Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Childhood trauma is due to the distressing event or events experienced by a child. Any kind of trauma, be it physical, mental or emotional, would eventually affect the mind of the child. From an Ayurveda perspective these adverse childhood experiences would affect manovaha srotas (channels related to the mind and conveyance of the thoughts and other faculties related to mind) and manas (mind).
Related Reading – Childhood Trauma: Causes, Symptoms, Treatment
Mind, knowledge, information – Ayurveda perspective
Mind is an important component in the sequence and process of gaining knowledge.
The sense objects, sense organs, mind, intellect and soul form a linear equation for any information to be received, processed and transformed into a wanted and understandable knowledge which will later be stored in the subconscious level in the form of memories.
How does this happen?
First the sense object connects to the sense organ. The sense organ perceives its object / subject and conveys it to the mind. The mind passes this piece of perceived information to the soul for the later to experience it. In between this, the intellect would come into the play and scan the piece of perceived information. It would process and decide if the information collected is conducive or harmful to the self and passes the information further to the soul. The soul would experience the perceived knowledge which has been filtered and passed on to it. So, the ultimate recipient i.e. soul will only observe everything and enjoy the knowledge. This is the sequence of gaining jnana – knowledge according to Ayurveda. If the mana or mind is not present in the equation or is diverted, there will be interruption of passage of information in the cycle. The same sequence happens with each and every indriya i.e. sense organ and its indriyartha i.e. the sense object in the process of gaining knowledge. The knowledge gained is called pratyaksha jnana i.e. knowledge perceived by direct contact of the sense organ with its sense object.
From childhood trauma perspective – The manas – mind of children is delicate. It is like a clean canvas, anything good or bad can be imprinted on it. Constant impressions and traumatic experiences will affect the mind in a bad way so as to cause many mental and psychosomatic disorders like unmada, apasmara, atatvabhinivesha, etc. The symptoms explained in childhood trauma are similar to some symptoms mentioned in these diseases or their sub-types.
The understanding of the manas is important because it is the entity which we will be addressing in the treatment process. Dhee – intellectual training, Dhairya – instilling courage and counseling and Atmadi Vijnana – education about self importance which are the mainstays of treating a mental disorder according to Ayurveda work by operating on the mind of the child.
Indriyartha Sannikarsha
The equation and chemistry between a sense organ and its object is known as indriyartha sannikarsha. According to Ayurveda, ‘Asatmya Indriyartha Sannikarsha’ is one of the main causes for any disease and in mental disorders it is definitely contributory. It means ‘improper contact between a sense organ and its object’. This can either be deficit contact, excessive contact or perverted contact – all being equally harmful in the long run.
From childhood trauma perspective – The traumatizing experiences would reach the mind through these sense organs. Example – physical or sexual abuse or bad touch through the skin, seeing the loss of a loved one, a road accident, a natural disaster, a loved one suffer, domestic violence, separation of patents etc through eyes, hearing about the loss of loved ones, being bullied and scolded or abused through ears etc.
Excessive contact – atiyoga – of the sense organs with unwanted, disturbing and traumatizing objects and events and exposure to them for long time periods would gradually take over the child in the worst possible way.
The understanding of this sannikarsha would help the physician to help the child by keeping him or her away from or detached from those objects or events from the contact of their sense organs so as to prevent repeated or recurring trauma or as a part of intervention, to divert the child from the familiar traumatizing people and conditions to enable quick mind healing and in treating the trauma.
Manovaha Sroto Dushti
Manovaha Srotas or the channels related to mind and emotions are definitely affected in the children who have had traumatic experiences. These experiences aggravate the doshas, mainly vata and pitta. These doshas would in turn invade these channels and cause a wide array of symptoms. Heart and its great (10) blood vessels are considered to be the channels of the mind. Many have considered ‘the brain’ as the hrdaya and dasha dhamanis as nerves instead of arteries.
