Archive for November, 2013

The Great Churning

Written by Heal Your Heart on . Posted in Yoga Practices

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The Bhagavatam (also called Bhagavata Purana) is one of the most loved texts in Hindu dharma. Written by the great sage Veda Vyasa, it drips with devotion and sublime knowledge. It is indeed one of the most beautiful examples of Bhakti (devotion) expressed in poetry. The Bhagavatam consists of innumerable stories of the various avatars of Lord Vishnu, each story steeped in deep symbolic significance.

One well-known story from the Bhagavatam is the one of the churning of the milky ocean. Vishnu agrees to help the devas (good forces) when they approach him after being defeated by the asuras (evil forces). He asks the two parties to churn the great milky ocean, which thus churned, would produce the nectar of immortality. The party that consumes this nectar could then permanently defeat the other. However, this churning would need to be a collaborative effort for the mission to be successful. The devas and asuras agree to set aside their differences temporarily. When the day comes, Vishnu directs them to a favorable spot in the ocean, brings the great mountain Meru to the agreed upon spot to serve as the axis, convinces Vasuki the king of snakes to function as the rope, and Himself assumes the form of a turtle, perching under the mountain and stabilizing it. Thus begins the enormous effort to churn the ocean using Meru with Vasuki wrapped around it, the devas and asuras rhythmically pulling each end of the great snake to disperse the waters and reveal it’s treasures. As the teams tire out with the excessive effort, Vishnu Himself takes up the churning on both sides with his yogic powers. Vasuki begins spewing deadly poison from being used as a rope, this poison threatening to consume the entire cosmos. At this juncture, Lord Shiva, the great yogi and ascetic graciously steps in and consumes the poison, effortlessly holding it in his throat chakra (and comes to be known as Neelakantha, the blue-throated one). Eventually, mystical objects and phenomena begin to arise from the ocean, including Airavata the celestial elephant, Ucchaisravas, the flying horse, gems and treasures. Vishnu distributes the “gifts” equally to both parties. The churning continues until the radiant Mahalakshmi arises from the churning waters. Dazzling and beautiful beyond description, she ignores the amorous advances of the devas and asuras, choosing Vishnu as her husband. She disappears into his heart and lives there as his Shakti for eternity. Finally, Vishnu himself takes the form of Dhanvantari, who comes forth bearing the much-awaited nectar (amrita). Vishnu then takes the form of Mohini, the bewitching damsel and tricks the asuras by distributing all of the nectar to the devas. A war ensues between the devas and asuras, and the devas (aided by the nectar of immortality) win back their heavenly abode.

There is a much deeper symbolism to this story from the standpoint of spiritual practices and progress along the path of yoga. Below is my interpretation of amritha-mathanam (churning the ocean for amrita) from this angle. It is said that the Atman (soul) hovers around the mother after conception, waiting to enter the fetus. Around month 6 of pregnancy is when it “enters” the fetus, forming the subtle chakras and nadis “top down”. The sahasrara (crown chakra) is the first chakra to be formed, where there is only Brahman/Supreme Consciousness/Oneness, with no individual “I”. It is when the anahata (heart chakra) is formed that the “I-ness” emerges (ahamkara), that gets denser and stronger as the manipura (navel chakra) and swadishtana (sex chakra) are formed. Finally, that soul completes formation of the base/root chakra, the muladhara (complete individualization), becoming dormant as the latent Kundalini. The chakras lie along subtle channels along the spine, the central sushumna flanked by ida and pingala. The ida and pingala channels criss-cross around the sushumna like the well-known symbol of medicine, the caduceus. In most of us, the sushumna remains closed, with all energy supplied for sustenance through the ida and pingala (that correspond to the sympathetic and parasympathetic nervous systems). These two channels represent the sun and the moon, and driven by separation, all opposites that we are continuously prone to – pain and pleasure, likes and dislikes, dark and light, heat and cold, etc. The sahasrara represents devas ruling over the kingdom of “heaven” (Oneness), while the muladhara represents asuras ruling over “hell” (separation or loss of knowledge of Oneness).

