Satvavajaya Chikitsa In

Bhaya W.S.R. To Fear of

Examinations.
Scholar- Dr. Mahesh C. Kundagol
Guide- Dr. Narayan Prakash B.
M.D. (Ayu)

Co-Guide- Dr. Suhas Kumar Shetty

M.D. (Ayu)
 Introduction
1) Examinations.

2) Examination Fear.

3) Satvavajaya Chikitsa.
?
Aims and Objectives

 AIMS AND OBJECTIVES

 1)To evaluate the effect of Satvavajaya
chikitsa in the management of Bhaya.
 2)To evaluate the Nidana Panchaka of
Bhaya
 3)To provide a cost effective self
assessable drugless therapy.
Historical review
 VEDA PERIOD

a) Rig-Veda –Pisacha.
b) Yajur-Veda – Shivasankalpa Sutra.
c) Atharvana-Veda – Manasikabhavas.

 SAMHITA PERIOD
Review of Bhaya

‘Bhayam Parmastrsahah’

 In Bhagavad-Gita it is said that ‘The coward ness

which is originated as a result of the gain of the
unpleasant thing and the loss of the pleasant
thing is termed the Bhaya.
( Bh.G. 16/1 Jayadmala Goendaka Comm).
.
Review of Bhaya
 Nidana – Etiology of Bhaya.
a) Prajnyaparadha.
b) Vata Dosha.
c) Manasika Prakriti.
d) Avara Satva.
c) Negative thoughts.
Types of Bhaya – (B.G.16/1)

a) Pratistha Nasah Bhaya-

b) Apamana Bhaya -.

d) Vyadhi Bhaya -

e) Bhuta Pretadi Bhaya -Fear of ghosts, devils etc.

f) Mrityu Bhaya

g) Vyaghradi Bhaya.

h) Jalatraasa

i) Anagata Bhaya
 Poorvaroopa of Bhaya

a) Chirakari Vyadhi.

b) Vata Dosha.
 Roopa -

1) Vishada
2) Bhita
3) Svedavepathumaan
4) Trastha
5) Shuskashyavavakrah
Samprapti
Nidana Sevana (Exam fear) Mano Dosha Kopa Sharirika Dosha Kopa
Raja, Tama Vata, Pitta, Kapha

Hridaya Dusti Agni Vikrit Rasadi

Dhatudusti
Hina Satva
Manovaha Srotodusti Rasadi Sarva Srotodusti
Prolonged nidana

Manas Lakshana Uttpati Sharira Lakshana

Uttpati

Bhayaa
Samprapti Ghataka:
1. Dosha – Manas – Raja, Tama
Shareera – Vata – Prana,
Udana & Vyana
Pitta – Sadhaka
Kapha – Tarpaka
2. Dushya –Rasadi Sarvadhatu
3. Agni – Jatharagni – Manda, Vishama
4. Srotas – Manovaha, Sarvasrotodushti
5. Srotodushti - Atipravrtti
6. Udbhava Sthana - Hrdaya
7. Sanchara Sthana - Manovaha Srotas/ Sarva
Shareera
8. Adhishthana - Manovaha Srotas
9. Vyakta Sthana – Manas and Shareera
10. Sadhya Sadhyata – Krcchra Sadhya
vyadhi
11. Roga Swabhava - Ashukaritva
12. Upadrava - Manovikara/ Shareera Vikara
Concept of exam fear
 Causes of Exam Fear-
1) Negative thoughts.

2) Worrying about past performance

3) Comparison.

4)Lack of confidence.

5) Failure to organize course information.

5) Poor study habits.

6) Poor time management.

7) Lack of confidence.

8) Study environment.
Symptoms
1) Fear of loosing control or going crazy.
2) Loss of memory.
3) Fear of failure.
4) Profuse sweating.
5) Feeling of Choking.
6) Insomnia.
7) Nausea or abdominal discomfort.
8) Feeling Dizzy, unsteady, light headed or
faint.
9) Palpitation, beating heart, or accelerated
heart rate.
10) Chills or hot flushes.
11) Paresthesia
12) Sensation of shortness of breath or
smothering.
Complications of Exam Fear
1) Failure in the exams.
2) Avoidance of exams.
3) Discontinuing of the studies.
4) Mental and physical illness.
5) Suicidal tendency.
 Concept of Satvavajaya
ChikitsaChikitsa
Satvavajaya

“Satvavajaym Punarahithebhyo Arthebhyo

Mano Nigrahah.” (Ch. Su. 11/55)
 Techniques of the Satvavajaya Chikitsa

a) “Manaso Gnana Vignnyana Dhairya Smriti

Samadibih”

b) “ Dhi Dhairyatmaadi Vignynam

Manodoshoushadim Param”.
1) Gnyana. Atma, Kula, Bala, Desa,

2) Vignyana.