From childhood trauma perspective- Among the physical impact of childhood trauma it is said that there are likely chances that the child would carry the risk of developing stroke or coronary heart diseases / cardiovascular diseases, autoimmune diseases in the long run. Here we see that the heart and brain conditions, both are mentioned. This shows the involvement of hrdaya as a heart and as a brain also.
Keeping hrdaya as heart, we would find the heart zone and the functions of the heart are mainly monitored by vyana vata, avalambaka kapha, ranjaka pitta and udana vata. Keeping hrdaya as brain, prana vata, sadhaka pitta and tarpaka kapha are the main doshas in this zone. These doshas are invariably disturbed in childhood trauma.
Among the physical impacts we can also see that the immune system is hampered. Ojas, which is located in the heart and is circulated all over, is considered to be an important component of the immune system.
Thorough understanding of the anatomical and physicological aspects of manovaha srotas would enable the physician to diagnose the dosha imbalances taking place in these channels, analyze the symptoms and provide suitable remedies. Example, a child who has undergone traumatic experiences showing a lot of anxiety, fear, restlessness etc can be seen as having vata aggravation in the mind channels. A silent, introvert and depressed child would have kapha predominance and an aggressive, repulsive, rebellious and angry child as having pitta predominance.
Unmada – Psychoses, Mania, Syndrome of mental conditions
The invasion of manovaha srotas by the morbid doshas has been mentioned in the pathogenesis of unmada.
From childhood trauma perspective – Childhood traumatic experiences can lead to psychological effects including depression, emotional distress, anger issues, immense stress, psychotic disorders and PTSD. All these symptoms can be found in one or the other types of unmada. Dissociation, a product of complex traumas in children, is a part and parcel of the clinical picture of unmada and apasmara (memory disorders, epilepsy). Suicide attempts are common in adults who have experienced traumas in their childhood. Self harm is explained in Unmada. Having trust issues, being scared about the surroundings (believing that the world is an insecure and scary place to live), not interacting positively with people around them, not being able to manage and maintain relationships and other kinds of fears and insecurities are also a result of unmada. If not exactly, symptoms in close proximity to these have been mentioned in the context of unmada.
Tendency of being violent, being of criminal mindset, troubles in reasoning, increased self harming tendency, less impulse control, high risk behavior, and low self esteem, intense reactions are also mentioned amongst the symptoms of different kinds of unmada.
PTSD which is common outcome of childhood trauma will present with behavioral changes, avoiding once liked activities, difficulty in focusing, overreacting, anxiousness, depression, increased sadness or fear, increased anger or aggression, volatile emotions, isolation, avoidance, hyperactivity, irritability, attention issues, development of new fears, concerns about safety and death, being hyper-vigilant, problems with people and authority figures, not gelling with people, detachment, changes in appetite and sleeping etc, which are all found in cases of unmada.
Understanding these concepts from Ayurveda perspective would enable the physician to think of treating these conditions on the lines of ‘treatment principles of unmada’. Bhutonmada and its treatment too shall be considered.
Read more: Unmada-Insanity: Ayurvedic Understanding And Management
Rajas and Tamas involvement
The manas is made up of three attributes – sattva, raja and tama. Raja (rajas) and Tama (tamas) are said to be the doshas i.e. contaminants of the mind. In the pathological conditions related to mind, the mind doshas i.e. rajas and tamas are mainly vitiated.
From a childhood trauma perspective – Childhood trauma can result in high and low end behaviors of the child. Being angry and hyperactive can be a high end behavior and is attributed to the imbalance or predominance of rajas quality of the mind. Similarly, being depressed, isolation, low attention, detachment etc can be regarded as low end behaviors which are due to imbalance or predominance of tamas quality in the mind. The same doshas i.e. rajas and tamas are said to contaminate the manovaha srotas also.
