Dr.V.

Veera Balaji Kumar

 There are five systems of psychotherapy that are
being practiced and developed during the last
two centuries in the Western world.
 They are:
1: Chemotherapy
2: Electroplexy
3: Psychosurgery
4: Behavior therapy
5: Psychoanalysis
1: Chemotherapy is the most popular and intensely
used method of psychotherapy. Psychiatrists use
chemicals or chemical compounds to create
balance between the body and the mind of the
mental patient.
 2: Electroplexy is also a special therapy; only
Psychiatrists can use it. The mental patients are
given electric shocks of short duration from
special electrical devices and they do not notice
the psychology of mental patients.
 3: Psychosurgery is the brain operation with a
view to altering or normalizing certain behavior
patterns of mental patients. This method is so
dangerous to the risk of the mental patient that it
has not been popular.
 4: Behavior therapy: The behavioral scientists or
social psychologists have used the advanced system
of therapy in order to change or remove the
symptoms of mental sickness so that normal behavior
would be restored.
 5: Psychoanalysis: According to Freud,
Psychoanalysis is called depth psychology. Some
techniques are used to help the mental patient to
become aware of the causes of his mental sickness. It
can be used to analyze experience and behavior of
the depth consciousness of mental patients,
especially with the discernment of the dreams and
mental disorders that have the same character of
neurotic symptoms
 Similarity and differences
 The Freudian formal saying: "We are all somewhat
hysterical". It sounds like an utterance of Buddhist
introspection (Sabbe puthujjanā ummattakā) "All
worldlings are prone to be mental illness."
 Psychoanalytic treatment has been proved to have three
limitations such as: high cost, time-restriction and not
good effect in many cases. In many cases the most it can
do is to enable the subject to come to terms with himself
and 'live with' his condition.
 The limited nature of its success is indicated by the need
to resort to physical treatment for cases that have passed
from neurosis to psychosis, such as electro convulsive
therapy for acute depressive moods, insulin injections for
the early stages of schizophrenia, frontal lobotomy for
prolonged anxiety states and the use of the class of
drugs known as tranquilizers
 Patañjali (4th century BC) is the compiler of
the Yoga Sutras, an important collection of
aphorisms on Yoga practice.
 The Yoga Sūtras codifies the royal or best (rāja)
yoga practices, presenting these as a eight-
limbed system (ashtānga). The philosophic
tradition is related to the school. The focus is on
the mind; the second sutra defines Yoga - it is
the cessation of all mental fluctuations, all
wandering thoughts cease and the mind is
focused on a single thought (ekāgratā).
1. yama, ethics, restraint and ahimsā,
2. niyama, cleanliness, ascetism, etc.
3. Asana, posture
4. Pranayama, breath-control
5. Pratyahara, sense-withdrawal
6. Dhāraṇā, concentration
7. dhyāna meditation, and
8. samadhi, oneness in quality of and
Paramatma (but eternal difference in
quantity) with the Pranava of the Ishvara.
 Over two and a half millennium years ago Buddha
taught during a period of forty- five years
 has been studied in various aspects by a long line
Buddhist patriarchies down generations of master-
pupils lineage
 It is possible to find out in the canon the aspect of
Buddhist psychotherapy takes shape.
 He taught self management of mental suffering
through mindful awareness practices – leading edge
of modern psychotherapy.
 The following two stanzas which are opening of the
Dhammapada, were spoken by Gotama Buddha
more than 2,500 years ago.
 They elucidate the crucial theme of Buddhist
teaching, the human mind.
 Mind is the forerunner of all
(evil) conditions.
Mind is their chief, and they
are mind-made.
If, with an impure mind, one
speaks or acts,
Suffering follows one even as
the cart-wheel follows the
hoof of the ox
 Mind is the forerunner of
all (good) conditions.
Mind is their chief, and
they are mind-made.
If, with a pure mind, one
speaks or acts,
Happiness follows one like
his never-departing
shadow
 The 'mano' here also signifies six-fold sense
experience that is eye, ear, nose, tongue, body
(touch/tactile) and mind episode.
 The happiness or suffering depends on the
attitude of one's own mind: correct or incorect
(yoniso-manasikāra vā ayoniso- manasikāra).
 If the mind understands in a good way, happiness
arises.
 On the other hand if the mind interprets in a bad
way, suffering is a consequent result and when the
mind is out of control, mental disorder occurs.
 Buddha was the first one to point out a disparity
between mental sickness and physical sickness.
 “apart from those whose cankers are destroyed.
(i.e the Saint or Arahants), beings who say that
they have been mentally healthy for even a
moment are rare in the world." (AN, Catukka-
Nipāta, Roga Sutta No. 157).
 The three cardinal causes of mental sickness
could be discovered more than 2,000 years in
Charaka Samita.
 They are:
1: rajas: defilements;
2: thamas: darkness or confusion;
3: satva: the imbalance of mind, bile, phlegm.
 With the technique of analysis of the mind
contents, the mental cause have to be exposed
either by the mental patient's knowing or seeing.
 Man is the most honorable creature in the whole
