The Gerson Institute of Ayurvedic Medicine

Yoga and Ayurveda by Scott Gerson, MD, M. Phil. (Ayu), Ph.D. (Ayu)

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According to Ayurveda, all disease and misery ultimately is caused by an imbalance of the three bioenergies known as the doshas. Like all energies (gravity, electromagnetic, subatomic forces), the doshas too ultimately arise from the field of pure consciousness. If the mind is pure, the energy of pure consciousness flows through us permeating our reality and brings the experience of well-being, eternal peace, and wisdom.

However, when the mind becomes impure due to attachment to external objects and desires, the connection to the source of pure consciousness is lost and we experience pain and fragmentation. In Ayurveda we recognize that the mind is mirror-like in nature wherein are reflected the objects seen by the physical eyes, heard by the physical ears, tasted by the physical tongue, and so on. But even more fantastical than the most imaginative fairy tale, the images reflected in the mirror of our minds take on a life of their own! So, within our minds there evolves an imagined world - a world of images of things seen, heard, tasted, smelled and touched. A world which compares and contrasts images, remembers them, and forms ideas around them. Quickly, there arises desires, aversions, ambitions, envy, hatred, attractions, plans, theories, and an entire imagined universe.

The practice of Yoga, or unification, re-establishes the connection between the individual and the universal field of pure consciousness. Yoga removes the attachment to external objects and false knowledge and corrects psychological trauma by merging the mind with the real, the virtuous, and the wellspring of harmony. It really is true. Since the mind plays such an important role in creating health, Yoga plays a vital role in Ayurvedic medicine.

When I was learning yoga as a young man while in Ayurvedic college in India, my guru would often remind me of this sloka:

Chale vatah chalam cittam   Nishchale nishchalam bhavet

(If Vata is in balance, the mind will be calm, and if the mind is calm Vata will be in balance)

Patanjali, the compiler of the original Yoga Sutras, lived approximately between 900-800 B.C. - a time when Ayurveda was flourishing. This profound piece of writing is comprised of merely 195 short aphorisms which would take up no more than twenty pages or so in modern typewritten pages. Yet, the Ayurvedic scholars who were contemporaries of Patanjali recognized the practical wisdom in these lines: the attainment of spiritual reality through the purification of the physical and mental bodies.

Patanjali is quite detailed and clear as to how mankind can shed the veils and vestures of his emotional and intellectual mind. It is interesting to note that the Yoga teaching, like all true teachings, rests on a solid and strong foundation of spiritual rules which include honesty, truth, cleanliness, discipline, and obedience. It is these ethical laws of human conduct which are almost completely ignored in the majority of the so-called "yoga centers" which have sprung up throughout the world over the past few decades.

The original teaching of Patanjali's system of yoga describes a consecutive sequence of eight stages, ashtanga yoga, to achieve unification with pure consciousness (ashta = eight). Although many volumes can be written on each of these stages, it is here sufficient to point out that Ayurveda has adopted aspects of each of these eight steps. In the following section, we will summarize these eight steps.

The Eight Stages of Yoga

1. Yama - Right Conduct Towards Others

2.    Niyama - Right Conduct Towards Oneself

3.    Asana - Physical Postures

4.    Pranayama - Control of the Breath

5.    Pratyahara - Control of the Mind and Sense Organs

6.    Dharana - Concentration and Control of the Attention

7.    Dhyana - Meditation

8.    Samadhi - Perfect Balance and Unification

The first two stages, Yama and Niyama, define the moral and ethical principles of human life - how we should conduct ourselves. Together they constitute the instructions for Dharma, or right living. Realizing one's dharma means understanding what behaviors are appropriate for one, both as an individual and as a member of society. No authentic or permanent progress can be made spiritually without firmly establishing correct inner and outer conduct.


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Yama (Sansk. root, yam: self-restraint, rein, curb), has been distilled by the vaidyas into a list of behaviors as relevant today as when they were originally conceived. This list has become known in Ayurveda as sadvritta, or the ethical guidelines:

  • Avoid anger.

  • Avoid violence in any form.

  • Do not overexert the physical body.

  • Observe celibacy and enjoy sexual acts according to law.

  • Do not indulge in alcoholic beverages.

  • Promote calm and peace of mind.

  • Never utter words which are hurtful to others.

  • Do not steal in any form.

  • Bath and clean the body regularly.

  • Behave with courage and patience in all matters.

  • Give freely to others.

  • Observe religious acts according to your faith.

  • Respect your teachers, elders, guru, and priests.

  • Respect all animals.

  • Never act in a cruel manner towards any living thing.

  • Show mercy to all those who are in need.

  • Maintain the proper balance of waking and sleep.

  • Respect those who have mastered the control of their senses.

  • Maintain your religious practices.

  • Act in an appropriate manner, time, and place.

  • Resolve to follow reasonably made plans.

  • Turn your back on the ego.

  • Cultivate the attainment of pure awareness.

  • Mimic the behavior of the great sages and sadhus of society.

  • Study philosophy, science, and the arts and use your knowledge for the benefit of all mankind.


