Indian approaches to Psychotherapy

Psychology in India as an academic discipline is not a recent phenomena. It has a long history,
not too far behind the West. B.N. Seal is reported to have established a psychological laboratory
in 1905. We may recall that the first such laboratory was established by Wilhelm Wundt in
Leipzig, Germany in 1879. Thus, India was about a quarter of century behind the West in this
respect. The first university department of psychology was established at the University of
Calcutta 100 years ago in 1915. Now, one would think that while celebrating the centennial of
this great event, we could boast of a thriving discipline of psychology as in the West. However,
this hardly seems to be the case despite its proliferation as an academic discipline.

Psychology, unlike physics and chemistry, is culture bound. It is not entirely a positive and
value-free science. It is a human science, normative and socially connected. Community and
culture are no less its flesh and blood than any intrinsic laws implied in human behavior.
Divorced from the native ethos and unconnected with community conditions, it becomes a
lifeless skeleton. What we have in India is a psychology of sorts and not Indian psychology. N.N.
Sengupta who headed the first Department of Psychology at the University of Calcutta received
his training under Hugo Münsterberg at Harvard University. Since then and even after
independence, many of the leading psychologists in Indian universities have been trained in the
U.S. and the U.K. They brought with them Western concepts, methods, and even research topics.
They subscribed by and large to a positivist philosophy of science and shared the dominant trend
to model psychology after Newtonian physics.

If psychology in general suffers from “physics envy,” psychology in India struggles under
“Western envy.” It has been observed often that much of psychological research that goes on in
India with few exceptions is largely imitative of what goes on in the West.

What Is Psychology in the Indian Tradition?

With a sense of indignation that the “concerns of Western psychology of yester years are the
current interests of the Indian psychologists”. A decade later, the same situation was noted by
Kao and Sinha (1997). They observed that psychological researches in this part of the world
were “largely imitative of foreign studies.

Psychologists in these countries became recipients rather than exchange agents of knowledge”.
More recently Misra (2011) observed that psychology in India remains an extension of the Euro-
American tradition and continues with Western concepts and methods. However, he noticed
some change in the attitudes and activities of a significant number of psychologists in India in
recent years indicating “a struggle towards a paradigm shift which is occurring. If we browse the
psychological journals coming out of India, including the journal Psychological Studies edited
by Misra himself and, go through the various papers presented at the annual conferences of the
National Academy of Psychology and the Indian Academy of Applied Psychology and so on, we
find that an overwhelming majority of them continue along the old paradigm with little notice of
the emerging new paradigm. Therefore, it is not far from the truth to say that Indian psychology
and psychology in India continue at the present time to carry different connotations.

Sources of Indian Psychology

The original sources of Indian psychology are the classical texts beginning with the Vedas and
the variety of psycho-spiritual practices prevalent in the Indian sub continent since antiquity.
Some of these practices could be pre-Vedic. Yogic motifs in a number of seals of the Indus
Valley civilization were found at the historic sites of Mohenjo-Daro and Harappa, which
possibly date back to pre-Vedic times, a few millennia before Christ. Significant speculations on
the nature of mind, consciousness, and their role in human behavior and conduct were made
from the time of the Vedas and Upaniṣads to Sri Aurobindo. We find in the Ṛig Veda, for
example, a distinction made between two aspects of the mind—manas and citta. Manas is the
processor and citta is the depository of a variety of mental phenomena like thoughts and feelings.
The Kaṭha Upaniṣad likens the human quest to the chariot.

“The Ātman is the rider of the chariot, buddhi is the charioteer, manas is the reins and the senses
are the horses drawing the chariot”. The Kaṭha Upaniṣad points to the central role of the mind in
our quest for liberation. The Taittirīya Upaniṣad depicts the person as encased in five sheaths
(kośas). The Māṇdūkya Upaniṣad explains the different states of consciousness like wakefulness,
dream, and deep sleep, as well as the extraordinary.

