Concept of Satwavajaya Chikitsa ( Psychotherapy ) in Manasroga .

Health is defined as, a state of complete physical, mental and social wellbeing and not merely an absence of disease or infirmity. Manas or Satwa plays an important role in keeping person healthy, even during the time of physical disorder Manas helps in relieving it. But during present day’s lifestyle and stress related environment, human beings are suffering from many psychological disorders, As many as 450 million people suffer from a mental or behavioural disorder. Among them nearly 1 million people commit suicide every year (WHO). So this balancing nature of mind nowadays is getting deprived under the influence of growing stress and strain in life. But treatment is not absolute in the modern science, but Ayurveda may provide better treatment modality in controlling or curing these than other existing sciences. Satwavajaya Chikitsa is a unique nonpharmacological approach for treating the mental disorders. It is the first of its kind and if developed can really prove much useful. So Satwavajaya plays major role to get rid of these problems. So it is very much essential to understand the concept of Satwavajaya Chikitsa.

over. [6] Hence Satwavajaya means to have controll over the mind and thus abstaining from things that are not good for the health. [7,8 ] A person is called healthy not only when Dosha, Dhatu, Mala and Agni are in equilibrium condition but also the Manas should be in normal condition in the presence of Atma for proper and healthy state of Shareera and Indriya. 9 So also WHO also considers "Health as a state of complete physical, mental and social wellbeing and not merely an absence of disease or infirmity". [10] So Manas or Satwa plays an important role in keeping person healthy, even during the time of physical disorder Manas helps in relieving it. So Satwavajaya has major role in treatment. Each person is different from another because of his discriminatory, creative and instinctive mind. Mind is a special gift to mankind, which is very complex in nature. It has potentiality to act mainly as dual nature. It is creative as well as destructive, positive as well as negative, active as well as dull, happy as well as sad. All these entities are well balanced by mind knowingly or unknowingly to people in their life. But this balancing nature of mind nowadays is getting deprived under the influence of growing stress and strains in life. Intellect, thinking power, memory, temperament, behavior, social attitude, etc., of an individual depends upon mental faculties. So to get rid of these problems it is very much essential to understand the concept of Satwavajaya Chikitsa. So this present review article throws light on the concept of Satwavajaya Chikitsa in Ayurveda and its utility in Chikitsa.

MATERIALS AND METHODS :
The classical texts of Ayurveda with their commentaries, other Ayurvedic texts and journals, Relevant websites, articles and presentation were referred.

Trividha Aushadha
The method of treatment in Ayurveda as a whole has been classified into three categories by Charaka 1. Daiva Vyapashryadivine therapy 2. Yukti Vyapashryarational therapy 3. Satvavajayapsycho therapy Daiva Vyapashraya It is a sort of divine therapy derived mainly from Atharveda. It is a faith therapy used in management of Manasaroga. Faith is a part and parcel of human psychology and this treatment is a play of faith where in patient should have full belief in the medicine and the method of treatment. The term 'Daiva' essentially refers to, belonging to divine, celestial, to the action of past life. So this therapy is designed to exhaust evil acts of the past to combat Daivikruta diseases. [11] The word 'Vyapashraya' refers to depending on taking refuge with, having recourse to. Daivavyapashraya is literally translated to mean any therapy that depends on or linked to Daiva or unknown. As a matter of fact, Daivavyapashraya is concerned with all the unknown circumstance, which is beyond the purview of reasoning. Hence this treatment is often referred to as spiritual therapy. Some of the measures are concerned with religious rituals like benedictions and offerings. Hence the term magico-religious practice has aptly been applied. 'Occult practice', 'Faith practices' are terms which are generally employed to suggest this "Daiva Vyapashraya' treatment.
In Atharvaveda and Kousitski Sutra, the two authentic sources of this therapy, many 'occult' method have been described to deal with demons and with crafts because Atharvans were the first to establish relation between demons and diseases. [13] The methods adopted by Charaka as a part of Daiva Vyapashraya treatment are 1. Mantra (Hymns) 2. Aushadha (Amulets, Talisman) 3. Mani (Wearing of gems) 4. Mangala (Auspicious ceremony) 5. Bali (Offering to god) 6. Upahara (Gift) 7. Homa(Oblations) 8. Niyamana (Observance of scriptural rules) 9. Prayascita (Atonement) 10. Upavasa (Fasting) 11. Svastyayana (Chanting of auspicious, Hymns) 12. Pranipata (Observance to the god) 13. Gamana (Going to pilgrimage) Yukti Vyapashraya The term 'Yukti' refers to union, connection, reasoning device, strategy, artifice, expedients and application. [14] In medical context the word however is in the sense of application of reason to diagnose and treat the diseases. Charaka counts Yukti among the means of Pramana (valid knowledge) and defines it as utilization of rational faculties by the physician, oath for understanding the causes and the nature of the diseases and for deciding upon proper course of treatment. Yukti Vyapashraya is based on Yukti, or rational thinking and represents careful and purposeful employment of a drug or a method of treatment. It's by far the most scientific of the methods in as much as it removes the causes and undertakes to diffuse the pathogenesis. Charaka defines, Yukti Vyapashraya Chikitsa is a judicious use of Ahara and Aushadha according to proper use, plan or Yojana. [ 15 ] Charaka mentions three types of therapies; Antahparimarjana (internal cleansing), Bahirparimarjana (external cleansing) and Shastra Pranidhana (surgical methods). [16] Satwavajaya Chikitsa As there is detailed description of Yukti Vyapashraya Chikitsa (rational therapy) for the treatment of Sharirika Roga (somatic diseases) in Ayurvedic texts, [17] a specific line of treatment is essential for the management of Manasa Roga [18]to normalize Manasa Doshas similar to the Tridosha theory related to bodily disorders. It should be different from Daiva Vyapashraya Chikitsa, which to some extent also include treatment of psychiatric disorders. So considering these factors Satwavajaya, a special method of treatment especially for mental diseases has been found very effective. It was Acharya Charaka, who introduced Satwavajaya Chikitsa for mental disorders, [19] which is a nonpharmacological approach equivalent to modern psychotherapy. The word Satwavajaya comprises of 'Satwa' and 'Avajaya'. The word 'Satwa' is derived from the Sanskrit root 'Sat' by adding suffix 'Ktva'. The word 'Avajaya'-Ava + Ji -Achaparajaye 'Yenendralokhavajayaya' means overcoming, victory, conquer [21,22] and the word 'Satwavajaya' refers to self command, strength of mind or character. [22] In other words, Satwavajaya literally means overcoming of mind or victory over mind or control of mind. [23] Satwavajaya therapy aims at the control of mind by restraining the mind from desires for wholesome objects. Acharya Charaka was the first person to use the word Satwavajaya but only once. No further description of Satwavajaya is available in Charaka Samhita. Even, this word is never mentioned anywhere else in the ancient literature. It seems that Acharya Charaka used the word to name the treatment of the diseases where Satwa's balance is interfered with. Hence, he has defined it as a method of controlling or restraining the mind from unwholesome objects. It can be achieved by increasing Satwa to subdue the exaggerated Rajas and Tamas. The definition gives a lot of scope for expansion i.e. "Satvavajayah Punah Ahitebhyo Arthebhyo Mano Nigraha" A look at the above definition shows 3 words i.e. Ahita, Artha and Mano Nigraha. Ahita -Does not carry any special meaning, it just conveys that something is unwholesome to the other. Artha -It is a wide variety of objects each Indriya has its own object that only it can perceive, i.e. Gandha is the object of Ghranendriya etc. Satva which is considered as Ubhayendriya has been referred to as having at least five Artha. Apart from these five, anything that can be perceived by Satva can also be included in this category. [24]

