mental health

Long pepper treatment (pippali-vardhamana)

Pippali/Long pepper

Pippali/Long pepper

Pippalī-vardhamāna is a kind of treatment in which (pippalī) long pepper corns are taken in increasing and decreasing quantity.

This treatment is excellent for detoxing body and also for mental health and wellbeing.

These benefits of this treatment have long been recognised:

  • The Caraka Saṃhitā is one of the classical texts of Ayurveda, it is dated to between the first and second century CE. In this text, pippalī-vardhamāna is described as a rejuvenation therapy which is nourishing and a promoter of a long life and a healthy mind.

  • The Bower Manuscript is an ancient Buddhist text, also dated to around the second century CE. In this text, various healing potions, similar and sometimes identical to those of the classical Ayurvedic texts, are described. The Bower Manuscript also mentions pippalī-vardhamāna and describes it as suitable in the treatment of mental health problems.

Herbal Ghee (ghrta) for the mind and mental health


Ghee is one of the medicines which the Buddha recognized, and the use of ghrita (ghee) for mental health problems is very common within the Ayurvedic texts, it continues to be regarded as ‘the best drug of oleation’, and assimilates the properties of substances accompanying it. Medical uses of ghrita include drinking it, nasal drops, massaging on the body, bathing in it and various other applications.

Classical Ayurvedic texts give around 20 different recipes for types of herbal ghee recommended for the treatment of mental health problems. Recent initial small scale research in India using randomised placebo controlled clinical trials is beginning to show that the total effect of Brahmi ghee is statistically highly significant compared with placebo for conditions such as depression and anxiety.

Manasa Ayurveda carefully produces our own herbal ghee using special combinations of herbs traditionally recognsised as highly effective for the mind and mental health.

Face-to-face consultation: taking your blood pressure


Our Manasa Ayurveda consultations are undertaken by registered healthcare professionals and as well as using traditional Ayurvedic methods also include conventional physical health checks. One of these checks is of blood pressure.

Why do we do this?

We measure blood pressure so we can see how well this part of your circulatory system is working. Your Manasa Ayurveda therapist will measure your blood pressure during your consultation and during therapy sessions where monitoring is helpful.

A blood pressure that is too low can lead to fainting and falls, whereas a high blood pressure, if untreated for long periods may cause problems such as kidney damage or stroke. We usually cannot tell if our blood pressure is too high as there are no obvious signs and symptoms. The only way we know is by measuring it.

What happens?

We measure blood pressure by hand (manually) for the most accurate readings:

  • We will ask you to sit down with your arm supported on a table. Sometimes we will check your blood pressure laying down or standing up.

  • A cuff is placed on your upper arm.

  • The cuff is tightened and you will feel tightening.

  • The air is then slowly let out of the cuff.

  • Your Manasa Ayurveda therapist will then place a stethoscope on your arm just below the cuff and listen to your pulse whilst the air is being let out.

  • It is best to do this three times to get the most accurate reading.

  • The therapist will tell you the result and write it down on a chart.

What do the results mean?

  • Blood pressure is measured in millimetres of mercury (mmHg). Ideally blood pressure should be lower than 120/80 mmHg.

  • The first number is called the systolic blood pressure. It is the highest level your blood pressure reaches when your heart beats.

  • According to Ayurvedic principles a systolic blood pressure of less than 95mmHg may be associated with vāta, whereas a systolic blood pressure of over 130mmHg may be associated with pitta.

  • The second number is called the diastolic blood pressure and is the lowest level your blood pressure reaches as your heart relaxes between beats.

  • From your blood pressure, your pulse pressure (PP) can be calculated (systolic – diastolic) and this is pressure is known as bala (force) according to ancient Ayurvedic understanding.

We can make helpful suggestions to help you manage high or low blood pressure using an Ayurvedic approach, including diet, exercise, sleep and meditation practices and may also recommend that you inform your GP so that they also remain informed of your health condition.

Face-to-face consultation: taking your temperature...


Our Manasa Ayurveda consultations are undertaken by registered healthcare professionals and as well as using traditional Ayurvedic methods, can also include physical health checks which are used within NHS hospitals. One of these checks is taking temperature.

Why do we do this?

