Once a week I have occasion to walk through the area around 6th street, south of market, in San Francisco. I love walking. This particular walk has a challenging quality to it. The chaos of 6th St. is not a place I worry for my well-being in the middle of the afternoon. But I worry for other's well-being; the well-being of society. Many of the people there are broken, their bodies, faces, movements, countenance crooked, dried and twisted. So many missing limbs, missing also psychological parts essential to access the comforts of society. Mumbling in a sour cloud, crumpled in the middle of the sidewalk, too out-of-it to find a comfortable doorway, old women with scrawled lipstick in macabre mimicry of their apartment tower neighbors, young women looking for a cheap $20. The intricate dance of those with nothing, seeking what they need on street corners; huddled convos on the rate of prescription pills to collected glass bottles. Wiley-ness the product of necessity. Some are so sunk in a normality of addiction and madness that it is impossible to see them in any other way. These individuals spun out from an (imagined) center of social acceptability do not (can not) 'hold it together' as society insists.
I can't help but to superimpose images of tender babies over the faces I see. All of them were loved by someone (even if in a challenged way) at one time. I wish to see them as simple seedlings of human potential that they were. What paths let to these scarred, scared, and (can I say it?) not-quite-human states?
Ayurveda conditions me to find causes. What brings people to this place, barely getting day-to-day needs met? What role does society play? The vast riches and privilege of the Bay Area has some perverse role. Simplistically we can blame addiction and mental health problems (and a severe lack of responsible care and services). But addiction and mental health problems are surely only symptoms that themselves do not develop in such great numbers in healthy people/societies.
Ayurveda gives us tools to investigate the deeper causes of any problem. It is the only path towards a solution and provides an understanding of the mechanism of dis-order. What principles of Ayurveda can be mapped onto this phenomenon?
Lets start with what we know. Most of these people are experiencing altered realities; their senses are not supplying them with clear knowledge of their surroundings, of their bodies needs, of socially appropriate behavior. This being the case they make decisions based on distortions of 'reality'. Inevitably these decisions won't be so great. This distorted condition spirals and feeds itself so that eventually there is little left to connect with objective reality.
Flaws in perception (sensory understanding) are a major indication of imbalance according to Ayurvedic nidan (illness theory and process). The senses (perception of external reality, proprioception, and emotional awareness) are our way of understanding the world and ourselves. Ordinarily our body and mind is a finely tuned sensing organism supplying us with all sorts of information to navigate the world by. Senses inform our relationships to our environment and others, they tell us when we are healthy and when we are ill. Dulled or distorted perceptions are an indication that there are excess Doshas (disturbing factors) in the body. Mild depression, emotional excesses, memory loss, impaired senses are the first signs that this imbalance is occurring. 'Insanity' or unmad and other 'mental health problems' are a sign that very high levels of doshas are effecting the mind. When this happens the doshas have gotten so dysfunctional and excessive that the only answer it to throw them out of the body through measures like Pancha Karma (deep cleansing and purgation). Pancha Karma is the necessary first step in correcting mental health problems.
How do doshas get so out of whack that they affect the ability to perceive the world clearly? Drug and alcohol abuse certainly affects perceptions, so by inference these activities increase doshas. But the choice of using drugs and alcohol are caused by an imbalance in perceptions in the first place. As we know people seek out drugs (including pharmaceuticals) and alcohol as an attempt to correct discomfort. Doshas can be increased right from birth by poor foods, environmental chemicals, chaotic environments, stress and trauma. Weaknesses can be passed on from parents, but manifestation of illness must be triggered by food, behavior and environments that increase the doshas. The illness is not inevitable. Calm, care, safety, healthy, nourishing foods, a role in society that gives life meaning are all prophylactics against the manifestation of disease. Chaotic, stressful, fast-paced and uncertain lives and a panoply of chemicals and other unknowns like radiation are daily increasing the doshas in our bodies and leading us towards both physical and mental diseases. If there is a weakness caused by heredity (or injury or another stress that weakens the mind) these Doshas go directly to the mind and start wreaking havoc.
Society, as we live it, is a mill for creating people with mental health problems. There is instability and stress everywhere. Even going to the movies is stressful (what is a movie without murder and a car chase?), much of our music is relatively violent, long commutes in traffic are unsettling. Why wonder the numbers of homeless and disoriented or the skyrocketing rates of psychoactive drug prescriptions.
So as to not add greater stress (and contribute to the declining mental health of my readers) I add this comment: this is in our control. Decisions that make life simpler and calmer, your (and your family’s) life more secure and nourished are the right choices for long term health. Regular cleanses (panchakarma) maintain stability in the mind as well as the body. In traditional Indian society these principles are followed (as they have been for millennia) to for individual as well as social wellbeing. In our very different world we must daily decide to create health in accordance with our progressive lifestyles. It is a lot more work, but exciting work. And very necessary so that tender lives are not distorted and destroyed by the excesses of our culture.