1.       Introduction 

Ayurveda, the ancient Indian science of medicine is directed towards positive health. It aims at studying man in his social, religious, seasonal, climatic and regional environment. It is known as Ashtanga Ayurveda because of its eight disciplines. Bhoot vidya, one of them, refers to the study of psychological & emotional disorders. After studying Ayurveda in general & Bhoot vidya in particular, one observes that there is more emphasis on maintenance and preservation of normal physical & mental health than on the treatment of any disease or illness. Moreover, the role of life style, life goals, personality, and dietary, cultural & social habits in health is highlighted. Medications have been assigned a secondary role. We have now understood the limitations of modern medicine. Most of the illnesses except acute infections require long term treatment e.g. Diabetes, Hypertension, Cardiac disorders, Rheumatic disorders etc. It is only recently that physicians trained in modern medicine have studied the role of personality, life style, dietary & social habits in genesis & perpetuation of these disorders. One may say that ancient Indian medicine begins where modern medicine ends - when acute phase of an illness is over and efforts must be directed to maintain normal health & well being. 

2.       Definition of Health and Normality 

Health and normality have always remained elusive to define. The presence of health goes unnoticed; it is only the disease (disease) or illness which is noticed immediately. Normality or health has been variously described as absence of illness, presence of average health, presence of ideal health, health as adaptation etc. None of these definitions is completely satisfactory. World Health Organization (WHO) had defined health as “not merely the absence of disease or infirmity but positive physical, mental, social & spiritual health”. However, this definition is ambiguous, idealistic and can’t be used in practice [1,2]. 

Patanjali has defined health as “Optimal utilization of one’s physical, intellectual and emotional faculties to maintain harmony with self without undue preoccupation with the environment.” This definition is easily the best among all other definitions. It takes into account capabilities of an individual and emphasizes harmony with self. It stresses to avoid undue & excessive comparison with others which is a major source of unhappiness. 

Sushruta has not defined health but has elaborated certain parameters of health. They are 1) Samdosha - equilibrium of body humours, 2) Samagni - uniform healthy digestion, 3) Samadhatu - normal body tissues, 4) Malakriya - normal process of excretion and 5) Prasannatmanendriyamana - coordination of functions of body organs, mind & soul to maintain happiness. 

3.       Structure and Function of Mind

Kapil muni has discussed in detail the constituents of human being consisting of twenty-five elements. 

A.      Panchmahabhutas - the five great elements - 1) Prithvi (Earth), 2) Jala (Water), 3) Vayu (Air), 4) Akasha (Sky), and 5) Tejas (Sun)

B.      Sense Organs - 6) Eyes, 7) Ears, 8) Nose, 9) Tongue, 10) Skin

C.      Motor organs - 11) hands, 12) Feet, 13) Speech, 14) Excretory function, 15) Reproductive function.

D.       Tanmatra or perceptual processes - 16) Vision, 17) Hearing, 18) Odour, 19) Taste and 20) Touch.

E.      Directive elements - 21) Cognitive apparatus - helps to process and appreciate experiences received through sensory organs & tanmatra. 22) Intelligence, 23) ‘I‘concept, 24) An element which is source of all, and 25) An element which directs, creates, maintains & organizes. 

Patanajli has observed that there is a constant rhythmic interaction & harmony between all the element of mind i.e. Cognitive apparatus, Psychological self, Physical self and Social self (Figure 1). The shat ripus (six foes) - Kama (lust), Krodha (anger), Lobha (greed), Mada (Pride or aggression), Moha (desire), and Matsar (jealousy) or the primary instincts increase the vulnerability of an individual. These can be compared to the Id in Freudian terms.

4.       Life Style and Life Goal 

An individual was prescribed certain nodal functions according to his age & social status; which were known as the four Ashramas. The Brahmacharyashrama covered late childhood, adolescence and young adulthood. The person was supposed to reside with his teacher (and teacher’s family) along with other students known as Gurukul (clan of the teacher). Besides formal education they were taught martial arts, religion & morality. The teacher taught the students according to their ability, aptitude & inclination. A student was also expected to participate in the day to day household chores cooperatively with other students. 

In Grihasthashrama, an individual got married, established his household & raised his family. He was directed to pursue Dharma (Religion), Artha (money), Kama (sex) and Moksha (Enlightenement & Emancipation of soul). In Vanprasthashrma, the individual was supposed to relinquish his desires in the material world and retreat to a quiet place. He still maintained interest in his family affairs & offered counsel & guidance whenever solicited. In Sanyasashrama, the detachment from the worldly affairs was complete and the person spent his time in spiritual activities & in contemplation. If this system is followed today, the problem of generation gap and disturbed family relationship would be greatly reduced. 