According to Ayurveda, body temperature can be affected by the three “doshas”. For example, an excess of “pitta” is often connected with more heat in the body, and this may be associated with symptoms such as, acne, heartburn, skin rashes and diarrhoea. Temperature can also be affected if you have an infection, by taking certain medicines, if you are dehydrated and if you are very emotional. We need to know if your temperature is too low, normal or too high, because this can help us plan the therapies we offer.

What happens?

A professional Manasa Ayurveda therapist will take your temperature during the face-to-face consultation. We will check your temperature using an electronic thermometer which is placed in your ear for a few seconds. Your therapist will write down what the result is on the chart. During your therapy programme we may continue to monitor your temperature if this is found to be an especially important factor for you.

What do the results mean?

Normal temperature is around 35-37°C. According to Ayurvedic principles, cooler temperatures may be associated with aggravation of vāta and warmer temperatures associated with aggravation of pitta.

Developing mental wellbeing through seeing things as they are: a traditional Buddhist Ayurvedic perspective

Western mental health professionals are now increasingly adopting mindfulness-, acceptance- and compassion-focused therapy approaches which ‘present concepts derived from Buddhist psychology as separate from the philosophical context from which they have emerged’ (p.18, Tirch et al. 2016). Research into the clinical utility of Buddhist-derived interventions (BDIs) has increased greatly over the last decade, and continues to grow: 

‘...although clinical interest has predominantly focused on mindfulness meditation, there also has been an increase in the scientific investigation of interventions that integrate other Buddhist principles...’ (Shonin et al, 2014). 

There are concerns over the rapidity at which mindfulness has been extracted from its traditional Buddhist setting and introduced into psychiatric treatment domains, and writing on innovations and advances in Cognitive Behaviour Therapy (CBT), Huxter (2007) has suggested that: 

‘...attempts to distil and separate mindfulness from Buddhism run the risk of losing the skill knowledge and conceptual framework that this tradition offers... attempts to reinvent the wheel, without reference to earlier models are, perhaps a retrograde step’ (p.53, Huxter, 2007). 

Although psychiatric nosology has continued in Europe since the mid-eighteenth century CE, definitions of mental health problems still remain subject to debate, with no definition accepted within Western psychiatry to specify the precise boundaries for the concept of mental disorder. 

This article focuses upon buddhi vibhrama (impaired or deranged buddhi) as one of the defining features of mental health problems according to a traditional Buddhist Ayurvedic perspective. It also introduces the trilakṣaṇa (three marks of existence) which have an important place in addressing mental health problems as part of ‘cognitive therapy’ (vipassanā-paññā) in the practice of Buddhist Āyurvedic Counselling and Psychiatry (BĀCP).

According to premodern Buddhist and Āyurvedic texts mental health problems may arise as impairment, disturbance, loss, destruction, distortions or in other ways. In the Ayurvedic classical texts, mental health problems (in particular unmāda - a term often translated as mental disorder) are characterised as the impairment, disturbance, loss, destruction, distortions etc. of various mental processes or factors. Problems associated with buddhi (intellect) and smṛti (memory/mindfulness) are most frequently mentioned. 

Buddhi (intellect) is the ability to understand correctly, it is the discriminative function, that which knows, and is one of the inner instruments of cognition. Buddhi vibhrama (impaired or deranged buddhi) is a condition wherein ‘perverted’ judgments are made.

Mental health problems are understood as conditions in which buddhi ‘loses its balance’ and buddhi vibhrama is specifically and directly associated with mental health problems from the Ayurvedic perspective. 

Examples of disturbed buddhi are given in the classic Ayurvedic text, the Caraka Samhita: 

‘If something eternal is viewed as ephemeral and something harmful, as useful and vice versa, this is indicative of the impairment of intellect. For the intellect normally views things as they are’ (CS.Sar.I.99).

What does it mean to clearly see things as they are? 

The Ayurvedic classical text, the Caraka Samhita offers a clear answer to this in a very important passage. This passage in the classical Ayurvedic literature makes explicit reference to the Buddhist teaching of the three marks of existence (trilakṣaṇa) in what Wujastyk (2012) has described as ‘completely Buddhist terms... taken directly from the Buddhist meditational and doctrinal milieu’ (p.35, Wujastyk, 2012). Below two different transalations of the original Ayurvedic Sanskrit are given: 

‘Any thing that has a cause constitutes misery [duḥkha (Pāli:dukkha)]; it is alien [anātman (Pāli:anattā)] and ephemeral [anitya (Pāli:aniccā)]. It is not produced by the Soul (Atman); but one has got a feeling of its ownership until one has got real knowledge to the effect that this is something different from him; and is not his own. As soon as one knows it, he gets rid of all (miseries)’ (CS.Sar.I.152-153). 

