Evaluation of Integrated Approach of Psycho and Yoga Therapy in Management of Anxiety Neurosis: A Case Study
Evaluation of Integrated Approach of Psycho and Yoga Therapy in Management of Anxiety Neurosis: A Case Study
Evaluation of Integrated Approach of Psycho and Yoga Therapy in Management of Anxiety Neurosis: A Case Study
DOI: https://doi.org/10.29121/j-ahim.v2.i1.2021.10
Keywords:
Integrated Approach of Psycho &
Yoga Therapy (IAPYT)
Eight State Parameters
1. INTRODUCTION
Psychology: - Psychology is the subject by which we perform study of mind and behavior. It may be either
normal or abnormal. The branch of psychology, which deals with normal human behaviors, is known as general
psychology. In addition, the one dealing with abnormal is known as abnormal psychology.
Behavior: - Behavior is the end product of brain knowledge observation nervous system physical condition, post
experience virtue mind, and body in the form of thoughts action and feelings.
Abnormal Behavior: -When behavior is not usual not typical that is known as abnormal behavior. Breakdown
cognition is lead to abnormality acquiring something and adopt in day to day life, as known as learning when a person
learn some bad things which leads abnormal behavior is called maladaptations.
© 2021 The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original author and source are credited. 1
Evaluation of Integrated Approach of Psycho and Yoga Therapy in Management of Anxiety Neurosis: A Case Study
The term abnormal implies away from the normal, some other opinion that the term abnormal has arises from the
word ANOMALOUS “ANO” means not and “Malous” stands for regular. Thus the word abnormal implies normal. The
usual characteristics, of abnormal behaviour person are: - they are self-centered punish inconsiderate unduly
emotional and bad tempered antisocial etc. Now we can understand some view points about abnormal behavior.
Psychiatric Disorder:- A psychiatric disorder is impairment of the nervous, causing impairment in thinking
and acting. There is rather difficult definition for mental and like wise illness. In common medical understanding,
mental illness is characterized by abnormal changes in thinking, feeling, memory, perceptions and judgment,
resulting in changes of talk and behavior. Mental illness can be of different types.
Psychiatric disorders can be classified as mild and severe in nature. The milder type and most commonly
concentrated psychiatric disorder are Neurosis. The severe type is the Psychosis.
Neurosis: - Neurosis is a deviation in personality but this derivation may not be an alarming nature. A neurotic
person may be performing his normal duties of life. But maladjustment day to day behavior may be seen. A
neurotic person is unnecessarily sensitive and bewildered even in the normal situation of life. The neurotic person
has no courage and self-confidence. Neurosis can be of different types and one of the commonest is Anxiety. Others
are: -
• Anxiety Neurosis
• Phobia Neurosis
• Hypochondria Neurosis
• Hyposthenia Neurosis
• Neurasthenia
• Depressive Neurosis
• Combat Neurosis
• Pathos and Organ Neurosis
• Obsessive and Compulsive Neurosis
Anxiety Neurosis: - It is one of the most commonly encountered Psychiatric Disorders. It is a functional
disorder consisting of a group of minor mental disorders involving only a segment of the personality. Neurotics do
not loose touch with reality and are quite able to meet the ordinary demands of every day living. The basic and
predominant features being tension, fear, and worry, but there is a general agreement that the effect of anxiety is
the basic component in all type of neurosis.
Anxiety Neurosis is also known as anxiety reaction. On the basis of several investigations it has been found that
cases of Anxiety Neurosis are more common in people than other types of Neurosis. It has been estimated that 30%
to 40% cases of neurotic patients are cases of anxiety.
2. CAUSES ANXIETY
• Feeling of guilt.
• Decision creating Anxiety
• Some prior painful experience
• Threat from some repressed desires
• Fear of loss of status
• Excessive use of intoxicants
• Identification with the Anxiety attitude of parents
• Defective socialization
• Indifference and lack of cordiality in family relationship
• Extra marital affaires of parents
• Child who lost one parent due to
1) Divorce
2) Conflicts
3) Natural cause
Psychosis: - It is more serious psychiatric disorder than neurosis. It disintegrated the total personality.
Whimsicalness in behavior. The patient’s relationship with external world broken. He does not remember
experiences of the past. His violent behavior a threat to others. He is fit for mental hospital.
Thus psychosis is such a sever disorder. That’s the personality of the individual is alarmingly disturbed. The
powers of thinking and cognitive aspect of this behavior also appear to be disintegrated.