Buddhistic psychology is essentially an attempt to understand the nature of transcendence

(nirvāṇa) and the methods of attaining it. In Buddhism we find that normal consciousness and the
psychological processes associated with it are so organized that they generate a sense of stable
and enduring ego, which in turn influences, colors, and even determines our passions, thoughts,
and actions. This is seen, however, as the cause of manifest suffering. The person in pursuit of
salvation needs to transcend the ego by achieving a transpersonal state where the psychological
processes lose their ego-reference. Buddhism believes not only in the existence of such a
transpersonal, egoless state but also in the possibility of attaining it by following certain
practices. By describing the different stages involved in the progress from the normal to the
transcendental, transpersonal states, Buddhism provides us with an interesting and detailed
phenomenology of consciousness.

MEDITATION
The word “meditation” is derived from the Latin meditari, which means “to engage in
contemplation or reflection.” The word meditation comes from the same Greek and Latin root as
the word medicine. Manocha (2000) described meditation as a discrete and well-defined
experience of a state of “thoughtless awareness” or mental silence, in which the activity of the
mind is minimized without reducing the level of alertness. Walsh and Shapiro (2006) defined
meditation from cognitive and psychological perspective, as a family of self-regulation practices
that aim to bring mental processes under voluntary control through focusing attention and
awareness. Other major descriptions of meditation emphasize components such as relaxation,
concentration, an altered state of awareness, suspension of logical thought processes, and
maintenance of self-observing attitude (Craven, 1989). Thus, meditation has been conceptualized
in many ways and there exists no consensus definition. It is very difficult to capture its essence in
one definition. However, Cardoso et al. developed an operational definition encompassing both
traditional and clinical parameters.

They defined any practice as meditation if it:

(1) utilizes a specific and clearly defined technique,

(2) Involves muscle relaxation somewhere during the process,

(3) Involves logic relaxation (i.e., not “to intend” to analyze the possible psychophysical effects,
not “to intend” to judge the possible results, not “to intend” to create any type of expectation
regarding the process),

(4) A self induced state, and

(5) The use of a self-focus skill or “anchor” for attention.

Presently many meditation techniques are being practiced. However, all of them can be grouped
into two basic approaches- concentrative meditations and mindfulness/ insight meditations.
Concentration meditation aims at single pointed focus on some sound, image or sensation to still
the mind and achieve greater awareness. Most popular form of this meditation is “transcendental
meditation”(TM) developed by Maharshi Mahesh Yogi in 1958. TM is generally done by
focusing the mind on some mantra (sound) to achieve transcendental state of
consciousness.Mindfulness meditation on the other hand involves opening up or becoming more
alert to the continuous passing stream of thoughts, images, emotions and sensations without
identifying oneself with them. Such practice helps in developing a non-reactive state of mind,
which is the foundation for a calm and peaceful state of consciousness. Here instead of
narrowing the focus (concentration) practitioner becomes alert to the entire field of
consciousness. Vipassana and Zen meditations belong to this category.

Mikulas (1990) propounded the classification of meditative practice into four components- form,
object, attitude, and behaviors of the mind. Form refers to the setting of meditation and the
activity of body during the meditation, whereas object refers to object of one’s attention during
the meditation. Attitude is the mental set with which one approaches meditation. Behaviors of
mind connotes whether the meditation is based on concentration or mindfulness.

Effects of Meditation

Physiological
Even though meditation is a mental activity, its effects on human physiology has received much
attention. Few Indian studies have attempted to examine and establish the neurological correlates
of yogic practices, including meditation, the development of brain imaging technique has thrown
the ball in the Western court. The unavailability of adequate infrastructure and needed scientific
temperament within the country has made very few centers move parallel to the Western labs.
Some of physiological effects are summarized here.

Heart rate - Studies have indicated that heart rate slows down during quite meditation and
quickens in the moments of ecstasy during meditation. Meditations like TM, Zen, relaxation
response and other calming forms of meditation generally decrease the rate of heart beat (Bono,
1984; Delmonte, 1984a). However, very pronounced decrease in heart rate is found among long
term practitioners only.

Blood pressure and hypertension - Blood pressure is one of the easiest measurable physiological
variables. There is strong evidence that meditation lowers blood pressure for the people who are
normal or moderate hypertensive. However, most studies indicate that the benefit disappears
once practice is discontinued.

