What's the hardest thing to heal?
When learning about Ayurveda, everyone eventually will ask me some version of the question, "What is the hardest condition for you to treat?"
I have been asked this question by my students, patients, and by non-Ayurvedic health professionals. I'm going to write today about my answer to this question, because I believe that it is important to enhance awareness of how the doshas can influence manifestations of illness. I can see five people with the same "diagnosis", and they may all require different treatment because of how the doshas are acting within each individual.
Please note while reading that this article is not written "about" any specific person. I often have people say things like, "I felt like you were talking directly to me!"
That's great, because it means that I am in tune with the Universal flow. I write whatever I feel needs to be written, and if it speaks to you that means it was written for you!
Alright, moving on...
What I have found over my years of practice is that there is a very specific kind of imbalance that is the most difficult to work with. That imbalance is IBS (irritable bowel syndrome), when it occurs in a person who is Pitta-dominant by nature, but who is presently experiencing a Vata-type imbalance manifesting with high anxiety. The difficulty in achieving good results is not due to any complexity with this type of IBS. In fact, the treatment is theoretically very simple.
IBS is very easy to treat from the Ayurvedic perspective. I have worked with countless individuals over the years who have healed IBS completely in a matter of months. In all cases, prior to my involvement, these patients had received many years of medical treatment for their condition with no significant improvement.
Thus far in my practice, most (not all) of the people who have been able to heal IBS have been Pitta folks with Pitta-type IBS. In Ayurveda, we describe this situation as "tikshagni", which broadly means overactive and acidic digestion with inflammation in the digestive tract. In a Pitta-type person with Pitta-type IBS, healing is easy because the perfectionistic nature of Pitta allows them to follow treatment recommendations to the letter. Their excellent follow-through usually results in rapid healing.
The most difficult type of IBS to heal is what we call "vishamagni" in Ayurveda, which means inconsistent digestion. This is the Vata-Pitta type of IBS. In these cases, sometimes a person will eat and feel fine, and other times they will eat and experience extreme episodes of bloating with severe discomfort. There is often chronic constipation or alternation between episodes of constipation and diarrhea. If symptoms proceed long enough without treatment, the person typically experiences severe weight loss and loss of appetite.
I typically see vishamagni occur in Pitta-type people who have developed Vata-type imbalances. These people are typically perfectionists by nature, have a love of learning, are competitive, enjoy taking action to solve problems, like to be physically active, respect those who they perceive as being intelligent, and tend to be harsh critics of themselves and/or others. In the unbalanced state, they will be frustrated, have angry outbursts, experience trouble sleeping, and feel anxiety. To self-heal, they will often engage in frequent fasting or strict dietary regimens, which are misguided attempt to seek balance. These are independent people who will spend hours reading online trying to find out how to heal themselves.
Healing becomes difficult for these folks with Vata-Pitta IBS because they tend to fall into a self-sabotaging pattern. This pattern is subconscious, and is consciously perceived as taking independent action towards healing or trusting in one's own body. When the doshas are unbalanced, the perception is not accurate. So although someone can trust that their healthy mind-body will guide them well, their unbalanced mind-body will not. In this subconscious sabotage pattern of Vata-Pitta IBS, the Pitta drive for independence and understanding interacts with the erratic nature of Vata, causing a characteristic cycle of self-diagnosis causing lack of follow-through with treatment recommendations. I will summarize below this pattern as I have seen it play out in all cases of Vata-Pitta IBS that I have treated in my practice so far:
1) The patient will usually self-diagnose. They come into the appointment telling me what they need and what treatments they think will work. This foundation makes treatment difficult because the patient is resistant to professional recommendations that are not aligned with their ideas about self-diagnosis and self-treatment.
2) There is typically an inability to control speech. The patient will often talk through most of the session, leaving little time for me to ask diagnostic questions or provide professional advice, and usually will interrupt me when I speak. In these cases, even when asked questions and instructed to "please answer only yes or no", the patient will give lengthy answers.
