Stress Management through Shirodhara By Leslie Flynn

 In yogic sciences there are a number of procedures explained for relaxation of body and mind.  By these procedures like meditation and relaxation the mind comes down to a tranquil state, it reduces stress, helps in normal and better function of mind.  All the benefits of meditation and relaxation are achieved by the procedure of Shirodhara. 4   Shirodhara is no doubt the most popular Ayurvedic treatment in the West.   Shirodhara is a classical and a well-established ayurvedic procedure of slowly and steadily dripping medicated oil or other liquids on the forehead.  The word shiro means head and the word dhara means stream. 11   This procedure induces a relaxed state of awareness that results in a dynamic psycho-somatic balance. 2   Shirodhara is one of the most powerful treatments to relieve Vata (wind) in the mind.  Preoccupied with swarming thoughts, the mind has a difficult time slowing down.  This can lead to inability to handle stress, creating nervousness, anxiety, depression, insomnia, fatigue, psychological disorders, and more.  Shirodhara is the specific treatment for these orders and any other disorder that is stress related.  With eighty percent of all disease in the West now attributed to stress, Shirodhara becomes one of the most important treatments. 11

Shirodhara: Classical Descriptions and Types

Shirodhara is a titillating form of snehana treatment, whereby the oil or therapeutic substance methodically drips along a course thread onto the forehead.  A metal or clay vessel, the dhara patra, is suspended directly above the forehead. 10   This treatment involves pouring a stream of oil over the guest’s forehead.  Most commonly medicated sesame oil is used for this treatment.  Traditionally, specifically prepared herbalized oils, milk, or buttermilk are used. 11    The oil or other fluid is poured into the pot, and then seeps through a hole in the bottom of the pot and slides down a 4-inch-long thread, half of which hangs through the hole.  The drops of oil from the thread drip directly onto the subject’s third eye, or center of the forehead.   An ancient technique, Shirodhara is meant to be maintained at a certain rhythmic speed while awakening the third eye.  Vast and miraculous healing occurs when this technique is performed to perfection.  The rhythm of the oil trickling onto the third eye, which is the seat of our cognitive vision, evokes deep cognitive memories.  Through the arousal of these memories, bodily tissues are transformed and good health is restored.  Before Shirodhara is administered, the preliminary procedure of abhyanga massage is performed.   A soporific treat, Shirodhara soothes and invigorate the senses as well as the mind.  A total state of wellness is induced in the process. 10   There are several kinds of dhara techniques, depending on the medium for dripping.  For example, takra dhara uses takra that is prepared with the curd of cow’s milk.  Kshira dhara uses cow’s milk mixed with some medicinal herbs such as Sida cordifolia or Asparagus rasemosus.  Taila dhara uses medicated oil mixed with cow’s milk, water, herbs, and sesame oil.  9  

Generally, sesame oil processed with various Indian herbs is used for Shirodhara. However, milk and buttermilk processed with herbs are also used in this treatment depending on the condition. Shirodhara with Brahmi oil may be beneficial for moderate to severe insomnia. 1    Brahmi is one of the most sattvic herbs known in Ayurvedic pharmacopeia since Vedic times. It aids in the recovery from exhaustion, stress, debility and aggravation of vata. 12                                                                          

Shirodhara by Bala Taila, which is known to have a beneficial effect on all the sensory organs and to make the patient quiet and calm.  Continuous pouring of Bala Taila on the forehead for a specific period has a tranquilizing effect and induces sleep.  The effect on the mind is such that the patient is said to become free from anxiety and stress.  Bala Taila Shirodhara also modifies the energy condition of the mind. 3

Lavender Shirodhara is superior to plain Shirodhara in its’ anxiolytic and ASC-promoting effects.  The mechanism of Shirodhara with lavender oil is related to the well-known soothing effect of lavender.  Lavender oil may stimulate the olfactory nerves, and impulses may be transmitted to the hypothalamus to soothe the mood and alter the autonomic nervous balance.  Linalool, the main constituent of lavender oil, may also be absorbed into the bloodstream through the skin or mucosa of the respiratory tract.   The complicated pharmaco-physio-psychologic effects of lavender Shirodhara reflect a principle of traditional Indian oil therapy. 5

Insomrid and Shirodhara with luke warm milk have potent effect on the management of Anidra, Insomnia.  The milk used for the Shirodhara has Madhura Rasa, Snigdha Guna, Sheeta Veerya and Madhura Vipaka which subside Vata and Pitta Doshas and increases the Kapha Dosha.  It also increases Tamoguna in the Shirah Pradesha.  Hence it helps in production of Nidra. 4