Cortical activity - Evidence from many studies indicates that during meditation alpha activity
increases significantly. Alpha waves are slow and high amplitude brain waves with frequency
ranging from eight to thirteen cycles per second. Alpha activity is generally indicator of deep
relaxed state of mind. Long term meditation practitioners also exhibit theta brain wave activity
(five to seven cycle per second) during which they report peaceful and pleasant experience with
intact self awareness. Research also indicates that during meditation right brain activity
increases.

Metabolism and respiration - Many studies have shown that during meditation oxygen
consumption is reduced (sometime up to 50%), carbon dioxide elimination is reduced (sometime
up to 50%) and respiration rate is lessened.

Skin resistance - Low skin resistance (measured in terms of galvanic skin response) is a good
indicator of stress. As expected high skin resistance has been documented by many researchers
especially among TM practitioners (Bono, 1984; Bagga & Gandhi, 1983).

Psychological
Many perceptual and cognitive abilities are associated with meditation practices. These abilities
may range from normal to paranormal. Many scientific investigations have been conducted to
measure various psychological and behavioral effects of meditation.

Perceptual ability - Brown, Forte, and Dysart (1984a, 1984b) conducted experiments on visual
sensitivity among Buddhist meditation practitioners using before-after and control group design.
Post test was conducted after three months of rigorous meditation practice. Visual sensitivity was
measured by detection threshold and discrimination threshold using simple light flashes. They
reported significant improvement in visual sensitivity after the meditation retreat. Other studies
also reported similar decrease in visual threshold and increased auditory acuity after the
meditation (McEvoy, Frumking, and Harkins, 1980; Keithler 1981). Other studies reported
increased visual imagery abilities (Heil, 1983), enhanced attentive ability (Linden, 1973),
reduction of perceptual noise (Walsh, 1978), increased reaction time (Robertson, 1983), and
enhanced perceptual motor speed (Jedrczak, Toomey, & Clements, 1986).

Memory and intelligence - Jedrczak et al. (1986) reported that number of months of TM practice
predicted the higher performance on nonverbal intelligence test. Other researchers also reported
similar results of improvements in cognitive abilities (Verma, Jayashan, & Palani, 1982). Studies
on TM practitioners generally reported to have positive impact on intelligence, school grades,
learning ability, short and long term memory (Cranson et al., 1991).

Creativity and self actualization - Mixed results have been reported regarding creativity and
meditation. TM researchers in particular reported enhanced creativity with TM practice (Ball,
1980; Orme Johnson & Granieri, 1977). However, other researchers could not find any
relationship between meditation and creativity (O’Haire & Marcia, 1980; Domino, 1977). Self
actualization is thought to be the major goal of dedicated meditation practitioner. Various studies
have measured several aspects of self actualization and experiences in meditation. Alexander,
Rainforth, and Gelderloos (1991) performed a meta-analysis on 42 studies on the effects of TM
and other forms of relaxation on self actualization. Their measure of self actualization included
three independent factors: affective maturity, integrative perspective on the self and world, and
resilient sense of self. They found effect size of TM on self actualization is approximately three
times larger than other forms of meditation and relaxation practices. Other studies also reported
increase in various dimensions of self actualization with meditation (Gelderloos, Walton, Orme
Johnson, and Alexander, 1990).

Mechanisms for the therapeutic effects of Meditation

Helminiak (1981) described six possible mechanisms through which meditation works. These six
mechanisms capture most of the explanations found in the existing literature. They are:

(1) Relaxation: Relaxation is one of the primary components of all kinds of meditation which
induce a pleasant and deep relaxed state of body and mind. Herbert Benson (1976) developed a
therapeutic technique called “relaxation response” which is a form of meditation. His whole
concern with meditation was to reduce stress and hypertension by inducing a state of deep
relaxation. Benson (1976) measured series of physiolo gical parameters in response to relaxation
response. Various effects include-decrease in the rate of metabolism, decrease in the rate of heart
beat, muscle relaxation, slow and rhythmic breathing, decrease in blood pressure, and so on. All
this effects help in balancing physiological abnormalities and promotes healing.