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The second limb, Niyama, (Sansk. roots, ni: within, down, back, into; yam: self-restraint, rein, curb) turns the attention inward to the thoughts and feelings in the different levels of one's own mind. It involves keeping one's mind free from anxiety, sadness, depression, low self-esteem, doubt, worry, and fear and negative states such as hatred, anger, jealousy, avarice, and pride. It also implies eliminating these negative qualities and re-establishing positive ones: contentment, purity, self-discipline, scriptural study, and devotion to god. According to Vedic philosophy, negative thoughts and feelings are like mirages in the desert; they are only illusions. The reality is the supremely positive presence of the One Self within you.


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Having achieved purity and steadfastness of mind during these first two limbs, the third limb, the Asanas, are used in Ayurveda to develop strength and flexibility of the physical body as well as to promote the unimpeded flow of energy throughout the mind body. Various postures also help to release and move stagnant energies, tensions, and impurities which have accumulated in the marma points and chakras. When allowed to remain stagnant these energies often give rise to physical and psychological disorders.

There are also specific asanas which are most suitable for individuals of each constitutional type. These should be prescribed individually by an Ayurvedic practitioner completely familiar with the science of yoga asanas and with the medical condition of the patient.


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The word pranayama means "control or regulation of the breath." Breathing is a natural, automatic activity for almost everyone most of the time. Ayurveda emphasizes the connection between breathing correctly and the vital energy of an individual. In fact in the Sanskrit language the word for “breath” and the word for “life” is the same prana. Some people do unfortunately develop breathing disorders or suffer from diseases which affect the breathing. These disturbances in breathing may affect the strength of an individual's will-power, mental alertness, sleeping pattern, and mental stability. You can understand, in light of this, why breathing is so vital to health. Fortunately, most people can learn to improve their breathing with very little effort. Specialized breathing techniques can be used especially by individuals of different constitutions. Ayurveda borrows a number of highly specialized techniques from the Yoga tradition which have been adopted for specific health issues. However, before moving into the practice of these specific techniques, Ayurveda generally recommends that all people first master a technique known as purakarechaka (puraka means inhalation, rechaka means exhalation). To be certain, all the other pranayama techniques are merely variations upon this fundamental exercise.

This technique is nothing more than full, natural breathing through the nose. In natural breathing, inhalation causes the middle ribs, i.e. those located just beneath the breasts, to expand more than the upper and lower ribs. The abdomen expands too, but only slightly; the sternum moves out and away from the spine. Exhalation involves a relaxation of the muscles of inspiration. The diaphragm releases its tension and the outflow of air is not willfully modified by the respiratory muscles. Between inhalation and exhalation there is a brief interval during which there is no movement of air. Actually, there are two of these periods: one just after full inhalation and one just after full exhalation. The duration of these intervals are controlled unconsciously and should be manipulated only with extreme care.

Deep Breathing Technique (Purakarechaka)

1. Sit in a balanced, upright posture in a chair with a straight back. Feet should be flat on the floor about shoulder width apart; remove the shoes and socks. Place hands on the lap, palms up. Mouth should be closed. All breathing is through the nostrils.

2. Exhale whatever air is in the lungs.

3. Take a normal inhalation observing the following:

  • the initial movement is that of the abdomen expanding slightly.

  • the chest expands next starting in its lower zone, followed by the middle zone, and finally the upper zone.

  • do not constrict the throat in any way or make any sound during inhalation

  • the sternum (breast bone) moves out away from the spine.

  • do not strain to fill the lungs; the inhalation will stop naturally at the precise lung volume which is required. Observe this as it happens.

  • at the end of inhalation, a brief interval of no air movement occurs. Observe this without in any way interfering or prolonging it.

4. Exhale normally observing the following:

  • do not force the exhalation or use extra effort or undue haste.

  • as you observe the breathing the exhalation phase naturally becomes slightly longer and deeper than inhalation phase. Allow this to occur.

  • relax the abdominal muscles as you exhale.

  • do not allow the head and chest to slouch forward during exhalation.

  • at the end of exhalation, a brief period of no air movement occurs. Observe this without in any way interfering or prolonging it.

5. This completes one cycle. It is recommended to complete 16 cycles per session. Perform this exercise twice a day; morning and evening. It requires approximately 90 seconds to complete each session.

It is usual for most individuals to use Purakarechaka as their pranayama exercise for six to eight weeks before advancing to the more specific exercises described for each constitutional type which are beyond the scope of this page. This will be time well invested. Pranayama is a conduit leading to deeper levels of consciousness; it is a key to release energies and impressions held in the subconscious mind. After these energies are harmonized, we can dive deeper towards the source of all.


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This commonly overlooked fifth stage of Yoga creates control and integration of the five senses and prevents fragmentation and dissociation. Fragmentation of the root of the five senses leads to distraction in whichever direction the senses lead us. A person under the control of the senses has no true established inner strength or stability because he becomes an instrument which reacts only to the environment.

