AYURVEDIC PSYCHOLOGY

By - Dr. Bhskar Patil

Modern era is a remarkable era in the field of innovation, research

and entire development of mankind. World is going through a phase of
enormous change in the developmental process. If we compare other
centuries and history of evolution, the change in last centuries was
gradual but continuous one. This century denotes radical and fast
change (like mutation) which, to some extent is difficult for a mankind
to cope up with speed of its transformation. This has resulted in lot
more psychological than physical suffering. Developed and
developing countries as well today are facing these problems.
Mental-psychological conditions are almost epidemic
today.- Even children are commonly suffering from these conditions.
The current drug-based medicine is developing special designer
medications to treat these conditions, which try to follow the rule of
radical change, which again becomes difficult for the body to cope up
with and results in reactive phase, named as 'side effects'.
Ayurveda provides the best choice for mind and psychological
disorders through various formulations and allied therapies. This
cultural disturbed psychology requires that Ayurvedic practitioners
have the psychological tools to deal with it. Many of the patients who
come to Ayurvedic practitioners today do so seeking some spiritual or
psychological relief. They will expect that the Ayurvedic practitioner
can handle emotional and spiritual issues and not just treat them on a
physical level. So the role of Ayurveda in psychology is quite important
and Psychology is an integral part of practice of an Ayurvedic
practitioner.
The branch which we describe today as Psychiatry' was termed as
Bhoot Vidya during Veda period. Atharvaveda (of which ayurveda is

upaveda /sub branch) describes this branch in details, of which some

part is mentioned in ayurvedic scripts. Graha chikitsa is one of the
eight branches of Ayurveda, which describes psychological and
spiritual aspect.
All four Vedas- viz. Rig-Veda, Sama-Veda, Yajur-Veda and AtharvaVeda describes mantras, music, art, rituals for the betterment of
mankind. The intension of all these acts is not merely for physical
goodness but is for mental and spiritual betterment of mankind.
From health point of view, Atharva-Veda describes most of this
psychological aspect and Ayurveda explains all these practices in the
form of daily regimen, seasonal regimen, do's and don'ts, behavioral
rasayana etc.

AYURVEDIC PSYCHOLOGY - 2
By - Dr. Bhskar Patil

One of the basic concepts of Ayurveda is constitution / Prakruti.

Ayurveda describes both physical and mental constitution. Mental
constitution is vital in diagnosing and treating the disease and many a
times ignored by Ayurvedic physicians and merely physical
constitution is analyzed. We should know that, mental constitutional
evaluation is as important as physical constitutional analysis.
While examining and treating a patient Sattva Parikshan or mental
examination of a patient is one of the important factors and should be
thoroughly examined by Ayurvedic physician as it is very helpful in
understanding the response of medications prescribed to him.

In case of line of treatment of psychological disorders, threefold

treatment is described. Viz
1) Yuktiva-vyapashraya / Rational therapy:
2) Sattvavajaya / Psychotherapies:
3) Daiva-vyaapashraya / Divine or Spiritual therapies
In case of medications and various formulations described for
psychological disorders it is easy to describe relationship of the
medication with the dosha vitiation and the action of medication.
In psychological disorders Counseling is an integral part of the
treatment. Ayurveda, particularly in the West today, is largely a
counseling based system of medicine. It consists of educating the
patient how to change their life-style to prevent disease from arising
and to optimize their health, as well as to treat specific diseases.
While this may center outwardly on dietary, herbal and exercise
recommendations, it requires an understanding of the psychology of
people. Otherwise we will not have the proper rapport with the patient
to ensure right communication and compliance with treatment
recommendations.
It is not enough in that we as practitioners can arrive at a correct
diagnosis and treatment plan, we must have the counseling skills to
enable patients to effectively implement these.
In case of divine or psychotherapies, many a times it is difficult to
understand the relationship between described procedure and
pathogenesis of disease. In evidence based practices, it is difficult to
show mathematical calculation for the explanation of physiological
and pharmacological actions.