‘Everything that has a cause is pain [duḥkha], not the self [anātman] and impermanent [anitya]. For that is not manufactured by the self. And in that arises ownership, as long as the true realization has not arisen by which the knower, having known “I am not this, this is not mine”, transcends everything’ (CS.Sar.I.152-153; p.41, Wujastyk, 2012). 

Within the Buddhist tradition, at an advanced stage of mindfulness practice (satipaṭṭhāna) insight (vipassanā) into the three marks of existence (trilakṣaṇa; Pāli:tilakkhaṇa) is purposefully developed: 

  1. sabbe saṅkhārā aniccā (all saṅkhāras (conditioned things) are impermanent)

  2. sabbe saṅkhārā dukkha (all saṅkhāras are unsatisfactory)

  3. sabbe dhammā anattā (all dharmas (conditioned or unconditioned things) are not self)

According to Ayurveda, the term prajñāparādha (violation of good judgement) can be defined in terms of impairment in buddhi (intellect), dhṛti (constancy/patience/steadfastness) and smṛti (memory/mindfulness). Prajñāparādha is closely connected with avidyā (ignorance) and foundational for the arising of mental health problems. From the Buddhist perspective avidyā is essentially ignorance of (a failure to grasp directly) the three marks of existence:

‘Perceiving permanence in the impermanent [aniccā], 

perceiving pleasure in what is suffering [dukkha], 

perceiving a self in what is non-self [anattā],

and perceiving attractiveness in what is unattractive, 

beings resort to wrong views, 

their minds deranged [khitta-citta],

their perception twisted [vi-saññino]’ (AN.IV.49). 

Reference to the three marks of existence (trilakṣaṇa) in classical Ayurvedic medical texts in association with mental health problems, suggests that whilst this understanding of mental health problems is informed by the Buddha’s wisdom, knowledge of the three marks of existence need not be restricted or confined uniquely to Buddhism. A recent study in Australia focused on ‘putting Buddhist understanding back into mindfulness training’ found that an understanding of the trilakṣaṇa (three marks of existence) contributed to improving well-being and reducing distress among both Buddhists and non-Buddhists cross-culturally (Jarukasemthawee, 2015). 

Buddhist Āyurvedic Counselling and Psychiatry (BĀCP), is a new subject in Buddhist studies, developed and introduced by Prof. Sumanapala Galmangoda in Sri Lanka at the Nāgānanda International Institute for Buddhist Studies (NIIBS) in Manelwatta, Kelaniya. Prof. Sumanapala Galmangoda (Royal Pandit, Senior Professor and Director, Postgraduate Institute of Pāli and Buddhist Studies, University of Kelaniya) is an Āyurvedic doctor, specialist in Buddhist Abhidhamma and a respected authority on the ‘traditional cultural approaches’ to promoting mental well-being which have been practiced in South-East Asia for centuries and continue to be valued (p.15, WHO, 2009; p.39, WHO, 2012). 

BĀCP encompasses both Anusāsanī (instruction, teaching, advice, counselling - which can include therapeutic application of sīla (behavioural therapy), Samatha-samādhi (mental therapy) and Vipassanā-paññā (cognitive therapy)) and yukthivyapāsraya (logic-based physio-pharmacological therapies). The strong theoretical basis of Buddhist Āyurvedic Counselling and Psychiatry (BĀCP) makes it more than the sum of its parts. In practice it is a complex psycho-physical intervention and combines different treatment methods. 

Buddhi vibhrama is impaired or deranged intellect, it is a condition in which distorted judgments are made due to a distorted view of how things are. This is a defining part of mental health problems, but also something we are all subject to.

Both the classical Ayurvedic texts and Buddhist texts agree that buddhi vibhrama can be identified in ‘perceiving permanence in the impermanent’, ‘perceiving pleasure in what is suffering’, and ‘perceiving a self in what is non-self’. 

