What is Ayurveda?

History of Ayurveda

Ayurveda is thought by many scholars to be the oldest healing system on earth. Approximately 4,000 years ago, Indo-Europeans moved into the Indus Valley and found an ancient civilization still flourishing with cities, agriculture, organized religion and sophisticated art and architecture. From the fusion of these two cultures, Vedic culture and sciences emerged. The newcomers brought their religious beliefs, along with lyrical hymns in an ancient form of Sanskrit. These hymns reveal a mystical bond between the worshipper and their environment. They worshiped natural forces and elemental powers of life: sun and wind, storm and rain, dawn and night, earth and heaven, fire and offering. The three main Vedic gods: Indra, Agni and Soma are manifested in the three doshas of Ayurveda: Vata (Air), Pitta (Fire) andKapha (water). Indra has the energy of air and the life force and is often equated with Vata or Vayu. Agni is the essential energy of fire and Soma, the essential energy of water. Before the advent of writing, the ancient wisdom of healing, prevention and longevity were all aspects of the spiritual tradition.

The priests produced commentaries to explain the meaning of their ancient rituals. Hymns and commentaries together became a sacred heritage passed from generation to generation. These are the Vedas, India’s scriptures and among the oldest bodies of recorded knowledge in human culture. There are four collections: Rig, Sama, Yajur and Atharva, with the Rig Veda being the oldest. Most scholars believe the origins of Ayurveda originate in the Atharva Veda. Vedic tradition is composed of highly spiritual wisdom revealed through the hearts of enlightened seers (rishis). Vedic wisdom was passed from teacher (guru) to student in small caves and ashrams.

Vedic sciences include yoga, meditation, mantra and astrology. Ayurveda is the special branch for healing both body and mind and is the sister science of Yoga. In the Vedic and Yogic systems, health is seen as an integral part of creative and spiritual growth. Yoga provides us with the exercises for physical health, flexibility, and dissolution of tension. Ayurveda includes herbal medicine, dietetics, bodywork, surgery, psychology and spirituality. Both Ayurveda and Yoga serve as a means of harmonizing our physical, spiritual and mental bodies.By 3,000 BP, Ayurveda developed into eight branches and two schools: Atreya, the school of physicians and Dhanvanari, the school of surgeons. All the material from the Vedas were collected into compilations (samhita): Charaka, Sushruta and Asthang Hridaya. The first two were written around the time of Krishna (1500 – 1,000 BP). Charaka Samhita is the classical text of internal medicine; Sushruta samhita is considered the father of surgery and Asthang Hridaya includes a section outlining the eight branches of Ayurveda as well as text in the form of a beautiful poem.

People from many parts of the ancient world traveled along the Silk Road to India to learn Ayurvedic medicine. Chinese, Tibetans, Greeks, Romans, Egyptians, Afghanis, Persians, and others traveled to absorb the wisdom and bring it back to their own countries. Ayurvedic institutions of higher learning, including Nalanda at Patna were established and supplemented the guru system. Ayurveda became the basis of the healing traditions of Tibet, Sri Lanka, Burma and influenced Chinese medicine. Many great Buddhist sages were also Ayurvedic doctors. The influence of Ayurveda in Greek medicine is evidenced by the central importance of humors, elements, qualities and seasons. The emphasis on the genesis of illness as written by Hippocrates and a treatise by Plato also exhibit the influence of Ayurveda. The trade in herbs and spices along the Silk Road brought concepts of Ayurvedic nutrition and herbology to the west.

In the early 1800′s, Vedic texts were translated into English and influenced the American Transcentalists, particularly Emerson and Thoreau. Teachers from India began to arrive in the US to teach Vedic wisdom and a few students also travelled to India to study with their gurus. In 1893, Swami Vivekananda arrived in the US. He taught Americans about the Vedas, Yoga and Hinduism and spoke at large events, including the World Parliament of Religions at the World’s Columbian Exposition. He and his followers started the Vedanta Society in New York the following year. In the 1920′s Jagadish Catterji taught yoga in San Francisco’s Haigh-Ashbury district, lecturing on pranayama, Ayurvedic medicine and Samkhya philosophy. In 1929, Swami Prabhavananda arrived in Hollywood. He influenced Aldous Huxley, Christopher Isherwood and other intelligentsia in southern California. Throughout the latter half of the 20th century, the exchange of teachers from India and students from the US and Europe skyrocketed, especially focused on yoga and meditation.