3. CLASSIFICATION OF ANXIETY
Generalized Anxiety
• There is no specific reason for Anxiety
• It is difficult to cure
• The cause of Anxiety are not visible
Specific Anxiety
• There is no specific reason for Anxiety
• We can cure it easily.
• The cause of Anxiety are visible
It is the functional type of disorders the role of some organic factor is always there similarly, in the organic type
of disorder, the role of some psychogenic or functional factor can not be denied.
• Poor concentration
• No appetite, Tremors
• Psychological Symptoms
• Apprehension
• Anxiety in Sleep and dream
• Dream of physical torture
• Feels inadequate to meet any Emergency
• Afraid of committing any mistakes
• Irritability and morbid fear
• Re-personalization
• Excessive sweating
• Disturbed sleep
• Palpitation
• Lack of concentration and attention
• Restlessness, tiredness
• Rear of body and mind
• An autonomic imbalance gives to various visceral symptoms
6. MEDICAL MANAGEMENT
Medical Management Anxiety: -Both psychosomatic and medical treatment may be necessary. Psychosomatic
treatment is more important. The patient should be told about the role of his unconscious and the fact should be
impressive upon him that his Anxiety is meaningless. Desensitizing of situations causing anxiety. Tranquilizers may
release the tension, courage, patience and frustration- tolerance capacity should be developed in the patient personal
interview of great utility. In case of severe attack hospitalization must.
7. DRUG THERAPY
• Anxiolytics
• Antidepressants
• Psychotherapy
On pharmacological level many drugs have proved highly effective. Although such medication may relive anxiety
reactions. It cannot be replace psychological and other therapies.
8. YOGIC MANAGEMENT
The Human body is made up five sheaths of existence of man, according to Yoga and Upanisad. The first and the
grossest the physical frame that we are also familiar with is called “Annamaya Kosa”. The second subtler layer is the
“Pränamaya Kosa” featured by the predominance of prana the life principle which flows through the invisible
channels called Nadis. The other three sheaths are “Manomaya Kosa, Vijnanamaya Kosa & Anandamaya Kosa”.
Anandamaya Kosa is the subtlest & inner most sheath’s the sheath become ruler the freedom of operation in the
living increases, the bliss associated with its also increases. While in Manomaya Kosa the creative power pre-
dominates, in Vijnanamaya Kosa. It is the power to discern and discriminate. “Bliss” is embodied in Anandamaya
Kosa, the highest stage of evolution in the manifested existence. It is the subtle among the five sheaths of existence.
In his journey towards the ultimate, man crosses these sheaths of existence one by one, through analysis called
“Panca Kosa Viveka”.
In Anandamaya Kosa, the man is the healthiest with a perfect harmony and balance of all his faculties. At
Vijnanamaya Kosa there are movements, but are canalized in the right direction. As such, it is in the Manomaya level
that imbalances start, say the yoga texts. Likes and dislikes have come to play at this level. These imbalances amplify
themselves resulting in mental illness called “Adhis”. At these stages, there are no symptoms at the physical level.
The Adhis (Primary diseases) are two folds, “Samanya” (Ordinary) and “Sara” the (essential). The former
includes the diseases incidental to the body with the latter, the rebirth, to which all men are subject. The Samanya
are normally produced during the interaction within the world. These may be termed as psychosomatic ailments.
“Sara” who causes the birth of the physical body can be destroyed only by the realization of the causal states of mind
and corresponding ability to live in Vijnanamaya Kosa and Anandamaya Kosas. In that sense, man transcends the
cycles of birth and death.
When the mind is agitated during our interactions with the world at large and the physical body follows in its wake,
this agitation causes fluctuations in the flow of Prana in the Nadis. The Prana flows in wrong paths flying from one
to another without rhythm and harmony. The Nadis can no more in this condition, maintain stability and steadiness,
but quiver. Due to these disturbances in the Prana and unsteadiness in the Nadis, the food does not get digested
properly.
There are some disturbances in the Manomaya Kosa which percolates into the physical Sheath (Anandamaya Kosa)
through Pränamaya Kosa. Hence, in the treatment of these psychosomatic ailments it becomes, mandatory to work
at all these levels of our existence to bring about the quickest results. The Integrated Approach consists in not only
dealing with physical sheath, the relief of which could at the best be temporary ( as it happening with diseases of the
psychosomatic type like Asthma, Diabetes Mellitus, Hypertension, etc.,) but also using techniques to operate on
different sheaths of our existence, the overall health improvement is brought about.