(2) Systematic desensitization: Joseph Wolpe’s (1961) behavioural therapy is especially

instrumental in reducing anxiety. This therapy involves three steps. First, the client is thought to
induce a deep state of muscle relaxation. This is followed by preparing a hierarchical list of
stimuli inducing anxiety. Finally, in a deep relaxed state client confronts (either by imagination
or by presentation of actual stimuli) each of the anxiety producing stimuli progressing in
hierarchy. This therapy is based on the principle of reciprocal inhibition. Since anxiety and
relaxation are incompatible to each other, the stimuli loose their anxiety provoking quality.
Client continues this process until he is desensitized to highest item in the hierarchy. In
meditation also a practitioner undergoes similar steps. Every meditation involves induction of a
relaxed state. In meditation, the practitioner first enters in deep relaxation and suspends
conscious thoughts by either detached observation or concentration. As a result, many anxiety
provoking repressed memories, thoughts, and feelings arise in the mind. When one confronts
them in a deeply relaxed state, these factors loose their power to induce anxiety and finally get
eliminated.

(3) Release of repressed psychic material: This is related to systematic desensitization. With
regular practice of meditation, most of the practitioners encounter release of repressed
unconscious thoughts, emotions, and images (Schwartz, 1974). This is very similar to the release
of unconscious phenomenon during free association in psychoanalysis. This could be initially
disturbing, but with constant practice unconscious mind gets cleaned of such memories and
healthy mind is achieved. During meditation, the practitioner remains under low arousal and
sensory deprivation for a long time and under such condition repressed feelings and thoughts
arises (Benson, 1976).

(4) Unstressing: Parallel to release of repressed memories, many practitioner reports many
physical reactions during intense meditation. This could be involuntary muscular skeletal
movements such as repeated twitches, spasms, gasps, tingling, tics, jerking, swaying, pains,
shaking, aches, internal pressures, headaches, weeping, and laughter. The experience covers the
range from extreme pleasure to acute distress (Goleman, 1971). TM practitioner calls this as
“unstressing”. Goleman (1971) interprets this phenomenon on the basis of psycho-physiological
principle contemplating that all psychic and emotional phenomena have parallel physiological
processes.

(5) Dissolution of habitual patterns of perception: Human beings are mostly governed by rigid
and fixed patterns of thinking, feeling, and reactions. Many of these patterns are unhealthy and
cause neurotic and psychotic problems. Most of the unhealthy habitual patterns are due to our
identification with emotions that we are not able to control and regulate. With detached
observation, emotions and thoughts loose their power and practitioner is able to identify the
unhealthy patterns of behavior and remove them with healthy ones.

(6) Cosmic consciousness: Attainment of cosmic consciousness is a mystical concept and not
available for scientific investigation. Many terms are used to represent cosmic consciousness
such as samadhi, nirvana, satori, and moksha. It is the highest goal achieved by meditation in
esoteric traditions where a person transcends his personal ego. In the state of cosmic
consciousness a person realizes that he/ she is one with the whole cosmos and is not separate
from others. As a result, a tremendous sense of love and compassion arises in him and it is the
highest state a human can achieve.

YOGA
Yoga practitioners, mental health professionals, and researchers have become increasingly aware
of the health benefits of yoga practice, including stress-reduction, physical benefits, and mental
health benefits. Although yoga is not a substitute for professional psychological and psychiatric
care, many mental health professionals will agree that yoga practices can greatly benefit their
clients in a number of important ways (through exercise, relaxation, deep breathing, and the
support of spiritual practices, beliefs, and communities). Yoga is a holistic practice that
integrates and develops the mind, body, breath, and spirit. For some clients, yoga practice may
be an important or essential adjunctive treatment, complementing standard psychotherapeutic
and psychiatric modalities. For other clients, the integration of yoga practices and psychotherapy
may enhance the benefits of talktherapy or medication. Some clients may benefit more when
traditional therapy and body oriented, nonverbal, intra psychic therapies are combined.