When the spiritual aspirant realizes that the devas have “lost” the battle (that there is something more to human life than material gains), he/she calls to his/her inner guru (Vishnu) to help regain the “kingdom of heaven”. And so the churning of the ocean of consciousness begins with the devas (sahasrara) and asuras (muladhara) at the two ends of the great snake (sushumna), yogic practices resulting in gradual opening of the sushumna. As a result, the latent Kundalini residing at the root chakra awakens and begins the ascent up the sushumna. The manipura is the “middle ground”, the anchor of consciousness (the navel is where the fetus is joined with its mother through the umbilical cord; it is said that during astral travel, what keeps us in the body is a cord attached to the navel). The manipura (literally, “city of gems”) is thus “churned” by the devas and asuras (opposing tendencies that are responsible for all inner conflict). The ego represents Mount Meru, the anchor that is used to churn the ocean. This anchor is held steady by the tortoise underneath, the inward drawn mind. Anyone that has practiced yoga will know that all sorts of subconscious tendencies and pain are brought up into conscious awareness with continued practices; this is the poison spewed by the great snake in the churning process. In yoga, Shiva represents inner silence and awareness. Thus, poison spewed up with continued yoga practices is consumed by Shiva – when we let go of the churned up stuff, it is Shiva (inner silence) that consumes it, leaving no trace of these karmic tendencies and burning up conditioned patterns that keep the illusion of the separate self strong. All sorts of “gems” (siddhis/latent abilities) and insights come up in the churning, for example, Airavatha the celestial elephant (intuition) and Ucchaisravas the celestial horse (inner strength). Now, in the Bhagavatam story, Vishnu distributes these gems among the devas and asuras – exactly what happens on the spiritual path; if these siddhis produce attachment, the asuras in us can begin to use them for purposes far from divine. On the other hand, if they are let go of, we get closer to the kingdom of heaven. Importantly, even deep insights and knowledge must be given away to gain entry into the kingdom of heaven. Nothing can be kept or owned for oneself. Goddess Lakshmi represents the inherent bliss and beauty that is present in all of creation. She cannot be “had” by either the devas or asuras; thus, she chooses Vishnu, the sustainer of the cosmos, for she is the essence (Shakti) needed for all sustenance and creativity. As the churning continues, Dhanavantari finally makes an appearance with Amrita, the nectar of immortality – not merely the amrita that trickles down from the crown from the nectar cycle, a well-known phenomenon among yogis, but the nectar that gives back the devas their kingdom of heaven (Oneness). Immortality is that state where one is beyond all dualities and pairs of opposites. Not driven by past conditioning and with no fear of the future, the immortal yogi resides in the eternal present.

All through this churning, it is the inner guru/light (Vishnu) that is responsible for the spiritual aspiration, for planting the idea of churning the great ocean, for “doing” the churning, for stabilizing the ocean as a tortoise (withdrawing the mind within itself like a tortoise, as explained in the Bhagavad Gita, 2:58), bringing up the gems and finally coming up with amrita as Dhanavantari. This inner guru also takes the form of Mohini to help the aspirant along the way to detach from lower, asuric tendencies and to favor the higher, deva-like ones. In all of this, it was never the individual seeker “doing” anything; he/she was under the illusion of Vishnu’s own created illusion (Maya), simply believing that he/she was the doer.

On with the churning!

The War Within

Written by Heal Your Heart on . Posted in Living the Bhagavad Gita

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The armies have been assembled, the choices made. On the appointed day at the appointed time, the armies face-off on the battlefield of Kurukshetra (near present day New Delhi).

The entire Gita is written from the standpoint of Sanjaya, the messenger of the blind king Dhrithrasthtra. The two station themselves remotely, with Sanjaya providing “live” details as they happen, being blessed with divine vision (ability to see remote events clearly) by Krishna.

The very first verse of the Gita begins with Dhritharasthra asking Sanjaya, “O Sanjaya, what did my sons and the sons of Pandu do when eager to fight, they gathered on Kurukshetra the battleground of Dharma?”