Buddhist Āyurvedic Counselling and Psychiatry (BĀCP) includes cognitive therapy (vipassanā-paññā) as one of its holistic therapeutic approaches. This entails developing awareness of the trilakṣaṇa (three marks of existence) as a therapeutic intervention. Research in Australia found that an understanding of the trilakṣaṇa (three marks of existence) can contribute to improving well-being and reducing distress among both Buddhists and non-Buddhists cross-culturally. Manasa Ayurveda therapists are now introducing BĀCP in the UK and developing an understanding of the three marks of existence is an important part of their therapeutic programmes.

Psychosis and the Three Refuges

The following article on 'Psychosis and the Three Refuges' is, for the most part, an account of recovery from periods of 'psychosis' in relation to a Buddhist practice. It was originally published in The Middle Way: Journal of the Buddhist Society.

The Three Refuges are also known as the Three Jewels

The Three Refuges are also known as the Three Jewels


Psychosis sounds scary. It is the name of a 2010 horror film based on a serial killer who “unleashes his blood lust”. The first thing people often ask, when I tell them I work with people who have psychosis is: “aren’t you scared?” So what can psychosis have to do with the Three Refuges (the Buddha, Dharma and Sangha)?   


In psychiatry psychosis is sometimes used as a synonym for ‘severe mental disorder’ and according to the mental health charity, Mind, there is actually more chance of being killed by lightning than by someone with a mental illness.  Most narrowly defined, psychosis is simply the presence of delusions and/or hallucinations. 

Delusions, as understood in psychiatry, are beliefs that are clearly false and that indicate an abnormality in the affected person's content of thought. Hallucinations in psychosis are often auditory, hearing voices is a well known example. They can also be visual, and some people with psychosis experience strong smells or have sensations on or under the skin when nothing is actually there as far as other people are concerned. 

Whilst some of us may have a greater predisposition, all of us can potentially experience psychosis. The British Psychological Society (2000) has estimated that around 10-15% of the general population experience what could be described as psychotic phenomena, and most are neither distressed, nor seek help. Studies have shown that all sorts of beliefs Western psychiatry might see as delusions (including beliefs in magic, aliens, telepathy and spiritualist beliefs) are actually extremely common in the general population (Peters et al. 1999). 

Psychosis may be triggered by many things including stress, traumatic life events, drug use or even Buddhist practice. Buddhism traditionally that such experiences can arise in the practice of zazen. The Japanese term makyo, roughly “diabolic phenomenon” from “ma” (akuma), “devil” and kyo, “phenomenon, objective world” is used to describe such hallucinatory or delusional experiences in this practice. VanderKoor (1997) describes the example of Sara, who on a Buddhist meditation retreat had intense makyo. Following the retreat she was hospitalized and received antipsychotic medication.

Although I have a specific qualification in interventions for psychosis and around 7 years experience in working with others with these experiences, my most direct understanding comes not from training, work or study, but from personal first-hand experience of psychosis both within and without the mental health system. 

My first experience of psychosis, when eighteen, was thought by psychiatrists to have been a reaction to stress and bereavement. In 1996 I began reading books on religion and Zen and believed that I was making a 'breakthrough'. My presentation quickly led to a psychiatric hospital admission. The following are extracts from my personal health records of the time: 

...he is acutely psychotic, with paranoid delusions... hospital treatment is the only option...
— Record of receipt of medical recommendation(s) and formal admission to hospital became necessary... for police to handcuff him and force him into the ambulance where he was strapped to a stretcher...
— Mental Health Act 1983 Social Circumstances Report 

In hospital I was further restrained and heavily medicated with antipsychotic injections by force. Fortunately the admission was brief and once discharged I stopped all medication after about 6 weeks. Since then over a number of years, at times of stress, I experienced brief psychotic symptoms. I chose not to disclose these symptoms to medical professionals at the time and navigated my way through, getting on with my life without subsequent compulsory psychiatric hospitalisations or forced injections.

During 1999-2000, whilst at university, I had a period of experiencing what a nurse described as “anxiety attacks”. The nurse recommended abdominal breathing. This worked for me and reminded me of the Zen books I had read over the previous few years, so I decided to try the practice of zazen (seated meditation). Later in 2002 I formally became a lay Buddhist at a Jukai ceremony and now consider the Three Refuges as vital to my personal recovery. 