world. All men are one's own brothers, as the
members of the same great family of humankind
without any discrimination of race, caste or rank.
 In another words, by mere birth it does not make
man noble or ignoble but by three fold actions:
bodily, verbal and mental actions
 Angulimāla was a son of a minister who became a
notorious robber but when he was transformed
into a disciple of the Buddha, he became an
arahant - the noblest stage
 According to Buddhist psychological aspect,
the disposition of man is conditioned and
nourished by the action of mind (manas) and as
a result the personality and destiny of man are
also likewise decided by the mind.
 Man is a psychophysical combination of mind
and body (nāma- rūpa). Sensation (vedana),
perception (saññā), mental formation
(sankhāra) and consciousness (viññāṇa) are
the non-physical factors in man collectively
regarded as mind (nāma);
 The four great primaries or elements (cattāri mahā
bhūtāni) have their characteristics as extensions
(earth- pathāvi), cohesion (water- āpo), heat (fire- tejo)
and vibration (wind-vāyo).
 These are the physical factors in man collectively
regarded as body (rūpa).
 These five various groups (rūpā or material component
on the one hand and vedanā, saññā, saṅkhāra and
viññāṇa on the other) in which the psychophysical
entity called man in analyzable are referred to in
Buddhist texts as khandha (fivefold aggregate)
 It constitutes the basic so-called individual or
personality.
 Man must be skillful in his own welfare but at
the same time he should cultivate his spiritual
life. A locality where there is no chance for a
person to develop his morality is not suitable to
choose for one's living.
 A man should have (kalyānamitta) a spiritual
teacher to instruct him in the moral aspect, and
should associate with and serve as his ideal. A
locality where there is such a person to be
found is a suitable to live in.
 Association with the wise may prevent one
from having mental disorders to some extent
and make progress in the spiritual life
 It should be also known that the distinction
between the worldlings and the arahants is clinging
(upādāna).
 A worldling has been clinging to sensual and
sexual desire, to his viewpoint as well as his own
body; hence his fivefold clinging aggregate
(pañcuppādānakkhandhā).
 Therefore he is subject to suffering (dukkha)
mentally and physically.
 The paramount importance is eradication of these
clingings (upādānā), in other words total absence
of greed, hatred and ignorance
 According to Psychoanalysis there are two basic
intuitions which hide behind the evident ego
intuition and object intuition, namely, eros (the
unifying intuition- positive wishes), the intuition
that attempts for ever-closer union and thanatos
(or the death with the destructive intuition-
negative wishes) that results in the decay of what
is living.
 The demonstration of the force of eros is named
libido that comes from the Latin word for 'lust'.
 The Buddhist term for 'lust' is 'taghā'
 There are three kinds of 'taghā' that are (Kāma-
taghā):
 craving for sense-delight, (bhava-taghā);
 craving for self-protection and (vibhava-taghā);
 craving for non-existence.
 Thus kāma-taghā as explained in Buddhism accords
with the libido of Freudian Psychology.
 Sigmund Freud says that the central part of what is
meant by love consists in sexual love with sexual
union as its purpose that is inseparable from this
certain affectionate and friendly stimulus.
 The love for parents and children, friendship, love
for humanity and even the devotion to abstract
ideals are manifestations of the same instinctive
root.
 Craving for sense-delight as a demonstration of
greed (lobha) and greed that is a fundamental root
(mūla) rouses unhealthful state
 every human has potential craving (taghā) or
defilements (kilesa) the cardinal importance is how
much one can be able to control oneself. The way
to control oneself is nothing than mindfulness.
 Mindfulness is awareness of every rousing of the
mind. If one can be able to detect at the first
moment of every response of one's mind, which is
very useful to one's own cultivation and one's
purification of mind.
 On the other hand if one fails to detect at the time
of its rousing in one's mind, one can be carried
away by verbal action and bodily action. Even in
such a state if one is unable to control it, it means
one becomes mentally ill.
 On the superficial aspect, a cause of mental
disorders is consumerism that is ceaselessly
stimulating and propagating desires which
worldlings (puthujjanā) are unable to satisfy fully
and become frustrated.
 According to Buddhist Psychology the worldling is
identified by mental reactions of craving for states
which are impermanent (aniccā), subject to
suffering, devoid of reality and inherently impure.
 They mistakenly assume phenomena to be
permanent, to engender happiness and endowed
with self-existence.
 Accordingly in Buddhist Psychology mind is not
just cognition.
 It embraces one's emotion as well as all
unconscious mental-emotion reactive motifs.
Emotions arise at the scene where mind and
body encounter.
 It is the body's reaction to one's mind or
reflections of one's mind in the body.
 For example, an antipathy thought will cause a
process of energy in the body called anger. The
body is getting prone to conflict
 Research has proved that robust emotions even