And so it is that right from the outset, this is not about a war fought in an ancient world, but the war waging within each of us at any given moment. Kurukshetra is right here, right now – the inner conflict that is the hallmark of human existence. And it all has to do with what has been termed dharma.

Dharma is quite simply, natural law – that upon which all creation rests. If we can remain rooted in our own personal dharma, there would be no inner conflict and there would be peace at all times. However, although it is a simple definition, the murky thing is to know what one’s dharma is. In the context of the Gita and other Vedic literature, in order to understand dharma, it helps to understand three other concepts – guna, varna and ashrama.

Guna is “quality”, tendency or aptitude. All of creation can be seen to be composed of 3 gunas – tamas, rajas and sattva. Tamas refers to the quality of inertia, darkness, and/or heaviness, rajas of movement, action, dynamism and sattva of purity, lightness, light. Tamas makes up the structure of the universe, rajas provides movement, and sattva the intelligence. In all creatures, these qualities in specific combinations, make up the individual psyche/nature/personality. Evolution entails moving from tamas to rajas to sattva. Tamas in us results in inertia, lack of motivation, laziness, etc, rajas results in activity (and hyperactivity), movement, determination, accomplishment, etc and sattva results in quiet mind, clarity, purity of being, etc. The gunas also determine the “tightness” of ego-identification or “I- and my-ness”. Tamas results in total entrapment in the ego (separate self) on all levels, rajas to a lower degree and sattva to a still lower degree of such clinging to “I” and “me”.

Varna is the sorting, classification or division of a group. In 4:13, Krishna declares that he created 4 varnas (castes) according to guna and work/vocation: Brahmin (not Brahman), Kshatriya, Vaishya, and Sudra. This classification exists universally in every society, government, organization or group. Brahmins are those individuals that have a guna combination of sattva, rajas, tamas (in that order) and make up the segment of society that comes up with ideas, concepts and discoveries (scientists, philosophers and the like). Kshatriyas have the guna combination of rajas, sattva and tamas and are the leaders, the ones that take on the task of bringing ideas to fruition (politicians, military commanders, CEOs, etc). Vaishyas are driven by the guna combination of rajas, tamas and sattva, and excel at finding resources for the project (economists, financial planners, fundraisers, etc). Sudras with gunas combining in tamas, rajas and sattva are the workers, the ones that do the actual producing of results.

In the Vedic system, a person chose his “caste” according to his/her aptitude and type of work.  Thus, a Brahmin’s son could become a warrior (Kshatriya), a Sudra’s son a Brahmin, etc based on one’s personal aptitute driven by gunas, and according to the “ashrama” system.

Ashrama is the stage of life that along with guna and varna, will determine one’s unique dharma. Upto a certain age, everyone was a celibate student (Brahmacharya). Upon entering adulthood and finishing education (that was pretty equivalent for all, consisting of learning about the greater purpose of life and integration into society), most married and became householders (Grihastha). Once these duties were performed and children were raised, the householder left all material ties and retired to a quiet place for reflection (Vanaprastha), becoming celibate again. Finally, with further development of non-attachment, one entered the final stage of life (Sannyasa), renouncing everything and withdrawing inward.

In the context of guna, varna and ashram, it is easy to know what one’s dharma is. Thus, as a Brahmacharya (celibate student), one’s dharma is to study, to honor and obey the guru and parents and to direct all energies toward learning. Upon entering Grihastha ashrama, if one became a Kshatriya, one’s dharma was to first and foremost serve/protect and to lead by example, but also care for his family (since he would also be a Grihastha). If one had followed the ashrama system as it was designed, one would be ready to renounce material possessions when the time for Vanaprastha came.

