Ancient Rome: Clinical Psychiatry and Humane Treatment

Reference: SC: Psychology

NOTE: Text in color contains Vinaire’s comments.

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Progressive Physicians

Asclepiades of Bithynia (124-40 BCE) represents one of history’s most progressive psychiatric reformers. Practicing in Rome, he rejected Hippocratic humoral theory, instead proposing that disease resulted from blockages in the movement of önkoi (imperceptible atomic particles) through theoretical pores in the body—including the brain. This proto-molecular medicine led him to fundamentally different therapeutic approaches.

Most revolutionary were Asclepiades’ humane treatment methods:

  • Fresh air and natural light rather than darkness and dungeons
  • Music therapy using soothing sounds to calm agitated patients
  • Hydrotherapy with therapeutic baths
  • Massage and exercise programs
  • Proper diet to support recovery
  • Pleasant environments conducive to healing

His therapeutic motto—“cito, tuto, jucunde” (safely, swiftly, pleasantly)—stood in stark contrast to the chains, whipping, bloodletting, and forced emetics commonly employed. Asclepiades advocated releasing mentally ill persons from confinement and treating them with dignity, recognizing that the mind could be healed through gentle, supportive interventions.

Celsus (1st century CE) provided the first systematic taxonomy of mental illnesses (genera insaniae) in his De Medicina. He distinguished three primary types:

  1. Phrenitis: acute delirium accompanied by fever, fluctuating pulse rates, and spastic movements—likely organic delirium from physical illness
  2. Mania: characterized by chaotic thoughts, frenzy, anger, and delusions occurring without fever—corresponding to what we would call acute psychosis or manic episodes
  3. Melancholy: persistent sadness, fear, despair, and withdrawal from external reality into an “impenetrable inner world”—encompassing both depression and paranoid or catatonic states we might now associate with schizophrenia

Soranus of Ephesus (1st-2nd century CE), whose work was translated by Caelius Aurelianus, provided detailed clinical descriptions and developed sophisticated treatment protocols including restoration therapy after acute phases subsided.

Galen of Pergamon (129-216 CE) synthesized and expanded Greek medical knowledge, creating a comprehensive system that dominated Western medicine for 1,500 years. Galen:

  • Emphasized the brain’s central role in mental functioning, developing a proto-neurological approach
  • Described how imbalanced humors specifically affected brain operations
  • Recognized anxiety disorders, noting patients with symptoms resembling generalized anxiety or major depression—sweating, indigestion, palpitations, dizziness, insomnia, weight loss
  • Observed that anxiety could “develop into melancholia” when black bile accumulated in the brain, causing delirium, aggression, or suicidal behavior
  • Described brain injuries and their cognitive consequences

Aretaeus of Cappadocia (2nd century CE) provided remarkably modern clinical descriptions, noting melancholic patients’ “aversion to food, despondency, sleeplessness, irritability, and restlessness”. His observations of aura, convulsions, and postictal states in epilepsy closely resemble modern clinical understanding.

In ancient Rome, in the centuries just before and after Christ, much progress was made in the understanding of mental illness, which led to its humane treatment.

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Treatment Modalities

Roman therapeutic approaches combined:

  1. Environmental interventions: well-lit rooms, moderate temperatures, therapeutic gardens
  2. Physical therapies: massage, exercise, hydrotherapy at Roman baths
  3. Dietary regimens: carefully calibrated to restore humoral balance
  4. Pharmacological treatments: various herbs and compounds
  5. Bloodletting, emetics, and purging: to expel excess humors (though now recognized as harmful)
  6. Asclepian temple healing: serene sanctuaries providing relaxation, proper diet, dream interpretation, and social support
  7. Musical therapy: using soothing music therapeutically

Wealthy Roman families sometimes employed personal physicians specializing in mental conditions, providing individualized care in home settings.

The treatment modalities basically involved getting the mental patient in better touch with the environment besides improving his nutritional intake.