cause fluctuation in the biochemistry of the body.

 The biochemical fluctuation exemplifies the visible

aspect of emotion

 it is not usual to be conscious of all thought motifs,

but it is beneficial to one if one can watch one's own

emotions so that one can bring them into awareness.
 Failing to watch one's own emotions and often
being carried away by unwholesome emotions
such as:
 greed (lobha) or sensuous desire (kāmacchanda),
hatred (dosa) or ill-will (vyāpāda), laziness and apathy
or sloth and torpor (thīna-middha), agitation and
hesitation or restlessness and worry (uddhacca-
kukkucca) and mistrust or doubt (vichikicchā).
 In other words one may be captured by one of
these five hindrances (nivaraṇa) and one's mind
becomes disorder
 At the time of knowing the sense desire (that was
arising in the preceding moment) that sense
desire no longer exists (but only the act of
knowing)."
 The more one is identified with one's thinking,
one's like and dislike, judgment, interpretation
and proliferation of mind, which is to say the less
present one is as the watching consciousness,
the stronger the emotional energy will be,
whether one is able to be aware of it or not.
 The unhealthy emotional and motivational tracks

become toughened by the incessant repetition of

motifs of manners that escort their expression

 A mannered shift at the level of overt expression of a

person's emotion becomes needed in order to

enfeeble or to root out the unhealthy emotion.
 The healing begins when the mental patients come to
know how to observe their own mind, how often they
behave like unrestrained disputants steadily opposing
each other and denying listening to the other side's
arguments because of their lack of courage to accept
their practical, moral or intellectual reasoning.
 If they continue to look into more carefully their mind
more carefully, their thoughts or judgments, they will
have to recognize that many of them are just the
product of habit, led by prejudices of intellect or
emotion, by their pet liking or disliking, by laziness or
selfishness by unsound or cursory attentions.
 The dark and untidy corners of the mind are the
hideaways of one's most dangerous enemies
and one can be attacked unconsciously and
much too often defeated by them
 Nothing more challenging is needed than to
acquire the practice of directing bare and pure
attention to these elementary thoughts as often
as possible.
 The simple fact should be known that two
thoughts are unable to coexist at the same time:
if the clear light of mindfulness is present, there
is no room for mental dusk.
 Psychotherapy is a psychological process that
helps to change the mental patient's illusion or
hallucination.
 That is the concept of 'I' and 'mine', happiness
and permanence.
 With the guidance of the psychotherapist, this
process helps the mental patient gradually
understand and accept the three cardinal
aspects of all things: anicca (changing,
impermanent), dukkha (suffering) and anatta
(non -self);
 At the first session, the aims of mental patient
and the psychotherapist are at variance. The
psychotherapist should make the mental
patient burst out his obsessive story and listen
to him attentively without taking down notes in
front of him.
 The psychotherapist should ask the mental
patient some questions concerning the
change in some visible things or persons
around him. Gradually the psychotherapist
helps the mental patient to be aware of the
law of change...
 When the mental patient comes to accept the
law of change (anicca), with the delicate
guidance of the psychotherapist, the mental
patient slowly realizes how much suffering there
is in himself as well as in his near and dear ones.
 The task of psychotherapy is one of reconciling
the out-bursting emotions of the mental patient. It
is hoped that the development of communication
and relationship among the psychotherapist,
mental patient and his family will bring him soon
to the normal state.