In the context of the Mahabharata, Duryodhana was a king (therefore Kshatriya) and his dharma was to rule justly, to give the Pandavas the kingdom he had promised them before their exile. His dharma was to protect his people, not subject them to the horrors of war. However, (especially once the war was announced and particularly after the conches were blown), it was Arjuna’s dharma (also as a Kshatriya) to fight against injustice. To not fight would be adharma (opposite of dharma) for him and akin to “sin”. Throughout the Gita, Krishna emphasizes that swadharma (one’s own dharma) is far superior to paradharma (someone else’s dharma). As an example, premature renunciation of one’s family/life to retire into a life of contemplation (because someone else did that) would be adharma.

Even though knowledge of one’s gunas/varna/ashrama makes it somewhat easier to know what one’s dharma is, it is not always easy to follow it. Humans have the unique ability to choose or discriminate between what is right and what is pleasurable. A tiger does not wonder if it should kill for food and if that is the right thing to do. It is driven by instinct. We humans, on the other hand, are plagued with constant assessment and re-assessment of our thoughts and actions, heavily caught up in what we have learned to be right or wrong from our culture and upbringing. There is one part of us that knows what the right thing to do is; yet the other part that desires pleasure nags in an overpowering fashion. One adharmic action leads to one more and then one more and so on until we are lost in the perpetual war within. In every moment, opposing forces pull us in one direction or the other, in the form of self-judgment, jealousy and comparison to others, endless desire for “more” (more admiration and approval from others, more material wealth, more status, more fame…). The Bhagavad Gita is really about this war – Dharmakshetra, Kurukshetra.

On the spiritual path as well, it may not always be clear what our dharma is, at least initially. This is also true because as spiritual practices are taken up, there is continuous evolution in terms of the gunas; becoming more and more sattvic. This may (and does) result in a draw toward drastically different types of work/vocation and lifestyles to be in line with the inner transformation. Previously enjoyed work may not appeal so much as the need for external validations in terms of approval, fame, wealth and such falls away.  Also, the need for external reminders of our dharma in terms of guna/varna/ashrama lessens with surrendering to and trusting that which arises from deep within.

Dharma is not merely “should” or “should not” but the universal law that inherently benefits and upholds the whole, rather than the individual. Thus, any action undertaken with the motive of benefitting solely oneself is inherently adharmic. As one progresses along the path of yoga, the war within subsides and all thoughts and actions that arise become inherently dharmic, without a conscious choosing between what is right and what gives pleasure. Such actions of a perfected yogi benefit everyone around and he/she takes no personal credit for it.

The New Heart Disease Guidelines – the Good and the Bad

Written by Heal Your Heart on . Posted in Heart Health

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Earlier this week, the American College of Cardiology/American Heart Association (ACC/AHA) released long-awaited updates on guidelines for managing high cholesterol. In addition, they simultaneously released three other guidelines – on heart disease prevention, management of obesity, and on risk stratification for cardiovascular disease. These guidelines are definite steps in the right direction. For example, the new cholesterol management guidelines have done away with treating LDL cholesterol to specific “numbers” (such as less than 70 mg/dL in those with known cardiovascular disease, and less than 100 mg/dL to prevent the first event in those without known disease), and have adopted a more “individualized” approach to treatment with moderate-intensity (medium dose) or high-intensity (high dose) statin drugs.

Along these lines, four risk groups have been identified that might benefit the most from statin therapy – those with known cardiovascular disease, those with LDL cholesterol >190 mg/dL, those with diabetes and no known disease in the age range of 40-75 years with LDL cholesterol anywhere between 70 and 189 mg/dL and those with estimated 10-year risk of clinical cardiovascular disease of >7.5%. The general recommendation is to use the maximum dose of statin drugs that an individual patient may tolerate, to achieve LDL levels that may be optimum for them. For example, the lowest LDL level that someone with known disease is able to achieve on the highest dose of statins may be optimal for them. The new guidelines specifically discard the notion of using  additional non-statin drugs just to get the LDL “number” lower, since no big study has definitely proven the additive value of such an approach.

These guidelines also make an attempt to incorporate the use of imaging data in decision-making, albeit minimally. The recommendation is to possibly treat individuals with calcium scores >300 Agatston units with intermediate-to-high intensity statins. Alarmingly, in this recommendation, the guidelines miss an important lesson learned from the vast wealth of cardiac calcium scoring studies – any calcium in the coronary arteries confers a higher risk of downstream events, not just >300 Agatston units.

