Shedding light on why different Ayurvedic doctors give you different opinions of your Prakriti
In Ayurveda the three Doshas are considered to be of fundamental importance in treating and preventing physical and mental disease. Unlike biochemical medicine, the Ayurvedic approach gives significant responsibility to the patient who is invited to learn about their own Doshas. This is the trend in the West as Ayurveda is emerging as a popular form of traditional medicine.
However, as with all schools of knowledge, incomplete or inaccurate learning leads to misunderstanding, confusion, potentially damaging or hindering the integrity of the system. In this blog article I would like to address one of the most common areas of confusion among the general public concerning the concept of “My Dosha” specifically Prakriti: your Ayurvedic constitution.
Below is an excerpt of an email I received recently, it perfectly illustrates a very common dilemma and is not the first time I have been confronted with this kind of question:
I have been studying, following, and loving Ayurveda for several years. As I understand, one of the essential bases for anything in Ayurveda is knowing one’s Dosha. When I first discovered Ayurveda, I did many online questionnaires to determine my Dosha: they revealed me to be either Pitta-Vata or Vata-Pitta, both Doshas being quite close to each other in prominence in me.
Since then, I have met several Ayurvedic doctors – all of them qualified and professionally trained, some of them very respected, all from India.
The first was a well-known Ayurvedic doctor whom I consulted while he was visiting Switzerland. Through pulse diagnosis, he told me, emphatically, that I was Pitta. There is also a lot of Vata, but my Prakriti was Pitta, according to him.
The second was a good doctor from South India whom I consulted in another European country. He told me that I was Vata, with also some Pitta, but Prakriti: Vata.
Two months ago I had a full Ayurvedic treatment in South India, where I am at the moment. The doctor is very well-respected. He said that I was quite obviously Vata, and that I also might have some Kapha secondarily, but he was not sure. He said he did not see much Pitta in me.
Since I am still in India, I decided yesterday to see what other doctors would say about my Prakriti, because I believe this is important to know. One doctor, professionally-trained as all the others, checked my pulse and told me that I am Pitta. The second checked my pulse and told me that I am Vata, with Kapha secondarily. He said that he did not see Pitta in me.
I respect Ayurveda as a science. The pulse diagnosis is something that one is trained to do, I expect rigorously, during one’s professional studies of Ayurveda. Establishing a person’s Dosha is the basis of the basis, one of the most fundamental things in an Ayurvedic diagnosis.
I understand that different doctors can have different approaches and differing treatments that may seem contradictory with each other, but each of which, taken alone, can lead to good results.
But establishing one’s Dosha is basic. Either one is a particular Dosha, or one isn’t. The pulse diagnosis should give the objective basis to determine this.
How is it possible that five different doctors, all of them professionally-trained and practicing, all of them qualified and with experience, gave me five completely different diagnoses of my Dosha [Prakriti]?
If you can help me understand this, I would be grateful. Many thanks in advance!
This email was sent to me recently, and it reminded me of many people I know who are in the same or similar situation. In no particular order of priority, I am going to do my best to form a reply.
What is Prakriti?
Prakriti is your innate unique tendency of Dosha state. It is determined at the moment of conception and during pregnancy. It appears to be an important factor in understanding your physical, metabolic and to a lesser extent, your psychological nature throughout life. Prakriti literally means nature.
Prakriti is expressed in terms of the relative proportion of the three Doshas: Vata, Pitta and Kapha. Think of the Doshas in terms of managers of our biology. In fact thinking of them as three forms of intelligence, or even three actual people, can be a very useful metaphor. These three managers of our complex organism are dynamic, ever changing in their daily cycles of activity. They interact, depend on each other, and ultimately represent nothing other than three aspects of one ‘life force’. Or, if you prefer to remain free from esoteric notions, the Doshas are the three fundamental biological behaviours of (human) life. Vata represents the principle of movement, Pitta the principle of transformation, and Kapha the principle of cohesion.
