AAMJ ISSN: 2395-4159 Review Articleaamj.in/wp-content/uploads/Volume2/Issue5/AAMJ_994_1000.pdf · ISSN: 2395-4159 Review Article Clinical Implementation of the ... Homa, Havana, Japa,

AAMJ / Vol. 2 / Issue 5 / September – October 2016

A A M J Anveshana Ayurveda Medical Journal

www.aamj.in ISSN: 2395-4159

Review Article

Clinical Implementation of the Satvāvajaya Chikista in Ayurvedic

Paediatric Practice

Devendra Kumar 1 Shrinidhi K Acharya 2

A b s t r a c t

Satvāvajaya Chikista is the third form of the treatment in Ayurveda which form a rational treatment for

disturbances of the mind. Satva is the synonym of the mind and treatment aimed to optimse its different

facets are called as Satvāvajaya Chikista. The definition of the Satvāvajaya Chikista is– Satvāvajayo

punar ahithebhyo arthebhyo mano nigraha, i.e. the treatment is mainly aimed to control, regularize

motivate, guide to right inclination of the mind. This is also related with prevention of mind being gets

exposed to unusual, abnormal unethical life style, proper education training, desensitization against

which are unwholesome factors. In total mind should be prepared to differentiate between good

and bad immediately after its exposal to external environmental hazards, unconfused and able to

take a decision by keeping interest of healthy status of body Daivavyāpāśraya Chikista is basic pre-

requisite before any kind of disease or treatment which is aimed to prepare the mind towards positivity,

faith and hope. Faith towards a visible or invisible entity cuts off many undue negative feeling of the

mind. Similarly fixing the mind to an invisible power like Daivikaśakti not only restrict the flow of

negativity but also reduces the stress and creates a new hope. Practical implementation of principles

of Satvāvajaya Chikitsa and Daiva Vyāpāśraya chikitsa are very beneficial although now it is followed

on a randomized way without a fixed protocol. Although it is quite challenging as psychological pa-

rameters of individuals vary a lot from person to person there should be some fixed guideline in the

form of protocol with scope of modification is quite essential. Hence this article highlights certain points

which should be kept in mind to prepare clinical protocol and counseling module as per principles

Satvāvajaya Chikitsa which can be effectively practiced in clinical practice.

Key words – Ahita, counseling, Daiva Vyāpāśraya Chikitsa, Daivika Śakti, faith, Satvāvajaya chikitsa

1 PG Scholar, Assistant Professor, Department of P.G. Studies in Kaumarabhritya, National Institute of

Ayurveda, Jaipur.

CORRESPONDING AUTHOR

Dr. DEVENDRA KUMAR

PG Scholar,

Department of P.G. Studies in Kaumarabhritya,

National Institute of Ayurveda,

Jaipur, Rajasthan, (India).

Email: [email protected]

Devendra & Shrinidhi: Clinical Implementation of the Satvāvajaya Chikista in Ayurvedic Paediatric Practice

AAMJ / Vol. 2 / Issue 5 / September – October 2016 995

INTRODUCTION

ccording to Ayurveda, Chikista Puruṣa is the

adhiṣṭāna for all types of Roga and obviously

treatment should be aimed to same. Chikista

Puruṣa is the combination of physical and the mental

elements with soul as administrator guided and motivat-

ed by Manas. Combination of above with integrated

functioning of Indriya establishes the homeostasis of

the body. As Manas guides the physical body treat-

ment for motivating the same in the right path to bring

back the equilibrium of mental facets of Chikista Puruṣa

is the key factor which ultimately results even in normal-

cy of physical derangements. Combination of Satva,

Indriya and the Ātma is also called as Anthakaraṇa

which always guard the mental stability of the Puruṣa [i].