3) At the end of each appointment, we create an action plan together. The patient will subsequently do some form of self-analysis, reading, and/or Internet research. This activity is driven by the Pitta part of their nature wanting to learn and understand everything, and further unbalances Vata by creating anxiety and fear. The patient begins to question the validity of the action plan and may even become afraid that following it will exacerbate their digestive symptoms.
5) The patient contacts me repeatedly through various mediums to tell me why, based on their recent self-analysis and/or reading, they believe that they should not follow through with their action plan.
6) The patient decides that they can self-diagnose and self-treat better than any healing professional can guide them and they stop treatment entirely, OR they "jump practitioners" because the Pitta part of them is impatient for results and interacting with the Vata tendency to continually seek new things.
This is the 6-step pattern that I have observed over my years of practice. I hope that my sharing this doesn't sound like I am judging these folks. These are lovely and amazing people who unfortunately get stuck in a pattern of behavior that is not beneficial to them.
My hopes in writing this article are:
1) to provide helpful information so that those suffering from the Vata-Pitta type of IBS can better understand what is happening with them,
2) to help other health practitioners better understand the different types of IBS in order to provide better treatment.
The only way to successfully heal the condition of IBS with Vata-Pitta imbalance is for the patient to consistently follow through with the treatment recommendations. Consistent follow-through brings Vata back into balance, which allows anxiety to decrease and digestion to become more regular. Patients must also commit to the cessation of self-diagnosis and attempts to self-treat, as doing so will only heighten their Pitta imbalance, which in turn will fuel a further imbalance of Vata.
This cycle of suffering from Vata-Pitta type IBS is one that I have observed repeatedly. It is always challenging for me to deal with as a practitioner because I care so deeply about each one of my patients. When I know that someone would feel better if only they did not give up, and I watch them quit on their own healing process, it makes me want to cry every time. But part of my doing this work is to accept that I cannot do anyone's healing for them...even if I really wish that I could.
If anyone has questions about Ayurveda and IBS, I can be reached by email at firstname.lastname@example.org. Please understand that I cannot provide treatment recommendations for anyone without having a consultation, but I am happy to answer general inquiries.
I'm finding that it's important to raise awareness about the distinction between someone having an anxiety disorder and someone experiencing stress-related anxiety.
Ayurvedically speaking, a true anxiety disorder is typically Vata in nature - it originates within the person, caused by a lifelong overactivity in the "fight or flight" nervous system response. Examples of Vata-type anxiety disorders include generalized anxiety disorder, phobias, and panic.
Feelings of anxiety caused by external stressors typically begin with a Pitta imbalance, which then causes a Vata imbalance - an agitated response to a stressful situation causes the "fight or flight" response to become activated. Examples of Pitta-Vata anxiety disorders include posttraumatic stress disorder, obsessive compulsive disorder, and social anxiety.
I've noticed that a lot of people today equate anxiety with the experience of stressful life situations. It is important to understand that feelings of anxiety caused by stressful circumstances are not the same thing as having an anxiety disorder.
Whereas external stressors can cause the neurochemical responses that give us feelings of anxiety, these anxious feelings are situational and they go away when the stressor goes away. This is not the case with an anxiety disorder. An anxiety disorder happens because of a neurochemical tendency and does not go away when life isn't stressful. It's important for people to understand this because while we can all make choices about how we respond to external stressors, someone with anxiety can't just make the choice to "calm down". It's not that simple.
Let's all work together to end the shame that surrounds the experience of anxiety.🌻
My first Ayurvedic Detoxification ("Panchakarma") treatment took place several years ago and healed my recurrent pancreatitis. My second round of Panchakarma four months later got rid of my allergic asthma. I have experienced the benefits of this therapy firsthand, and I continue to practice it every Autumn and Spring to maintain my health.
I'd like to share a few words about Panchakarma and draw attention to important distinctions between "colon cleansing" and this Ayurvedic Detoxification protocol.