The word “yoga” is derived from the Sanskrit root yuj, which means to yoke, bind, unite, join, or
harness. It is a determined pursuit to transcend the inherent limitations of phenomenal awareness
to achieve higher states of consciousness in which awareness is progressively delinked from
sensory processing and gets closer to “true” knowledge. Patañjali at the very outset states in his
Yoga Sūtras that the practice of yoga is to control the vṛttis (fluctuating forms) of the mind,
which in many ways disturb its proper functioning. When a state of transcendence is reached and
awareness is successfully delinked and dissociated from sensory mode in a state of samādhi the
mind gets fully absorbed in the object of consciousness. Transcendence signifies a state of pure
consciousness; it involves experiencing consciousness as-such. Knowledge obtained in such a
state is considered perfect and beyond falsification and doubt. It is indubitable and authentic by
self-certification. The practice of Yoga is thus believed to lead to a state of niruddha, complete
control and transcendence of sense processes, which enables one to achieve a state of
unconditioned freedom in thought and perfection in being (kaivalya).
Yoga can be seen as a philosophy and practice of connection, as an individual develops his/her
sense of relatedness to other people, other beings, the environment, and the universe. An
individual also develops his/her sense of connection to him/herself through yoga, becoming more
and more aware of the links between mind, body, breath, feelings, memories, experiences,
health, and states of consciousness. The techniques of yoga aim to uncover and highlight these
connections. Yoga begins with the body and the breath, but also develops the mind, awareness
and concentration, and levels of consciousness. Yoga practices are one way to integrate work
with the body, the breath, emotions, thoughts, interpersonal relationships, self-acceptance,
healthy lifestyle choices, and self-awareness (emotionally, physically, mentally, socially, and
spiritually/ existentially).

In addition to bodily changes, yoga practices involve behavioral, cognitive, and affective
changes. Yoga may help increase one’s self-awareness and insight, altering one’s relationship to
others, the environment, and the universe. Yoga may help cultivate and strengthen healthy
attitudes and behavior such as mindfulness, compassion, focus, generosity, equanimity, joy, and
ethical behavior. Yoga may help one learn to be present and cope with anxiety, tension, anger,
negative memories, and conflicts. In a world where stress is so prevalent, yoga practices can help
reduce physical and mental tension. Although we are surrounded by messages to avoid pain and
to seek pleasure and gratification, yoga may help teach clients to be present with what is. Yoga
practices can help one access one’s natural healing capacity. Yoga can be a powerful tool when
combined with psychotherapy. It can be a way to work with clients who have more difficulty
expressing themselves and healing through traditional (talk) therapy. We are beings with bodies
and experiences that are sometimes difficult to describe through language. Emotions and
sensations are often embodied in physical experiences. Clients may be blocked or struggling with
powerful physical reactions and memories, such as those evoked by trauma, eating disorders,
anxiety, or medical concerns. Physical work may assist therapeutic goals such as helping clients
feel more comfortable in and accepting of their bodies, as well as helping clients who have
problematic reactions to their bodies and bodily functions. Relaxation, deep breathing, and the
release of physical tension may help clients, not only feel better and be more self-aware, but alter
their perspectives and patterns. The definition of ideal psychological health proposed by yoga
psychology is enlightenment, awakening, or realization. Health is seen as more than being free of
symptoms, or adjusting and compromising to life’s constraints and difficulties. Yoga promotes
physical and mental health, rather than being curative medicine or seeking physical wellbeing
alone (Singh, 1986). Yoga practice promotes physical and mental health, through “the
maximization of joy and the complete unfolding of the human potential”.

Yoga practices encourage health by promoting physical and mental suppleness, strength,
endurance, balance, and relaxation. Working with the body can affect the mind. One of the goals
of physical postures is to gain perspective on the body by gaining distance from it, fostering
neutral observation and promoting higher levels of growth (Rama, Ballentine, & Ajaya, 1976).
As the body releases tension and postures become effortless, the mind becomes calmer. Mental
concentration and focused attention result and one naturally become more introspective, allowing
access to intuition and one’s inherent wisdom.

Because the breath is both a voluntary and involuntary function (regulated by mind and body), it
can be considered an intermediary between mind and body (Morse, Cohen, Furst, & Martin,
1984). The rhythm of the breath is often one of the most obvious physical indications of a
person’s emotional and mental state. Although mental and emotional states often feel difficult to
control, the irregularities of the breath can be easily observed and controlled. Yogic breathing
exercises (pranayama) teach awareness of the breath, healthy breathing, and concentration. The
breathing practices also teach one to be aware of and to control energy shifts.