Ātma from whom the creation of universe begins, simi-

larly inside the physical body too, all manifestations are

related with Ātma. The Śārīrika and the Mānasika

Doṣas are mutually inter-related; hence a single psycho-

somatic existence of the life is made possible. Manas

plays a very significant role in maintaining psycho so-

matic existence of the life as it is mediator in this unit

and acts like a guide for Ātma. It not only scrutinizes

the matters (Viṣaya), but also motivates the Ātma to-

wards the positivity, hence called as Satva

(Pravarthaka). Ātmaguṇa i.e Buddhi has got direct in-

fluence of Manas hence obviously knowledge of good

and bad, and all sort of perception ,happiness

and grief experienced by the Ātma depends on accu-

racy, ability, inclination, observation, positivity, orienta-

tion and functional capacity of the Manas. However,

physical body always responds to the commands of

the mind hence variations in magnitude of qualities of

mind like Satva, Raja, Tama leads to reciprocal chang-

es in Pitta, Vāta and Kapha. Hence it is rightly told that

Mana is responsible cause (Kāraṇa) for Bandha and

Mokśa.[ii]

So efforts of keeping the mind under normalcy and

equilibrium is the best possible remedy to combat all

possible Dhukhās of the body (that is disease). Con-

trolling the fluctuating mind from its abnormal deviation

towards unhealthy physical and psychological activities,

unhealthy food and life style and directing the same in

the right path is the ultimate solution to all existing

problems of the mankind. Rightly psycho somatic ap-

proach in the treatment has been explained by Ayur-

veda as evidenced by Chikista Prakāra (Treatment

modules) Daiva, Yukthi and the Satvāvajaya. Two of

them are for mental faculty and one for physical faculty

(Yukthi).[iii]

Daivavyāpāśraya Chikitsa is basic prerequisite before

any kind of disease or treatment which is aimed to pre-

pare the mind towards positivity, faith and hope. Faith

towards a visible or invisible entity cuts off many undue

negative feeling of the mind. Similarly fixing the mind

to an invisible power like Daivikaśakti not only restrict

the flow of negativity but also reduces the stress and

creates a new hope. Once the mind has been lifted

towards positivity by faith, later it is easy to correct the

homeostasis of mind, in turn that of body. Same has

been achieved in Ayurveda by following Daiva

Vyāpāśraya Chikitsa in Ayurveda through different

Mantras, Maṇi, Mala auspicious and religious ceremo-

nies, like Bali, Homa, Havana, Japa, and Swasthi

Vāchana. Etc. Rudra pūja in Unmāda and Apasmāra.

Jwara, Viśnusahasranāma in Viṣama Jwara, Bali, Homa

etc. in Graha Rogas are few of the examples[iii]. This

has been the right approach to deal with disorders of

psycho somatic nature, and as per Ayurveda all disor-

ders carry tendency of same.

Yukthi Vyāpāśraya is like a rational treatment based on

the reasoning and with necessary planning. Causative

factors and symptoms and pathological changes in

the disease is identified and a suitable treatment to

bring back the body elements to normalcy has been

employed. Fundamental principles of the Ayurveda like

Sāmānya – Viśeṣa Siddhānta, Loka Puruṣa Vāda[v] were

kept in the mind during management.

General description

Satvāvajaya Chikista is the third form of the treatment in

Ayurveda which form a rational treatment for disturb-

ances of the mind Satva is the synonym of the mind and

treatment aimed to optimse its different facets is called

as Satvāvajaya Chikista[vi]. The definition of the

Satvāvajaya Chikista is – Satvāvajayao punar

ahithebhyo arthebhyo mano nigraha, i.e. the treatment

is mainly aimed to control, regularize motivate, guide to

right inclination of the mind. This is also related with

prevention of mind being gets exposed to unusual, ab-

normal unethical life style, proper education training,

desensitization against which are Ahitas (unwhole-

some factors) . In total mind should be prepared to dif-

ferentiate between good and bad immediately after its

exposal to external environmental hazards, unconfused

and able to take a decision by keeping interest of

healthy status of body and mind [vii].