1) Ahitanam Anupsevana and Hitanam Upasevana
One should strive for discarding Ahitakara (harmful) and adopting Hitakara (useful) after careful consideration. In other words, it has been advised that mind should be restrained from unwholesome objects and engaged in wholesome, which is infact Satwavajaya or Ayurvedic psychotherapy.

2) Trivarga Anvekshanam
While treating the mentally ill person, the course of conduct relating to Trivarga i.e. three objectives of life viz. Dharma (virtue), Artha (wealth) and Kama (desire) should be attended because Trivarga is responsible for Sukha and Dukha etc. Therefore, contemplation of Trivarga is must, which can be attained by Jnana (knowledge or cognition).

3) Tadvidyaseva
One should go in the service of those who are well versed in nature and treatment of mental diseases i.e. specialities of the therapy and the therapy should be done by them. It seems that Saywavajaya Chikitsa was done by specialities at that time.

4) Atmadi Vigyanam
One should attain the knowledge of Atma  There are some psycho-supportive techniques like assurance, guidance and suggestions, education and awareness, induction of verbal, physical and mental shock, replacement of emotions, psychoshock therapy and recreational therapy etc. Satwavajaya is that typical Ayurvedic approach which not only prevents the impairment of intellect, patience of memory, but also bring them back to a normal state, whenever they are impaired. Thus Satwavajaya plays a significant role in the maintenance of a harmonious state between these three important factorsintellect, memory and patience, ultimately leading to a happy healthy state of the individual. It is quite logical here to state that patience (Dhrti) has a very important role to play for the successful management through Satwavajaya. Charaka says that, it is the patience that restrains the mind from its harmful objects. It is a known fact that Satwavajaya is nothing but restraining the mind from the harmful objects. A good clue is, control the patience and control the mind. The applied aspects of Satwavajaya can be summarized as follows; Lord Krishna was the first counsellor who delivered the message of Gita to Arjuna in the battle field of Mahabharata when the latter got depressed. This is a beautiful example of counselling, a sort of psychotherapy.
[32] On exploring the literature it has been found that concept of Satwavajaya i.e. psychotherapy has been described in brief and concise from in Ayurvedic literature. Controlling or restraining the mind from desire for unwholesome objects is nothing but Satwavajaya , which can be achieved by increasing Satwa to subdue the vitiated Manasa Dosha i.e. Rajasa and Tamasa. The application of Satwavajaya have not been described as such in any literature, but on compilation of different procedures mentioned in Ayurvedic and allied literature, associated with control of mind can be considered as the different approaches of psychotherapy. The best approaches to achieves the goal of Satwavajaya is by developing the, Vigyana, Dhairya, Smriti and Samadhi . Avoidance of Pragyaparadha plays an important role in Satwavajaya Chikitsa. Emphasizing on need of compassion and positive attitude towards the patient in administrating Satwavajaya , it is said that the patient should be claimed down after establishing friendly doctor-patient relationship.