The Three Refuges are the Buddha (meaning both the historical Buddha and the Eternal Buddha Nature), the Dharma (the teaching of the Buddha and of our own Buddha Nature), and the Sangha (those who follow the Buddha and those who seek, long for and know the Eternal) (Schomberg, 1996).

The Three Refuges

The Buddha

Mindfulness was originally integrated into Western healthcare in the late 1970s by Kabat-Zinn; he describes mindfulness as: “paying attention in a particular way: on purpose, in the present moment and non-judgementally” (Kabat-Zinn, 1994 p.4). In healthcare the importance of presenting mindfulness as secular and distinct from Buddhism is frequently emphasised; psychologists now often present mindfulness as something from psychology or something that Kabat-Zinn ‘came up with’. In fact he was a student of Zen Master Seung Sahn (Streitfeld, 1991) and recent healthcare treatments such as Dialectical Behaviour Therapy (DBT; Linehan et al., 1991; Linehan et al., 1993) and Mindfulness-Based Cognitive Therapy (MBCT; Segal et al, 2002) also have a basis in adaptations of Buddhist teachings (Welch et al., 2006; Gilpin, 2006). The Dalai Lama has stated: 

...what we are trying to do here is to see, among the age old meditative practices, aspects which can be adapted into the domain of health...
— The Dalai Lama (2005)

Studies are now beginning to support the use of Mindfulness practices drawn from Buddhism in the clinical treatment of psychosis (Abba, et al, 2006; Bach and Hayes, 2002; Chadwick, 2006; Gaudiano and Herbert, 2006). Paul Chadwick (2005; 2006), for example, is a clinical psychologist who has drawn on the teachings of Ajahn Sumedho (1992) and now advocates relating mindfully to unpleasant psychotic sensations; with a clear, open and gentle awareness of whatever is present. 

Daishin Morgan, Abbot of Throssel Hole Buddhist Abbey in England, sees the therapeutic and enlightenment aims of meditation as on one continuum. He reminds us that whilst it is good to see some of the benefits of Buddhist practice made available to those who might not otherwise find them, the fundamental aim of Buddhist practice goes much further (Morgan, 2004). 

Koshin Schomberg (1996a), Abbot of North Cascades Buddhist Priory in the USA, teaches that, in Buddhist training, difficulty in accepting the full religious implications of meditation can be an obstacle: Buddhism is a religion, and requires us to have real faith. This faith is not a matter of professed creed or belief. It is the faith that there is That which is a true Refuge and that we can find this Refuge through meditation and training. 

In my own life, this practice is more than just a technique for changing my relationship to unpleasant experiences; zazen is directly taking Refuge in the Buddha. 

The Dharma

Whilst I was in hospital with psychosis, I was convinced that the world and all that relates to it had ceased to exist – nothing was real. All that remained was an illusion, placed there by the devil to keep me bonded to false reality and ultimately in hell. I also believed that various people including my family were in fact this devil in disguise attempting to keep me in bondage.  

After looking at a landscape painting on the hospital wall for some time, I had a sudden belief that it was a window into the true reality beyond the devil’s illusion – a window into heaven. In order to show trust in God, I stood upright and allowed myself to fall backwards hoping to land in the heavenly reality shown in the painting. As I allowed myself to fall backwards my head hit the edge of a table. I lay on the floor, my head now bleeding. “Look at the blood” said the nursing staff around me, “What blood?” I answered, defying what I believed were the devil’s attempts to bind me.

Knowing what is real and what is not can be especially difficult when experiencing psychosis. For me, taking Refuge in the Dharma, the Buddhist teachings (which reject both extremes of eternalism and nihilism), provides a source of stability and confidence. In particular the teaching of the Buddhist precepts; beginning with “Cease from evil”, provides an anchor in the midst of the changing conditions of daily life, and an essential guide to action no matter what may happen (or appear to happen). Even within psychosis the Dharma, and in particular the teaching of the precepts, provides an anchor.      

