Svasthya (स्वास्थ्यम्)

Svasthya (Samskrit: स्वास्थ्यम्) refers to the concept of well-being and an overall sense of goodness in a human life. Since ages people aspired and strove for a long, satisfying and meaningful life. Well-being (svasthya) and happiness (Ananda) are interwoven concepts in Indian traditions. Today the popular and globally used Indian invocation which embodies the essence of the characteristics of the state of human well-being, is as follows

सर्वे भवन्तु सुखिनः सर्वे सन्तु निरामयाः। सर्वे भद्राणि पश्यन्तु मा कश्चिद्दुःखभाग् भवेत्।। sarve bhavantu sukhinaḥ sarve santu nirāmayāḥ| sarve bhadrāṇi paśyantu mā kaścidduḥkhabhāg bhavet||

Meaning: May all be happy; May all be free from infirmities; May all see good; May none partake suffering. Interestingly this invocation is from Puranic sources such as Garuda Purana (most commonly, wrongly mentioned as available in Brhdaranyaka Upanishad) and other sources as noted by Dr. Sampadananda Mishra, and he describes the essence as follows

"This is perhaps the most beautiful verse illustrating the whole idea of ‘well-being of all’ and is enormously quoted in the context of spirituality, dharma, universality, well-being etc".

Needless to say, the nature of well-being and happiness is a matter of debate through the ancient times since their conceptualization and has varied across cultures on a spectrum ranging from hedonic (connected with feeling of pleasure) to transcendent (beyond limits of ordinary experience) viewpoints. In common terms, happiness refers to the positive or pleasant emotions ranging from contentment to intense joy and well-being refers to how people evaluate their lives. Philosophers and religious thinkers often define happiness in terms of living a good life, or flourishing, rather than simply as an emotion. In the western context, well-being is limited to bio-psycho-social aspects of human nature whereas in the Indian traditions the spiritual dimension (consciousness and self) brings about a whole new perspective to this topic.

परिचयः ॥ Introduction

Popularly, in describing the concept of well-being, the factors of health and material condition of the individual and the community inevitably come to the fore. A person is "gauged" as happy if he is free from ailments and is in good health and when his family possesses enough means to meet his physical needs and other demands. But equating well-being with health and economic condition alone is taking a very partial and narrow view of man that ignores mental, psychological and social aspects of his existence.

Though physical health, nutritional status, material and economic aspects are important, one cannot meaningfully talk of well-being without taking into account the individual's entire existential condition. Hence, psychological and social development, environmental adjustments, and it's effect on unfolding an individual's personality as a whole are equally significant. Therefore, apart from designing and initiating policies and programs to ensure individual well-being, it is also essential to have a clear idea as to what well-being actually means, and develop a set of indicators.

Material wealth and affluence, fulfilment of one’s desires, human relationships, development of one’s potentialities and individuality, one’s own psychological state, faith in a religion and spirituality are thus, some of the variables, considered as relevant and significant in the context of assessing happiness and well-being. Their importance varies from culture to culture and reflect the socio-cultural differences in the conceptualization of subjective well-being. The Indian concepts of self outline how people feel their identities or self-sense are intricately connected with the physical, physiological and mental dimensions and it is human tendency to remain established at that level. However, some persons either spontaneously or through induction from meditation, yoga and such other practices are able to move beyond these sheaths and narrow self-definitions.

Many factors influence our life style and combine to create serious health hazards. The hectic pace of life, environmental factors, and increasing role of greed etc., (arishadvargas) are making people’s lives stressful. There a dire need to study this area and it involves many modern subject areas such as psychology, medicine, sociology, anthropology etc. Awareness, adoption and practice of healthy lifestyle are the keys to our well-being.

Well-being is an expression commonly used in popular parlance, and does not usually find a place in technical literature. Therefore, it is all the more essential to define it and delimit its meaning.