 Those who would like to help others by this
approach needs first of all to become familiar
with the technique and have much personal
experience in Insight Meditation so that their
radiation of wisdom and compassion (karuṇa)
will attract the attention of the mental patient.
 Restoration of normalcy and mental health of
the mental patients are the purpose of the
psychotherapist.
 All worldlings have their own mental defilements
such as greed, hatred, conceit...and for a long
time they can control themselves; such person are
not in the domain of psychotherapist but those
who are unable to control their defilements and
violently or unconsciously carried away by them in
their verbal and bodily expressions are in their real
domain.
 The target of the psychotherapist is to help the
mental patient be capable of managing their own
defilements and to be active as well as understand
with an average level of self- awareness.
 Making of cartharsis in the mental patients, the
psychotherapist must not tell the carthasis of the
mental patient to anyone and be a sensitive
listener and base on that data to classify the
temperament of mental patients such as:
1: Rāga temper: sexual lust driven temper
2: Dosa temper: antipathy driven temper
3: Moha temper: confusion temper
4: Māna temper: those who always make
comparisons between themselves and others.
 the psychotherapist should choose topics to
converse according to their inclinations.
 The psychotherapist at the beginning of
developing communication has to show his
empathy to the mental patient with a great
enthusiasm to know his situation and soothe him
from suffering due to sickness by forgiving and
letting go and opening revaluation for him.
 Task of psychotherapist

 The psychotherapist is endowed with the understanding

the four Noble Truths, and able to diagnose a sickness
(Dukkha Sacca), designate its cause (Samudaya Sacca),
say whether the sickness is curable (Nirodha Sacca) and
trace the means of cure (Magga Sacca).
 Then, the psychotherapist should make the mental patient
understand that every thing is subject to change therefore
the mental patient's sickness also will be changed.
 Good communication has to be set up in the triangular
relationship among Psychotherapist (P), to mental patient
(M) and his family (F): from P to M, from (M) to (P); from
(P) to (F), and from (F) to (M), from (M) to (F) and from (F)
to (P).
 Passing of the mental patient's emotions on the
psychotherapist is a distinctive obstacle that all
psychotherapists have to face.
 For instance, the antipathy or lust or even sexual
thirst that exist in the mental patient, may shift such
emotions on to the psychotherapist
 psychotherapist should ask the mental patient to
keep the eyes closed during the time of
conversation about thirty minutes.
 After a break for drinking some kind of beverage,
he should suggest the mental patient do
breathing exercise with him either sitting on a
chair or lying on a bed without pillow: breathing in
and out normally five times and then breathing
deeply and keeping the breath in the chest for a
while and breathing out strongly.
 This exercise is good for blood circulation and
many functions of internal organs
 psychotherapist must practice patience on the
mental patient, carefully and attentively listen to
the bursting words of the mental patient and have
capacity to detect the character of the mental
patient by noticing on their facial reactions and
bodily behaviors.
 interpretation of the mental patient's dreams and
find out its cause hidden in the unconscious.
 If he agrees, the psychotherapist should give an
exact appointment and good expectation about
the mental patient's neat and clean appearance
and polite behaviors.
 One of the more widespread modern adaptations of
traditional consciousness-training practices is the
Vipassana Meditation technique, which has recently
become popular among both the lay public and
workers in the mental health field.