When physical trauma leads to mental symptoms in childhood trauma, the physical doshas i.e. vata, pitta and kapha would get aggravated first and later contaminate the manas, manovaha srotas and later rajas and tamas get involved in the pathogenesis and symptoms of childhood trauma. When childhood trauma is directly due to imbalance or aggravation of mental doshas, the rajas and tamas qualities are first disturbed and disturb the mind. In the later time, the physical doshas too would get involved giving rise to physical symptoms.
Understanding this would enable the physician to analyze rajas and tamas imbalances in childhood trauma, to reason out physical symptoms in mental trauma and mental symptoms in physical trauma.
Apasmara – memory disorders, epilepsy
Apasmara is one of the diseases related to the mind. Apasmara has been popularly equated with epilepsy / epileptic disorders. But the definition of apasmara points towards ‘memory related disorders’. When the word ‘bhibhatsa chesta’ i.e. scary / abnormal physical activities (which denotes seizures) is understood along with ‘smruteh apagamanam’ i.e. deviation of memory (fluctuations in memory) the condition would look like epilepsy. The morbid doshas are said to cause Apasmara when they get lodged in the Hrt-Srotas i.e. channels of the hrdaya . Here the channels of hrdaya shall be considered as the same 10 dhamanis mentioned in the context of mind related channels and hrdaya shall be considered as brain.
From a childhood trauma perspective – Epileptic seizures have not been explained in the context of childhood trauma but memory fluctuations and memory disorders with or without neurological disorders are common. Finding trouble in reasoning, inability to prepare for the future, inability to plan are related to disturbances in memory and thought process and constitute apasmara.
Understanding this perspective would enable the physician to consider the treatment principles of apasmara in treating mind and memory issues commonly found in children who have been exposed to traumatic experiences. In Ayurveda, Unmada and Apasmara have been considered as interrelated conditions and the treatments for these two conditions too are interchangeably implemented.
Read more: Apasmara Meaning And Understanding
Atatvabhinivesha
This is a condition wherein a person will not be in a position to discriminate between real and non-real, good and bad. This is due to extreme clouding of the mind and intellect.
From a childhood trauma perspective – ‘Not knowing what is real and what not’ is amongst the symptoms of childhood trauma and PTSD resulting from it.
Understanding this aspect would enable the physician to blend treatment of atatvabhinivesha in the treatment of childhood trauma as and when needed. Atatvabhinivesha has a specific treatment plan but can be treated on the lines of treating unmada and apasmara.
Bhuta Roga / Graha
Graha Chikitsa is a branch amongst the eight elite branches of Ayurveda. It is also known as Bhuta Vidya. This branch deals with psychology and psychiatry. They deal with setting right various imbalances occurring in the mind and in a way deals with psychotherapy. Ayurveda believes that many mental diseases are caused due to the affliction by bhutas which means evil spirits, supernatural powers and unseen entities like Gandharva, Pisacha, etc.
Ayurveda has also explained many Grahas – unseen and unperceived entities which afflict the child and cause many mental and psychosomatic disorders. Each graha will affect in a different way and would produce a different set of symptoms.
To sum up in brief, bhuta vidya / Graha Chikitsa deals with diseases caused by unknown causes. The bacterial or viral disorders fall under the bracket of these diseases.
From a childhood trauma perspective – Many symptoms of Graha and Bhuta Rogas are also found in the description of childhood trauma and ADHD.
Understanding this aspect will give added advantage to the physicians to inculcate the treatment principles of bhuta vidya / graha rogas in treating childhood trauma effectively.
Vata
When vata is severely aggravated it can cause many mind related symptoms along with somatic ones by afflicting the mind. Pitta and Kapha too can afflict the mind but not as severely as vata. This is because pitta and kapha depend on vata to be pushed and pulled in the body. Apart from this, vata is the motivator and controller of the mind and sense organs and is responsible for their functions.
From childhood trauma perspective – Symptoms like anxiety, restlessness, confused nature, not being able to take decisions, being scared; fluctuant behavioral changes, nervousness etc are caused due to the affliction of mind by vitiated vata.
Understanding this aspect would help the physician to understand that aggravated vata might be causal or may be a trigger of ‘childhood trauma’ symptoms and also to identify vata symptoms in these conditions. This will help in plugging in the principles of treating vata disorders in handling childhood trauma.
Pitta and Kapha
Involvement of pitta and kapha too are seen in some children though vata most often dominates the picture.
From childhood trauma perspective – Pitta aggravation would give rise to high end emotions like anger; aggressiveness etc and Kapha involvement would give rise to depression, detachment, isolation etc.
Understanding this perspective will enable the physician to address high pitta and kapha symptoms in conditions of childhood trauma as and when they are evitable.
Ayurveda Treatment Principles for Childhood Trauma
Nidana Parivarjana – keeping away the etiological factors
Keeping away from the nidanas – etiological factors, isolation of the child from traumatic situations and troublesome environments is the key to treat childhood trauma effectively.
Important causes of vitiation of mind and mind related channels
– Foods and activities which cause aggravation of rajas and tamas qualities of the mind and diminution of sattva quality of mind
– Foods and activities which cause aggravation of physical doshas – vata, pitta and kapha
– Excessive expression of the mind emotions like anger, greed, lust, fear, panic, jealousy etc
– Nidana – All etiological factors mentioned in the context of unmada, apasmara and murcha (insanity, epilepsy or fainting disorders)
– Mano Abhighata – Mental injuries / mental trauma and any causes leading to the same
– Asatmya Indriyartha Sannikarsha – incompatible or inappropriate association of the sense organs and sense objects
– Prajnaparadha – mistakes done in a state of consciousness
– Alpa Sattva / Avara Sattva – Weak mindedness
– Chronic / long standing physical and mental disorders
The involvement of these etiological factors shall be considered in children suffering from childhood trauma.
Read more: Graha Roga: Psychiatric Disorders of Children
Dhee, Dhairya, Atmadi Vijnana
Treatment principles of contamination of channels of mind and childhood trauma
There are many ways in which mental disorders can be dealt with. Among them, the three basic principles of treating the mental disorders are –
– Dhee – proper and skilful use of / training the intellect
– Dhairya – seeding courage in one’s mind
– Atmadi Vijnanam – to make one to realize the importance of ‘self worth’
The same are the best treatments for the mind related channels.
These are the golden principles to be followed in treating any mental or psychosomatic disorders. Modern medicine too follows similar principles in treating mental disorders and also in handling and managing childhood trauma.
Daivavyapashraya – divine therapies
It forms one third of the trividha chikitsa – threefold treatments. They are used to treat physical, mental and psychosomatic disorders. They can be considered as divine or spiritual therapies or ‘belief treatment’. These are used when conventional medicines and therapies fail to yield desired results.
Some measures included in the daiva vyapashraya chikitsa are concerned with religious rituals like offerings and benedictions. Therefore these therapies can also be named as magical practices, magical-religious practices, occult practices and faith practices.
Hymns, wearing amulets, gems etc, performing auspicious ceremonies, offerings, sacrificial rituals, charity, oblations, observance of scriptural rules, atonement, fasting, chanting of auspicious hymns, observance to God and going to pilgrimage are included in these therapies. Among these, those which are suitable for children shall be chosen.
Read more: Daiva Vyapashraya Chikitsa – Divine Therapies of Ayurveda
Yuktivyapashraya Chikitsa
Yuktivyapashraya Chikitsa includes rational treatments which can be planned as per condition and patient. In short skilful planning and customization of treatment protocols (therapies like Panchakarma), medicines, lifestyle practices and dietetic protocol are included in this type of treatment.