व्युतपत्तिः ॥ Etymology

The term Svasthya (स्वास्थ्यम्) includes स्व (Sva) = self, and स्थ (Stha) = being established (grounded in). The word svastha in its original meaning refers to स्वस्मिन् तिष्ठति इति स्वस्थः। being grounded in one’s Self (Atman) which leads to svasthya, a sense of wellbeing. However, it is also used as a suffix in deha svasthya (देहस्वास्थ्यम्) and manah svasthya (मनस्स्वास्थ्यम्), to refer to physical and mental health and wellbeing. Thus it is used as a generic term. People tend to experience and define svaasthya depending on one’s level of identification at physical, mental and transcendental levels.

Vachaspatyam quotes the term svasthya as applicable in health (आरोग्ये) and contentment (सन्तोषे). The Apte Sanskrit Hindi Dictionary mentions the meanings as

1. self-reliance
2. fortitude
3. sound state
4. prosperity
5. ease

Well-being is an expression commonly used in popular parlance, but does not usually find a place in technical literature. Therefore, it is all the more essential to define it and delimit its meaning in various contexts. In psychological as well as popular parlance the concepts that are used frequently when talking about well-being are welfare, adjustment, adaptation, balance, equilibrium, homeostasis, competence and health. In recent years, the expression 'quality of life' has also come in.

As defined in Oxford Dictionary, the term 'well-being" is equated with "welfare" which in turn is conceptualized as "satisfactory state, health, prosperity". According to Monier Williams Cologne Dictionary it is defined as self-dependence, sound state (of body or soul), health, ease, comfort, contentment, and satisfaction.

Ayurveda's definition of Svastha

Acharya Sushruta has defined the term Svastha as below,

समदोषः समाग्निश्च समधातुमलक्रियः। प्रसन्नात्मेन्द्रियमनः स्वस्थ इति अभिधीयते।। (Sush. Samh.15.48)

Meaning: Svastha means the one who has an equilibrium (सम) of doshas, agni, dhatus and well balanced mala activities (in body) along with energetic/well functioning indriyas (इन्द्रियाणि) and manas (मनः) as well as Atman.

Defining the context of Svasthya or Well-being

The term ‘svasthya’ includes many aspects such as, happiness, energy, leisure, peace with oneself, contentment and sensitivity to environment. Well-being involves not only happiness and pleasure but also experiencing/feeling satisfaction in life, presence of positive feeling or affect (e g. interest, love, surprise, pleasure) and the absence of negative feelings (e.g. anxiety, depression, stress). Well-being is a matter of how one experiences and interprets one’s life conditions. Money, property, power, social standing and prestige provide us with limited sense of well-being. While material prosperity is positively related to self satisfaction to some extent, left unchecked it undermines the well-being of a person.

Goals of indefinite material prosperity, ignoring the human needs of the surrounding people, developing an attitude of insensitivity due to increasing selfishness only leads to an alienation between people, and thereby societies, to eventually chaos and despair. The interrelationship between the social and behavioral sciences have to be accounted for the well-being of both an individual and the society on the whole. Researchers are presenting new findings that the conceptualization of the nature of happiness and well-being primarily depend on the worldview one holds and this aspect has been uniquely dealt with in the Upanishads and other ancient texts of India.

Processes involved in Svasthya

Svasthya denotes a desirable state of affairs of the individual that ensures proper development of his potential so that he is able to meet the various demands of his environment, and satisfy his needs in a socially acceptable manner. And to bring about this "highly desirable state" an organism may undergo transformative processes to maintain equilibrium at the psychological, emotional, and physiological or biological levels. All men desire to avoid every kind of pain, and attain a state of enjoyment and well-being at all times putting an end to all sufferings. But on this earth we cannot have pleasure only and exclude pain altogether. Therefore, during one's earthy existence the best a person can do is to maintain a kind of balance or equilibrium which is itself a state of well-being.

Adjustment

In modern psychological studies, the technical concept that comes closest to describing Svasthya is that of 'adjustment'. Ruch, defines the adjustment process as "the continuous process of attempting to overcome inner and outer obstacles to the satisfaction of biological and social needs". It implies a continuous process of interaction between the individual and his environment and this includes the aspect of maladjustment. Adjustment is equated with those responses which denote harmonious and effective relationship with the environment whereby psychological growth is promoted.