 Vipassana is a Pali word meaning "insight". It is a
system of self-transformation by self-observation;
the object is to eventually reach a state of inner and
outer calmness and balance of mind (Thray Sithu
Sayagyi U Ba Khin, 1983).
 This model of mental activity is an "object relation"
theory in the broadest sense: its basic dynamic is the
ongoing relationship of mental states to sensory objects.
 "Sense objects" include precepts in the five main sensory
modalities, plus thought or cognitive activity, which in
this system is seen as a "sixth sense".
 "Mental states" are in continuous change and flux: in this
analysis, the rate of change of the smallest unit of mental
states-a mind moment which is a moment of awareness-
is incredibly fast, described as arising at the rate of
millions in the time of a flash of lightning.
 Each successive mental state is composed of a set of
properties, or mental factors, which gives it its
distinctive characteristics: there are 52 basic
perceptual, cognitive and affective categories of these
properties (Narada Thera, 1968).
 The basic dichotomy in this analysis of mental
factors is that between pure, wholesome or healthy
and impure, unwholesome or unhealthy mental
properties.
 Just as in systematic desensitization, where tension
is supplanted by its physiologic opposite relaxation
(Wolpe J., 1957), healthy mental states are
antagonistic to unhealthy ones, inhibiting them.
 Vipassana Meditation aims to eradicate these
unhealthy properties from the psychological
economy.
 The operational definition of mental health is their
complete absence, as in the case of the arahat or
saint (Goleman D., 1977).
 Vipassana meditation trains the concentrated
attention to follow the mechanics of mental
processing in a detached fashion.
 This perspective of an observer allows the controlled
release of mental contents like craving and aversion,
past and future in a seemingly endless stream of
memories, wishes, thoughts, conversations, scenes,
desires, dreads, lusts and thousands upon thousands
of emotionally driven pictures of every kind-which
rise to the surface of the mind and pass away without
provoking a reaction, while simultaneously
anchoring one in concrete, contemporary reality
(Fleischman P.R., 1986)
 Since the meditator is at the same time deeply relaxed,
the whole contents of his mind can be seen as composing
a "Desensitization hierarchy"; in this sense, Vipassana
meditation may be natural global self-desensitization
(Goleman D.,1977).
 The mind is deconditioned with meditation altering the
process of conditioning per se, so that it is no longer a
prime determinant of future acts (Goleman D.,1977); a
refinement of awareness occurs and one responds
consciously to life situations thereby becoming free from
limitations which were forged by mere reactions to them.
 One's life becomes characterized by increased awareness,
reality-orientation, non-delusion, self-control and peace
(Fleischman P.R., 1986).
 The clinical utility of Vipassana Meditation is
more likely to be in terms of providing a general
psychological pattern of positive mental states
rather than as a response to any particular
presenting problem; generally, the conventional
psychotherapies are generated as treatments for
the latter.
 Vipassana Meditation, as a supplementary
treatment and has found it to be effective in
psychoneurotic and psychosomatic disorders.
 It should be noted that the therapist ought to be well
conversant with the technique of Vipassana
Meditation and a mature meditator himself. Speaking
in Vipassana parlance, the patient observes his
respiration (Anapana meditation), while the therapist
practises Metta (loving kindness meditation).
 Before commencing the formal therapy, the therapist
explains to the patient its potential benefits,
particularly relaxation, which helps reduce the latter's
apprehension and enables him to co-operate and
participate actively in the treatment.
 It is necessary to ensure that the physical environment
is one which will facilitate relaxation; the place should
be quiet and free from interruptions and the patient's
should be reasonably comfortable.
 The patient is asked to lie comfortably on the couch, close his
eyes and observe the flow of respiration by concentrating on
the area of the upper lip just below the nostrils; whether in-
breath or out-breath, deep or shallow, fast or slow, natural
breath, bare breath and only breath.
 If and when his mind wanders, the patient is instructed to
passively disregard the intrusion and repeatedly focus his
attention on his breath, without getting upset or disturbed
about the drift.
 Two things happen: one-his mind gets concentrated on the
flow of respiration and two-he becomes aware of the
relationship between mental states and the flow of respiration,
that whenever there is agitation in the mind-anger, hatred,
fear, passion, etc... the natural flow of respiration gets affected
and disturbed. He thus learns to simply observe and remain
alert, vigilant and equanimous.
 this technique shortens the total duration of treatment,
and helps the patient to cope better in the community, by
providing a general pattern of stress-responsivity less
likely to trigger specific over-learned maladaptive
responses, whether psychological or somatic.
 there is a change in the patient's internal state, whereby
his attention is focused, his perceptual and motor
systems function optimally, and his anxiety is minimal;
and this in spite of, and while meeting a great variation in
the external environmental demand by virtue of self-
regulating and developing one's internal capacities