | 15-Nov-2021 |
| Date of Acceptance | 15-Nov-2021 |
| Date of Web Publication | 23-Dec-2021 |
Correspondence Address:
Prof. Rakesh Kumar Chadda
Head, Depatment of Psychiatry, and Chief, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi - 110 029
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/wsp.wsp_50_21
India is one of the oldest civilizations in the world and has a rich cultural heritage. Ancient Indian scriptures (Vedas, Upanishads, and Bhagavad Gita) and epics (Ramayana and Mahabharata) are a great source of knowledge. Some of the principles, described in these texts, have applicability to the discipline of psychiatry in the contemporary scene. Ayurveda, the Indian system of medicine with history dating back to the Vedic period, also recognizes mental disorders, giving their descriptions, and explaining their etiology and management. Bhagavad Gita has given detailed description of crisis management and dealing with anxiety, stress, and depression and elucidated the principles of psychotherapy. Buddhism, one of the religions with origin in India, describes the principles of meditation and ways of dealing with stress and anxiety. Yoga, an important gift of ancient India, has been found to be effective in the management of anxiety and psychosomatic disorders. Various meditation techniques practiced today make the use of principles that date back to ancient India. Epics such as Ramayana and Mahabharata include multiple descriptions of dealing with stress and mental health issues which have relevance in the contemporary psychiatry. The methods of stress and crisis management as described in the ancient Indian literature have also applicability in dealing with certain mental health issues during the crisis situations such as the COVID-19 pandemic.
Keywords: Ancient India, history, mental health promotion
How to cite this article:
Chadda RK, Rajhans P. Learnings from Ancient India: Relevance to Contemporary Psychiatry. World Soc Psychiatry 2021;3:150-3 |
| Introduction | |  |
The Indian subcontinent is home to one of the oldest civilizations of the world. Around 3300 BCE, during the bronze age, Indus valley civilization flourished on the banks of the Indus River.[1] It was mainly centered in North-Western India and was contemporaneous with Mesopotamia and ancient Egypt. The Harappan civilization was followed by the Vedic period extending from 1500 to 600 BCE. The period saw the emergence of four sacred Hindu texts, the four Vedas.[1] The oldest Vedic scripture, the Rig Veda dates back to 1500–1200 BCE. The other three Vedas, Yajur Veda, Sama Veda, and Atharva Veda date back to 1200-900 BCE. During the period spanning from 800 to 400 BCE, Upanishads or Vedanta (conclusion of Vedas) were written.[2] These form the basis of classical Hinduism. Three different religions originated in the country including Hinduism, Jainism, and Buddhism.[3] The two famous Indian epics Ramayana and Mahabharata date back to around 5000 and 3000 BCE, respectively. The Bhagavad Gita is a later Hindu text than the Vedas and is regarded by many scholars of Hinduism as a distillation of key Vedic concepts, and a more practical document than the Vedas for the purpose of interpreting the conceptualization of wisdom in ancient Hindu literature.
| Contribution of Ancient India in the Field of Mental Health | | |
The Vedic texts including the Rig Veda, Yajur Veda, Sama Veda, and Atharva Veda laid down the basic framework of the traditional Indian medicine.[4] Rig Veda, one of the world's oldest scripture, includes the descriptions of surgical procedures.[5] The scripture also has details about prayers and methods to promote mental happiness, empower mind, and build up intelligence to aid in healing and the speed of mind.[6] Atharva Veda gives a description of possession by supernatural elements as leading to mental illness. Rig Veda and Yajur Veda describe mantras (rhymes), which help in development of noble thoughts that prevent mental pain (depression).[2] Strong willpower and control over one's emotions can be made possible with the help of prayers and thus contributing to positive mental health. Yajur Veda and Atharva Veda conceptualize mind as the inner flame of knowledge, instrument of hypnotism, and a basis of consciousness.[2] Atharva Veda has 10 parts which include witchcraft, sorcery, hysteria, pathological fear, insanity, guilt, and jealousy. Mental illnesses were considered as occurring due to the curse of God.[7] Upanishads, described as synopsis of Vedas, have a more recent origin, and welcomed the new ideas marking a transition from the traditional Vedic ritualism, and include theories of consciousness, memory, thought, and perception. There are also descriptions of dreaming state, waking state, deep sleep state, and Samadhi.[6] The concept of personality of the modern times has been described as “Prakriti.”[2] The mythological epics such as Ramayana and Mahabharata also include descriptions of various psychiatric disorders. In Ramayana, a family history of unipolar depression can be found among different characters. King Dashratha dies in extreme grief, and in the end of the story, Lord Rama also goes into depression and kills himself by going into the Saryu river. Descriptions of other disorders such as impotence, alcoholism, and epilepsy can also be found in these ancient epics.[5]