Thompson has spelled out at some length the psychological processes that are associated with a satisfactory state of well-being. He argues that person who makes majority of his adjustments within normal range has learned to do the following:

(i) seek long term gains, deny or delay immediate need satisfaction or short term gains,

(ii) discern between what is socially acceptable and what is not by perceiving the difference between socially acceptable and unacceptable goals that promise to satisfy his needs,

(iii) set realistic goals to avoid stress, to select goals that are realistic and within his grasp,

(iv) practice need based goal setting, select goals for satisfying his needs e.g., compensation mechanism whereby he substitutes, if necessary, his goals that cannot be satisfied,

(v) be accommodative in nature, to vary his behaviour as required for a situation,

(vi) not indulge in fantasy, satisfy majority of psychological needs on "reality level" rather than resort frequently to fantasy,

(vii) develop tolerance for frustration by making goal-oriented rather than ego-defensive reactions to frustration,

(viii) cope with anxiety by tolerating a reasonable amount of anxiety so that his behaviour is not disrupted,

(ix) seek alternative goals to satisfy psychological needs - seek variety of goals to satisfy his psychological needs so that socially unacceptable eccentricities in behaviour patterns is prevented,

(x) accept responsibility of actions and prepare for outcomes - accept natural and social outcomes of his behaviour and plans for future accordingly, i.e., profit from experience, re-evaluate the situation and try another approach,

(xi) maintain healthy relationships and develop warm personal relationships with a reasonable number of associates,

(xii) face future, re-direct his behaviour in terms of past experience and not be psychologically paralysed by guilt feelings over past failures, inadequacies and behaviour transgressions,

(xiii) promote self assurance measures such as self-report that he feels "happy", "adequate" and,

(xiv) identify stressful situations and adopt measures to cope with them without paying a price or getting damaged mentally and physically.

Maladjustment

In a reverse situation to adjustment, the absence of well-being would mean that the individual makes maladjustive responses to the environment so that his needs are not satisfied, and when faced with problem solving situations, conflicts and frustrations, he reacts in what is often termed as ego-defensive ways which hardly enable him to cope successfully with his problems. He experiences unhappiness, anxiety, frustration, depression and so on which are all indicative of absence of psycho-social well-being. Instead of being overwhelmed by intensive anxiety which is debilitating and saps the available energy of the individual so that he is unable to solve the problems, a healthy, adjusted and normal person bounces back from those frustrations, disappointments and disabling states, and continues on his path of goal-oriented behaviour. To use an analogy, the individual is like gold which when put into fire comes out shining and more brilliant.

Homeostasis or being balanced

In its original form, the term homeostasis connotes internal form of self-regulation for maintaining an internal bodily balance or adjustment. From this internal self-regulatory mechanism, the connotation of homeostasis has been expanded to comprise the process of psychological and even compensatory social adjustment. This aspect of avoidance of extremes and thereby maintaining an equilibrium is considered vital to man's health: अति सर्वत्र वर्जयेत् (Ati sarvatra varjayet) or excess is to be avoided everywhere. This is true not only with regard to bodily functions, pleasures of senses, but with the total life and conduct.

Physiological Equilibrium

Freeman observes that an organism or an individual tends to maintain normality against external and internal disrupting agencies by making certain psychological alterations with respect to physical and social surroundings. Thus, homeostasis which connotes an automatic normalizing physiological parameter exemplified by maintenance of body temperature, oxygen and carbondioxide levels, and so on has acquired a psychological connotation to include perceptual, and intellectual functioning of an individual. Homeostasis is a dynamic equilibrium, because the individual is constantly taking corrective/adjustive action to restore the balance.

Holistic Approach in Ayurveda

Acharya Charaka relates the terms Prakrti, Svasthya, Sukha, Arogya, Dhatusamya as synonyms of health. He stresses that disorder is disequilibrium (asantulana) of Dhatus and their equilibrium is health. Having various qualities in right or natural quantities (sama) is considered essential for health. Asantulan (imbalance) is the cause of illness. Being healthy means balance, harmony and equilibrium in all the physiological activities of body and mind. This harmonious situation gives pleasure and eternal happiness devoid of any stress. Ayurveda considers the imbalance of the three Dosha as the immediate cause of all types of disease in the body. It also describes ways to attain mental balance by ‘Sadvrutta’ which means good regimen, a code of conduct for keeping a balanced condition of body and mind. Speaking truth, avoiding losing of temper in any circumstances, controlling passions and desires, not harming anyone are some of the ethical conducts described. Acharya Sushruta also advocates the maintenance of balance (samatva) or equilibrium of the doshas, dhatus, malas and agni in the body to be a Svastha.

