Satvavajaya Chikitsa or Cognitive Behavioral Therapy in Ayurveda (सत्वावजय चिकित्सा)

Satvavajaya Chikitsa is one of the treatment modality in Ayurveda. This type of treatment is focused at controlling the ever wondering mind that has a potential to develop variety of health disorders in a human. There are certain illnesses which are caused by the disturbances in one's mind and thus can not be cured until the the causative agent, the mid, is treated or controlled. In such situations, pharmacological treatments may not work effectively. Thus a treatment modality which can handle the manas (mind) related component in the diseases or which can help to manage psychological disorders had been developed and known as Satvavajaya chikitsa in Ayurveda.

Introduction

Satvaaajaya chikitsa is one of the fundamental treatment modalities among Daivavyapashraya and yuktivyapashraya chikitsa. This treatment approach is meant exclusively for the “manah” or mind and its related attributes.

The term “Sattva” means mind or intellect and “avajay” means to withdraw or to overcome, thus literally, Sattvaavajay means, to withdraw the mind from unwholesome objects or to overcome difficulties of mind. finding a correct balance between satva, raja and tamas, meaning to increase the satva guna by diminishing the other two doshas of manah, encompasses satvavajaya chikitsa method.  In comparison with modern sciences, satvavajaya chikitsa can be mildly co-related to the Psychiatric aspect of the human body.

Definition

सत्त्वावजयः- पुनरहितेभ्योऽर्थेभ्यो मनोनिग्रहः|| (cha.sut.11.56)

“ahitebhyo” means harmful, unhealthy. “Artha” means object of sensory organs. “Mano nigraha” refers to controlling the mind. Thus, the chikitsa method that restraints the mind from the desires of harmful objects by preferably increasing the sattva guna(property of the mind) is known as the Satvaavajaya chikitsa.

Functions of mind - Physiology and pathophysiology

These are the fundamental functions of the mind or basic physiology,

इन्द्रियाभिग्रहः कर्म मनसः स्वस्य निग्रहः| ऊहो विचारश्च, ततः परं बुद्धिः प्रवर्तते||२१||

Indriyabhinighraha – denotes control over one’s senses, and thought process.

Svasya nigraha – having control over one’s actions or being self-restraint means svasy anigraha

Uhya – the ability to analyze or being able to speculate is uhya.

Vichara  - Thinking, decision making, or having a controlled thought process means vichara.

Manasa dosha  treatment aspects

As there are shareera doshas Vata, pitta and kapha, there are manasa doshas which are rajas and tamas. Attaining a balance between rajas, tamas and satva guna with various methods as enlisted below encompasses Savavajaya chikitsa techniques.

मानसो ज्ञानविज्ञानधैर्यस्मृतिसमाधिभिः||(cha.sut.1.58)

Jnyana – here jnyana denotes knowledge of self.

Vijnyana – vijnyaa denotes knowledge of shastras(doctrines)

Dhairya -  means courage or strength

Smriti – means memory or capacity to remember.

Samadhi – denotes meditation

These methods convey the idea of basi principles of satvaavajaya chikitsa.

Application of Satvaavajaya chikitsa concerning certain diseases

Jwara

क्रोधप्रवातव्यायामान् कषायांश्च विवर्जयेत्|१३९|(cha.chi.3.139)

Acharya Charaka explained in cases of nava jwara or the initial stages of fever, one must avoid anger or krodha, which is a dosha of manah or the mind.(cha.hi.3.320-324)

There are explanations of jwara caused due to excessive krodha, which is treated with sadvakya(good advise), kamya artha(giving desired object), manodnya artha(giving pleasing object). (cha.hi.3.320-324)

Ashwasana chikitsa or assurance in cases of jwara caused due to bhaya(fear), shoka(grief). (cha.hi.3.320-324)

विचित्रैश्च विषयैर्नाशयेत् स्मृतिम्| (cha.hi.3.324)

When an individual suffers from jwara even by thinking about it, then it is managed by diverting the mind by rememebering about different and surprising incidents.

Rajayakshma

हर्षणाश्वासनै..( cha.chi.8.187)

Harshana or inducig happiness and ashwasana (providing assurance) are mentioned as other treatment aspects in rajayakshma chikitsa.

Unmada

(cha.chi.9.79-84)

आश्वासयेत् सुहृद्वा तं वाक्यैर्धर्मार्थसंहितैः|

Ashwasana(providing assurance) chikitsa by a friend is applied again in Unmada disease as well. (this type of treatment method can be associated with modern counseling methods)

Moral speech and virtuous words are used as well. appropriate guidance and suggestions are given.

Measures like inducing fear in the mind, by exhibiting surprising events or showing extraordinary things for distraction are used.

कामशोकभयक्रोधहर्षेर्ष्यालोभसम्भवान्| परस्परप्रतिद्वन्द्वैरेभिरेव शमं नयेत्|| (cha.chi.9.86)

If the cause of the disease is kama(passion). Shoka(grief), bhaya(fear), krodha(anger), etc then replacement by opposite emotions are performed.

Apasmara

सुहृदश्चानुकूलास्तं स्वाप्ता धर्मार्थवादिनः| संयोजयेयुर्विज्ञानधैर्यस्मृतिसमाधिभिः || (cha.chi.10.63)

Vidnyana(wisdom), dhairya(courage), smriti(memory), samadhi(meditative knowledge) are values that are inculcated in apasmara disease by friends, well-wishers, religious sermons, etc.

Hikka

शीताम्बुसेकः सहसा त्रासो विस्मापनं भयम् | क्रोधहर्षप्रियोद्वेगा हिक्काप्रच्यावना मताः ||(cha.chi.17.137)

There are certain measures explained by Acharya Charaka which alleviate Hikka, like the distraction from thoughts, inducing fear, anger, anxiety, and sudden happiness.

Thus, here krodha(anger) and bhaya(fear) are used as treatment methods being dosha(morbidity) of manah or mind.

Visarpa

As there are indications of satvavajaya chikitsa methods in certain diseases there are contraindications as well.

क्रोधव्यायामसूर्याग्निप्रवातांश्च विवर्जयेत् ||(cha.ch.21.115)

In Visarpa krodha(anger) is varja meaning contraindicated along with other lifestyle modulation.

Madatyaya

Harshana chikitsa is mentioned as a treatment method in madatya(alcoholism/intoxication)

वनानि रमणीयानि (roaming around n beautiful gardens), विशदान्यन्नपानानि(decent food and pleasant drinks), माल्यानि गन्धयोगाश्च वासांसि विमलानि (wearing pleasant-smelling flower garlands, perfumes), गान्धर्वशब्दाः(listening to melodious music). These are few examples mentionedas harshna cikitsa(exhilaration method of management).

Madya or liquor cannot intoxicate a person without affecting the mind, thus these methods of management are adopted.