The Caraka Samhita (a very old and important Ayurvedic “bible”) defines Prakriti as your congenitally aggravated Dosha. This definition puts emphasis on the inherent risk that your dominant Dosha or Doshas have in terms of giving you a unique predisposition to certain types of Diseases. Vata dominance predisposes us to neurological and movement related diseases. Pitta to inflammatory diseases, and Kapha to congestive diseases of excess.
At any point in time, we can assess our current activity or state of the Doshas via a number of subjective and objective measurements. A thorough assessment requires us to take multiple factors into account: examination of the tongue, eyes, the skin, nails, hair, body shape, urine, stool, sweat, pulse etc. Questioning into numerous aspects of the patient’s subjective and objective experience are use din conjunction with these observations. Modern analysis (blood, scans etc) can also provide valuable information when interpreted from an Ayurvedic viewpoint. Only this complete evaluation can approach a reliable estimate of your Prakriti. Therefore:
Anyone who claims to make a reliable evaluation of your Prakriti or current Dosha state via the pulse alone is probably either delusional or being untruthful.
I have been told that there is a very rare select few who have become almost clairvoyant in their ability to “read you” via the pulse alone, however, in order for them to do it, you need to follow a strict pre-evaluation diet and lifestyle for several days. Because Ayurveda is mostly unregulated in the West and the East, quackery is rife!
Prakriti is hard-wired into your system, no doubt your DNA. It is unchangeable and exerts a strong influence on the way you are: your body shape (somatotype), metabolic type (slow, fast, variable), and numerous other things. Prakriti cannot be modified. However, your Doshas can and frequently do deviate form your Prakriti. This can cause much confusion for all of us! Especially if our understanding of the concept of Prakriti is limited or overly simplified. This deviation is known as Vikriti which literally means “deviation from nature”. Whenever one or more of your Doshas increases (or decreases) outwith normal healthy limits, you are in a state of Vikriti. It is possible and frequently seen that the Dosha or Doshas which go out of whack are not necessarily the same Doshas that you have as dominant in your congenital nature (Prakriti).
The most useful way of thinking about your Prakriti is to think of it as a strong lifelong tendency that will always exert an influence on your current state of Doshas. Most people are either single Dosha or double Dosha types (where either one or two Doshas dominate in your nature). A rare few people seem to have a triple Dosha type where all three Doshas exert equal dominance.
Your Dosha state today may or may not reflect your Prakriti Dosha profile. It depends on how you live: what you eat, your environment, your lifestyle habits, everything. Perhaps I am a dual Vata-Pitta type, but today my Kapha Dosha is excessive due to overconsumption of Kapha-increasing foods. The thing is with Prakriti, it is a Dosha tendency profile, it is not the actual Doshas.
There are certain markers that are quite reliable indicators of Prakriti (skeletal structure and tongue shape for example). But ultimately, once you actually do things in the therapeutic sense with the Doshas in mind, you will be able to gauge what is happening with them and gradually find out the Prakriti through guided trial and error. This is the most reliable way and the key point that I want to make in this article:
Your understanding of Prakriti, your Dosha tendency profile, emerges over time due to experience. It is not something that can determined from a single evaluation of the Doshas.
A naïve approach to Ayurveda can result in patients having unrealistic expectations who want to be told by the ‘Ayurvedic guru’ the answer to the mystery of their life. “Doctor, what is my Dosha [i.e. Prakriti]” should be replied to with something like this “Be patient, we will find out in time. It seems to me that your dominant Dosha is Vata, but I could be wrong. A certain amount of experimentation will be required”.
In my opinion, too much emphasis is placed on the notion of knowing one’s Prakriti from the word go, and not enough emphasis on knowing how to read the Doshas in their actual present state and how to manage that information in the interests of prevention or disease management.
Many of the most effective preventative and curative Ayurvedic dietary and lifestyle interventions focus on the management of Vata Dosha. Vata is the most important Dosha. It governs the other Doshas. It is the most complex and fragile in its work responsibilities. Modern life is highly Vata-aggravating: drying, mobile, agitated, changeable, fast, intense etc. Learning to help pacify and maintain a healthy Vata Dosha is already an excellent starting point for most people in the modern world. Make that your focus today and worry about your Ayurvedic Prakriti tomorrow.