Ayurveda, also known as the “Science of Life,” is the most ancient formal Indian medical system.[8] Its origin dates to the 6th century BCE. Charaka Samhita and Sushruta Samhita were the two important medical texts written during that period, with the former dealing with medical diagnosis and management, and the later dealing with surgical diagnosis and techniques.[5] According to Ayurveda, the traditional concept of health in India was about maintaining balance between the five bhutas or elements which constitute the human body including earth, fire, air, sky, and water and three doshas or humors including wind (vata), bile (pitta), and phlegm (kaph).[7] To maintain the balance at physical, psychological, physiological, and spiritual level, the excretion and digestion must be unimpaired. The person must have clarity about mind, his senses, and soul, and must be blessed with tranquility. The ancient texts also mention a suprasensory organ, the Manas which regulates all other senses. Manas is equivalent to the concept of mind. There is also mention of an entity Buddhi (intelligence), ranked higher than Manas that refers to the judgmental capacity.[7]
Bhoot vidya was one of the eight disciplines of Ashtanga Ayurveda which included the branch of psychiatry.[9] Descriptions of possession states can be found in Charaka Samhita. The ancient texts also mention three personality types or trigunas, one of which is present at the time of birth of an individual and determines his/her “prakriti.” These include the balanced type (Satvika), the emotional type (Rajasik), and the lustful (Tamasik). Psychosis is termed “Unmad,” a deluded state, and mental disorders are named after Gods and devils. Some endogenous disorders have loose correlation with the modern-day psychiatric disorders. These endogenous disorders are thought to be provoked by the three humors. Vatonmad is like schizophrenia, Kaphonamad is closer to depression, and Pittonmad is similar to mania. Causative factors as described include a lack of healthy habits and preoccupation with the six foes: nervous temperament, wrong diet, demonic possession, etc.[9] Four types of mental illnesses have been defined. These include illnesses caused due to exclusive involvement of emotions, due to exclusive involvement of the three humors, disorders of body mind involvement such as unmada, alcoholism, and disorders with mind–body involvement including psychosomatic illnesses. Treatment described included medications, psychotherapy, dietary modifications, and shock therapy. Exogenous disorders known as bhutonmada were treated using worships and psychotherapy.[5] Thus, there are many similarities in the descriptions of the mental illnesses as given in the ancient Indian literature with the modern psychiatry, though there are differences in approach to treatment.[7]
The Indian culture attaches huge importance to spiritual life which may not be synonymous with the mental health but it values inner mental life and experiences.[7] Detachment from material things and self-realization is the ultimate goal of life. This is the reason for yoga and meditation having a special place in Indian philosophy. Yoga originates from the word “Yuj” which in Sanskrit means “to unite.”[4] It has four divisions including Mantra yoga, Hatha yoga, Laya yoga, and Raja Yoga.[10] The Yoga Sutras were compiled by Sage Patanjali who is also known as the father of Yoga. These Sutras form the basis of Raja Yoga which is considered the ultimate among the four divisions.[10] Raja Yoga contains the descriptions of the eight limbed path of yoga for overall personality development known as the “Astanga Yoga” which is the key to attain the ultimate spiritual goal of self-realization.[11] These eight levels are divided into preparatory phases, the internal and external aids to yoga. Yama (self-control) and Niyama (observation of rules) are the preparatory phases, and the two along with Pranayama (regulation of breath), Asana (assuming certain postures), and Pratyahara (restraint of senses) form the Bahiranga sadhna or external aids. Antaranga sadhna or internal aids consist of Dhyana (meditation), Dharana (steadying of mind), and Samadhi (contemplation of universal consciousness).[10] The cognitive apparatus, physical, psychological, and social self-interact with each other and remain in harmony according to Patanjali. The six foes including lust (Kama), anger (Krodha), pride (Mada), jealousy (Matsar), greed (Lobha), and desire (Moha) are comparable to Freudian Id and make the individual more vulnerable.[9]
Some of these concepts of yoga and meditation have been prevalent in India for centuries and used for the treatment of anxiety and psychosomatic disorders. They help in developing control over the voluntary and involuntary nervous functions.[12] The therapeutic adequacy and validity of these practices have been reported by the Indian researchers for more than 50 years.[12] A meta-analysis conducted in 2011 indicated the statistically significant role of yoga therapy as an adjunctive treatment of depression and anxiety disorders. Yogic principles may be useful as complementary treatment options for mental illnesses and have the privilege of having fewer side effects and contraindications.[13] Some studies have tried to look for the neurobiological basis of action of yoga. Practice of Sudarshan Kriya Yoga decreases the adrenocorticotropic hormone and serum cortisol levels and increases P300 amplitude. These changes correlate with improvement in psychiatric symptoms.[14] Gamma-aminobutyric acid (GABA) levels tend to decrease in anxiety and depressive disorders, and yoga sessions increase GABA levels. Deactivation of the limbic region has been seen on functional MRI while chanting Om during Yoga sessions, and this could possibly lead to the regulation of emotions.[14] Some studies have also highlighted similarities between the trance state in Patanjali yoga sutras and trance in hypnosis.[15] The similarities are in the fields of induction and deepening techniques, and the phenomena described during the trance states.