The word ‘Artha’ carries a wide range of meaning

and covers all possible knowledge acquired by the

sense organs including Manas which is

Ubhayendriya. Gandha is the special Artha of the

A



Ghraṇendriya and if Rasanendriya is not able to

avoid itself from excess eating and violate all the rules

of Mātrāvath Āhāra Lakśaṇa, then the same is referred

as Ati yoga of Rasanendriya Artha and this may be

root cause of certain disorders. Meanwhile abnormal

functioning of Rasanendriya leads to the Mithyā yoga

of Rasanendriya Artha. On conveying this knowledge

of Athi and Mithyā Yogas to the mind, it should take a

final decision and proceeds further. An error commit-

ted by the mind, at this stage leads to Pragñyāparādha

and becomes a cause of the future disease. As Mans is

Ubhayendriya it has got its control over both sen-

sory and the motor functions. Right decision taken by

mind in spite of a strong sensory perception for

Athiyoga, denote a healthy thinking mind which refuse

to react it by withholding the motor response to it .

An unhealthy, disturbed mind can commit an error at

this juncture and leads to squeal of manifestations in

future. Same is also true for the other objects of

Indriya. Similarly when a person is exposed to loud

sound for long time and mind fail to take a decision to

avoid it and gets acquainted with it in due course

of time may leads to stress and psychological disturb-

ances . Meanwhile habit of perception of low frequency

and less audible sounds leads to Hīna yoga. Listening

high frequency sounds with variable frequency very

close to ear like mobile head phones leads to

Mithya yoga of the Śabda Artha. When these varia-

bles are accepted by the mind, becomes the cause of

the disease. The factors which helps the mind to take a

stable, firm and right decision with interest of healthy

body and mind i.e. Samyak Artha Grahaṇa is nothing

but Dhī, Dhṛti, and Smṛti[viii].

Dhī or true knowledge (Samam Buddhi hi Paśyathi)

helps the mind to identify the actual fact and its conse-

quences on body, when any matter is presented before

it. This is the tool for the formation of right thought,

which later leads to right decision. So this is a cogni-

tive ability of the mind which constitute the thought

by proper reasoning, planning, attention and the anal-

ysis which further leads to proper decision. Excess

consumption of alcohol where the mind fails to make

right thought as result it may take wrong decision. In

paranoid personality mind identify a person with false

knowledge and wrong thought and suspect everybody.

When person refuses offer of an illegal activity is right

thought and decision with well identified truth of its

bad effects. So when each objects are proposed in

front of mind should able to perform this highly cogni-

tive function failing which will leads to disequilibrium

in the status of Mind[ix]. Therefore it is told that Samam

Buddhi hi Paśyathi that is objects should be perceived

with their true knowledge.

Dhṛti (Dhṛti hi niyamāthmaka) once the true knowledge

is identified and decision has been taken same has to

be retained, supported, and stabilized further. Mind is

constantly gets exposed to lot of sensory and motor

stimulus in every second and original decision need not

to be tampered. To prevent the hurdles to already en-

coded thought and truth, mind has to fight constantly

with other secondary level thought process which arises

from continuous flow of Artha (objective knowledge.) to

mind and prevent its manipulation. So Dhṛti does the

function of thought integration and process it and guid-

ance for its external representation. Depending on the

capacity of Dhṛti, personality and the behavior of the

individual changes. Control offered by Dhṛti regulates

the out bursting of emotions by clearing confusion

which hurdles in the path of true knowledge .A person

who know that alcohol is dangerous to health, some-

time fail to retain and stabilize and permanently inte-

grate this truth in absence of Dhṛti & become alcohol-

ic. Attitude and behavior of person will be always vul-

nerable to fluctuate in the deficiency of Dhṛti as occur

in case of behavioral problems. Person with right per-

ception may also commit mistakes in execution if Dhṛti

is not controlling the mind. Therefore it is told that Dhṛti

hi niyamāthmaka.[x]