As the western world was discovering Yoga, Ayurveda and Hinduism, Ayurvedic colleges in India were closed and books destroyed. During the nineteenth and twentieth centuries, the British ruled India and closed most of the remaining Ayurvedic universities. During this time, Ayurveda was practiced in secret and Vedic sciences continued to be taught by gurus in caves and at small ashrams. In 1920, with the help of the Indian government, Ayurveda reemerged and universities were rebuilt. Today more than 150 Ayurvedic universities and 100 Ayurvedic colleges exist in India. Now, people throughout the world are rediscovering Ayurveda.

Resources:

Upanishads translated by Eknath Easwaran
From the River of Heaven: Hindu and Vedic Knowledge for the Modern Age by David Frawley
The Ayurvedic Encyclopedia: Natural Secrets to Healing, Prevention and Longevity by Swami Sadashiva Tirtha
Ayurvedic Healing by David Frawley
Ayurveda Fundamental Principles by Vasant Lad
Passions and Tempers: A History of humours by Noga Aritka
The Subtle Body: The Story of Yoga in America

Thank you to Heidi Mair for collecting this information for WAMA

 

Practitioners

The minimum academic requirements as set by National Ayurvedic Medical Association for a Practitioner Level Membership are as follows:

500 hours of classes which include:

* 350 hours of Core Classes in Ayurveda

• 300 of those hours need to be in the presence of a teacher (classroom, gurukula or live interactivevideo and audio instruction)

* 50 hours of internship to include a minimum of:

• 25 hours case management, (observing client consultations, consultation critique, etc.)
• 25 hours 1-on-1 client consultations (client assessments, recommendations, etc)

*100 hours of Peripheral Classes (see list: Sanskrit, Yoga, Jyotish, etc)

* Certification must be obtained from a legally-operating institution stating completion of 500 hours and competency in core curriculum as established by the school.

Click here to search a list of Washington State Ayurvedic Practitioners

Scope of Practice

SUGGESTED SCOPE OF PRACTICE FOR THE WASHINGTON STATE AYURVEDIC PRACTIONER

Compiled by Melanie Farmer and reviewed and approved by WAMA Committee

CLINICAL AYURVEDIC PRACTICE

As of June 2011, there is no significant regulation of Ayurvedic practice or education in America. Schools in most states must apply for a State license or State approval to provide education however; several states do not make this a requirement.

Ayurvedic practitioners are not licensed in the United States and ayurvedic practice is not regulated by state or federal agencies. Standards of competency are set by individual schools that have received state approval.

In addition, there are no state health departments that require a license to practice Ayurveda.   Because there is no formal scope of practice as defined by any state legislation, the practice of Ayurveda is currently defined more by what practitioners cannot do then by the art itself.

The following scope of practice as defined by Kerala Ayurveda located in Seattle, WA is similar to the Washington State Health Department requirements for the massage therapist:

1. Ayurvedic practitioners cannot refer to themselves as doctor, even if possessing a doctorate degree from India or a PhD. degree in the United States.
2. Ayurvedic practitioners may not diagnose or treat medical disease or condition. A practitioner cannot act in the capacity of a licensed health care providing a diagnosis or treatment of a disease using common Western medical terminology.
3. Ayurvedic practitioners cannot interfere with the prescriptions or recommendations made by a licensed physician. A practitioner who tells a patient not to take their medications is considered practicing medicine without a license.
4. Ayurvedic  practitioners cannot invade the body or perform any other procedure that penetrates the skin or any orifice of the body. This includes the practice of nasya and basti.
5. Ayurvedic practitioner should disclose to clients his/her educational background
6. Ayurvedic practitioner should act as  a guide or educator to promote wellness and as a resource providing Ayurvedic information to improve wellness.