Pratyahara (prati = towards, beside, near; hri = to keep back, dispel, to avert) is the discipline of withdrawing the senses from the sense objects. It is often mis-translated “withdrawing the sense” but this is not precisely what is meant. The senses do not stop operating. It is their connection with their sense objects which is broken. It is a technique of maintaining a kind of neutrality between the senses and the sense objects and being in control of their input.

Ayurveda cites three main causes of human disease. Among them is asatindriyasamyoga which literally means "inappropriate connection of the senses with the sense organs.” Inappropriate operation of the senses may include either excessive, insufficient, or inappropriate use. The way we use our five senses determines the forms of energies we assimilate from the outside world and creates, in large part, who we are.

There are classically two main approaches to pratyahara and both are extremely useful. The first is to simply remove sensory stimulation. This can be accomplished by being in a very quiet, darkened room with no artificial smells and very little if any clothing on the skin. Abstaining from sensory stimulation in this way will allow the mind to clear and detoxify itself. It also permits the usually drowned out subtle, deep, subconscious memories, impressions, and "mental and emotional residues" to float up to awareness where they can be digested and processed.

The second approach to pratyahara is executed during normal acts of sensory perception. It involves perception with an aloofness and non-involvement of what is perceived. We do not judge, measure, or even name what we perceive - we simply allow our sensory apparatus to operate in their role of receiving appropriate impressions. We are then perceiving external objects for exactly what they are without projecting our own subtext onto them. This form of pratyhara can inform the student about the play and interactions of various energies and can be a profound and reorienting experience. Although no special environment is required, it is important for aspirants to be under the guidance of a guru to discuss questions which may arise. Ayurveda incorporates this knowledge into its medical tradition through the prescription of mantras, yantras, essential oils, colors, massage techniques (touch), and tastes.


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Attention is the cornerstone of knowledge. Dharana is the capacity to focus the attention on a given object or region and steadfastly hold it there. Dharana, (from the Sanskrit root dhri, meaning to hold, to keep fixed, to direct towards, to confer) consists of different techniques for developing one-pointed concentration. The methods of Dharana and Pratyahara are outwardly very similar, hence the confusion regarding the latter. In Pratyhara the attention is focused through the senses but the energy is drawn inward into the mind. In Dharana, the energy is focused on various objects, which can be external or internal.

Dharana techniques include fixing the gaze on the flame of a ghee lamp or candle, on a yantra, on an image of a deity or guru, on a mountain, tree, or other natural object. It can also involve focusing the mind on an internal point, light, sound, or concept.

Only if the mind can be properly focused can there be the establishment of personal aims, disciplines, pursuits, or spiritual development. Dharana brings about the capacity to control the mind instead of the mind controlling you. The antithesis of this state in the condition known today as ADD, or attention deficit disorder. It is increasing worldwide in prevalence in both children and adults. Have you ever read a paragraph with your mind on something else and then realize that you have no idea what you just read? So you read it again with your mind still on something else, with the exact same result. This is also a common form of attention deficit disorder, only it doesn't have a medical term. Rather than administering harmful drugs like Ritalin, the Yoga system provides a method of approaching this condition in a very effective and natural way. In fact, Dharana methods are useful in many psychological conditions as well as in learning any new material or strengthening the memory. In order to develop spiritual knowledge, one must first be able to master spiritual attention.


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Meditation is the single-minded, sustained attention resting on one object. While Dharana develops the ability to focus the attention on an object for some short time, Dhyana is the ability to fix it there. One can gradually extend periods of Dharana practice and it will eventually mature into Dhyana. When the mind is able to sustain its attention on a particular object, it receives the essence of that object. The true significance of the object is revealed as if a strong constant light were shining upon it until all of its previously hidden details were now uncovered.

Meditation can be dynamic or passive. Dynamic forms of meditation involve effort by which we reflect upon aspects of the Self. These techniques can illuminate cosmic intelligence. Passive meditation is effortless and involves a detached witnessing of the workings of the mind without any involvement. These techniques can create a vacuum into which flows the light of pure consciousness.

Whichever technique one utilizes, the ultimate purpose of meditation is to transcend all thought. This cannot be achieved by a mind which is distracted by an agitated, frustrated, or otherwise disturbed energy. It requires that an individual has maintained the Yamas and Niyamas, has controlled his breath, and physical body, and that he has learned the secrets of the senses and the attention. Otherwise, all attempts at meditation will mutate into something quite different and will ultimately fail. Much of what is called meditation in the modern world is merely relaxation, visualization, or stress reduction-all useful and valid techniques but not true meditation. For the true meditative state to emerge, a person must already have released all worldly attachments and be free of all the usual and distracting problems of human life. This is even more difficult for the modern aspirant than it was for the original sages. Perhaps that is why they retired to live in total seclusion after reaching the age of seventy.


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Samadhi, the final stage of Yoga, is defined in Patanjali's Yoga Sutras as the state in which the perceiving consciousness totally merges with the object of perception and becomes free from any sense of separateness or individuality. In other words, Samadhi is the unification of one's consciousness with Universal Consciousness. This brings a permanent state of consciousness (sat), knowledge (chit), and bliss (ananda).