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Persistent Popular Beliefs

Despite medical advances, popular Roman culture maintained traditional supernatural explanations. Cicero (106-43 BCE) distinguished between:

  • Insania: a relatively mild condition caused by moral weakness or failure of will
  • Furens: serious, total loss of mental reasoning making individuals unable to function—inflicted by the Furies (Erinyes), three bloodthirsty goddesses who drove mortals mad as divine punishment

The rise of Christianity saw a resurgence of demonic possession theories, temporarily eclipsing the naturalistic medical tradition.

This rise of Christianity, however, led to the popularity of demonic possession theories, especially for those mental cases that were difficult to manage.

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January 14, 2026 – 7:02 PM Categories: Psychology | Post a comment

Ancient Greece: From Divine Madness to Brain Disease

Reference: SC: Psychology

NOTE: Text in color contains Vinaire’s comments.

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The Homeric Worldview

In Homer’s epics (8th century BCE), mental illness bore the unmistakable stamp of divine intervention. Até (madness, delusion, reckless behavior) descended upon individuals as an “invisible fluid” sent by angry deities or malevolent demons (alástores). When Odysseus or Agamemnon acted irrationally, Homer attributed this not to psychological or physiological causes but to external demonic forces clouding judgment.

The Homeric conception located the psychic center in the heart (kradiē or ētor) rather than the brain, viewing it as the seat of emotions and cognitive functions. No clear separation existed between psychic and somatic conditions—both belonged to the same continuum of divine influence upon the body.

Greek tragedy perpetuated these themes. Euripides and Aeschylus depicted Orestes suffering terrifying hallucinations, wild ravings, and suicidal despair after matricide—tormented by the Furies (Erinyes), avenging goddesses who drove mortals to madness as divine punishment. Popular treatments involved katharmos (purification) to remove religious pollution (miasma) and sacrifices to appease offended deities.

In Homer’s time in Greece, madness was assigned supernatural causes, and popular treatments involved religious purification and sacrifices to appease offended deities.

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The Hippocratic Revolution

The Hippocratic Corpus (5th-4th century BCE), particularly the treatise “On the Sacred Disease” concerning epilepsy, marked one of history’s most consequential intellectual revolutions. The author (traditionally Hippocrates) began with a direct challenge:

“I am about to discuss the disease called ‘sacred.’ It is not, in my opinion, any more divine or more sacred than other diseases, but has a natural cause, and its supposed divine origin is due to men’s inexperience and to their wonder at its peculiar character”.

This represented a fundamental shift: mental and neurological disorders arose from natural, not supernatural, causes. Epilepsy wasn’t divine punishment but a disease of the brain. The Hippocratic physicians argued that:

  • The brain is the seat of consciousness, emotion, sensation, pleasure, pain, thought, and madness
  • Mental illness results from material causes—specifically imbalances in bodily fluids
  • Treating madness as supernatural pollution represents “ignorance and wonder,” not medical knowledge

The Hippocratic revolution in Greece around 5th-4th century BCE represented a fundamental shift that mental and neurological disorders arose in the brain, from natural, not supernatural, causes.

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The Humoral Theory

Hippocratic medicine developed the humoral theory, which dominated Western medicine for two millennia. Health depended on proper balance among four bodily fluids:

  • Blood (sanguine temperament): optimistic, cheerful
  • Phlegm (phlegmatic temperament): calm, composed
  • Yellow bile (choleric temperament): irritable, angry
  • Black bile (melancholic temperament): sad, fearful

Melancholia (literally “black bile”) became the paradigmatic mental illness—what we would call severe depression, attributed to excess black bile accumulating in the brain. Hippocratic texts described symptoms including persistent sadness, anxiety, despondency, sleeplessness, and social withdrawal.

Mania represented the opposite extreme—excessive excitement, delusions, agitation, and sometimes violence, associated with yellow bile imbalance. The physician Celsus described manic patients as those who “laugh and are cheerful without cause” and sometimes exhibit “incautious rage”.

Phrenitis—acute mental disturbance with fever, roughly corresponding to delirium—was distinguished from chronic conditions, showing awareness that temporary altered states differed from persistent mental illness.

Hippocratic medicine developed the humoral theory, which dominated Western medicine for two millennia.