Wisdom, a multidimensional construct, has become another area of research in recent times. The concept could be of importance to modern psychiatry in the development of more individualistic and holistic psychotherapeutic interventions aiming at well-being in general and not just the reduction of psychiatric symptoms. The interest may be new, but the concept has been described in some of the ancient Indian texts. The Bhagavad Gita conceptualizes wisdom as having multiple domains. These include knowledge of life, control over desires, love of and faith in God, emotional regulation, duty and work, humility or insight, decisiveness, self-contentedness, yoga, and compassion/sacrifice. In Bhagavad Gita, the personality is compared to the chariot which is driven by horses. The intellect or buddhi is the charioteer, and the horses are comparable to our senses. Bhagavad Gita illustrates the principles of psychotherapy and crisis intervention and teaches the person to be his/her own master.[9]
Question may arise if these traditional concepts are applicable to the modern world. Jeste and Vahia[16] in a detailed analysis of the concepts of Gita conclude that the concept of wisdom in ancient texts has several similarities with the modern scientific literature. The emphasis in Gita on the abandonment of materialistic pleasure and control over desires are among the differences in comparison to modern concepts. It may be argued that these concepts from Bhagavad Gita are traditional and there may be discrepancy while comparing and applying it to modern life. However, one should be aware that various Indian scholars like Vivekananda have found these teachings to be meaningful in modern society and have written about it. Even some Western writers have emphasized on their relevance and applicability for the Western culture.[16] The teachings of Bhagavad Gita also held relevance in dealing with the COVID-19 pandemic and recently, some authors have revisited these teachings. The three paths of yoga emphasized in Gita may hold relevance in reliance-focused psychotherapy while dealing with the burden of the pandemic. First is the path of knowledge (jnana yoga) which helps in shifting our focus from “I” to “we,” thus helping in self-awareness so that we can focus on dealing with the pandemic in a collective manner. Second is the path of action (karma yoga) which is applicable to all front-line workers for working selflessly. The guiding principle for the health-care workers is karma or duty. Third is the path of meditation (raja yoga) which may help in developing resilience and reducing stress by adopting a healthy lifestyle.[17]
These ancient concepts pertaining to the nature of mind are increasingly being deliberated upon in the contemporary psychiatry. The person-centered approach in psychiatry has especially been emphasized in recent times. When care is centered around the patient and their caregiver, it is important to have some basic understanding about the social, cultural, ethnic, and religious background of the patient. India has a collectivistic society and even to date, the family shares a great degree of cohesion. The family members constitute a great resource when it comes to providing care to the mentally ill.[18]
Philosophical and religious concepts native to India can be utilized by therapists while dealing with patients as these are more acceptable. Surya and Jayaram included the legend of Savitri in their framework of psychotherapy. The mythological story of Hanuman (a character in the epic Ramayana), who was wise and brave but did not realize his potential to fly until Jambavanta (another character in the epic) reminded him of the same. This phenomenon is comparable to a patient who has lost his confidence and can be made to realize his potential which lies within him to change his life and was named as Hanuman complex by NN Wig. The concept has a great relevance in psychotherapy in India, especially in the background of depression, where the patient is reminded of his strengths. The traditional concept of Guru or teacher who is seen as a role model by the student was propounded by Neki as “Guru-Chela” paradigm in psychotherapy. The model is especially relevant in South Asia.[18]
The knowledge pool related to psychiatry derived from our ancient texts has enriched international psychiatry.[6] Classification and course of mental disorders, transcultural variations in clinical features and traditional methods of care such as yoga and meditation have been some of the important contributions of Indian psychiatrists to global psychiatry.[6] The current concept of psychosomatic medicine has some parallel concepts in Ayurveda according to which multiple etiological factors contribute to the disease including various psychological factors.[19]
| Conclusion | | |
The Indian culture is remarkably adaptable and has the capacity to adjust to new demands by retaining as well as modifying the ancient traditional knowledge with reference to societal changes. This is true in the field of mental health as well. Handling patients with mental illness requires a holistic approach, and a great significance is attached to the sociocultural and religious beliefs of the patient. Various leading figures of Indian psychiatry have stressed upon the fact that it is possible to combine our rich philosophical heritage with modern concepts and practices in science. Yoga and the teachings from the Gita and concepts of mind and personality as described in Vedas and Charaka Samhita have got relevance in the modern psychiatric practice. Ancient Indian texts and scriptures strongly advocate the concept of mental health promotion. The teachings imparted by the ancient Indian scriptures and mythological epics have again gained importance in the context of the recent pandemic which led some researchers and clinicians to revisit these areas. We hope that, in the coming years, more attempts will be made in understanding these traditional concepts and finding their applicability in contemporary psychiatry.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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