Third entity which guides the Manas to take the proper

decision is Smṛti. Basically when a stimuli is presented

in front of the Manas its response depends on

knowledge and past experience about that matter

which is already get coded in the mind . Recollection

or recalling of same knowledge when needed is called

as Smṛti. Past experiences many times clear the confu-

sion and help to gain the true knowledge and hence it

is also called Tatwajnyāna. Already existing Smṛti criti-

cally analyses the new matter in the light of past expe-

riences which leads to definite knowledge. When Smṛti

is active, person never motivates to do actions which

cause harmful effects. Person doesn’t touch fire or

friends will be identified soon as Smṛti is active. Person

never consumes unwholesome food due to memory of

bad past experience. But when Smṛti element fails, per-

son commits the same mistakes again and again due

Tama and Raja which mask the true knowledge (

Tatwajnyāna )[xi]

Hence proper functioning and integrity of these

three cognitive elements of mind enables the mind to

work its best , in contrary in the absence of same

Mind fails to make right decision .This situation of the

mind is called Dhī, Dhṛti and Smṛti Vibhramśa which



ultimately forcing the individual to commit the

Pragñyāparādha. So preventing a person from com-

mitting Pragñyāparādha and preservation of Dhī,

Dhṛti and Smṛti of patient is the main Objective of

Satvāvajaya Chikista.

Satvāvajaya deals also with Mano nigraha that means

the control of the mind. This is concerned with control

of voluntary and the involuntary and internal as well as

external thrust of the mind. It has to control and direct

the sense organs to obtain the true knowledge. This

has to take control over all the function of then the

body to lead it from front . This is also the meaning of

the word Abhigraha (rule with dominance). The same is

called as Indriyābhigraha [xii].

Similarly it has to control the self, which is a very diffi-

cult task. Self-regulation and self-monitoring is quite dif-

ficult where Yoga etc. procedures are explained by

classics to assist Mana to achieve the same. One has

to indulge in an object firmly by rejecting all the oth-

er bad objects ,restrain itself it for long time .Certain

external and the internal stimulus disturbing the mind

can lead s to failure of this chain system of mind .

Self-restraining or protecting self from the disturbances

of the unwanted objects is a stress inducing phenome-

non when it is done force fully.

This area of Manonigraha is real topic of Satvāvajaya,

and need to be identified Basically the Vishay’s of

the mind that is Chintya ( Thought process)

Vichārya (Critical analysis of a thought for its posi-

tive and negative effect) Ūhya ( Further objective

analysis of a particular topic and channeling ) Dheya

( further confirming the objectives ) Sankalapa ( taking

a decision to attain the objectives ) are gets disturbed

and method of correction of this process and modulat-

ing the Mano Viṣayas in the positive direction is the

subject of Satvāvajaya. By considering above all facets

related to Daiva Vyāpāśraya and Satvāvajaya Chikitsa

a clinical protocol has been made which include follow-

ing factors

Correction of Dhī – Dhī refers to the intellectual capacity

to differentiate between good and bad things. Child

as well as parents both should be cleared off all confu-

sion regarding the origin, causative factors, and mani-

festation of the disease. Failure to distinguish the exact

causative factors and consumption of the same may

further exaggerate the condition. All myths and misun-

derstanding regarding the disease and its manifesta-

tions should be cleared so that child has fair idea of

pathological changes so that it can prepare his mind

accordingly giving rise to formation of clear, true

thoughts. Counseling should be directed to correct

the problems in Dhī after asking certain questions to

child to know level of derangement of Dhī. Dhī may be

affected at mild, moderate and maximum levels.[xiii]

Correction of Dhṛti

Dhṛti has been explained as the controlling factor of

the Buddhi (Dhṛti manaso niyamātmaka buddhi).[xiv]

Mind is constantly gets exposed to lot of sensory and

motor stimuli’s in every second and original decision

may be tampered by them. A physically or psycho-

logically ill child patient constantly gets exposed to

variety of stimulations which disturbs him emotionally

and confuse him to react to a situation He may also

have such confusion while reacting with family

members . Any negative reinforcement behavior by the

parents may land – up depression where Dhṛti [xiv] will

be in totally collapsed state. Further fluctuation in the

state of Dhṛti may result in alternative positive and neg-

ative attitude of the child regarding confidence, faith

and hope as well as knowledge and prognosis of the

disease process. So fixing the Dhṛti at positive mode

should be done by counseling the child.

