Difference between revisions of "Dhriti"
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Consequently, dhriti may finally be understood as the principal regulatory component of intellect. It helps maintain a steady hold over perception by various senses, thereby improving knowledge (tattva gyana) as a student and social and professional skills as an entrepreneur or practitioner with constant practice. It requires the perfect balance of determination, desires and dedication to hone this intellectual component called dhriti. </p> | Consequently, dhriti may finally be understood as the principal regulatory component of intellect. It helps maintain a steady hold over perception by various senses, thereby improving knowledge (tattva gyana) as a student and social and professional skills as an entrepreneur or practitioner with constant practice. It requires the perfect balance of determination, desires and dedication to hone this intellectual component called dhriti. </p> | ||
− | + | == Current researches == | |
+ | <p style="text-align:justify;">A man devoid of gradually developed and properly functional intellectual faculties is apparently disabled in leading a desirable life. These intellectual errors (i.e. prajnaparadha) aggravates all the dosha becoming one of the trident causes of all forms of disease manifestation. Dhi, dhriti, and smriti being the three stages of prajna can give a bird’s eye view of an individual’s psychological development. In view of the above mentioned intellectual factors, many relative interpretations have been put forward to understand these. | ||
+ | <br/> | ||
+ | The exact interpretation of all these intellectual faculties of mind is debatable because their physiological functions overlap in nature. While some scholars are of the view that dhriti is the retention power of mind, others consider medha in that place. They later clarified that dhriti is that governing feature which averts the mind from indulging into destructive or potentially undesirable or non-beneficial substances and evaluation of medha is by grasping power (grahana samarthya)<ref name="ref3">Dr. Sujit kumar, Dr. Deepika Mehra, Dr. Vaidehi V Raole, Dr. Sunil P Nikhate (2019) : A conceptual study on Medha, Budhhi, Dhee, Dhruti, Smruti and Manas; Department of Kriya Sharir, Parul Institute of Ayurveda, Parul University, Vadodra, Gujarat.</ref> Broadly concluding the views of different authors over defining these terms, dhi is referred to the ability of correct perception (judgement), dhriti means self-control or will power or patience and smriti refers to the ability to recall past events.<ref name="ref4">Dr. Pooja Sharma, Dr. Anshu Sharma ; Ayurvedic aspect of dhee, dhriti, smriti w.s.r. to mild cognitive impairment; Ilkogretim Online - Elementary Education Online, 2020; Vol 19 (Issue 4): pp.3224-322</ref> | ||
+ | <br/> | ||
+ | As per classics, prajnaparadha (dhi dhriti smriti vibransha) is a fundamental intrinsic factor for the development of all diseases, especially diseases of psychotic origin. It is described that a person whose intellect, self-control, and memory are impaired falls into delusion and commits certain actions which aggravates tridosha at once, initiating the disease pathogenesis. Thus, avoiding all causative factors (nidana parivarjana), which lead to impairment of factors of prajna or manovaha strotas in general viz. virudhha ahara, vidahi-ushna-ruksha ahara, katu-amla- lavana rasa and certain manasa bhava: bhaya, chinta, shoka, moha, krodha, lobha should be of prime focus. This explains the importance of dhriti (power of self-control) in the light of a therapeutic modality as part of initial nidana parivajana.<ref name="ref4" /><ref name="ref5">Dr. Rakesh Kr. Srivastava(2020); Mental health, its promotive and preventive aspects:Ayurvedic view</ref> | ||
+ | <br/> | ||
+ | The above said practical dimension of dhi is evident in the concept of mano nigraha (restraining of mind). Mano nigraha is a state of self-control of mind guided by a perfect balance of desire, determination, and dedication. It forms the nodal principle behind satvavavjaya chikitsa (psychotherapy), which focusses over nigrahan (diversion) of mind from harmful subjects of senses (ahitartha) towards beneficial (hitartha). Dhriti is mentioned as ‘manaso niyamatmika’ i.e. regulatory body of mind. Hence, it is that property of mind which governs its actions viz. chintya (regulation of thought processes), vicharya (analysis of thoughts and ideas), uhya (logical reasoning), dhyeya (polishing objectives by focussing over them) and sankalpa (arriving at an apparently right conclusion/decision). Thereby being a check-dam to reckless indulgence in any morally or conventional undesirable behavioural or psychological attributes.<ref name="ref6">Bagali SS, Baragi UC, Deshmukh RA. Concept of Satwavajaya Chikitsa (Psychotherapy). J Ayurveda Integr Med Sci 2016;1(1):56-63.</ref> </p> | ||
Revision as of 08:44, 3 April 2023
Dhriti is one of the principal faculties of the mind (manas) that help to assert a restraining force over itself to prevent the yielding of senses (gyanendriya) to their subjects. [Chakrapani on Cha.Sa.Sharira Sthana 1/144] Atma (soul), manas (mind), and sharira (physical body) are the tripods of life. [Cha.Sa.Sutra Sthana 1/46]. Atma controls and regulates manas, and indriya [Su.Sa.Sharira Sthana 1/22] through its chaitanya bhava (consciousness).[Cha.Sa.Sharira Sthana 2/32]. Mind acts as a vehicle of expression for soul’s desires. Soul has no restraints once it comes into physiological momentum. Hence, in this condition, the mind can control itself (swasya nigraha) with an intellectual component called 'dhriti’. This article describes the concept of dhriti and its physiological functions.
Section/Chapter/topic | Concepts/Dhriti |
---|---|
Authors |
Bhojani M. K. 1, Verma Swati1 |
Reviewer | Basisht G.2, |
Editor | Deole Y.S.3 |
Affiliations |
1 Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India 2 Rheumatologist, Orlando, Florida, U.S.A. 3 Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India |
Correspondence emails |
meera.samhita@aiia.gov.in, carakasamhita@gmail.com |
Publisher | Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar, India |
Date of publication: | April 04, 2023 |
DOI | 10.47468/CSNE.2023.e01.s09.134 |
Etymology and derivation
The word dhriti is derived from the root ‘dhriyan dharane’ with the pratyaya ‘ktin’ which means to withhold.
Various dictionaries such as Monier Williams, Yates, Vachaspatya and shabdkalpadruma translate the word ‘dhriti’ as firmness, resolution, or willpower to keep ground or stand still to find contentment or satisfaction[1] i.e. tushti[2].
Thus, Dhriti can be understood as the property which protects from constantly indulging in diversions of life, thereby aiding to stay focussed on the task at hand or any long-term goal.
Contextual meanings
The term dhriti can be exemplified as follows in various contexts:
- Patron of knowledge (jnanadevta) [Cha.Sa.Sutra Sthana 1/39]
- Stage of cognition (prajna) [Chakrapani on Cha. Sa.Sharira Sthana1/98]
- Characteristics of prakriti types (physical and mental constitution) and atma (soul)
- Quality of an ideal student or a desirable teacher
- One of the characteristic feature of best quality muscular tissue (mamsa dhatu sara) [Cha.Sa.Vimana Sthana 8/105]
- Tendency to withhold mind from wandering amidst material desires
- A path to salvation (mokshasya upaya) [Cha.Sa.Sharira Sthana 1/144]
- Soul-origin constituent of human beings (atmaja bhava) [Cha.Sa.Sharira Sthana 3/10]
Physiological dimensions of dhriti
Dhriti has been quoted to be a function of mind. Dhriti is that functional component of mind that restrains it from delving into undesirable subjects of senses (ahitartha) [chakrapani on Cha.Sa.Sh. 1/20-22]. The physiological dimension of dhriti can be understood as follows:
- Atmaja bhava (spiritual factor in embryogenesis):
Dhriti is a factor derived from atma.[Cha.Sa.Sharira Sthana 1/72] , Atmaja bhava results from one’s daiva (destiny or deeds of previous life), immutable during embryogenesis. This signifies dhriti is a bridge between the spiritual and material world. It could be understood as a medium for the soul to keep itself from falling trapped into mindless desires. Also, it could be used as a tool to break the material ties step by step, all the while re-establishing one’s connection to the almighty, thereby accomplishing the ultimate goal of human birth i.e. moksha (salvation from cycles of re-birth) [Cha.Sa.Sharira Sthana 1/144] - Regulation of soul’s (atma) expression:
Atma (soul) is the supreme source of wisdom in this destructible world. Though nirvikar (devoid of bodily or psychological ailments and desires) and vibhu (omnipresent) [Cha.Sa.Sutra Sthana 1/55], atma becomes doer (karta) and enjoyes (bhokta) all the desires expressed through mana (mind) and indriya (senses), once it bears this mortal panchabhautika (elemental) body.[Cha.Sa.Sharira Sthana 1/74-75, 83].
A human’s desires know no bounds. They keep sprouting with the overpowering effect of rajas (one of the three fundamental qualities of the mind responsible for passion) over the mind. This is where one atma lakshana called 'dhriti’ steps in. As aforementioned, it restrains the mind from over-pursuing materialistic temptations. - Characterising prakriti modules:
Dhriti is innately expressed in certain prakriti types. Tridosha regulates all the physiological functions of the body. Dhriti, a quality comparable to slowing down or tranquillity, is more evident in kapha predominant deha prakriti types. [Cha.Sa.Sutra Sthana 18/51]. Among the five subtypes, tarpak kapha can be more precisely said to have major role since it nourishes the sense organs [Su.Sa.Sutra Sthana 21/14], , which are further controlled by mana.[ Cha.Sa.Sharira Sthana 1/21].
Such individuals tolerate extremes of all sorts, whether external conditions or inner conflicts. Though prone to a laidback attitude, the trait of dhriti helps these individuals to bounce back into action. This makes them balance well between rash reactions and level-headedness needed at different stages of life.
Udana vata, apart from imparting speech, also controls dhriti and smriti. [A.S.Sutra Sthana 20/6] Memorizing becomes easier when recited aloud repeatedly. However, if the mind is constantly unstable, even speech cannot help memorize. - Empowering sattva guna:
The sattvika psyche is considered on at the pedestal of virtuousness. Dhriti contributes a major role here. Mana is a trigunatmak entity comprising sattva, rajas and tamas in variable ratios resulting in various manas prakriti. [Cha.Sa.Sutra Sthana 8/6]. The predominance of sattva guna is beneficial for the acquisition of true unbiased knowledge. According to sankhyakarika, sattva is light (laghu) and enlightening (prakashak) i.e., it wards off ignorance and highlights the essence of truth. Rajas and tamas are delusional and dull. Being a seeker of truth requires keen attention, a balanced state of contentment, and planned actions toward the pursuit path. This psychomotor coordination is well moderated by dhriti. [Cha.Sa.Sharira Sthana 1/21].When attached to the subject of its senses, mind doesn’t deter because of dhriti which acts ‘niyamatmika’ by controlling and regulating this function of indriya abhigaraha as well as of swasya nigraha. [Chakrapani on Cha.Sa.Sharira Sthana 1/21] Thus, the mind can stay focussed for desirable period of time, so intellect can act thereafter over perceived information. - Pillars of true knowledge (prajna):
Dhriti is one of the fundamental constituents of cognition (prajna), taking this meticulous process to a significant crystal conclusion working with dhi and smriti. [Chakrapani on Cha.Sa. Sharira Sthana 1/98]
The transmutation of perceived information to a conclusive state after proper analysis is understood as ‘budhhi’ ( nischayatmika buddhi). [Chakrapani on Cha.Sa.Sutra Sthana 8/12] Being able to reach the same conclusion via different intellectual modalities repeatedly is ‘prajna’. Dhi can be understood as non-analytical perception (indriyartha sannikarsha), hence called ‘vyavsayatmika’.
The continuous inflow of information upon union of senses with objects (indriyartha sannikarsha) is withheld in place by dhriti. This keeps the mind focused on the subject (manso achanchalyam ) [Chakrapani on Ch.Sa.Sutra Sthana 1/39] On one hand, this persistence leads to the storage of information in deeper brain recesses such as smriti. While on the other hand, that inflow is also simultaneously being regulated by dhriti itself (dhritihi niyamatmika) [Chakrapani on Cha.Sa.Sharira Sthana 1/21). Such a counterbalance by dhriti prevents overindulgence in harmful pleasures of life and getting trapped in a spiral of futile overthinking.
Sukha- dukha are qualities of atma [Su.Sa.Sharira Sthana 1/22], which reside with mana in hrudaya. [Cha.Sa.Sutra Sthana 30/4]. Thus, it’s a close relationship with mana which explains why memories are often linked to emotional triggers. If dhriti is not strong enough, it is easy to fall into weakened or depressive states of mind. - Catalyst to smriti:
Dhi, dhriti, and smriti are tripod of true knowledge. [Chakrapani on Cha.Sa.Sharira Sthana 1/98] Without being mentally aware of in the present, one cannot excel in any pursuit of life. Dhriti is the moderating force between dhi and smriti, which regulates the amount of information being exchanged among the latter two components of prajna. Dhi is superficial perception, while smriti is a recollection of past events. [Chakrapani on Cha.Sa.Sutra Sthana 1/58] It’s not necessary for every piece of information gained via indriyartha sannikarsha to be imprinted in mind as smriti. Dhriti becomes the regulator of mind (mana) to facilitate a focussed understanding of a subject that may probably cause ingrained impact transmuting into smriti.
Hence, dhriti is that physiological state of mind which allows an individual to maintain an unfazed continuum of a desirable union of senses with objects (indriyartha samyoga) for as long as required. Eventually, this reaches a sustainable conclusive knowledge (prajna) after intensive and systematic analysis, working along with the counterparts - dhi and smriti.
Role of dhriti and its practical implications
- Qualities of a learner :
Dhriti is the capability of mind to stay satisfied and unwavering in all contexts. [Dalhan on Su.Sa.Sutra Sthana 31/4] It depicts the willpower of the mind to withhold itself from giving in potentially harmful temptations of this world. Hence, dhriti refers to attentive and focused behaviors of mind. This quality is essential for a learner or student.
This can be further substantiated by the qualities of an ideal disciple [Cha. Sa. Vimana Sthana 8/8]. It is instructed to teachers and students desirous of teaching and learning respectively to first examine the qualities of each other. Amongst many characteristic features of a disciple, dhriti finds a place too. It holds prime importance in the perception of sound information for it to be turned into actual knowledge (yathartha gyaan) with further processing by buddhi. [Cha. Sa. Vimana Sthana 8/8] - Means for attainment of salvation (mokshasya sadhana upaya):
Absolute mental control (para dhriti) is vital for salvation. [Cha.Sa.Sharira Sthana 1/144] . Chakrapani elaborates this as extreme control (atishayitam manoniyaman). To attain salvation, one should strive to improve constantly, restraining the mind from material distractions.
Apart from physiological implications, the concept of dhriti can help navigate certain pathological states of psychological origin. - Assessment of deha prakriti:
Dhriti is a feature of kapha dosha dominant prakriti. [Cha.Sa.Sutra Sthana 18/51] [Su.Sa.Sharira Sthana 4/71] Dhritiman is the one who is dhairyayukta – full of firmness, constancy, calmness, patience or courage.
While ‘chala dhriti’ (wavering retention power and attention) has been agreed upon as the characteristic feature of vata prakriti purusha by Acharya Vagbhata.
Hence, knowledge of the concept of dhriti helps to explain the tendencies of kapha and vata prakriti towards making a well-thought decision and a spontaneous uncalculated reaction, respectively.
Concept of Adhriti
Adhriti means inconsistency, unsteadiness, or loss of control in terms of diligence as per various dictionaries.
Adhriti was first mentioned by acharya sushruta while describing rajas ansha of mana. He mentioned it again for vataja prakriti purusha stating them to be adhairyayukta (as per Dalhana) i.e. not having enough patience or tolerance which causes wandering of mind at any given moment.
It is the exact opposite of dhriti. Dhriti is a conscious control over sensorial and intellectual functions, whereas adhriti refers to an apprehensive state of mind.
Clinical application of concept of dhriti
- Assessment of satvika and rajasika ansha of mana:
Dhriti is an attribute of predominantly sattvika conscience. [Su.Sa.Sharira Sthana 1/23]. Dhriti is an intellectual property that controls the unsteady nature of the mind.
On the other hand, rajasika mind has been said to bear the attribute of adhriti. [Su.Sa.Sharira Sthana 1/24]. Adhirata emphasizes the mind's fickle nature, i.e. constantly being distracted by any surrounding stimulus.
Thus, analyzing the above two attributes, dhriti can be rightly considered as the intellectual property of mind that aids to stay grounded in the face of adversities. When normal functioning of dhriti is hampered (bhransha), it becomes the cause of disease and misery. - Prajnapradha :
Prajnapradha is one of the three fundamental causes of disease origin (dukha hetu). [Cha.Sa.Sharira Sthana 1/98]. It is the derangement (bhramsha) of dhi (understanding), dhriti (control over mind and senses) and smriti (ability to recollect past events) when a person gains the undesired results and fails to attain his desires. [Cha.Sa.Sharira Sthana 1/102]. Mind tends to fall prey to worldly temptations. It requires a large amount of self-restraint and courage to not fall for the innocent triggers and avoid committing prajnapradha which holds the capacity to vitiate tridosha, eventually leading to physical ailments.
Hence, firm control over senses and desires (mind) is of utmost importance. So one must practice virtuous activities which cultivate contentment (sadvrutta), meditation, and promotion of wholesome thought processes to enhance the quality of dhriti oneself. - Satvavavjaya chikitsa :
The principal doctrine of Ayurveda psychotherapy, satvavajaya chikitsa revolves around the concept of dhriti. Sattva means mind and avjaya means to win over. [Cha.Sa.Sutra Sthana 11/54] Thus, it focusses over conscious withdrawal of mind from unwholesome objects. Thereby negating negative emotions and behavioural patterns and replacing them with positive factors in life.
This model of psychotherapy can be best administered in depressive illnesses, attention deficit hyperactivity disorder (A.D.H.D.), anxiety, low self-esteem, and unexplained mood swings. Even in diseases of psychosomatic descent (e.g., IBS), psychotherapy is used because such patients suffer from continuous anxiety due to overthinking their symptoms and every other piece of apparent advice by friends and family. By steadying one’s racing thoughts and identifying the stressors, we can consciously acknowledge them and evade as and when required. - Role of dhriti as arishta lakshan :
Sudden loss of dhriti is one of the near-death sign. [Su.Sa.Sutra Sthana 31/4]. It is a bad prognostic sign.
The manifold facets of dhriti in both physiological and pathological dimensions highlight its importance as an all-pervasive method to conquer adversities in life. Therefore, diligent efforts at improving the quality of mind (mana) in general should be undertaken.
Ashtanga yoga
Being a dimension of satvavavjaya chikitsa, dhriti aims at enhancing the quality of sattva guna of mind (manas). This strikes a harmonious balance between a man’s inner environment and outer environment.
The most desirable prerequisite for the pursuit of happiness and contentment is knowing one’s true inner self. Meditation and all other mind control (mano nigrahana) techniques serve this purpose by upscaling the component of dhriti.
Yoga is a unique blend of personal development and controlled social engagement while walking a path of spiritual enhancement. Ashtanga yoga is an eight-step flexible way towards psychological exploration, awakening and human liberation from temptations. Yama the first step, refers to ethical principles. While niyama, the second step, deals with the inner aspects of mind and spirit.
As per Patanjali Yogasutra, yama and niyama both includes five restraints.
- Yama (ethical restraints):
Ahimsa (non-violence), satya (truthfulness of thought, speech and actions), asteya (non-stealing of other’s property of any kind), brahmacharya (abstinence of senses from sensual pleasures as well as from potentially harmful or undesirable subjects of senses) and aparigraha (contentment with ones’ possessions).
But in texts like Shandilya upanishada, Varaha upnishada and Yoga Yajnyavalkya, ten tenets of yama have been mentioned: Ahimsa, satya, asteya, brahmacarya, kshama (forgiveness), dhriti, daya (compassion), arjava (non-hypocrisy, sincerity), mitahara (measured diet), shauch (purity and cleanliness of mind and body). - Niyama (spiritually oriented practices):
Shaucha (cleanliness), santosha (sense of contentment in all situations), tapa (persistence, discipline), swadhyaya (study of sacred texts or self-contemplation), ishvara pranidhana (devotion or contemplation towards divine).
Thus, in ashtanga yoga, dhriti signifies the preservation of firmness of mind at all periods of gain or loss of material wealth or mortal relationships. Yet it is often difficult to maintain the psychological equilibrium, therefore, all the other tenets of yama and niyama are equally important to be practiced religiously in life. Regular practice helps deal with negative emotions and ignorance of life, like laziness and dejection at the slightest inconvenience.
Consequently, dhriti may finally be understood as the principal regulatory component of intellect. It helps maintain a steady hold over perception by various senses, thereby improving knowledge (tattva gyana) as a student and social and professional skills as an entrepreneur or practitioner with constant practice. It requires the perfect balance of determination, desires and dedication to hone this intellectual component called dhriti.
Current researches
A man devoid of gradually developed and properly functional intellectual faculties is apparently disabled in leading a desirable life. These intellectual errors (i.e. prajnaparadha) aggravates all the dosha becoming one of the trident causes of all forms of disease manifestation. Dhi, dhriti, and smriti being the three stages of prajna can give a bird’s eye view of an individual’s psychological development. In view of the above mentioned intellectual factors, many relative interpretations have been put forward to understand these.
The exact interpretation of all these intellectual faculties of mind is debatable because their physiological functions overlap in nature. While some scholars are of the view that dhriti is the retention power of mind, others consider medha in that place. They later clarified that dhriti is that governing feature which averts the mind from indulging into destructive or potentially undesirable or non-beneficial substances and evaluation of medha is by grasping power (grahana samarthya)[3] Broadly concluding the views of different authors over defining these terms, dhi is referred to the ability of correct perception (judgement), dhriti means self-control or will power or patience and smriti refers to the ability to recall past events.[4]
As per classics, prajnaparadha (dhi dhriti smriti vibransha) is a fundamental intrinsic factor for the development of all diseases, especially diseases of psychotic origin. It is described that a person whose intellect, self-control, and memory are impaired falls into delusion and commits certain actions which aggravates tridosha at once, initiating the disease pathogenesis. Thus, avoiding all causative factors (nidana parivarjana), which lead to impairment of factors of prajna or manovaha strotas in general viz. virudhha ahara, vidahi-ushna-ruksha ahara, katu-amla- lavana rasa and certain manasa bhava: bhaya, chinta, shoka, moha, krodha, lobha should be of prime focus. This explains the importance of dhriti (power of self-control) in the light of a therapeutic modality as part of initial nidana parivajana.[4][5]
The above said practical dimension of dhi is evident in the concept of mano nigraha (restraining of mind). Mano nigraha is a state of self-control of mind guided by a perfect balance of desire, determination, and dedication. It forms the nodal principle behind satvavavjaya chikitsa (psychotherapy), which focusses over nigrahan (diversion) of mind from harmful subjects of senses (ahitartha) towards beneficial (hitartha). Dhriti is mentioned as ‘manaso niyamatmika’ i.e. regulatory body of mind. Hence, it is that property of mind which governs its actions viz. chintya (regulation of thought processes), vicharya (analysis of thoughts and ideas), uhya (logical reasoning), dhyeya (polishing objectives by focussing over them) and sankalpa (arriving at an apparently right conclusion/decision). Thereby being a check-dam to reckless indulgence in any morally or conventional undesirable behavioural or psychological attributes.[6]
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References
- ↑ Sir Williams-Monier. A Sanskrit-English Dictionary, Delhi: Motilal Banarsidass Publishers Pvt Ltd., Reprint edition 2011, pg 452.
- ↑ Radhakanthadeva. Shabda Kalpa Druma New Delhi: Rashtriya Sanskrit Pratishtana , reprint edition 2018, Vol 2, pg 804.
- ↑ Dr. Sujit kumar, Dr. Deepika Mehra, Dr. Vaidehi V Raole, Dr. Sunil P Nikhate (2019) : A conceptual study on Medha, Budhhi, Dhee, Dhruti, Smruti and Manas; Department of Kriya Sharir, Parul Institute of Ayurveda, Parul University, Vadodra, Gujarat.
- ↑ 4.0 4.1 Dr. Pooja Sharma, Dr. Anshu Sharma ; Ayurvedic aspect of dhee, dhriti, smriti w.s.r. to mild cognitive impairment; Ilkogretim Online - Elementary Education Online, 2020; Vol 19 (Issue 4): pp.3224-322
- ↑ Dr. Rakesh Kr. Srivastava(2020); Mental health, its promotive and preventive aspects:Ayurvedic view
- ↑ Bagali SS, Baragi UC, Deshmukh RA. Concept of Satwavajaya Chikitsa (Psychotherapy). J Ayurveda Integr Med Sci 2016;1(1):56-63.