3) Dhairya.

4) Smriti.

5) Samadhi.
Bhaya and Satvavajaya
Chikitsa
1)Rational persuasion –

a) Dhairya & Ashwaasana

b) Sadvrtta (good conduct)

c) Dharaniya Vega
.
2))Methods based on the deeper
understanding
 Atma Janna- who I am, what is beneficial to me
 Desha Janna – Society, his responsibility towards it.
 Kula Janna – Family and his relationship between
them.
 Kala Janna – Season, Pathya, Apathya during this
time.
 Bala Janna – Strength
 Shakti Janna – Capacity
3) Samadhi (Mental equanimity) –

1) Abridging of Indriyas Indriyani Samksipya.

2) Stilling the fickle mind (Cancalam Maanah

Samksipya).

3) To fix the mind into Soul.

 Methodology

 For the present clinical study, a survey study

was conducted in the Malnad College of
Engineering Hassan for the assessment of the
presence of the examination fear in students
and 30 students were selected for the study
who were coming under the criteria of the
examination fear.
Criteria of diagnosis:
The diagnosis of the examination fear in
students were done on the basis of presence
of the following symptoms in feared
conditions.
1) Fear of loosing control or going crazy.
2) Loss of memory.
3) Fear of failure.
4) Profuse Sweating.
5) Feeling of choking.
6) Insomnia.
7) Nausea or abdominal discomfort.
8) Feeling dizzy, unsteady. Light headed, or
faint.
9) Palpitation, beating of heart, or accelerated
heart rate.
10) Chills or hot flushes.
11) Paresthesia.
12) Sensations of shortness of breath or
smothering
Each symptoms were were given scorings as
0, 1,2,3,4, and their severity were denoted on
the personal scorings as,
0 - Not present
0-12 - Mild
13-24 - Moderate.
25-36 - Severe.
37-48 - Very severe
Inclusion criteria:
1. Students of 18 to 30 years of age.
2. Students presenting with general features of
fear of examination.

Exclusion criteria:
1. Students suffering from other psychiatric
and organic diseases
 Method of Satvavajaya Chikitsa:
 The Satvavajaya Chikitsa was designed
depending upon the cause of the fear in the
students. The students were interrogated in
detail for knowing the cause of the fear, and
then they were given the Satvavajaya in the
for of Dhairya and Ashwaasana Chikitsa for
45 mins, in a calm and peaceful room, twice
in a week for three weeks.
Assessment criteria:
Assessment of the patients of the patients will
be done on the basis of-
a) Self assessable questions were prepared
for the assessment.
b) All the symptoms were given suitable
score for the assessment of results. Total
effect of the treatment will be considered as
complete remission, marked improvement,
and unchanged.
c) Diagnosis and improvement in signs and
symptoms of the condition according to
Hamilton’s scale of anxiety.
 HAMILTON ANXIETY RATING SCALE:

1)Anxious mood
2)Tension
3)Fears
4)Insomnia
5)Intellectual (Cognitive)
6)Depressed mood
7)Somatic (Muscular)
8)Somatic (Sensory)
9)Cardiovascular Symptoms
10)Respiratory symptoms
11)Gastrointestinal Symptoms
12)Genitourinary Symptoms
13)Autonomic Symptoms
14)Behavior at interview
 Signs and symptoms mentioned in Hamilton scale
were assessed by adopting the following scoring
system:
 Degree of anxiety &