Unfortunately, the most important factors in prevention and management of cardiovascular disease have been somewhat glossed over in these new guidelines – lifestyle changes. By emphasizing the use of statins (which are not benign in terms of side effects), the guidelines are indirectly broadcasting the message of licentiousness for those variables that cause the majority of heart disease – lifestyle choices. The prevention guidelines effectively consolidate lifestyle choices into eating right and exercising. However, in my own cardiology practice, I have not come across one patient who does not already know this. Yet, knowing what to do and actually doing it are two different things. Unfortunately, most doctors simply do not have the time or the motivation to inspire meaningful lifestyle changes in their patients. And to inspire such changes would require delving deep into the patient’s psyche to discover what prevents them from adopting healthful changes. There are innumerable reasons for not being able to adopt right choices – psychosocial stress, depression, other concomitant chronic illnesses and so on. From the provider’s perspective, it is far easier to write out a prescription than spend time talking or counseling, a behavior that might potentially be reinforced with these new guidelines favoring drug therapy in an already prevalent “pill popping” culture.

Heart disease is a disease of lifestyle. And largely preventable. In the rapidly changing landscape of the practice of medicine, it would serve us well to focus on prevention – as in making the time and effort to help our patients make meaningful changes “from within”. And that would mean spending enough time and effort to alleviate their unique stresses and blocks that prevent them from doing what they need to do, instead of adopting the approach of a “blanket” statin prescription for all. This is true personalized medicine.

Universal Desires, Reincarnation and Liberation

Written by Heal Your Heart on . Posted in Living the Bhagavad Gita

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The ashrama system based on guna + varna was designed to fulfill the four basic categories of desires of human life:

1. Dharma, the desire to lead a purposeful life and to contribute to society according to one’s gunas.
2. Artha, the desire for basic needs [food, shelter, clothing] and material wealth/resources.
3. Kama, the desire for fulfillment of sense pleasures – art, music, beauty, sexual union and so on.
4. Moksha, the desire for liberation, and transcending the other three classes of desires.

These four categories simply describe the universality of desires and in the context of the spiritual path, refer to the “pull” or the hold of desires upon us. And what each of us desires is dependent upon our unique matrix of vasanas (conditioning).

Vasana literally means fragrance. Quite simply put, a vasana is an impression left by a particular action that drives future actions. As an example, if I have less than a positive experience interacting with a particular person, all my future interactions will be colored by the impression left by that first unpleasant encounter. Over time, this becomes a subconscious impression, associating a certain “type” of negativity with this “type” of person. And all our interactions with that “type” of person consequently become subtly colored. This type of coloring arises from the combination of: the faculty of memory plus the emotional component of feeling a certain way plus cultural/familial conditioning of what “should” or “should not” happen (“so-and-so should do such-and-such” and so on). Thus we go about our lives driven by likes and dislikes, love and hate, greed and generosity and such polar opposites, continually at the mercy of our vasanas – deeply embedded impressions. And these impressions do not reside only at the level of the mind – to understand this further, we will need to see about reincarnation, without which the understanding of vasanas is incomplete.

Vasanas are a result of impressions not only from this lifetime, but also of previous lifetimes. Death is applicable only to the physical body. At the time of death, the soul or Atman simply departs from the body that is no longer fit for it to inhabit (for various reasons). All impressions from this lifetime, which are “stored” in the causal body go into the pool or “bank” of impressions from all past lives. After a period of time spent in non-physical planes, the soul decides to take another birth (reincarnate). Why? To exhaust the vasanas that drive all desires. The soul decides what “set” of vasanas to exhaust in the next life, and along these lines, chooses the parents, the family, the culture and the community to be born into. If the chosen set of  vasanas are exhausted in that life without accumulating new ones, there is no further reason to live in that body and death is the logical conclusion. And another set of vasanas is chosen to exhaust (from the very vast “bank” accumulated over innumerable lifetimes) and another life chosen..