Psychological Equilibrium in Sankhya and Shrimad Bhagavadgita

Sankhya darshana greatly stresses on the need for equilibrium of the three gunas or qualities called the Sattva (the element of poise and illumination), Rajas (the element of action and painful (dukha) experiences) and Tamas (the element of passiveness that clouds intellect and produces apathy, indifference and confusion (moha). The relation among the three gunas constituting the world is one of the constant conflict as well as cooperation. It is on the basis of the preponderance of one or the other guna that one becomes intelligent, active or indolent, and experiences various degrees of well-being or otherwise. It is the state of samyavastha or equilibrium of the three that holds the secret to an individual's well-being.

The idea of avoidance of extremes and maintaining a kind of balance or equilibrium in all human functioning is repeatedly considered in Bhagavadgita to be the characteristic of a person who is wise and can enjoy a state of psychological well-being as seen from the references in many slokas.

यदृच्छालाभसन्तुष्टो द्वन्द्वातीतो विमत्सरः। समः सिद्धावसिद्धौ च कृत्वापि न निबध्यते।। (Bhag. Gita. 4.22)

He who is content with what comes to him without effort, is unaffected by conflict, and is free from envy; he is even-minded in success and failure and is not bound even while performing activity.

Even-minded in pleasure and pain, forbearing, ever content, steady in meditation, self-controlled and possessed of firm conviction are a few qualities of a steady minded person as mentioned in the shloka समदुःखसुखः क्षमी।। (Bhag. Gita. 12.13)

Role of Worldview in Svasthya

Underlying any concept of quality of life and wellbeing is a worldview, which provides a perspective on the nature of man, his place in the universe, and on the nature of the universe. Indian society is an amalgamation of the materialistic perspective (hedonistic) at one end, the spiritual perspective (transcendental) at the opposite end along and the various blends of materialistic and spiritual perspectives which is the collectivist perspective.

Charvaka Philosophy - Hedonistic Viewpoint

An exclusively materialist view, Charvaka or Lokaayata philosophy was based on hedonistic perspective which advocates that the fulfillment of desires, particularly of sensory nature, is the sole criterion of well being that leads to pleasure orientation. The followers of this philosophy adopted a totally worldly way of living, and were "sweet-tongued", probably because they supported what most human beings generally think viz., that pleasure is the ultimate aim of life.

This philosophy founded on positivism, admits the reality of whatever we can perceive with our senses and deny the reality of whatever cannot be perceived. Thus many Sanatana Dharma based paradigms such as Atman, Karma, Punarjanma, Dharma and Veda pramana etc. are rejected lock, stock and barrel according to this philosophy. Atman was that consciousness that was peculiar to living human body, which lasts as long as the deha-svasthya was maintained. Mind's function was totally directed outwards to know the world through the senses.

Svasthya according to them was physical health and sensual pleasure. It affirmed the view that life belongs only to this world and ends in this world and therefore one should try to make the best of this life. Man should do whatever is possible to enhance pleasure and avoid pain and any action done for the sake of pleasure is justified. Since pleasure is not possible without wealth (artha), one could beg, borrow or steal or even murder, to have more wealth and more pleasure.

However, in contemporary times we see that there are many indicators to say that this philosophy is taking hold of the Indian psyche. Under the influence of scientific and technological innovations, industrialization, modernisation, open trade policy, westernization and globalisation there is increased consumerism and ‘credit’ cards are becoming popular. It reminisces the famous statement of Charvaka: ऋणं कृत्वा घृतं पिबेत् । rnam krtva grtam pibheth, which means one should drink ghee (clarified butter) even if one has to take credit.