Each Kosa has unique features & therefore requires various type of practices & technique for balancing various
type of practices and technique for balancing it, like the imbalance in one effects the others, so does balancing ones,
helps in balancing the others as well it gives an integrated beneficial effect.
It is a way of life in its totality with its numerous beneficial practices. When this is done, the result is a fully
balanced personality totally free from diseases and negativity.
In psychiatric disorder “Stress is speed” is visibly seen at all level of existence. The heightened level of alertness
at the Background State of mind shows up as “sleeplessness”. The speed of flow of thoughts shows up as uncontrolled
emotional surges at panic, unexplained fear resulting in crowding of thoughts. Lack of concentration extreme
distractibility of mind. As uncultured mind with lack of control can not take decisions and waves between many
conflicts says Bhagawat Gita:
9. CASE HISTORY
Details of Personal
Name Mr. L. Chandraswamy
Age 45yrs
Sex Male
Marital Status Married
Education B.sc
Occupation Bank Employee
D.O.A 25th –Sep-2009
D.O.D 10th – Oct-2009
Diagnosis Anxiety & Neurosis
Medical History: - Mr. L. Chandraswamy was admitting to Psycho Clinic, Dev Sanskriti Vishwavidyalaya with
stammering, anxiety, negativity, disturbed dreams etc. In the age of 8 years, he suffered from polio. In schooling
career he had withdrawn himself from other curriculum activities because of teasing of his friends and others, and
Journal of Ayurvedic Herbal and Integrative Medicine 7
Evaluation of Integrated Approach of Psycho and Yoga Therapy in Management of Anxiety Neurosis: A Case Study
suspicious in nature. He has problem of Indigestion, Acidity, Irritability, Anger, Hopelessness-Low moods, Negativity,
overall Anxious, and Brooding (thinking deeply), poor social interaction.
Personal History
Appetite Not adequate Sleep Inadequate
Bowels Normal Micturation Normal
Smoking Rarely Alcohol Very rarely/ Social Drunker
Family History: - His first elder brother is suffering from Insomnia and always depressed in mood. His second
brother has acute anxiety and of late developed Diabetes.
11. MEDICATION
MEDICATION QUANTITIES
T. Nitrosun (10mg) 0-0-1
T. Anxit/Resty (0.50mg) S-O-S
T. Atenol (0.50mg) 1-0-0
T. Azona 40mg 0-0-1
T. Fluboxin 50mg 1-0-2
T. Subex 1-0-0
T. Sulyon 70mg 0-0-1
T. Parkin 1-0- 1
T. Nabox 2mg 0-0-1
• First week of every month, more anxiety, tension, and mussel tension.
• Lost his mother one and half years back.
• Unhappy childhood.
Counseling: - Counselor advised him to improve the self confidence and change his attitude towards the
situations. Work with awareness and without expectation. Try to be busy himself, cultivate his attitude and think
positively. Don’t afraid by happening, be calm and discriminate the situation, also be social with people make friends,
talk to peoples, and lastly advised him to emphasize more on dynamics and games which helps him to overcome his
problem. And attend Lectures and Satsanga more. Counselor suggested doing all kriyas.
12
10
8
4
2
0
Pranayama
Kriyas
Nadanusandhana
Yog Nidra
Om Meditation
Cyclic Meditation
Parameters
Trataka
DRT
Counseling
MSRT
Techniques
Special
TS
AS
Note Below
• TS – Total Sessions,
• AS – Attendant Sessions
• DRT – Deep Relaxation Techniques
• MSRT- Mind Sound Resonance Techniques
160
140
120
100
80
60
40
20
0
BP.Sys BP. Dia Weight
PR/min RR/min BHT (sec)
(mm/Hg) (mm/Hg) (Kg)
BY 142 92 96 28 13 71
AY 128 78 74 13 21 65
Note Below
• BT – Before Therapy
• AT – After Therapy
• PR – Pulse Rate
• RR- Respiration Rate
• BHT- Breath Holding Timing
20
15
Score
10
0
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Days
Note Below
• BT – Before Therapy
• AT – After Therapy
• SS - Symptom Score
• MS - Medication Score
Note Below
• BT – Before Therapy
• AT – After Therapy
15. RESULTS
General Parameters
BP- Before Therapy BP was measured 142/92 mm/Hg and After Therapy 128/78 mm/Hg with significant
change of 9.86% .
PR- Before Therapy Pulse Rate was measured 96/mint. and After Therapy 74/m with change of 22.92% .