I see "colon cleansing" programs advertised all the time, in stores and on social media. When I read the details about these programs or look into the supplements involved, what I find out is that these "cleanses" are just pricey ways to increase bowel movements (the herbal supplements involved are simply laxatives). It is true that bowel movements are an important aspect of our body's natural daily elimination of toxins. However, the idea that our colon should be "cleaned out" through extreme measures is very misguided. Having the bowels cleared out makes us feel lighter, and often results in temporary weight loss (which is really just loss of the fecal matter from the colon). You can poop all you want, but taking laxatives is not equivalent to detoxification.
The Ayurvedic detoxification process of Panchakarma is a clinical protocol designed to restore the body's natural balance. Unlike with "colon cleansing", the treatments used in Panchakarma are individualized to treat specific health conditions.
Panchakarma means "five actions", and each of the actions has the effect of restoring balance to a particular system in the body. The five classical actions include:
1) Expectorant therapy to remove excess mucous from the lungs and sinuses.
2) Herbally medicated enema given to nourish the colon. Dry colon mucosa is often the cause of chronic constipation. This therapy also calms anxiety and supports bone health. Some people have strong aversions to this step and we can work around it if that is your preference.
3) Herbal therapies for healing the sinuses.
4) "Blood cleansing": either donating blood to stimulate the spleen to produce new blood cells, and/or herbal medicines used to support these systems - liver, spleen, gallbladder, female reproductive system.
5) Purgation to remove toxins from the digestive tract (this is usually the final step of the program).
The "colon cleansing" that most people associate with detoxification is actually one of the final steps in Panchakarma. In Panchakarma, individualized therapeutic actions done for a specific number of days draw toxins from their stored locations in the body and bring them to the digestive tract for elimination. In the final stage of Panchakarma, purgative therapy is done to eliminate the contents of the bowels, including the toxins that have been drawn to the digestive tract during the detoxification period.
No Panchakarma or Detox program is complete without rejuvenation. After detoxification, a rejuvenation program is created to replenish the body with nourishing foods, herbal treatments, and daily practices such as Yoga and meditation.
In contrast to the popular “colon cleansing”, Panchakarma is a complete program, designed by a trained Ayurvedic health professional, to facilitate healing for a specific condition. Rather than just making us feel lighter, Panchakarma is known to heal such problems as eczema, psoriasis, lethargy, allergies, digestive disorders, acne, and foggy mind.
Since I started practicing Ayurveda, I have observed that I can tell everything I need to know about someone's dosha imbalances by the way they drive. Here are some clues
that will help you to do the same. Buckle up!
How to tell someone's dosha (or dosha imbalance) by the way they drive a car:
Vata: spacey drivers, erratic, often distracted trying to do multiple things while driving, drive at inconsistent speeds
Pitta: impatient drivers, usually have road rage (although some control it better than others), often yell and swear, most likely to drive above the speed limit, want to get to their destination as quickly as possible
Kapha: patient drivers, very courteous to others on the road, will slow down to let people into traffic, most likely to consistently drive the speed limit
So, if you really want to get to know someone, ask them to drive you somewhere! And if you really want your dosha analyzed in-depth, make an appointment with me by scheduling online at: http://mdexter.appointy.com/
Have fun learning!
Cinnamon is a powerful healing spice! In Ayurvedic Medicine, we use cinnamon to balance the doshas of Vata (air/space elements) and Kapha (water/earth elements). These doshas dominate the environment in Autumn and Winter. If at this point you find yourself saying, "What the #%$$ is a dosha?!", you can find out here.
We can see that people following their intuitive needs recognize the seasonality of cinnamon, even without paying attention to an "Ayurvedic" lifestyle. We tend to crave foods and drinks containing cinnamon during the cold months.
For many of us, the onset of fall brings cravings for apple cider, which contains cinnamon and balances the natural increase in cold and dryness that occurs in the body during this time. Cinnamon is a part of many winter holiday celebrations in the form of candles, wreaths, cinnamon brooms and pine cones, and recipes infused with this delicious spice.