The fruits (results or consequences, including the good, the bad and the ugly) of all actions and their associated impressions (vasanas) across all lifetimes makes up the “bank” of karma known as sanchita karma. What is picked out of this bank to work off in a particular lifetime is called prarabdha karma. Accumulation of more vasanas in a particular lifetime (instead of exhausting it all) results in agami karma, that gets added to sanchita karma. When does this end? When one becomes desireless. How? Through moksha.

Moksha or liberation is what gets us out of this endless loop of birth and death altogether. The result of moksha is the state of desirelessness. Moksha or liberation quite simply, is to know one’s true (divine) nature. This is not secular knowledge gained through books, but experiential knowing that is beyond the mind and intellect. With very few exceptions, moksha can be attained only during a human birth, which is why being born human is considered a great privilege and an opportunity not to be wasted. According to Vedic philosophy, human evolution mandates that all desires must be, and necessarily, are fulfilled in the particular order of dharma, artha, kama and moksha. For example, a person starving of hunger craves for food, not Van Gogh’s art or Mozart’s music. Yet, when one has fulfilled basic needs of food and shelter, there is a natural pull or drive for material success and recognition, and for gratification of sense pleasures. Thus, unless one’s basic needs are met, they cannot be asked to meditate or to desire transcendence. Similarly, someone driven by ambition to “make it” in the corporate world will find neither the time nor the interest to discover the deeper purpose of human life (moksha). Additionally, moksha cannot be attained unless one has experienced the other three to a certain degree.

Importantly, all vasanas must be exhausted within the context of one’s dharma in order to progress to moksha. Adharma results in further enmeshment in the continuous loop of vasanas, with moksha being lower and lower on the “list” of desires to be fulfilled. Desires also fall into categories of gunas; desires driven by a very dense matrix of vasanas tend to be tamasic and progressively become rajasic as the vasanas are exhausted. Following one’s dharma on a continuous basis results in a loosening of sorts from the vasana driven birth/death loop, the mind and psyche becoming progressively prepped for the sattvic desire of moksha. While this progression is something we must all go through, the timeline for this progression is different for each of us, occurring over many lifetimes. Thus, somebody extraordinary like Ramakrishna Paramahamsa or Ramana Maharishi may seem to have jumped right to moksha, but that is simply because they have been through the previous stages in previous lifetimes.

Arjuna (symbolizing us spiritual seekers) has come to this sacred battleground (Dharmakshetra) “ripe” for moksha. He has followed his dharma, has accomplished much in his life being a superb/decorated warrior with no wanting for wealth (artha), and has enjoyed all sense pleasures to his heart’s content (kama). At this juncture, it is clear that all his prior accomplishments were necessary but transient, and that they have not succeeded in erasing the war within. This inner conflict is the greatest gift of human life, that which can be harnessed to leave behind the drama of the birth-death cycle.



Written by Heal Your Heart on . Posted in Inspired Poetry

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How fickle is this mind, my Lord
That even in Thy divine presence
It cannot rest for long in peace?

How strong is this I-sense, Krishna
That while knowing to be the non-doer
It continues to assert it’s separateness?

How feeble is this heart, my Beloved
That while seeing the futility of seeking
It continues it’s search here and there?

How shaky is this faith, O Bhagavan
That knowing impermanence to be Truth
It is driven to question Thy Divine Will?

What can I ask of You, my Keshava?
For You are the very Source of asking.
Yet I plead and beg of Thee..

Give me rock-like steady faith
Such that through thick and thin
It wavers not like a flame in the wind

Give me such one-pointedness
That in every in and out breath
You consume my very heart and head

Devour me in Your blinding light
So that all remnants of I and mine
Burn to embers and ashes fine

May I see Your form in all forms
Hear Your Name in all names
And feel Your essence in all things

I beseech You, my divine Beloved
Even while it is plain to see
You are the cause of this angst and joy,
Which is but Your playful glee.