The Sangha

Buddhism is more than mindfulness with bells, gongs and incense, but it is no cure for psychosis. At the completion of my final exams at university I had been practicing zazen for a while, but nevertheless became psychotic again, believing that I was being spied on by government agents: 

When I was out I noticed that someone looked at me and touched their ear. This was a message that they had an ear piece and were listening to me. In a pub, believing I was being listened to by government agents, I began reading from my passport; hoping this would help give me protection:

Her Britannic Majesty’s Secretary of State requests and requires in the name of Her Majesty all those whom it may concern to allow the bearer to pass freely without let or hindrance, and to afford the bearer such assistance and protection as may be necessary

As I read this I looked across the pub and could see that a woman was touching her ear looking at me and smiling. I then knew that she could hear me through an ear piece and was a spy. There was also a television on in the pub, the news was on and I could see that there was a riot in another part of the country. This riot was connected to the things that were happening to me and it became clear that I was now on a secret government mission. The woman’s smile was a signal that I would indeed have "assistance and protection as may be necessary" on this mission...

Around this time I had a number of other unusual experiences and then decided that it may be beneficial to practice zazen (something I had not done for a while). So I sat down in my room, but attempting to practice whilst in this psychotic state was like getting hit by a mental tsunami. For a moment I saw just how incredibly unsettled my mind was and this was very disturbing. This disturbance inspired me to check out my recent experiences, with a Buddhist Monk in a local Zen temple. My intention was to ask the Monk what his opinion was of these beliefs and experiences. On my way to the temple I had various further experiences such as receiving messages from inanimate objects. I also felt elated and believed that this could be a spiritual experience. I intended to share all this with the monk in the temple. 

When I entered the temple I was invited to join meditation. We first read a scripture together but when it was time to move I stayed put. I was then told that meditation was over and was offered a cup of tea. 

Responding to my unusual perceptions and experiences, I began to act in a chaotic way in the temple, and was eventually asked to leave. On my way out I explained that I had come to find out if the monk thought I should see a psychiatrist and he said that he thought I should. Being advised by the monk to see a psychiatrist challenged my psychotic beliefs and helped to bring me back down to earth.  Fortunately this challenge gave me enough insight to move in the direction of recovery without actually seeking medication or hospitalisation at the time. In the next few weeks, having completed my exams, I attended my graduation ceremony and returned to my parents’ home for a while. 

For many, in the face of an unsatisfactory mental health system, it can be tempting to seek alternatives in Buddhism. Taking Refuge in the Sangha means trusting in and seeking the advice of those who follow the Buddha. Over 2000 years before Florence Nightingale, who is seen as the founder of the nursing profession, Buddhist teachings set forth the qualities of a good nurse in the Anguttara Nikaya. The Buddha stated: "Whoever, O monks, would nurse me, he should nurse the sick" and Buddhism has begun to enrich contemporary Western nursing. 

Even so, Buddhist centres which are not set up as treatment clinics or hospitals cannot be expected to function as such and in relation to psychosis the most essential role of the Sangha may indeed be to continue pointing those in need in the direction of professional healthcare providers.    

Psychosis and the Three Refuges

In reality, unlike the movies, psychosis is not about “unleashing blood lust”, in fact sometimes it is not scary at all, but it can be deeply disturbing for both those who directly experience it and their families. One does not need to be a Buddhist to practice mindfulness, and it may be helpful to people in getting grounded and letting go of disturbing sensations or thoughts; however, Buddhism goes much deeper and I believe that not only mindfulness, but the Buddha, Dharma and Sangha have been essential to my staying well after psychosis.  

Finally, the Three Refuges do not offer a miracle cure for psychosis which can be rolled out through the healthcare system in a secularised form. There are perhaps as many routes to recovery as there are people.

Aldridge, M.A. (2011) Psychosis and the three treasures, The Middle Way: Journal of the Buddhist Society, 86:3

The Foundations of Mindfulness

Mindfulness has become a ‘billion-dollar business’ in the West (Wiecznsner, 2016). Growing research indicates that as a cognitive therapy, it works, and Western mental health professionals have begun to use and evaluate its efficacy as a clinical intervention for people with psychosis. The connection of mindfulness with Buddhism has occasionally been acknowledged in this context, but traditional Buddhist approaches to mental health and healing have, for the most part, been ignored in the West, perhaps dismissed as among the “trappings” of Buddhism.