Herbs, Oils, and other Preparations Commonly used in Shirodhara

Shirodhara is administered by gently and methodically pouring warm herbalized oil over the forehead.  This procedure synchronizes brain waves and profoundly coordinates and calms the mind, body, and spirit. 11    Common Ayurvedic medicated oils contain many herbs as well as other constituents, including various kinds of polyphenols and volatile terpenes, and the concentration of these constituents greatly fluctuates depending on where they are harvested, prepared, and the season, so that speculation on the precise mechanism of Shirodhara would be difficult.   Plain sesame oil at 39 degrees C may stimulate thermosensors in the skin, such as transient receptor potential-vanilloid 3 (TRP-V3), to evoke nerve impulses in the trigeminal cranial nerve of the forehead, inducing the somato-autonomic reflex.  Viscid, dripped oil itself pulls as well as pushes the scalp hair while running down on the scalp skin.  The weight of sesame oil (about 16 grams on the forehead) may stimulate epithelial Na channels (ENaCs) pressure sensors in the skin.  The hair follicles have sensory fibers around them.  Dripped oil may stimulate the myelinated nerve fibers (AB-fiber) of the trigeminal nerve to induce the somatoautonomic reflex, resulting in HRV changes. 8    The guest’s comfort is crucial.  The room has to be the right temperature (warm), absolutely quiet, and the neck and low back have to be supported appropriately.   The type of vessel that is used can alter the effectiveness of the treatment.  Classically copper is used as it has effectiveness mostly for Vata and is also balancing for Pitta and Kapha.  A coconut vessel is said to be one of the best and is suited for all three types.  The most revered in India is a vessel made out of five metals called pancha dhatu.  This metal is a combination of copper, nickel, brass, silver, and gold. 11 

Different liquids are used depending on the conditions being treated.  Commonly used liquids include water, various oils, buttermilk, or coconut water. 14    First, the oil stream or dhara should be thick and heavy.  Second, the oil stream should be continuous so that if the treatment needs to last an hour, it can be provided.  Third, the oil needs to be warmed and needs to be maintained just above body temperature at all times.   The fourth component is that the stream needs to be moveable and not stationary. 11                                  

Season: All Year

Dashamula Oil   Vata Disorders:  16 c water, 1 c dashamula powder, 4 c sesame oil
Warm Sesame Oil   Vata and Kapha Disorders:  4 c sesame oil for Vata, 3 c for Kapha disorders
Warm Sesame Oil   Pitta Disorders: 2 c sesame oil, 1 ½ c pure ghee
Licorice Oil   Pitta Disorders:  12 c water, 3 c sesame oil, ¾ c licorice powder

Other Shirodhara Substances  Body Type: all types , conditions  Urinary disorders, heart disease, indigestion, anorexia, diseases of the eye and ear, premature graying and balding,  headache, insomnia, exhaustion, weakness of the joints, fear and anxiety.  A total restorative for all three doshas.     

Takra Dhara (medicated buttermilk) 1 c certified raw milk, 2 c water, 1 c amalaki powder         
Milk and Musta Cream 16 c water, 4 c milk, 1 c Musta powder, 2 c takra dhara (medicated buttermilk)                                                                                                                                  

Time of Application: 7:00 to 10:00am 10

Treatment Time:  It is recommended that the Vata treatment be longer than the Pitta and the Pitta treatment be longer than the Kapha. In extreme Vata imbalances the treatment can last 60 minutes.

Vata – 30-40 minutes
Pitta-25-30 minutes
Kapha-20-25 minutes

Pitta Horizontal Pattern:  Directing dhara (oil stream) across forehead, starting just above eyebrows, going from ear to ear without losing oil contact, working up to just past hairline.

Kapha Vertical Pattern:   Like a zigzag/up-down pattern working back and forth across forehead.