The Chaturvarna (four categories) system emphasized that a person takes up a vocation which suited his temperament, physical & intellectual abilities. The four basic vocational categories were Brahman (engaged in religious, philosophical & intellectual activities), Kshatriya (engaged in physical activities & in defense - warrior clan), Vaishya (engaged in trading, farmimg, artisan etc) and Shudra (engaged in menial labor). Of course over a period of time this system degenerated and became a tool of exploitation and discrimination against the weak. Each basic vocational type advocated an archetypal mode to achieve Moksha. Brahmans were advocated Bhakiyoga, Kshatriyas Karmayoga & Vaishyas Rajayoga. 

A person was extorted to keep only a quarter of his earning for himself, second quarter for any unsolicited guest (symbolizing the needy & underprivileged individual), third quarter for cow (symbolizing mother earth & concern for animal kingdom) and the last quarter for the priest (symbolizing the religion & the state). This system is not much different from the present day direct & indirect taxation! There were some philosophers like Charvak who advocated materialism. His advice was to enjoy life here & now without any regards for the consequences or the future. - Rinam kritva ghritam pibet (May you borrow and enjoy ghee). Though some did follow such bohemian life style, it was not a standard practice. 

5.       The System of Trigunas & Tridoshas 

The complementary triad of Trigunas (Sattva, Rajas & Tamas) and Tridoshas (Vata, Kapha & Pitta) represent dimensions of personality & constitution respectively. The food & diet were also classified according to this system to indicate foods which facilitate or inhibit the gunas or doshas. 

5.1.  Trigunas or Personality Types 

A)                 Satvika - intellectual, pure, strong, healthy, possessing long life & equanimity.

B)                  Rajasik - emotional, passionate, fiery & restless.

C)                 Tamasik - vegetative, ignorant, dull. (comparable to mental retardation) 

5.2.  Tridoshas or Constitutional Types 

A)                 Vata - ashthenic body build, tall & lean.

B)                  Pitta - pyknic body build, short & obese.

C)                 Kapha - athletic body build, muscular, well built. 

Effect of food - Food should be consumed to subdue the dominant element. Satvik guna is facilitated by food which is sweet, agreeable to taste. Rajasik guna is facilitated by sour, pungent, salty, spicy food. Tamasik guna is facilitated by stale, foul smelling food. Vata dosha is subdued by sweet, sour & salt and is aggravated by pungent, bitter & astringent food. Kapha is subdued by pungent, bitter & astringent and is aggravated by sour & salty food. Pitta is subdued by astringent, sweet & bitter, and aggravated by pungent, sour & salt. 

6.       Psychiatric Disorders 

Unmad was the term for psychosis. Mental disorders were named after Gods & devils. The terminology & clinical picture does not correlate well with the modern terms. However approximate & loose correlation is as follows - Endogenous disorders were provoked by humour or tridoshas. They are a) Vatonmad - similar to schizophrenia, b) Pittonmad - mania, c) Kaphonmad - depression, and d) Tridoshanmad - Depression. Exogenous disorders resembling schizophrenia were - Bhujang graha vyadhi, Rakshasa graha vyadhi, Pishachha graha vyadhi, asura graha vyadhi etc. Those resembling mania were - Daiva graha vyadhi, Yaksha graha vyadhi & Gandharva graha vyadhi. Pitru graha vyadhi resembled depression [3]. 

The following factors were described as causative:

1) weak will & nervous temperament; 2) wrong diet; 3) Lack of healthy habits; indulgence in wrong activities; 4) preoccupation with shat ripus; 5) preoccupation with something; 6) exhaustion and 7) demonological possessions. 

7.       Yoga and Mental Health 

Patanjali defines Yoga as Chitta Vritti Nirodha (Regulation of the turbulent forces of the mind). Abhyasa (Regular practice) and Vairagya (detachment) are essential to master Yoga. Yoga aims to lessen the five kleshas (afflictions) i.e. avidya (ignorance), asmita (egotism), raga (personal likes), dwesha (personal dislikes) and abhinivesha (possessiveness). Yoga consists of eight steps (Ashtanga Yoga). The first two, Yama & Niyama are social & ethical in nature. The next three Asana, Pranayama & Pratyahara are methods to discipline the mind. The last three, Dharana, Dhyana & Samadhi are crucial for enlightenment, emancipation of soul & to be with the God almighty [4]. 