As a result there are now growing concerns over the rapidity at which ‘mindfulness’ has been extracted from its traditional Buddhist setting and introduced into psychiatric treatment domains. As stated by Huxter (2007) on this matter:

Attempts to reinvent the wheel, without reference to earlier models are, perhaps a retrograde step
— Huxter, 2007

Sri Lanka has been a centre of Buddhist scholarship and learning since the introduction of Buddhism in the third century BCE and historically Buddhism and traditional medicine, particularly Āyurveda, in Sri Lanka have been closely related (Liyanaratne, 1995).

Whilst attending the sick, the Buddha explained the satipatthanas (four establishings of mindfulness) (SN.36.7,8) and when the Venerable Anuruddha was gravely ill he explained that through his practice of the satipatthanas: “...arisen bodily painful feelings do not persist obsessing my mind” (SN.52.10).

The satipatthanas (four foundations (or establishings) of mindfulness) forms an important part of our therapeutic programmes. The Satipattana Sutta and Maha Satipattana Suta are the most ancient known discourses on the practice of mindfulness.

The Satipattanas form the basis of our approach to 'cognitive therapy' which is an important part of our Manasa Ayurveda therapy programmes.

In the recording here, Ven. Dr Omalape Sobhita Maha Thero is chanting the Maha Satipatthana Sutta (the Buddha's discourse on the four foundations of mindfulness). 

The recitation of this Sutta is traditionally offered to those who are suffering from physical or mental health problems...

Crisis Support

Crisis Support.jpg

Manasa Ayurveda means Ayurveda for the mind. We are serious about mental health and wellbeing. Our service offers a traditional natural and holistic Ayurvedic approach to mental health. Our service is in demand, so we seek to ensure that everyone who approaches us has access to direct support when they need it.

A mental health crisis can mean different things to different people. In a mental health crisis, you might feel so distressed that you want to harm yourself or someone else. You might hear unpleasant voices, or feel that people are watching you or trying to hurt you. At such times it can help to tell someone you trust, maybe a family member or a friend. They can be with you and help you decide what to do. They can also contact services on your behalf.

If you need urgent help:

Call 111 to speak to the free NHS helpline for anyone with an urgent healthcare need. Tell them if you need a translator. They can:

  • give you self-care advice

  • connect you to a nurse or GP

  • book you a face-to-face appointment

  • send an ambulance, if necessary

  • direct you to the local service that can help you best

If you are with someone who has attempted suicide, call 999 and stay with them until the ambulance arrives.

If you need less urgent help:

Don’t suffer in silence. Get help. You could:

Speak to your GP. They can put you in touch with local services.

Contact the Samaritans - Call for free: 116 123 (24 hours a day) email:

London and national contacts:

Services for people who need help and those who are worried about them (numbers beginning 0800 and 0808 are free to call from landlines and mobiles. 0300 numbers are local rate).

Alcoholics Anonymous
call: 0800 9177 650 (24 hours)

CALM (Campaign Against Living Miserably) For men of all ages.
call: 0800 802 58 58 (5pm to midnight)

Alzheimer’s Society
call: 0300 222 11 22 (various times)

Domestic Violence Helpline
freephone: 0808 2000 247 (24 hours a day) email:

FRANK (Drugs and alcohol advice) call: 0300 123 6600 (24 hours a day)

HOPElineUK. For those aged up to 35. call: 0800 068 41 41 text: 07786 209697 email:

LGBT+ (Lesbian, Gay, Bisexual and Transgender+)
call: 0300 330 0630 (10am to 10pm)

National Association for People Abused in Childhood (NAPAC) call: 0808 801 0331 (various times)

Rape Crisis
(Support for women and girls)
call: 0808 802 9999 (various times)

call: 0300 304 7000 (6pm to 11pm)

Silverline - support for older people call: 0800 4 70 80 90 (24 hours)

Victim Support
call: 08 08 16 89 111 (various times)

Manasa Ayurveda Hospital in Sri Lanka wins International Health Care Award 2017

Dr Saman Hettige was awarded the "Sustainable Development Goals - International Health Care Award 2017" at the 55th International Congress of Integrative Medicine in Bali, Indonesia. He was awarded for his contribution to making the Neelamahara psychiatry tradition "popular internationally".  