In such situation, we should know basic principles and metaphysics of

Ayurveda. If we look at Pramana, Aptopadesha / Teachings of
Guru's is one of the important pramana's on which Ayurvedic
concepts are based on. Entire Ayurvedic science is based on
Aptopadesha pramana, along with other pramana's.
So as an Ayurvedic practitioner, it is important for all of us to follow the
science with full faith in it and unless and until we do so, it is difficult to
convince and counsel the patient to follow the regimen and take
Ayurvedic formulations and perform the prescribed rituals etc.
Now a days, we are just proving the said effects of particular herb and
formulations and name it as Research. That means we are re searching, already existed/proven things. So instead of wasting time
in re searching it, concentrate on the available proven Ayurvedic
formulations and follow it with full faith and confidence. Positive
results are bound to happen......
Importance of Psychology in Ayurveda Manas or Mind is an integral part of Ayurvedic medicinal system and need to be addressed at
each and every part of physical/mental disease. Without taking into consideration this mind
factor any disease cannot be managed properly. Therefore Psychology is an integral part of
practice of ayurvedic practitioner.
Advantage of Ayurvedic treatment in Psychological disorders:

1. Ayurvedic methods of treating psychological disorders are gentle, natural, and

effective.

2. Ayurvedic therapy contributes to a long-lasting state of balance that reduces the

tendency toward recurrences.

3. It offers a more complete understanding of the nature and causes of psychological

disorders.

4. Ayurveda offers effective treatment without negative side effects and the real
possibility of prevention.

5. It promotes higher levels of psychological health.

6. Ayurvedic methods not only increase the balance in the body, they also
progressively raise the overall level of inner contentment.

OVERVIEW
Healthcare facilities are designed not only to support and facilitate state-of-the-art medicine and technology,
patient safety, and quality patient care, but to also embrace the patient, family, and caregivers in a psycho-socially
supportive therapeutic environment. The characteristics of the physical environment in which a patient receives
care affects patient outcomes, patient satisfaction, patient safety, staff efficiency, staff satisfaction, and
organizational outcomes. The effects can be positive or negative. No environment is neutral.

A healthcare environment is therapeutic when it does all of the following:

Supports clinical excellence in the treatment of the physical body
Supports the psycho-social and spiritual needs of the patient, family, and staf
Produces measurable positive efects on patients' clinical outcomes and staf efectiveness

DESCRIPTION
A. Theory / Background
Therapeutic Environment theory stems from the fields of environmental psychology (the psycho-social effects
of environment), psychoneuroimmunology (the effects of environment on the immune system),
and neuroscience (how the brain perceives architecture). Patients in a healthcare facility are often fearful and
uncertain about their health, their safety, and their isolation from normal social relationships. The large, complex
environment of a typical hospital further contributes to the stressful situation. Stress can cause a person's
immune system to be suppressed, and can dampen a person's emotional and spiritual resources, impeding
recovery and healing.
Healthcare architects, interior designers, and researchers have identified four key factors which, if applied in the
design of a healthcare environment, can measurably improve patient outcomes:

Reduce or eliminate environmental stressors

Provide positive distractions
Enable social support
Give a sense of control
Research on completed projects by organizations including the Center for Health Design, Texas A&M University's
Center for Health Systems Design, the Academy of Neuroscience for Architecture, and by a growing number of
architectural firms and their clients shows measurable benefits to patient outcomes, safety, and quality of care,
from such factors.
The application of these factors has been focused on the patient and patient's family. However, there are also
recognized potential benefits for staff and caregivers in terms of satisfaction, effectiveness, and staff retention,
from environmental factors such as:

Noise reduction
Same-handed patient rooms

Access to daylight
Appropriate lighting
Providing 'of-stage' areas for respite
Proximity to other staf
Appropriate use of technology
Decentralized observation, supplies, and charting
The benefits staff receive from these environmental factors may impact the quality of care patients experience.
(For more information on design of effective workplaces, see WBDG Productive Branch.)
In general, Therapeutic Environments have been proven to be cost-effective by improving patient outcomes,
reducing length of stay, and by enhancing staff satisfaction, recruitment, and retention of staff.
Additional Information on Theory/Background

AIA Academy of Architecture for Health

Architecture and the Mind, John Eberhard, FAIA
Exploring Pathology: Relationships between Clinical and Environmental Psychology, Kathryn
H. Anthony and Nicholas Watkins. From Handbook of Environmental Psychology (pp. 129-146), R.
Bechtel and A. Churchman (Eds.) New York: John Wiley & Sons, 2002.
Hospital Interior Architecture: Creating Healing Environments for Special Patient
Populationsby Jain Malkin. New York: John Wiley & Sons, Inc., 1992.
"How Design Impacts Wellness" by Roger Ulrich, Ph.D.. Healthcare Forum Journal, 1992.
Humanscape: Environments for People by Stephen Kaplan, and Rachael Kaplan. Ann Arbor,
MI: Ulrich's Books, Inc.
Inquiry by Design, John Zeisel, 2006 Edition.