AYURVEDIC MASSAGE

Massage is regulated through state health department laws which include ayurvedic massage.  In Washington State, massage is defined as follows:

1. “Massage” and “massage therapy” mean a health care service involving the external manipulation or pressure of soft tissue for therapeutic purposes.
2. Massage therapy includes techniques such as tapping, compressions, friction, Swedish gymnastics or movements, gliding, kneading, shaking, and fascia or connective tissue stretching, with or without the aids of superficial heat, cold, water, lubricants, or salts.
3. The Massage therapist will not diagnosis disease or adjust or manipulate any articulations of the body or spine or mobilization of these articulations by the use of a thrusting force.
4. The Massage therapist will not practice any procedure that penetrates the skin or orifice of the body and includes genital manipulation.

 

Washington State requires 500 hours of education from an approved school or apprenticeship training as well as passing the National Certification Exam. Massage therapists are required to undergo criminal history checks as well as  complete 16 hours of continuing education every two years following initial licensure.

YOGA- SISTER SCIENCE TO AYURVEDA

Because ayurveda is a sister practice with yoga, listing the codes of practice as defined by the Yoga Alliace is appropriate. The following is required by all RYT’s and RYS.

“As a Registrant of Yoga Alliance and as a Registered Yoga Teacher (RYT) or representative of a Registered Yoga School (RYS), I agree to uphold the ethical goals set forth in the following Code of Conduct”.

1. Uphold the integrity of my vocation by conducting myself in a professional and conscientious manner.
2. Acknowledge the limitations of my skills and scope of practice and where appropriate, refer students to seek alternative instruction, advice, treatment, or direction.
3. Create and maintain a safe, clean, and comfortable environment for the practice of yoga.
4. Encourage diversity actively by respecting all students regardless of age, physical limitations, race, creed, gender, ethnicity, religion affiliation, or sexual orientation.
5. Respect the rights, dignity, and privacy of all students.
6. Avoid words and actions that constitute sexual harassment.
7. Adhere to the traditional yoga principles as written in the Yamas and Niyamas.
8. Follow all local government and national laws that pertain to my yoga teaching and business.

THE NUTRITIONALIST AND AYURVEDA

The following are a set of suggestions and practices for the dietitian that go beyond their professional standard scope of practice. Dietitians have experienced increased medical malpractice litigation over the last few years.

Because a large part of ayurvedic practice is providing  nutritional information, the following is included as suggested scope of practice and has been edited for the ayurvedic practitioner.

1. Give Good CareMake sure that you are confident in the advice that you are giving and the treatment that you are providing. Take a proactive approach by looking at all areas of your practice, including regulatory, scope of practice, federal and state rules, legal standards of care, professional scopes of practice and standards of practice, and healthcare facility policies, protocols, and guidelines.
2. Update Your SkillsChanges in the field must be reflected in your practice as they occur.  Protect yourself by keeping up-to-date.  Review at least annually and comply with established clinical protocols, guidelines, treatment standards, or critical pathways for your practice setting or specialty.

1. Don’t Accept an Unacceptable JobDon’t take a job that may put you at risk. One case can wipe out your whole practice.
2. Document, Document, DocumentRemember that well-worn adage: If you didn’t document it, it didn’t happen and If the documentation is illegible, illogical, or incomplete, how can it be defended in a court of law?  Make sure your notes and reports are well thought out and thorough.
3. Give Respectful CareTreat people as you would want to be treated. Respect, comfort, courtesy, understanding, and professionalism go a long way.  The bottom line is to provide quality care to every client we encounter. Our practice should be based on successful strategies that improve client outcomes and are based on sources of evidence, including research, policies, consensus statements, expert opinion, quality improvement data, and client preference. Do your job well and seek insurance for protection.

 

ETHICS AND AYURVEDA

 

Each person is unique with their own experiences and beliefs which can make defining ethics difficult.  The bottom line is as professions, we are responsible for the comfort and safety of our clients.

1. We serve best when we understand both the legal rights and moral needs of our clients.
2. We serve best when we have examined ourselves and worked through our own issues.
3. We serve them best when we focus on the development of ourselves.
4. We only guide the client to places that we have been willing to go ourselves.
5. The healing process can begin only when we realize that we are just facilitators.
6. The healing is the responsibility of the client alone.
7. The client must be given correct information in order for them to determine what is right for them and what they are going through.