RR- Before Therapy Respiratory Rate was measured 28/mint. and After Therapy 21/mint. with change of
53.57% .
BHT- Before Therapy Respiratory Breath Holding Time was measured 13sec and After Yoga 21sec with change
of 61.54%.
Wt: - Weight was measured 71Kg Before Therapy and After Therapy 65Kg with the change of 8.45%.
Psychological Parameters
Anxiety - Before Therapy Anxiety Score was measured 96% and After Therapy 38% significant change of
60.42%.
Stress - Before Therapy Stress Score was measured 94% and After Therapy 42% significant change of 55.32%.
Depression - Before Therapy Depression Score was measured 90% and After Therapy 46% significant change
of 48.89%.
Regression - Before Therapy Regression Score was measured 78% and After Therapy 42% over all change of
46.15%.
Fatigue - Before Therapy Fatigue Score was measured 92% and After Therapy 47% over all change of 48.91%.
Depression - Before Therapy Depression Score was measured 90% and After Therapy 46% significant change
of 48.89%.
Guilt - Before Therapy Guilt Score was measured 86% and After Therapy 34% significant change of 60.47%.
Extraversion - Before Therapy Extraversion Score was measured 42% and After Therapy 38% change of 9.52%.
Arousal - Before Therapy Arousal Score was measured 86% and After Therapy 42% change of 51.16%.
16. DISCUSSION
A 15 days IAPYT protocol was administered to a 45 year old participant with anxiety disorder. There was significant
reduction in trait anxiety at the time of discharge. This therapy helped him and it was easy to adopt. The IAPYT
consisting of Loosening Exercise, Yogasanas, Pranayama, Kriya, Meditation and Relaxation Techniques helped to
manage stress and reduced anxiety symptoms. It leads to physical and psychological benefits, which is discussed in
Yoga Vasistha (Venkatesananda, 1985). This case gives the proper clinical evidence of the use of integrated approach
of yoga therapy in anxiety disorders.
The researchers certify that he has obtained all appropriate patient consent forms. In the form, the patient has
given his consent for his images and other clinical information to be reported in the journal. The patient understands
Journal of Ayurvedic Herbal and Integrative Medicine 12
Dr. Shriram Shivajirao Ragad
that name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot
be guaranteed.
18. CONCLUSION
From the above case it can be concluded that IAYPT helps in psychosomatic disorders, but there should be proper
response patient side. During his staying he was exposing to intense IAYPT and Voice Culture along with regular
counseling for which he was found co-operative. At the time of discharge he was feeling better than earlier and
noticed some change in his talk (Positivist). He has been advised to continue the Special Technique and regular follow
up with the concerned doctor. IAYPT is an effective tool.
If someone practices very regularly with dedication it helps to control Anxiety. Thus we see IAYPT is helpful for all
psychosomatic ailments.
SOURCES OF FUNDING
None.
CONFLICT OF INTEREST
None.
REFERENCES
[1] Barlow, D. H., & Durand, V. M. (1995). Abnormal psychology: An integrated approach. Cengage Learning.
[2] De Visser, L., Van der Knaap, L. J., Van de Loo, A. J. A. E., Van der Weerd, C. M. M., Ohl, F., & Van Den Bos, R.
(2010). Trait anxiety affects decision-making differently in healthy men and women: towards gender-
specific endophenotypes of anxiety. Neuropsychologia, 48(6), 1598-1606.
[3] Dhansoia, V., Bhargav, H., & Metri, K. (2015). Immediate effect of mind sound resonance technique on state
anxiety and cognitive functions in patients suffering from generalized anxiety disorder: A self-controlled
pilot study. International journal of yoga, 8(1), 70.
[4] Freiheit, S. R., Vye, C., Swan, R., & Cady, M. (2004). Cognitive-Behavioral Therapy for Anxiety: Is
Dissemination Working? the Behavior Therapist, 27(2), 25–32.
[5] Kumar, N., & Pradhan, B. (2017). Immediate role of two yoga-based breathing technique on state anxiety in
patients suffering from anxiety disorder: A self as control pilot study. International Journal of Yoga-
Philosophy, Psychology and Parapsychology, 5(1), 18.
[6] Nagendra, H.R. (2010). Yoga its Basis and Applications. Bangalore: Swami Vivekananda Yoga Prakashana.
[7] Venkatesananda S. (1985). Vasistha’s Yoga. 1st ed. New York: State University of New York Press.