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Philosophical Contributions

Plato (427-347 BCE) developed a sophisticated psychology in the Republic and Timaeus. His tripartite soul comprised:

  • Logistikon (reason): the thinking part that loves truth
  • Thymoeides (spirit): the source of anger and spirited emotions
  • Epithymetikon (appetite): the seat of physical desires and pleasures

Mental health consisted in proper hierarchy—reason governing spirit and appetite—just as justice in the state requires each class to fulfill its proper function. Plato explicitly linked morality and mental health, arguing that “nobody is wicked because of his own choice but because of the ‘evil condition’ of the body and because of bad education”. This didn’t excuse immoral behavior but recognized it as “contrary to nature and thus treatable”.

Aristotle (384-322 BCE) applied his hylomorphism to psychology: the soul stands to the body as form to matter. Unlike Plato’s dualism, Aristotle insisted the soul cannot exist without the body. He described the melancholic temperament—those dominated by black bile—as emotionally unstable, impulsive, prone to vivid dreams and prophetic visions, sleeping little, eating much yet remaining thin. The pseudo-Aristotelian Problems suggested melancholics were predisposed to madness because of black bile’s “precarious nature”.

The Stoics contributed the concept of ataraxia (undisturbed tranquility) achieved through internal control over reactions to external events—presaging cognitive therapy. 

The Epicureans argued that anxiety and fear arose from misunderstanding nature, particularly regarding death and divine punishment, suggesting education as treatment.

Philosophical contributions by Plato, Aristotle, Stoics and Epicureans provided a metaphysical dimension to the understanding to mental illness and additional treatments.

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January 14, 2026 – 2:21 PM Categories: Psychology | Post a comment

Buddhism: The Phenomenology of Mental Defilement

Reference: SC: Psychology

NOTE: Text in color contains Vinaire’s comments.

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Citta, Cetasikas, and the Stream of Consciousness

Buddhist psychology, systematized in the Abhidhamma (Abhidharma), developed a radically different yet equally sophisticated understanding of mind and mental illness. Rather than locating mind in a physical organ, Buddhism conceived citta (consciousness/mind) as an “ever-flowing stream” continuously changing from conception to death and continuing into subsequent lives.

Accompanying each moment of citta were cetasikas (mental factors)—52 distinct psychological qualities that determine the ethical character and phenomenological texture of consciousness. These include:

Seven universal cetasikas present in every moment of consciousness: contact, feeling, perception, volition, one-pointedness, life faculty, and attention

Thirteen particulars that can be wholesome, unwholesome, or neutral depending on context

Twenty-five beautiful (wholesome) cetasikas including compassion, loving-kindness, mindfulness, and wisdom

Fourteen unwholesome cetasikas that constitute the essence of mental illness

Buddhism looks at the mind as software, and locates it in the whole body and around it. This mind has both wholesome and unwholesome aspects. The unwholesome aspects constitute the essence of mental illness.

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The Nature of Mental Illness

In perhaps the most radical conception in ancient psychology, Buddhism equated all mental defilement with mental illness. The Buddha taught: “Those beings who admit to being freed from mental illness even for a moment are difficult to find in the world, except those who have destroyed the contaminants”. From this perspective, only fully enlightened beings (arahants) are truly mentally healthy; everyone else suffers from varying degrees of mental illness.

Mental illness manifests through unwholesome states (akusala dhamma)—mental factors that are (1) mentally unhealthy, (2) morally blameworthy, (3) unskillful, and (4) productive of painful results. These states arise conditionally and are impermanent, making them treatable.

The fourteen unwholesome cetasikas divide into two categories:

Four universals appearing in all unwholesome consciousness:

  • Moha (delusion/ignorance)
  • Ahirika (shamelessness)
  • Anottapa (fearlessness of wrongdoing)
  • Uddhacca (restlessness/agitation)

Ten occasionals appearing in specific unwholesome states:

  • Lobha (greed), dosa (hatred)—the two primary unwholesome roots
  • Ditthi (wrong view), mana (conceit)
  • Issa (envy), macchariya (miserliness/pretense)
  • Kukkucca (worry), vicikiccha (doubt arising from temptation)
  • Thina (sloth), middha (torpor)—together constituting one of the Five Hindrances

Buddhism equates all mental defilements, which are listed in detail, with mental illness. From this perspective, only fully enlightened beings (arahants) are truly mentally healthy; everyone else suffers from varying degrees of mental illness.