B. Practice
To create a therapeutic environment, all members of the design teammedical planner, architect, engineer,
interior designer, site and landscape designer,are responsible for using the power of design to find solutions
that will affect the patients and staff in positive ways, throughout the facility; from the parking lot, approach, and
entry, to the public spaces, clinical spaces, and ultimately the patient room. Following are some specific design
criteria that are used or are being studied:
Reduce or Eliminate Environmental Stressors
For example:

Artwork and aesthetics can enhance the soothing and calming qualities of a space
Adequate space should be provided in public areas and waiting rooms to avoid crowding
Perceived waiting time can be mitigated by positive distractions
Visual and noise privacy
Odors that are objectionable or 'medical' can create stress
Wayfinding; the built environment should provide clear visual cues to orient patients and
families, and guide them to their destination and return. Landscaping, building elements, daylight,
color, texture, and pattern should all give cues, as well as artwork and signage
Reduce or eliminate sources of noise; other patients, public address systems, equipment
'clatter', loud conversations at nurse stations
Acoustical treatment of corridors adjacent to patient rooms; carpet tiles, rubber flooring
Acoustical separation of staf work areas from patient rooms; "even low noise levels (40-58
dB) combined with poor acoustics can reduce sleep quality and negatively afect other outcomes"
(Roger Ulrich, Ph.D., Healing Environments Virtual Seminar, AIA, 2003)
Appropriate lighting systems; "lighting can be a stressor that alters mood, increases stress,
disrupts daily rhythms, and modulates hormone production" (J. Roberts, Ph.D.)

Provide lighting that supports natural circadian rhythm; "Provide natural daylighting where
possible, or bright white lights (400-600nm) in the daytime. Ensure absolute darkness in the
evening; for nighttime movement only red lights (650-700nm) should be present in the rooms." (J.
Roberts, Ph.D.)
Maintain good indoor air quality; 100% outside air where climatic conditions allow
Color, while subjective, can be a design factor in reducing environmental stress when
understood and used in the context of the color preferences of a project-specific population.
Additional Information on Reducing Environmental Stressors

Patient Room Prototype (PDF 4.87 MB), Graduate Studies in Architecture + Health, Clemson
University, 2003-2004.
Ambulatory Facility Design and Patients' Perceptions of Healthcare Quality, Franklin Becker,
Ph.D., B. Sweeney, K. Parsons. Health Environments Research and Design Journal, August 2008.
"Color in Healthcare Environments; a Critical Review of the Research Literature" Coalition
for Health Environments Research
"Light and Immunomodulation" (PDF 443 KB, 11 pgs) by Joan E. Roberts, Ph.D. Department of
Natural Sciences, Fordham Universityimpact of light on the immune system
Mental health and the built environment: More than bricks and mortar?, David Halpern.
Bristol, PA: Taylor & Francis Ltd., 1995.
"Reducing noise pollution in the hospital setting by establishing a department of sound: a
survey of recent research on the efects of noise and music in health care." Cabrera, IN; Lee, MH,
Preventative Medicine, Volume 30, Number 4, April 2000 , pp. 339-345
When buildings don't work: The role of architecture in human health, Gary W. Evans and
Janetta M.M. Journal of Environmental Psychology, 18, 85-94, 1998.
Provide Positive Distraction
For example:

Views of nature, from patient rooms, and wherever possible in lobby, waiting, and other
'high stress' areas
Access to nature, healing gardens
Chapel, meditation room, and meditation gardens
Artwork depicting nature, including back-lighted photographs of nature
Music; live piano in public area, recorded music in patient room when programmed
specifically to create a healing environment
Mild physical exercise; corridors, public spaces, and gardens that invite walking when
appropriate
Pets and other activities or elements that allow for a sense of stimulation that help nurture
a patient's sense of positive well-being
Additional Information on Providing Positive Distraction

Art for Health Care; American Art Resources

Art Research Institute, A unique Interior Architecture for High Stress Treatment and other
Clinical areas, featuring the orginal imagery of internationally-acclaimed photographer Joey Fischer
Distinctive Art Source
Healing gardens: Therapeutic Benefits and Design Recommendations, C.C. Marcus and M.
Barnes (Eds.) New York: John Wiley & Sons, Inc., 1999.
Healing Healthcare Systemsmusic programming
Sky Tiles, Luminous Sky Tilesscenes of nature
Enable Social Support
For example:

Family zone in patient room; with furniture for sleeping, phone and internet connection,
reading light with separate control, and out of the way of staf

Provide places where patients can engage socially with family and other caregivers, such
as the Planetree feature of a Family kitchen on inpatient units where family members can prepare
food for patients and families to eat together
Provide accommodation for accompanying family member to be with patient throughout
the examination and treatment process
Organize Family Focus Groups and Patient and Family Advisory Councils to be an active part
of the design process, tuning in to the specific needs of the population and community to be
served, as recommended by the Institute for Family-Centered Care
Ensure culturally appropriate environments
Consider sociopetal versus sociofugal spaces: Sociopetal spaces facilitate social behaviors
and the development of social groups (nonfixed seating, round tables, etc); see Sommer, R. below
Additional Information on Enabling Social Support

Caring for Patients from Different Cultures by Geri-Ann Galanti. University of Pennsylvania
Press, 2003.
Institute for Family Centered Care
Personal Space: The Behavioral Basis of Design by Robert Sommer. Englewood Clifs, NJ:
Prentice-Hall, Inc., 1969
Putting Patients First: Best Practices in Patient-Centered Care, 2nd Edition by Susan B.
Frampton, Patrick A. Charmel, Planetree, Eds. New York: John Wiley & Sons, Inc., 2008. (2009,
Jossey-Bass)
The Design of Psychologists Offices; A Qualitative Evaluation of Environment - Function
Fit by Kathryn H. Anthony and Nicholas Watkins. Academy Journal, 2007.
Through the Patient's Eyes: Understanding and Promoting Patient-Centered Care by
Margaret Gerteis. Jossey-Bass, 1993.
Give a Sense of Control
The ability of the patient to control the environment directly contributes to successful patient outcomes. A sense
of control extends from privacy and lighting to choosing artwork being hung in the patient's bedroom during the
hospitalization, to ordering meals from room service.
For example:

Private patient rooms result in better outcomes, according to recent studies commissioned
by the Facilities Guidelines Institute and conducted for CHER (see below)
Give the patient as much privacy and control over it, as is consistent with the need for
nursing supervision
Give the patient control over the immediate environment; i.e., radio, TV, reading light,
night light
Wayfinding; the built environment should provide clear visual cues to orient patients and
families, and guide them to their destination and return. Landscaping, building elements, daylight,
color, texture, and pattern should all give cues, as well as artwork and signage
Provide mini-medical library and computer terminals so patients can research their
conditions and treatmentsas in the Planetree model
Choice of lighting; patients and staf can benefit from personal dimming controls
Choice of artwork
Volume and programming control of televisions in waiting areas
Room service/menu selection
Storage area for patient belongings
Additional Information on Giving a Sense of Control

Clanton & Associates,information on lighting controls

Planetree
St. Charles Health Systemsexamples from their successful programs and facilities

"The Use of Single Patient Rooms vs. Multiple Occupancy Rooms in Acute Care
Environments"(PDF 7.9 MB), by Habib Chaudhury, Atiya Mahmood and Maria Valente, Simon Fraser
University, November 20, 2003.

C. Tools
Every healthcare project should begin with a review of existing available literature on design interventions that
have been proven to improve patient outcomes, staff effectiveness and patient safety, and a decision made with
the users as to how each one might apply to the project, and what outcomes / benefits would be expected.
Checklists can assist designers and users in evaluating existing conditions and in setting goals for new facilities
planning and design. Design goals that are set and clearly defined at the beginning of a project can serve as
research questions to be answered by Post-Occupancy Surveys, data collection, and evaluation.
Additional Information on Tools

The Picker Institute's checklist for patient-centered care is available as part of a design
action kit, "Through the Patient's Eyes"
"Healing Environments" by Barbara J. Huelat, ASID. Medezyn, 2003.The author shares
several of her checklists for designing for the body, mind, and spirit.
Institute for Family Centered Careresources for design planning
Create your own and share it...!

D. Operational Models
Aligning the healthcare organization's operational model with the design goals early in the process is a key to
success in creating a collaborative, emotionally, spiritually, and socially supportive environment.
Additional Information on Operational Models

Healthcare Design Magazine, "Relating Facility Design to Organization Design" by Kirk

Hamilton, FAIA, FACHA. September 2003.

E. Research and Evidence

Research plays an important role in helping us continue to better understand the effects of the healthcare
environment, and identifying opportunities to make it an active agent for healing. A growing body of evidence is
emerging from research in several fields. Three kinds of research are being pursued: