Article by Prof. Dr. Martin Mittwede, Director of Studies Ayurveda Medicine at the European Academy of Ayurveda, and Dr. med. Ashish Bhalla, Ayurveda doctor.
Ayurveda literally means "the knowledge of life" and more specifically "the knowledge of long life". Thus, traditional Indian medicine is not only a diagnostic and therapeutic system, but also a teaching about the art of living right and maintaining health. In this sense it is also taught at the European Academy for Ayurveda. A holistic burnout therapy must deal intensively with these very issues if lasting success is to be achieved. Life habits that increase the stress factors must be gradually reduced and replaced by new coping strategies suitable for everyday life. Ayurveda offers a variety of possibilities for this, which can be used in an individually tailored way.
Opinions on the subject of burnout differ widely, some speak of a fashionable diagnosis that serves as a sick note, others speak of a burden that must be taken seriously from a health and economic point of view, and which would have increased in the last decades. The fact is that an exact diagnosis is required in every case in order to exclude other causes of exhaustion such as hormonal dysregulation, the development of a tumour or even depression. Ayurveda follows the principle of a comprehensive view of the human being (pariksha) when making a diagnosis, modern forms of diagnostics can and should therefore be integrated.
The central symptoms of a burnout state include emotional exhaustion and lack of drive, experiences of depersonalization, a negative assessment of personal performance competence as well as depressive states, all of which are based on a chronic overload - especially in the professional field. In the following, we will center on the overload syndrome as the cause of burnout.
The healing art of Ayurveda has its basis in an image of man, which describes the conditions for health and illness; according to this, being human is shaped by three aspects:
- Body (sharira)
- Psyche (sattva)
- Self (atman)
Body and psyche are constantly changing and can therefore be sick or healthy. The Self, on the other hand, is unchanging and the source of all power and life energy. It can never become ill. Every human being therefore carries the necessary resources for health within himself, in the sense of Paracelsus, according to whom the patient is the doctor and the doctor his assistant. Based on this conception of man, it must therefore be a matter of giving the person affected by burnout access to his own original resources again.
The balance of the life energies described in Ayurveda (Dosha: Vata - movement, Pitta - metabolic transformation, Kapha - substance stability) leads to health, the imbalance to illness. In this respect, health is not a static state, but the result of a dynamic flow equilibrium, which can tip in one direction at any time.
Proper therapy weakens doshas that are too strong and strengthens doshas that are too weak, so that the lost balance is restored. Every aspect of lifestyle, every environmental influence, all social contacts have a specific influence on the regulation and promote or weaken the respective balance. For example, a journey with many new impressions strengthens Vata, sleep, on the other hand, promotes Kapha, and quarrels lead to an increase in Pitta.
Each person has an individual mixture of these three regulatory forces, which make up his or her innate constitution. If, for example, Pitta predominates in a person's constitution, this person is more susceptible to illnesses that involve too much Pitta, e.g. inflammations. So in diagnosis, the question is not only, "What symptoms are signs of which dosha disorder?" But also, "Who is it that has now developed this disorder?" The therapy plan will thus always refer to constitutional and current aspects.
Besides the physical, Ayurveda also knows a mental constitution, which is also characterized by three aspects:
- Sattva - balance, flexibility
- Rajas - passion, temperament
- Tamas - inertia, persistence
The psychic disposition is not constitutionally unchangeable, even though every human being is already imprinted with it at birth (especially through prenatal experiences, which are also reflected upon in Ayurveda). Sattva, Rajas and Tamas essentially determine how a person deals with his illness and whether he is able to actively contribute to the healing process. In this respect, all therapeutic measures that strengthen Sattva are useful as concomitant therapy.
An already existing disease should not be suppressed or repressed. Rather, the therapy aims at strengthening the balance both on the physical and on the psychological level; in this sense it is a causal therapy. Greater balance is the basis for greater self-knowledge, so that the process of recovery is a path that the therapist can walk together with the patient.
Burnout and self-responsibility
"The wrong, non-occurring and excessive use of time, discrimination, senses and objects is the threefold summary of the causes that produce the diseases that have two fields of action (physical and mental)." Caraka Samhita 1.1.54
Even though Ayurveda, of course, recognizes diseases that come from outside, this definition of the causes of disease possesses a paradigmatic significance. Ultimately, disease can only arise when a person has disturbed the inner balance to such an extent through his own misconduct that it is no longer possible to compensate for external influences and maintain the balance.
This is where the painful process of realizing that it is not only the external professional or social circumstances that lead to burnout, but deeply ingrained emotional patterns and behaviors (samskara) that lead a person to no longer listen to his or her own signals and to misjudge physical and mental performance.
Therapeutic principles
For the therapy of diseases the view of Ayurveda means that there can be no universally applicable method for a certain disease. Rather, it is necessary to proceed individually in each case. Burnout as a complex syndrome has different histories and manifestations. The basis of an Ayurvedic therapy is the "comprehensive view (pariksha)", i.e. the inclusion of all factors in the diagnosis and therapy. This essentially includes the following aspects: 1. constitution of the patient 2. current disturbance of the doshas 3. time (season) 4. climate 5. living habits 6. psychological state 7. current reserves of strength 8. interaction of therapist, assistant, remedy and patient.
A sensible therapy plan will take all these influencing factors into account and thus approach the disease process from different angles. The individual therapy recommendations support each other and lead to balance and more vital energy.
From an Ayurvedic point of view, burnout involves a strong Vata problem, which is often caused by a combination of Rajas and Pitta: Rajas in the sense of passionate commitment and Pitta in the sense of ambition, which then lead to an instability of the mental state. In the acute breakdown of psycho-vegetative regulation, all three doshas are usually involved, and the nutritive juice (rasa) and vital energy (ojas) are drastically reduced.
Ayurvedic measures for burnout
The Sanskrit term for health is "svastha", literally translated this means "resting in the self". In this sense, health is a functioning self-reference, a situation in which the person knows himself to be in harmony with himself. This includes a knowledge of one's own constitution with its strengths and weaknesses and the affirmation of this individual being.
In the case of burnout, where this self-reference has broken down, the Ayurvedic therapist will not work with rules that have to be followed, but will gradually enable a new access to one's own resources through mindfulness and perception exercises.