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Madness and Possession

Beyond this universal “metaphorical-evaluative” sense of mental illness, Buddhist texts also recognized literal pathological madness. The Pali Jataka commentary provides an eightfold classification of madness types, acknowledging both naturally-caused conditions and possession—not just by demons but by Mara, understood simultaneously as a deity and a phenomenological reality.

Possession traditions existed across Buddhist cultures. Tibetan Buddhism recognized dön zhugs pa (possession by grahas)—spirits that could enter practitioners during intense meditation, especially in states of deep samadhi. The Shurangama Sutra describes fifty types of mental demons that can attack practitioners who cling to unusual experiences or visions during meditation, potentially causing insanity with extreme emotional swings between joy, sadness, and mania.

Buddhism also recognizes literal pathological madness. These include “possessions,” as if by external entities; but they are looked upon more as phenomena of the mind.

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Treatment and Practice

Buddhist treatment focused on cultivating wholesome cetasikas while eliminating unwholesome ones through the Noble Eightfold Path:

  • Right View as the foundation, correcting the fundamental delusion that fuels all mental defilement
  • Meditation practice—but with significant caveats about the risks of improper practice leading to possession or psychotic breaks
  • Moral conduct to eliminate shamelessness and fearlessness of wrong
  • Mindfulness to observe mental states without attachment
  • Mantra recitation—considered safer than visualization practices that can invite possession
  • Taking refuge in the Three Jewels (Buddha, Dharma, Sangha) as protection against negative entities

The tradition emphasized that those with “firm conviction” in the Dharma and who practice daily merit dedication cannot be harmed by demons. Nevertheless, practitioners were warned against clinging to visions or unusual experiences, as “if one claims to see Buddhas and bodhisattvas, these are demons”—meaning either literal entities or subjective delusions.

Buddhist treatment and practice includes mindfulness to spot anomalies and mediation to resolve them. This, assisted by taking refuge in the Three Jewels and mantra recitation, brings about right view, and moral conduct.

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January 14, 2026 – 9:19 AM Categories: Psychology | Post a comment

Ancient China: The Harmonious Flow of Qi and Spirit

Reference: SC: Psychology

NOTE: Text in color contains Vinaire’s comments.

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The Conception of Shen

Chinese medicine, systematized in the Huangdi Neijing (Yellow Emperor’s Inner Canon, 4th-2nd century BCE), developed a sophisticated psychology centered on Shen (spirit/mind). Unlike the Greek emphasis on the brain, Chinese medicine located Shen in the Heart, conceived as the “emperor of organs” and the seat of consciousness, thinking, emotions, memory, and awareness.

Shen formed one of the “Three Treasures” alongside Jing (essence) and Qi (vital energy). The Heart-Shen governed not just individual consciousness but coordinated the Five Spirits—distinct aspects of psychic life associated with different organs:

  • Shen (Heart): supreme consciousness, integration, self-awareness
  • Hun (Liver): ethereal soul providing dreams, intuition, creativity, movement
  • Po (Lungs): corporeal soul governing instincts, sensations, feelings
  • Yi (Spleen): thought, intention, concentration
  • Zhi (Kidneys): willpower, determination, long-term memory

Mental health depended on the harmonious cooperation of these five spirits under Shen’s governance. When the Heart-Shen “loses its governance,” disorder spreads throughout the psyche, just as chaos arises in a state when the sovereign fails.

The five spirits in Chinese conception show that there exists a gradient of awareness.