The Manasa Ayurveda hospital in Sri Lanka practices the Neelamahara psychiatry tradition which has continued for around 350 years in the Neelamahara Buddhist temple and surrounding village community. Ancestors of this tradition include both Buddhist Monks and lay Buddhist Doctors (see below). 

'Manasa Ayurveda' means "Ayurveda for the Mind" and as well as for the Manasa Ayurveda Hospital in Sri Lanka, this name has also been used for the 'Manasa Ayurveda Pharmacy' in India and for our specialist service in the UK offering 'Ayurveda for the mind, mental health and wellbeing'. Although the name 'Manasa Ayurveda' is used in common, these services are not part of the same organisation or company. Manasa Ayurveda (UK) remains independent from Manasa Ayurveda pharmacies and hospitals in India and Sri Lanka. Manasa Ayurveda (UK) is directed by mental health professionals registered and insured in the UK.

Manasa Ayurveda (UK) owes a debt of gratitude to Dr Saman Hettige for sharing knowledge and experience, and for supporting our efforts to introduce Ayurvedic psychiatric therapies in the UK. Some key ingredients used by Manasa Ayurveda (UK) are sourced directly through the Manasa Ayurveda hospital in Sri Lanka, and Manasa Ayurveda (UK) therapies are directly informed by first-hand learning and clinical experience within the Manasa Ayurveda Hospital in Sri Lanka. Manasa Ayurveda (UK) is proud that the Neelamahara tradition continues to inform our therapies.

Many congratulations to Dr Saman Hettige and the Manasa Ayurveda Hospital in Sri Lanka.

Dr Saman Hettige at the International Health Care Award Ceremony 2017

Dr Saman Hettige at the International Health Care Award Ceremony 2017

Ancestors of the Neelamahara Tradition

Rev. Dr. Werehera Sobitha (1854-1886)

Rev. Dr. Werehera Sobitha (1854-1886)

Rev. Dr. Erawwala Seelalankara (1906-1935)

Rev. Dr. Erawwala Seelalankara (1906-1935)

Rev. Dr. Dehiwala Dhammaloka (1935-1971)

Rev. Dr. Dehiwala Dhammaloka (1935-1971)

Ayur.Dr. Indrasena DeAlwis (1950-2000)

Ayur.Dr. Indrasena DeAlwis (1950-2000)

Rev. Dr. Dehiwala Buddarakkitha Thero (1965-2013)

Rev. Dr. Dehiwala Buddarakkitha Thero (1965-2013)

Ayur.Dr. D.S. Hettige (1965 - 2013)

Ayur.Dr. D.S. Hettige (1965 - 2013)

Ayur. Dr. S. Hettige - Present day Managing Director Manasa Ayurveda Hospital - Neelamahara

Ayur. Dr. S. Hettige - Present day Managing Director Manasa Ayurveda Hospital - Neelamahara

Manasa Ayurveda - Service User Feedback

The following is written feedback from Manasa Ayurveda clients and service users in London:

'For me a very positive well-being session. I hope to maintain a wellbeing attitude daily. I like the Ayurvedic approach’

‘I was happy and it was interesting what you use’

‘Very helpful and beneficial’

‘Having the peaceful sensation of a face massage is certainly worth having long-term’

‘Today was different in terms of more detail focus on feeding the senses and possible outcome; very useful and mindful and interesting’

‘very sufficient with the therapist’

‘I was interested in everything, it was something new’

‘Being able to verbally express my feelings around family life and circumstances has been mentally and emotionally de-stressing’

‘Extremely relaxing and I had positive reflections on wellbeing’

‘Mindfulness… I find very interesting in terms of its apparent simplicity though NOT simple and needs my attention and practice’

‘Very interesting’

'Today’s session was extremely beneficial and relaxing, beneficial discussing my sleep and wellbeing patterns; extremely useful for service users’.

'Very practical and beneficial’

‘The Nasya oil was introduced to me in today’s session; very soothing. I hope this will in time alleviate my congestion. I look forward to Ayurveda sessions’.

‘Excellent treatment’

‘The massage was very helpful and teas’

‘The mindful, sensual, wellbeing impact of Ayurveda creates thoughts of the possibility of a healthier future’

‘Very beneficial experience’

‘Today’s session was most helpful for me. Discussion on sleep, wellbeing and talking around my feelings helped greatly’