Pathological condition Scoring

 None 0
 Mild 1
 Moderate 2
 Severe 3
 Severe, grossly disabling 4
 OVERALL EFFECT OF THERAPY
 Overall effect of the therapy was assessed in
terms of complete remission, marked
improvement, moderate improvement, mild
improvement and unchanged by adopting the
following criteria:
 Complete remission - 100%,
 Marked improvement - 75 to 99 %,
 Moderate improvement - 51 to 74 %,
 Mild improvement – 25 to 50 %
 Un-changed - < 25 %.
 Statistical analysis –
For the statistical analysis of the above said
parameters, paired t-test method was
adopted and S.D, S.E, t and p values were
calculated.
Observations and results
 For the present study on examination fear a
survey study was conducted in the Malnad
College of Engineering at Hassan, a total of
500 students were given the questionnaire for
assessing the presence of the examination
fear, among them 30 students were selected
for the clinical study. The demographical data
of 30 patients studied are as follows
 Age: All the patients selected for the study
were from the age of 18, 19 and 20 years.
Among them 8 patients were of 18 years
(26.6%), 12 patients were of 19 years (40%),
and 10 patients were of 20 years of age
(33.3%).
 Educational Status: It is evident from the
study that maximum no. of patients 26.6 %
were from first Semester, followed by 40 %
were from second semester and 33.3 % were
from third semester B.E.
 Manasika Prakriti
In this study 70% of the patients were of Rajas
Prakriti, 13.3%were of Tamas Prakriti and
remaining 16.6% patients were of Rajas-
Tamasika Prakriti. This shows that the Rajasika
Prakriti people are more prone to Bhaya.
 Sharira Prakriti –
73.3% patients of this study were of Vata-Pitta
Prakriti, 6.6% patients were of Vata Kapha
Prakriti, and 13.3% were having Pitta Kapha
Prakriti.
Satva:
In this study 86.6 % patients had AVARA Satva and
13.3 % had Madhyama Satva.

Sara: In this study Mamsa Sara Purushas were

maximum i.e. 40 % and Twak, Medo and Asthi Sara
Purushas were of 20 % each.

Samhanana: In this study the Madhyama Samhanana

Purushas were maximum i.e. (70 %) and 23 % were of
Hina and 7% were of Uttama.
 Satmya – In this study maximum no. of patients was
graded as Madhyama Satmya i.e. 53.3 % and Pravara
were of 36.6 % and Avara Satmya people were of 10 %
Agni: Here 40% patients of this study were having
Visama Agni, 26.6% patients were having Manda Agni,
13.3% patients had Sama Agni and 20% of the patients
had Tikshna Agni
Personality: Table- Shows 73.3% of the patients were of
anxious personality, while 20% were of paranoid and
the remaining 6.6% were of aggressive personality
 Cardinal signs and symptoms complained
by 30 patients of Bhaya
Cardinal No. of %
signs and patients
symptoms
Fear of 26 86.6
loosing
control
Loss of 27 90
memory
Fear of 26 86.6
failure
Profuse 26 86.3
sweating

Feeling of 25 83.3
choking

Insomnia 23 76.6

Nausea or 17 56.6
abdominal
discomfort
Feeling dizzy 24 80

Palpitation 29 96.6

Chills 29 96.6

Paresthesia 20 66.6

Shortness of 28 93.3
breath
Effect of Satvavajaya Chikitsa on
signs and symptoms of Bhaya
( Examination fear)
2.5

1.5
A.T.
1 B.T
0.5

0
Fe.O.Los L.O.Mem Fe.O.Fal
 Cardinal signs and symptoms No. of patients %

Fear of loosing control 26 86.6

Loss of memory 27 90

Fear of failure 26 86.6

Profuse sweating 26 86.3

Feeling of choking 25 83.3

Insomnia 23 76.6

Nausea or abdominal discomfort 17 56.6

Feeling dizzy 24 80

Palpitation 29 96.6

Chills 29 96.6

Paresthesia 20 66.6

Shortness of breath 28 93.3

 2

1.5

1 A.T.
B.T
0.5

0
Pro.Sw . Fe.O.Ch. Insom n
 2

1.5

1 B.T.
A.T.
0.5

0
Nau.Ab.Ds Fe l.Dizz Palp.
 2

1.5

1 B.T.
B.T.
0.5

0
Chills Pare s t Shor.O.Br.
Effect of Satvavajaya
Chikitsa Hamilton Anxiety
rating Scale
Numb B.T. A.T. % 0f S.D. S.E. T P
er of relief Value Value
patient
s
30 32.86 18 45.23 5.89 1.52 9.76 <0.001
 Overall effect of Satvavajaya Chikitsa on 30 patients of Bhaya

Effect No. of Patients Percentage

Complete
remission
Marked
improvement
Moderate
improvement
Mild improvement

Unchanged
Discussion
1) Bhaya is one of Manasika Vikara. In the
manifestation of Bhaya, both Vata and Manas play
an important role. As Vata and Manas are inter-
dependent, so if one gets vitiated it also affects
other adversely.
2) Acharya Charaka advices Ashwasana and
Harshana Chikitsa for the Mnanagement of the
Bhaya. So for this study Satvavajaya Chikitsa was
given to 30 students who were suffering from the
Fear of the Examinations
Summary and conclusion
Annexure