 

IN ADDITION:

Confidentiality
A client’s information, both written and verbal belongs to the client. Conversations that occur during a session should not be repeated or included in the chart notes unless it is describing their physical condition. A client may also not want to be approached outside the treatment clinic. If you see a client walking down the street and stop and say hello, this may violate their right of confidentiality, as they may not want it be known that they are seeking treatment.

Boundaries
A Boundary is a space within a perimeter that may be a physical, emotional or mental space. The emotional (mental) space is determined by experiences, values, and morals. The physical space is the actual physical limits of space that is needed by each person to feel safe and secure. Boundaries can be communicated by verbal conversations or body language.

 

Some people, especially those with a history of abuse of some sort, may not be aware of their boundaries let alone able to maintain their boundary. Boundaries may be determined before a session to ensure the clients comfort.  Boundaries are often difficult to determine. What may be good for one person may not be appropriate for another.  It is important to explore boundaries and constantly readjust limits to accommodate each individual.  When boundaries are crossed, respect may be lost in the relationship. There are a main types of boundaries we deal with include legal boundaries, professional boundaries, and personal boundaries.
Legal boundaries are those that of course deal with the law and the rules and regulations that are set up by each state, city or county. Your scope of practice is defined legally. Your scope of practice is the limits or boundaries that apply to your practice. This may include areas you can work on and what you can or cannot do.

Professional boundaries are determined by many things such as your type of practice, your business rules and practices.

Personal boundaries are just that- everything that determines your safety zone. They may be influenced by experiences, beliefs, and values. Boundary violations usually begin quietly, little by little, and without many problems.

When you go through the process of looking at your values and needs and set your framework, boundary violations can be minimized.

Recognizing your own boundaries will be based on your values and needs. There is no right or wrong here – only what is what is important to you.

 

THE BASIC PSYCH IN CLIENT-PRACTITIONER RELATIONSHIP

Transference occurs when the client makes the professional relationship, personal. Indications of transference are things like the client brings you additional gifts or asks to see you for lunch or outside the treatment. Personal conversation can also be an indicator.

What you do depends on each situation. This can occur when clients are lacking in sufficient resources to take care of themselves. Unresolved needs, feelings, and issues are transferred to the helper or caretaker.

Counter-transference occurs when the therapist is unable to separate the therapeutic relationship from their personal feelings surrounding the client. Some of examples of this is when a therapist feels inadequate if the client is not making progress or excessive thinking about the client after the treatment is over. This occurs usually when the therapist plays the helper or fixer role.  Remember, we only facilitate the clients’s growth for their own healing.  Problems begin if we think we can fix the problem and that we have all the correct answers.

 

THE HEALTH FREEDOM ACT

In five states, California, Idaho, Minnesota, New Mexico and Rhode Island, specific laws, often referred to as “Health Freedom Acts”, were passed protecting the practice of alternative medicine and the practitioners who provide those services. The practice of Ayurveda is protected within these laws so long as the practice falls within the limitations of the law and does not impinge on the scope of practice of other licensed health care professions. Additional states are actively pursuing similar laws.

http://www.californiahealthfreedom.com/californiah/htdocs/documents/our_bill.asp

AHG Herbalists Code of Ethics

http://www.americanherbalistsguild.com/ethics

 

Education in the US

The education process for Ayurveda in the United States continues to evolve as we approach new levels of acceptance within each state. States that have established Health Freedom Acts: Minnesota, California, Rhode Island, Louisiana, Oklahoma, Idaho and New Mexico, have the ability to practice Ayurveda without a secondary health care license required by the state. All other states require a “license to touch” in order to properly assess lifestyle and/or administer Ayurvedic therapies. Due to the varied areas of practice, the education platforms vary. The National Ayurvedic Medical Association has set the standards for education levels.

The following link is a list schools currently approved and affiliated with the National Ayurvedic Medical Association.

 

US Schools:

http://ayurveda-nama.org/schools-programs/