Correction of the Smṛti factor

Smṛti plays a very important role in prevention of the

disease. Past experience gained by personal experi-

ence, bookish knowledge, observational knowledge

helps the patient to prevent himself from the disease by

avoiding the causative factors [xv]. In case of loss of

memory by disease process, ignorance, innocence, or

intentional or unknowingly may leads to the state of

Pragñyāparādha and need to be corrected. Effort

should be done to help the child to recollect the previ-

ous memory by different illustrations, examples, model

presentations, storytelling, referring the books etc. Such

an effort by physician by proper counseling by using

different modes helps a lot in treatment and also gives a

scope to modulate the status and future guidelines in the

management.

Correction of the Dhiarya factor - Dhairya is considered

as one of the best method of treating Mana - Doṣas.

Ensuring the Dhiarya to the patient prevent many mental

disorders and acts as a barrier against the same. Pres-

ence of Dhairya itself indicates the positivity of the

child. Correction of Dhairya refers to sense of patience,

reassurance, encouragement and support provided by

the physician the child. So Dhairya in the form of re-

assurance will definitely bring back the positive thinking

and helps to filter the confusions. Similarly child should

be kept away from such an environment or a person,

who discourages, give confusing statements, induces



the stress, and make the child afraid. Child’s attitude

to a given situation also depends on the level of Satva.

Hīna Satva child may show complete let loose behavior

while medium and the Pravara Satva may able to show

some tolerance and confidence. Physician to carry on

counseling by encouraging words, previous success

stories of the child , stories depicting the positive gain

due to adventure and courage, certain live examples ,

parental back-up, well-wishing’s, belief in god etc.

Correction of the Pragñyāparādha

Pragñyāparādha is the state where there will be aberra-

tions (Vibhramśa) in Dhī, Dhṛti and Smṛti Combined

effect of aberrations of these three may be different

from m individual effect of aberration and more severe,

although all the three are actually interrelated.

Pragñyāparādha includes all the cognitive and behav-

ioral problems in the child which leads to wrong per-

ception and assessment of given situations. Parents may

also show the Pragñyāparādha by their perverted be-

havior and altered love and concern to the child due

to existence and the progress and failure gets improve-

ment in disease status. This has to be checked by cer-

tain questionnaires aiming to assess the level of

Vibhrmaśa. Faults done by the child should be pointed

out during counseling. Different movies, clips of the

drama, etc highlighting errors committed by a person

due to ignorance can be shown to realize the effect of

Pragñyāparādha to the child. Child should be enquired

for possible internal thrust, complicit as well as exter-

nal triggering factors which made him to commit

Pragñyāparādha, and more focus has been given to

correct the same.

Correction of thought process (Chintya) or establishment

of the thought process is the first step in Mano nigraha.

Wrong establishment of the thought process is the root

cause for all and attempt has to be done to check

whether origin of the thought process carries positivity

or not. In case if it is vice versa, it should be converted

it in to positivity through Satvāvajaya technique. If

basic understanding of the disease and child’s inbuilt

thought regarding the diseases or a given situation is

negatively reinforced, then treatment never get suc-

ceed. Child due to a negative thought if believes that

‘proceedings not under my control’ or ‘nobody can help

me’ ‘can’t do anything.’ Is the major hindrance in

treatment etc. Child has to be educated , assisted to

change seeded negative thought process so that he

can able take a firm decision of overcoming it.

(Sankalpa). Skill fully while doing counseling pediatri-

cian should adopt all those techniques which van effec-

tively change the thought process, like art of controlling

the mind, practice yoga and Dhyāna , traṭaka, wor-

shiping the god, service to the public , respecting adults

etc.

Regulating the process of analyzing the thought

(Vichārya)

At times thought process might have been rooted posi-

tively and regular, but fails to concrete the same on

flow of many good and bad thoughts, which end-up in

improper analysis and confusions. Hence child should

be assisted for filtering out good, bad thoughts.