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Mental Illness Categories

The Huangdi Neijing described two major categories of mental illness:

Dian: marked by unhappiness, headache, red eyes, and a troubled mind—resembling what we might call depression or melancholic states

Kuang: characterized by manic forgetfulness, flying into rages, and wild activity—corresponding to manic or psychotic presentations

The Atharva Veda’s Chinese parallel distinguished between mild conditions (neurosis-like deviations from normal mental functioning) and severe disruptions (psychosis-like states).

The same categories of mental illnesses in different cultures show that man is the same in all cultures.

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The Five Emotions and Organ Pathology

Perhaps the most distinctive feature of Chinese medical psychology was its systematic theory linking specific emotions to particular organs through the Five Phases (Wu Xing) cosmological framework:

  1. Anger (nu) → Liver/Wood: causes Qi to rise excessively, leading to headaches, red face and eyes, irritability, and eventual Liver damage
  2. Joy (xi) → Heart/Fire: excessive elation makes Qi “loose” and scattered, impairing concentration and Heart function
  3. Worry/Pensiveness (si) → Spleen/Earth: causes Qi to “bind” or knot, creating digestive problems, obsessive thinking, and exhaustion
  4. Sadness/Grief (bei) → Lungs/Metal: makes Qi “disappear” or descend excessively, depleting vitality and weakening the Lungs
  5. Fear (kong) → Kidneys/Water: causes Qi to descend or withdraw, potentially leading to involuntary urination, weak knees, and Kidney depletion

The Huangdi Neijing taught: “When anger abounds and does not end, then it will harm the mind”. Emotions weren’t merely psychological phenomena but “movements of Qi” with direct physiological consequences. Each emotion in moderation represented a healthy response, but excess transformed natural propensities into pathological states—vigor becoming rage, ecstasy becoming hysteria, contemplation becoming worry.

The Chinese medical psychology links specific emotions to particular organs, indicating that mind and body influence each other.

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Treatment Philosophy

Chinese medicine emphasized prevention over cure, regulation over correction. The therapeutic goal was restoring the smooth, balanced flow of Qi and harmonizing the Five Spirits. Methods included:

  • Acupuncture at points like HT-7 (Shenmen, “Spirit Gate”) to calm the mind and nourish Heart Blood
  • Herbal formulas to nourish organs and regulate Qi flow
  • Dietary therapy following seasonal principles
  • Emotional interventions using the principle of “winning with emotions”—using one emotion to counterbalance another (e.g., joy to overcome sadness)
  • Lifestyle modifications including meditation, proper sleep, and seasonal regimens
  • Calming the Heart and settling Shen, while soothing the Liver and relieving constraint

The approach was fundamentally holistic, recognizing that “human mental activity is not merely the electrochemical activity of the cerebral cortex, but an outward projection of the flourishing or decline of the essential qi of the five zang and six fu organs”.

The Chinese treatment philosophy is prevention over cure, regulation over correction. This is very wise.

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January 14, 2026 – 7:08 AM Categories: Psychology | Comments (1)

Vedic India: The Integration of Spirit, Mind, and Body

Reference: SC: Psychology

NOTE: Text in color contains Vinaire’s comments.

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Foundational Concepts

In Vedic times, understanding of the mind emerged from texts spanning roughly 1500-500 BCE, particularly the Atharva Veda and later Ayurvedic medical texts like the Charaka Samhita and Sushruta Samhita. The Vedic conception distinguished the manas (mind) as separate from but intimately connected to the physical body, governed by three fundamental qualities or gunas: sattva (purity, balance), rajas (passion, activity), and tamas (darkness, inertia).

Ayurveda recognized two mental doshas—rajas and tamas—as the contaminants or distorting forces of the mind, while sattva represented the mind’s pure, ideal state. These interacted with the three physical doshas (vata, pitta, kapha)—biological humors governing physiological and psychological processes. Mental illness thus arose from imbalances in this integrated mind-body system.

Sattva (purity, balance) is the ideal state. Rajas and tamas depart from this ideal state. This ideal state may be defined as Oneness (continuity, consistency and harmony). Spirit, mind and body are one.