Vedic and Upanishadic Philosophy - Transcendent Viewpoint

On the other end of the psychological spectrum lies the ideal view of reality upheld across Indian traditions. Svasthya as well as Ananda (आनन्दम् । happiness) are purely subjective and do not depend on any objective conditions of reality, including one's state of body-mind-sense complex. This view is rooted in all Vedic and Upanishadic traditions of India. The Vedic and Upanishadic seers emphasized on realizing that which is eternal (नित्यम् । nitya) and permanent (सत्यम् । satya), rather than going after anything that is momentary (क्षणिकम् । kshanika) and that is liable to undergo decay and destruction (क्षरम् । kshara) or impermanent (मिथ्या । mithya) in the universe. This was an aspect of the more fundamental quest to know the ultimate truth, by seer and sages of India. They understood and defined the ultimate truth (concepts of satyam and mithya) with reference to that which is permanent and everlasting rather than that which is impermanent and transient. They applied this distinction in understanding everything in the universe: physical, biological, psychological, ethical, moral, and so on. They made use of this distinction even to evaluate what is good and not good, what is worthy and unworthy, what is desirable and undesirable, etc. So in defining happiness and wellbeing they applied the same rule.

Intuitive recognition of what is permanent and everlasting led to the revealing of an ultimate principle called variously as Brahman or Parabrahman, depending on the sampradaya. Brahman is referred to as having the signs of Satyam (सत्यम् । Existence), Jnanam (ज्ञानम् । Knowledge) and Anantam (अनन्तम् । Infinite). It is all-pervading, omniscient and hence considered as substratum of the universe as per Advaita Vedanta. The Jiva refers to an individual and the personal aspect of the ultimate principle of the universe encased in a Jiva (जीवः) was called as Atman (आत्मन्), the transcendental self. The Upanishadic seers laid out the philosophy that Atman/Brahman were satya (truth) and nitya (everlasting) and urged the human beings to realize Atman as it was the fountainhead of permanent joy or Ananda and helped one to overcome all miseries, sufferings and inadequacies in life. They declared that in this highest state of realization and in this lies the true well-being and welfare (kalyana) of one and all.

Purusharthas - Perspective of Purpose of Existence

While the Charvaka philosophy follows an out and out principle of sensual satiety, the Grhyasutras, Dharmashastras, Smrti granthas and other texts, established principles of a social framework and ground rules for good life, to ensure the well-being of the society. This perspective lies in between the hedonistic Charvaka philosophy and transcendent ideals of the Vedic texts. The ideals and practices of care, healing, and well-being in ancient Indian way of thinking are implicit in Grhya and Dharma Sutras. The former deals with domestic rites and the latter with the regulations for the socio-religious life. Its various aspects are interwoven with many of the other unique reflections and practices, such as: Samskaras, Purusharthas, Panchamahayajnas, and Varnashrama dharmas. As the human being evolved, there came into being the personal notions of "meaning and purpose of human existence" and consequently the conception of wellbeing. For this reason, the seers formulated four major goals of human existence called Purusharthas. They are dharma (values), artha (wealth), kaama (desires) and moksha (liberation). The idea of Purusharthas, is to create a four-fold network regarding what life is about and its connection to the general human quest for meaning and purposefulness. Well-being points to a sense of satisfaction and contentment with life as a whole, as well as an inner sense of feeling at peace with our surrounding world. More than the search for artificial forms of happiness, Hindus are taught to value well-being, a sense of satisfaction with life, as primary to a sense of purposefulness. Thus, they are encouraged to experience sensual pleasures (kama), to pursue profit and material prosperity (artha) and to fulfill their religious and moral duties toward family and society (dharma). A well-lived life requires that one pursue and achieve all these goals, especially during the early phases of one’s life when one marries and raises a family. The significance of moksa as an ultimate aim of life lies in its engendering a particular orientation to this world and its activities. It is the belief that every rebirth is an opportunity for humans to work toward the ultimate goal of liberation, or moksa—to break free from samsara, the never-ending cycle of rebirths and re-deaths. This belief assumes that the world around us, enchanting and seductive though it may appear, is ultimately unfulfilling. So, while enjoying the pleasures that this world has to offer has its place and is important, many recognize that, in the end, such enjoyment is unlikely to be truly satisfying.