In addition to promoting physical health, the physical yoga practices release tension and calm the
body. The breathing and concentration practices calm both the body and mind, increasing focus
and naturally promoting meditation. The mental and physical benefits of meditation practices,
such as mindfulness meditation, have been very well documented. Many mental health
practitioners already incorporate meditation into treatment. Yoga practices involving the physical
body, the breath, and concentration prepare practitioners for meditation. Meditation ultimately
leads to the experience of higher states of consciousness. This transpersonal consciousness – in
which awareness is manifested as intuition and wisdom – must be directly experienced (Rama et
al., 1976). The “witness consciousness” results in great bliss, joy, and peace. Ultimately, the
practices involve the experience of universal awareness, in which the distinction between subject
and object (knower and known) dissolves.

As we have seen, many psychotherapeutic goals are identical to those of yoga practice:
promoting health, regaining a sense of peace and joy, balancing physical, mental, and energetic
imbalances, creating cognitive, behavioral, and affective change, promoting introspection and
self-awareness, coping with difficult experiences and mental states (e.g., anxiety), and
developing self-acceptance and connection with others. There are also elements of yoga practice
that are beyond the realm of traditional psychotherapy, such as discussion of higher
consciousness and the integration of work with the physical body, breath, and mental experience.
Likewise, traditional psychotherapy and medication utilize different methods and well-
documented ways to support clients and promote mental health. Although it is important to
remember that they may be appropriate in different combinations with different clients, yoga,
psychotherapy, and psychiatric medication can be seen as complementary approaches that will
certainly enhance and inform one another.

Yoga is based in a number of “principles”  that may be useful

psychotherapeutically:
• There is wisdom in experiencing, in being. There is wisdom in your experience. 
• You are just right as you are. You have likely forgotten this; all you have to do is remember
or realize it. 
• Your body-mind is right the way it is; you are full of light. 
• Yoga (union) is your natural state. We are all interrelated. If everything is connected, you can
watch the body-mind breath to understand the self, the universe, and your relationship to the
universe. 
• Change is inevitable. Everything can and will change, including your body, your thinking
patterns, your lifestyle, and your breath. Yoga helps prepare for change when and as it occurs.
Yoga teaches you to be mindful of the transitions in life. 
• Yoga practices can help you become more aware of your body, breath, mind, spirit, and your
link to the universal. 
• You are different from your thoughts. Your mind is usually filled with continually changing
thoughts, images, internal commentary, and fantasies. It is possible to observe your thoughts if
you cultivate the ability to separate yourself from them. Although you are likely to initially
experience your identity as a stream of thoughts, emotions, and urges, you will eventually
witness the stream of consciousness. This is the experience of the observer, the witness, or the
witness consciousness. Eventually, both the witness and that which is witnessed will dissolve
into the experience of pure consciousness. 
• Yoga practices bring you into the present. Breath and movement are your connection to the
present moment. 
• Yoga practices bring calm, peace, and happiness to the moment. 
• Yoga helps you accept difficulties, accept pleasure and pain. Yoga helps you experience
relaxation in action – living life as free of tension as possible. 
• Yoga encourages moderation (e.g., eating until you are satisfied; neither eating too much nor
too little; eating in a way that is healthy for your body and questioning assumptions that we have
about this) 
• Yoga teaches you to be “where you are,” physically, mentally, spiritually. Rather than
pushing, “flow.” Witness your experience – thoughts, feelings, sensations. Do that for which you
are ready. Postures are not the goal – but mindfulness and flow. 
• In terms of hatha yoga: you will feel better if you physically strengthen, stretch, cleanse,
and stabilize your body (muscles, joints, spine, skeletal system, internal organs, glands, and
nerves). You will feel better if you learn to tune in to your energy level and internal energy flow
(prana). Yoga practices will help you revitalize, control, and enhance your energy. Meditation
and concentration practices will increase your positive thinking, mental clarity, and focus. A
conditioned, healthy body that holds as little tension as possible will help you be mindful, rest
and watch the mind/breath, and sit in meditation more easily. The body moves to help calm the
mind. The movement is also a point of focus for the mind, creating “meditation in motion.”