1.       YAMA - comprises of five abstensions. a) Ahinsa (non violence), b) Satya (truthfulness), c) Asteya (not stealing or avoidance of misappropriations in thought & action), d) Brahmacharya (sexual abstinence, some interpret as regulated sexual activity) and e) Aparigraha (non acquisitiveness).

2.       NIYAMA - has five observances. a) Shauch (purity in thought, word & action), b) Santosh (contentment), c) Tapas (self-denial, not to pamper body), d) Swadhyaya (self-enlightenment, objective study of self) and e) Ishwara pranidhana (submission to God’s wil, being one with the God).

3.       ASANA - right posture conducive for meditation.

4.       PRANAYAMA - right breathing technique, regular, slow, deep breathing with proper pauses.

5.       PRATYAHARA - to keep one away from distracting stimuli so as not to disturb meditation.

6.       DHARANA - concentration

7.       DHYANA - meditation

8.       SAMADHI - the ultimate step which implies contemplation leading to enlightenment 

9.       Gita and Mental Health 

Gita along with upanishadas and Brahmasutras form Prasthan trayi (scriptural trinity, helpful in the journey towards enlightenment. Gita is based partly on Ishavasyopnishad & Kathopnishad and on the philosophical systems of Sankhya & Yoga. The eighteen chapters of Gita with over seven hundred verses form an inset in the Bhishma parva of Mahabharata. Gita period is interpolated between the end of Upanishadic period and the elaboration of shat darshanas (six systems of Indian philosophy - Sankhya, Yoga, Nyaya, Vaiseshika, Mimansa & Vedanta) i.e. around the 3^rd & 4^th century B.C [5]. 

Gita is the forerunner of modern concept of tripartite mental functions, namely cognition (dnyana), conation (karma) and affect (ichcha or emotionally tinged desires or Bhakti). The inaugural verse of Gita, which incidentally is the only one from Dhritarashtra - “Gathered together at Kurukshetra, the field of religious activities, what, O Sanjaya, did my war inclined sons & those of Pandu do “Is a fine and elegant simile that epitomizes the natural state of affairs of human mind and the disturbing forces within it. The mind is like a veritable battle field. The whole of Gita is in reply to this question. The personality in Gita is compared to a chariot drawn by horses - the horses represent the senses, & buddhi is the charioteer, the reins denote the mind. Gita advocates the attainment of a state of evenness of mind - Samatham, its steadiness - Sthit pradnya and peace - Shanti. 

Gita illustrates exemplary psychotherapy. Lord Krishna represents the master healer of the minds of humanity while Arjuna symbolizes the person in a state of anguish. Gita depicts the arousal of gloomy & dejected Arjuna who is torn between intellectual doubts, ethical dilemma and filial bondage. Arjuna’s arousal is from three areas of inactivity - from ignorance to knowledge, from apathy to a positive feeling and from inertia to purposeful activity. It is important to note that the healer Lord Krishna did not force the ideas but suggested that certain things have been discussed & it was up to Arjuna to act as he likes. (Yatha ichchati tatha kuru). In psychotherapy to the client is not taught or forced to do certain things but is encouraged to choose positive & viable option after intellectual and emotional discussion. The final decision to act was taken by Arjuna while Lord Krishna only cleared his doubts. However, Lord Krishna gave advice in such a manner that Arjuna was left with no alternative but to fight! Table 1.

10.   Concluding Remarks 

The ancient Hindu texts - Vedas, Upanishads, Shrutis, Smrutis and Puranas house literally a treasure trove of knowledge. The time has come to perform the Amritmanthan (symbolic churning of the ocean of knowledge) once again to recover gems of knowledge from the ancient Hindu texts.

Figure 1: Patanjali’s Concept of Mind. Cognitive apparatus (I sense) is superimposed by psychological self which in turn is superimposed by physical self & social self.

Table 1: Determinants of Psychopathology.

1.       Gupta SP (1977) Psychopathology in Indian Medicine - Ayurveda. Aligarh. Ajay publishers. 1st Ed. P. 223

2.       Neki JS (1975) Psychotherapy - Past, Present & Future. Am J of Psychotherapy 29: 92.

3.       Verma LP (1965) Psychiatry in Ayurveda. Indian J Psychiat 7: 292.

4.       Verma LP (1979) Yoga, Meditation & Mysticism. Indian J Psychiat 21: 293-304.

5.       Rao VA (1980) Gita & Mental Sciences. Indian J Psychiat 22: 19-31.