For colds, I often recommend taking three teaspoons per day of cinnamon powder mixed with equal parts of raw honey. Taking it with a meal will help it to absorb into your body.
Medicinally, cinnamon supports the heart, blood, plasma, bone marrow, and nerves. It is useful in the treatment of colds and flu because it clears congestion from the lungs and sinuses.
I would recommend checking in with a healthcare practitioner before using cinnamon or any herb to treat any other medical conditions. Cinnamon should not be taken in medicinal doses during pregnancy or if you have bleeding ulcers.
If you would like more individualized recommendations, book your appointment with Michelle online: http://mdexter.appointy.com/
When the sinuses become dry, the body creates mucous in attempt to heal the dryness. Mucous provides a lovely home for viruses and bacteria to flourish. The practice of Nasya (oiling the nasal passages) keeps the sinuses moist, and is a superb preventative for all types of sinus problems!
Benefits of Nasya
Instructions for Practicing Nasya
1. Take a small amount of nasya oil, coconut oil, organic ghee or sesame oil (organic, cold-pressed, not toasted) onto the pinky finger.
2. Apply one drop of oil to each side of the septum. As you breathe, you will draw the molecules of oil into the sinuses, bringing moisture to the mucous membranes. For a more intensive therapy, you can tilt your head back and apply a few drops of oil into each nostril.
3. Perform morning and evening alone or after Neti.
You've probably heard about using the "Neti pot". Did you know that the practice of Neti (AKA saline sinus rinsing) originated in Ayurvedic Medicine, thousands of years ago?
Here is the lowdown on how to make Neti easy by saving money and making your own saline!
Simple Saline Recipe
Add 8 teaspoons of sea salt to 1 gallon distilled water. Shake until salt dissolves.
Note: Do not use iodized salt. It will burn.
Because I care about all of you, I'm going to share some information from the Neti handout that I give to my patients about doing Neti the right way:
Instructions for Practicing Neti
1. Fill your neti pot with your Simple Saline.
2. Stand over a sink, tuck your chin, and tilt your head to the right. Place the spout of the neti pot in your right nostril and slowly pour the water. Adjust your head position if needed to allow water to flow out of the left nostril.
4. Repeat on the other side.
5. IMPORTANT: Remove excess water from the sinuses after irrigation by bending forward and twisting to either side. When in the twist, shake the head a little to encourage and excess water to flow out. You may also do a forward bend for 60 seconds, leaning over so that you feel slight pressure in the sinuses of the forehead. This will allow any excess saline to drain.
6. Gently blow your nose.
7. Follow with Nasya to prevent over-drying.
8. Neti can be done up to three times every day and can be useful in healing sinus infections.
A “cold” (rhinovirus) is an imbalance of the air, space, water, and earth elements in the body. These elements are considered to be “cold” elements in Ayurveda, so the popular name of the virus makes good sense. The virus enters the sinuses and will thrive if they are dry.
The sinuses are a space in the body and excess air in the sinuses will dry them out. The mucous that builds up in the sinuses during a cold is a mixture of earth and water.
Healing a cold requires boosting immune response, bringing heat (fire element) into the body, preventing bacterial growth that leads to a sinus infection, and bringing moisture into the environment.
Colds often cause post-nasal drip, which leads to bronchitis. Mucous in the sinuses that is present during a cold is a wonderful place for bacteria to grow. It is important when treating a cold to prevent it from becoming a sinus infection or bronchitis.
This is the regimen I use to kick my colds, which I can typically get over in 2 days (or less). Although, full disclosure: I hardly ever get sick since I began my Ayurvedic life!
1. Stay home and rest!
2. Echinacea and Elderberry tea: Echinacea improves immune response. Elderberry has been clinically proven to have antiviral properties (it kills viruses). Always cover tea when steeping to prevent the loss of effective components in the steam. Drink 3 cups per day. Helpful hint: If an Echinacea tea doesn’t make your tongue tingle, it’s not effective. I recommend Traditional Medicinals or Pukka brands.