Sattvavajaya Chikitsa
Sattvavajaya Chikitsa includes treatment approaches made to heal the mind and instill courage and confidence in the mind so that he or she would get ready to face the realities in a practical way and design themselves to tackle and come out of their problems. This includes psychotherapy and counseling. This may not be useful for small children but young adults and parents can be subjected to this treatment.
Yoga & Meditation
Yoga and meditation are extremely helpful in streaming the mind and thoughts in the right channel and direction. They help in comprehensive psychosomatic healing. Again they come with limitations. They can be designed for young adults but are difficult to bring little children into practicing these, but it is not impossible.
Important Yoga postures for tackling Childhood Trauma
– Balasana – child’s pose
– Adho Mukha Svanasana – downward facing dog pose
– Utkatasana – chair pose
– Urdhva Mukha Svanasana – upward facing dog pose
– Virabhadrasana II – warrior II pose
– Baddha Konasana – bound angle pose / Cobbler’s Pos
– Garudasana – eagle pose
– Simhasana – lion pose
– Tadagasana – pond pose
– Tadasana – mountain pose
– Salamba Sirsasana – Headstand
– Uttana Shishosana – extended puppy pose
– Savasana (variant with bent legs) – constructive rest
Panchakarma
The morbid doshas indulged in causing or triggering the episodes of traumatic experiences shall be dealt with cleansing and detoxifying therapies. Vasti – therapeutic enemas and Virechana – therapeutic purgation is extremely useful since ‘childhood trauma’ is predominant with vata and pitta symptoms. These therapies shall be selectively used, when the morbid doshas are on the surge and are excited enough to be expelled from the body. Vamana – therapeutic emesis shall be considered when kapha is exacerbated. Again young children cannot be convinced to undergo these therapies. They can be readily administered in young adults and adults who had experienced trauma as children especially so when they display symptoms of dosha aggravation and are still undergoing these experiences.
Bahya Chikitsa – External therapies
External therapies like Shirodhara and other forms of Murdni Taila procedures (oil therapies done on head) are useful. They provide relaxation to body and mind, induce good sleep, heal the body, senses and mind and rejuvenate the child. Abhyanga (herbal oil massage) and Sarvanga Dhara (oil showering all over the body) / Ksheera Dhara (milk therapy done on head or body with medicated milk) are also helpful and serve the same purpose of shirodhara.
Rasayana
Childhood trauma would have a deep impact on many systems including nervous, endocrine and immunological systems. Apart from customized Panchakarma therapies to cleanse the body, disease specific and dosha specific medicines, Rasayana (immune modulators, anti-ageing medicines, and antioxidants) should be administered. They not only rejuvenate the system but also enhance immunity. They would also prevent the recurrence of symptoms. Daivavyapashraya and Sattvavajaya Chikitsa shall be skillfully blended with these therapies and medicines to provide comprehensive cure. Medhya Rasayanas – brain tonics are also beneficial.
Achara Rasayana & Sadvrutta
The child shall be introduced to various activities and deeds which would act like Rasayana (Achara Rasayana). The child should be protected and secured and nurtured amidst an ideal thriving environment, good people and caretakers, friends and family (Sadvrutta). This will give a positive impact and provide affecting healing over a period of time.
Read more: Achara Rasayana – Behavioral Therapy For Calm Mind And Long Life
Other treatment principles
Treatment principles of the below mentioned conditions (along with medicines, therapies, dietetic and lifestyle changes / customization) should be considered in treating childhood trauma –
– Unmada chikitsa
– Apasmara chikitsa
– Chittodvega chikitsa
– Atattvabhinivesha chikitsa
– Hrdroga chikitsa
– Vata vyadhi chikitsa
– Manovaha sroto dushti chikitsa
Useful formulations in Childhood Trauma
– Brahmi Ghrita
– Kalyanaka Ghrta
– Saraswatha Ghrta
– Panchagavya Ghrta
– Kalyanaka Kashayam
– Saraswatharishtam
– Saraswatha Churna
– Manasamitra Vati
– Gorochanadi Vati
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