Meanwhile at times child may have problems into be

firm on one good thought among many, which was

most appropriate. So effort has to be done under-

stand level of confusion and analyzing deficit exist-

ing in the child and methods has to be employed to

correct it.

Increasing the knowledge of the self (Ātmādi Vignyāna)

Many times child may not be aware of self-capacity in

comparison to surrounding situations, resulting in nega-

tive attitude and behavior about self. So it is very

important to realize the child about his capacities

strength, ability and even weakness (to prevent haz-

ards of over confidence) so that child can take the

right decision . So child should be made realize the

role Manas and other day to day activities in

origin of fear, anger , frustration and disappointment

and methods to avoid them . Child should be educated

to have comprehensive accurate knowledge which is

devoid of confusion and other apprehensions. Once

child realize the significance once own mind , body

and Ātma and Indriya s in attaining the right

knowledge errors will be minimized leading to posi-

tive changes in the child.

Creating the faith

Faith plays an important factor in the success of the

treatment and always creates a positive attitude. Faith

therapy is now days becoming more and more popu-

lar which was explained by Ayurveda long back

with name of Diva Vyapāśraya treatment. Faith

guides the man in the track goal by removing obses-

sions present in its way. Faith with physician and coun-

selor, medicines and self are very important for success.

Understanding the desire and complicit of the child-

Understanding the desire and the complicit of the child

is very important step in Satvāvajaya chikitsa without

which the purpose of the treatment cannot be achieved.

It is told that Iśṭasya alābha and aniśṭasya lābha is

main cause of psychological disorders. In order to



understand the Iśṭa and Aniśṭa (desire and complicit)

of the child or likes and dislikes , thorough interroga-

tion of the child and the parents is very crucial .Child

may dislike the association of certain person around

him or at times vice versa.. Child may not be comfort-

able with certain friends whom he has been compelled

to go and play. Child might have been prevented from

watching his favorite T.V Chanel. Child may not like

certain teachers and certain relatives to whom he will

be constantly exposed and unavoidable Child might

have been nurtured forcefully in disliking family envi-

ronment. Limitation of parents in providing desired

playing toys , eatables due to economic, security or

causes or providing the alternative one which un liked

by the child, may be the root cause of the problem. To

understand this complicit of the child certain questions

to be asked for both parents and the child.

CONCLUSION

Satvāvajaya Chikista is the third form of the treatment in

Ayurveda which form a rational treatment for disturb-

ances of the mind. As mind plays vital role in control-

ling both physical as well as Psychological integration

of the body keeping the mind in healthy state is the mo-

to of Satvāvajaya Chikitsa. Although we often highlight

the importance of Satvāvajaya Chikitsa in treatment, no

fixed protocol be followed has been prepared so for.

Nevertheless, practical implementation of principles of

Satvāvajaya Chikitsa is challenge and need an inte-

grated approach. This article high light certain points

based up on which Satvāvajaya Chikitsa can be practi-

cally implemented. However this should be considered

as Ayurvedic method of counseling the child which co-

vers larger area when compared to contemporary med-

ical sciences. Many psychological disorders of the child

like Śayyā mūtra, Habit disorders, learning disorders,

depression, phobia, separation anxiety, adjustment

problems, bipolar disorders, rumination disorders, veg-

etative disorders, behavioral problems can be effective-

ly managed by this specialty of treatment. This should

be extended not only to psychological disorders but

also to the physical disorders. Different questionnaires

should be prepared to assess the severity of derange-

ment of each facet.

ΛΛΛΛ

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edition;

Source of Support: Nil.

Conflict of Interest: None declared

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How to cite this article: Devendra & Shrinidhi: Clinical Im-

plementation of the Satvāvajaya Chikista in Ayurvedic

Paediatric Practice. AAMJ 2016; 5:994 – 1000.

AAMJ ISSN: 2395-4159 Review Articleaamj.in/wp-content/uploads/Volume2/Issue5/AAMJ_994_1000.pdf · ISSN: 2395-4159 Review Article Clinical Implementation of the ... Homa, Havana, Japa,

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