3. Ginger tea: Ginger works in the body through the same mechanisms as aspirin to provide pain relief and bring down inflammation. I drink 3 cups per day to ease pain in the sinuses during a cold. I recommend the Yogi brand Ginger tea because it is a medicinal blend that also contains herbs to benefit the lungs.
Note: Ginger thins the blood, so it should not be taken with other blood-thinning medications. Take Ginger at least 2 hours away from aspirin.
4. Heat and Humidify: Take warm showers to breathe the humid air. Place a humidifier in whatever room you are in most of the day, and add eucalyptus oil to the water. Eucalyptus has antibacterial properties and is healing to the sinuses and lungs.
5. Neti: If you're not too congested, use a neti pot to rinse the sinuses with saline 3 times per day. See my quick and easy recipe for saline here. Saltwater kills bacteria and heals the irritated mucous membranes in the sinuses.
6. Spicy food: I eat very spicy foods when I feel a cold coming on – red curry, green chilies, and soup with hot sauce. Spicy foods act as diaphoretics (sweat-inducers), which help to eliminate the virus from the body.
7. No dairy or sugar: Dairy increases congestion by boosting your body’s ability to make mucous. Sugar enhances bacterial growth.
8. Supplements: Eat 1-2 raw cloves of garlic per day while you are sick (cut them up and swallow the pieces like pills, preferably with some food), and take Goldenseal tincture to kill bacteria. I take Goldenseal 3 times per day at the dose recommended on the package. Although my symptoms are typically gone by the end of 2 days, I take my supplements for 7 days. I then take a probiotic supplement for another 7 days to replenish beneficial bacteria.
If you would like to make an appointment for more individualized assistance, contact me:
email@example.com or 443-253-6221
Ayurveda FAQ: Regarding Probiotics
Q: Why do you often recommend that people stop their use of probiotic supplements? What is the Ayurvedic perspective on probiotics?
A: When I see a patient in my office who has been taking probiotics for more than a month, that is usually a sign of an underlying problem. Unless that patient is on long-term antibiotic therapy under physician supervision, their physician is recommending that they take probiotics daily, or some other such health condition exists, I will often recommend that the patient discontinue probiotic use. The reason for this recommendation is that we need to see if the digestive system can function properly without the external probiotic input.
Your body should be able to maintain a healthy bacterial balance in the digestive tract without the input of probiotic supplements. Dietary sources of probiotics should be sufficient, and these should be eaten in moderation. I have noticed that Americans tend to hear that something is good for them and then proceed to eat it in excessive amounts. If your body is not able to maintain a healthy bacterial balance without the continual input of probiotic supplements, that is a sign that there is a serious underlying issue in the digestive system that needs to be addressed. If your body cannot digest normally without you taking probiotics, it is important to address the underlying cause of poor digestion, rather than putting a band-aid on it with supplements. Long-term use of probiotics supplements does not fix the problem, it masks the symptoms of underlying digestive illnesses.
Some signs of poor digestion include: depression; anxiety; acne; heartburn; constipation; loose stools; stools that are yellowish, orange-colored, or greenish; belching; passing gas; bloating; recurrent yeast infections; and allergies.
From the Ayurvedic perspective, the human body in its natural healthy state is capable of performing all necessary functions without the long-term use of supplements. This is why Ayurvedic Practitioners use herbal medicines as a temporary input while we address underlying causes of illness by guiding our patients to implement dosha-appropriate diet and lifestyle practices. In the case of probiotics, an Ayurvedic Practitioner may recommend them as one aspect of a complete process to reset digestive function.
The Ayurvedic digestive reset protocol involves evaluation of you as an individual to determine what specific issues exist in the digestive system. We will often recommend that you undergo the Ayurvedic Detoxificaton process is called "panchakarma", which means "five actions". Read more about panchakarma here.
These five actions have been clinically proven to eliminate toxins from the body. The panchakarma process eliminates all excess doshas from the body, restoring healthy digestion. Without addressing underlying causes of the need for probiotic use, treatment is incomplete.
I hope this helps!