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Causes: A Dual Framework

Vedic understanding operated on two parallel tracks that were never fully separated:

Supernatural causation remained prominent throughout the Vedic period. Mental illness could result from:

  • Demonic possession by various classes of malevolent spirits: bhutas (hostile spirits), pretas (ghosts), pisacas (flesh-eating demons), raksasas (sense-stealing demons), and apsaras (seductive spirits causing amorous madness)
  • Divine punishment from gods like Rudra, Varuna, or Soma for moral transgressions, insults to elders, or breaking taboos
  • Witchcraft and curses (sapatha), particularly the “evil eye”
  • Karma from past lives (purvakrta karma)—actions in previous incarnations manifesting as mental affliction

Natural causation developed alongside these supernatural explanations:

  • Dosha imbalances: excess or deficiency of vata, pitta, or kapha affecting mental functioning
  • Prajnaparadha (“intellectual blasphemy” or “offense against wisdom”)—the conscious commission of harmful acts through defective judgment, considered by some scholars the primary natural cause
  • Mental shock (mano abhighata) from unbearable losses—death of loved ones, loss of property or status
  • Extreme emotions: fear (bhaya), grief (shoka), anger (krodha)
  • Physical factors: contaminated food, heredity, infection

“Supernatural” causation was something that was not properly understood, and, therefore, it was given a specious explanation. Today we have a better understanding of such causation.

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Classification: The Six Types of Unmada (उन्माद)

Unmada (insanity, mental derangement) represented the comprehensive category for serious mental illness, defined as the perversion of intellect (buddhi), mind (manas), consciousness (sanjna), knowledge, memory (smriti), desire, behavior, and conduct. Ayurveda classified six distinct types:

  1. Vatonmada (vata-caused): restlessness, rapid/incoherent speech, violent behavior, laughing/crying inappropriately, loss of appetite
  2. Pittonmada (pitta-caused): anger, aggression, threatening others, attacking with fists or stones, desire for coolness, seeing flames and lights that aren’t present, yellow skin coloration
  3. Kaphonmada (kapha-caused): loss of appetite, vomiting, minimal desires and speech, excessive sleep, copious saliva and nasal secretions, swelling of face, symptoms worse at night and after eating
  4. Sannipatonmada: combined vitiation of all three doshas, most severe and difficult to treat
  5. Citta Ghataja Unmada: mental shock from unbearable losses, characterized by pallor, fainting, weeping, praising lost objects/persons, inability to sleep, performing unusual acts
  6. Visaja Unmada: poisoning-induced, with blue face, red eyes, loss of strength and sensory function, unstable mind

The Atharva Veda further distinguished between severe disruptions like unmada and milder impairments of mental function such as krodha (anger), moh (attachment), shok (depression), and dushswapna (bad dreams).

These are different symptoms that have the same general cause in traumatic and other mental impressions that get activated.

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Treatment: The Threefold Approach

Ayurveda developed a remarkably comprehensive therapeutic system encompassing spiritual, rational, and psychological interventions:

Daivavyapashraya (divine/spiritual therapy) addressed supernatural causes through prayers, mantras, rituals, and offerings to specific deities. The Atharva Veda contains numerous exorcism mantras designed to expel possessing entities.

Yukti vyapashraya (rational therapy based on clinical reasoning) employed systematic treatments:

  • Panchakarma purification procedures (induced vomiting, purgation, enemas)
  • Herbal medicines: notably Sarpagandha (Rauwolfia serpentina), used for millennia to treat psychotic disorders and later providing reserpine to Western psychiatry
  • Dietary regimens to restore dosha balance
  • Physical therapies

Satwavajaya (psychotherapy—literally “conquering the mind”) aimed to bring intellect (dhi), fortitude (dhrti), and memory (smrti) into proper condition through:

  • Mind control and restraint
  • Replacement of harmful emotions with beneficial ones
  • Spiritual knowledge and philosophy
  • Concentration and remembrance practices
  • Environmental and behavioral modifications

This integrated approach recognized that treatment must address the whole person—body, mind, and spirit—with methods calibrated to the specific type and cause of illness.

The treatment must address the whole person—body, mind, and spirit.

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January 13, 2026 – 9:43 PM Categories: Psychology | Post a comment