Dharma, Samskaras, and Panchamahayajnas - Socially oriented or Collective Perspective

While Purusharthas spell out an individual's goals to lead a meaningful life, the foundation viz., Dharma, encompasses not just an individual's pleasure and need satisfaction but also stresses on socially oriented responses for collective good. As Kuppuswamy notes

प्रभवार्थाय भूतानां धर्मप्रवचनं कृतम्। यः स्यात्प्रभवसंयुक्तः स धर्म इति निश्चयः।। (Mahabharat. Shan. Parv. 109.10)

“Mahabharatha, one of the two great epic poems of India, declares, ‘Dharma is created for the well-being of all creation, ‘all that is free from doing harm to any created being is certainly dharma; for indeed, dharma is created to keep all creation free from any harm’; ‘dharma is so called because it protects all; dharma preserves all that is capable of preserving the universe.’ (Shaanti Parva 109-10, 11, 58)”.

It is complex paradigm to define and has different connotations in different contexts. Broadly speaking, the concept stands for the fundamental order in social affairs and in moral life and is a principle which maintains the stability of society. In the present context, maanava dharma (dharma of human beings), svadharma (dharma of self), and varnaashramadharma (dharma of different groups of people and stages of life) carry weightage in establishing the collective social perspective. Manu defines the characteristics of maanava dharma, as dharma of all human beings sans all kinds of distinctions, which is universal (Manu 6.92). Arthashastra, lists harmlessness, truthfulness, purity, wisdom, freedom from spite, abstinence from cruelty, and forgiveness as the essential constituents of manava dharma. Svadharma refers to a person’s unique potentialities, aptitudes, abilities, likes, dislikes, etc. Ancient Indian thinkers designated individuals into four different groups depending on their guna (a concept which represent both temperamental and motivational traits) and karma (the avocation one is suited to pursue) which is known as varna classification. Ashrama dharmas refer to the prescriptions associated with the four stages of human life.

Samskaras, on the other hand, mark the continuous series of important events in a human life-time and they arose primarily as self-expression of the joys and sorrows experienced during life. In allowing such self-expression these samskaras promote the holistic wellbeing of a person. They depict the social life-cycle of man aimed at shaping the personality of an individual allowing him to enjoy artha and kama within the framework of Dharma.

Panchamahayajnas are directly linked to an individual's responsibility as a caregiver to fellow human-beings, animals and other creatures as well as paying homage to the rshis, ancestors and divine beings. They prioritize care for parents and elders, honouring guests, extending hospitality to all, and demarcate the striving for the well-being of every being.

Ayurveda - Perspective of health

World Health Organization defined the concept of health that ―Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Components of health and well-being are mutually interrelated (WHO, 1948). In Indian traditions, Ayurveda is recognized as a special branch of knowledge of life that deals with body and mind and holistic well-being. The term Ayurveda is derived from two Sanskrit words: Ayus (meaning life) and veda (meaning knowledge or science).

हिताहितं सुखं दुःखम् आयुस् तस्य हिताहितम् । मानं च तच्च यत्रोक्तम् आयुर्वेदः स उच्यते ।। hitāhitaṁ sukhaṁ duḥkham āyus tasya hitāhitam । mānaṁ ca tacca yatroktam āyurvedaḥ sa ucyate ।।(Char. Samh. 1.1.41)

Ayus, referring to the whole of life in its all conditions, is comprised of happiness (sukha), sorrow (duhkha), good (hita), and bad (ahita). Being free from physical and mental diseases and bestowed with vigour, strength, energy, and vitality, along with enjoyment and success, displays a life of happiness (Sukhmayuh). In order to maintain well-being and health, Ayurveda advocates daily and seasonal routines (dinacharya and rutucharya), a healthy diet, exercise, and good conduct. It focuses on attempts to restore the relation of the body to the whole of the cosmos. Such a holistic health perspective is required to fulfil human goals of Purusharthas as mentioned by Acharya Charaka.

धर्मार्थकाममोक्षाणामरोग्यं मूलमूत्तमम् (Char. Samh. 1.1)