Vata Stationary Pattern:   Holding oil stream over third eye for extended period of time. 11    The recipe for oleation therapy can be given exceeding the limit of seven days only when the body is not saturated with medicated ghee, etc., within the prescribed limited period of seven days.  Though it is mentioned that the minimum period of oleation should be three days, there are recipes which cause instantaneous oleation even with one day.   Oleation therapy alleviates aggravated vayu, softens the body and disintegrates the adhered morbid material [in the channels of circulation]. In the person who has undergone oleation therapy, fomentation liquefies the adhered morbid material (even) in the fine channels of the body. 8    The Ayurvedic Practitioner determines both the duration and number of days according to the patient’s age, constitution, and dosha status, and the severity of the disease.  1

Indications

Patients of Insomnia with mild hypertension, mild depression and anxiety disorders without any complications of any other diseases. 4   Shirodhara is suitable for patients suffering from Shiroroga, metabolic disorders, and the different kinds of mental diseases described in Ayurveda. 3    It has long been conducted to combat insomnia, headache, anxiety neurosis, depression, schizophrenia, motor-neurosis, depression, schizophrenia, motor-neuron disease, hypertension, and several kinds of psychosis. 9    Shirodhara has been shown to be effective in attention deficit/hyperactively disorder in children, hypertension, menopause, cerebral ataxia, general anxiety disorder, headache, and insomnia. 1   Vata Disorders: prickling pain in the head; loss of hair; loss of hearing; fatigue and mental exhaustion; grayish coating on the tongue; dryness of face and scalp; constipation.  Pitta Disorders: burning sensation in head and body; ulcerated or inflammatory conditions of the head; pharyngitis; conjunctivitis; excess sweating; dimness of vision; blood disorders; hemorrhaging; jaundice; herpes; yellowish coating on the tongue; greenish or yellowish coloring of urine and feces.  Kapha Disorders: excessive sleep; heaviness of body; indigestion; mucus; obesity; weak digestion; white coating on the tongue; white urine and feces; loss of appetite; repulsion for food; anorexia.  In addition to relieving the disorders listed above, this treatment has the added effect of awakening the third eye, invigorating the boy and mind, and stimulating cognitive memories. 10

Contraindications

Patients with alcohol dependency or drug dependency.   Patients with acute illness like Cardio Vascular Accident, Congestive Cardiac Failure, Myocardial Infarction, Chronic Obstructive Pulmonary Disorders, meningitis, acute pain conditions. 4

Research into the Effects of Shirodhara on the Mind

Along with the economic advancement, man is going far away from Nature, and in order to find an honorable place in the society, he is often exposed to physical fatigue and mental tension.  This stressful living is the raisen d’ etre for many of the present day maladies of psycho-neurotic nature.   According to ayurveda, the function of the mind and nerves is dependent upon vayu or vata.  All the functions of the body, according to ayurveda are controlled by three elements which in ayurvedic parlance are called doshas. 7    The complicated pharmaco-physio-psychologic action of Ayurvedic oil treatment may provide a useful model for future pharmaco-physio-psychotherapy. 5

Shirodhara is one of the oil treatments originating from Keraliya Panchakarma.  

The neurophysiological mechanism of the effects of Shirodhara on the psycho-physiological changes may be related to the tactile stimulation of the skin or hair follicles innervated by the first branch of the trigeminal nerves (ophthalmic nerve).  The impulses would be transmitted to the thalamus through the principal nucleus and forward to the cerebral cortex (somato-sensory field) or limbic system. 9    While most Ayurvedic therapies have their impact on the physical and energy sheaths of the subtle body system, Shirodhara most effectively purifies the mental sheath, where patterns of behavior (vasanas) and emotional traumas can distract the mind from its’ role in supporting good health and spiritual growth.   When during a therapy the guest is taken into a deep, meditative state of silence, the basal metabolic rate is significantly lowered, and with successive treatment, it is lowered even more.   If the body were a lake, it would become totally calm and crystal clear.  In this state the body experiences itself more profoundly as a unified field of consciousness rather than thousands of physical parts.  In this procedure the metabolic rate drops, and the brain waves become slow and coherent.  The state of calm achieved with Shirodhara is unparalleled by other relaxation techniques, and it brings the nervous system into the depths of inner silence.   In Ayurveda, pain has a specific purpose in the body.  Pain is said to be the direct opposite of bliss or pure consciousness.  The purpose of the pain is to bring the body’s awareness to the pain and then through the pain to establish itself in the bliss.  Let’s say the body is deeply settled and the protective nervous system is disarmed during a Shirodhara or a two-person Ayurvedic massage.  In this deep stillness the nervous system becomes aware of any stress or strain that inhibits the flow of stillness into every cell of the body.   The goal is to have this pure experience of consciousness in every cell of the body – moving pure consciousness from the bliss sheath (anandamaya kosha) to the physical sheath (annamaya kosha).  When this happens, the chakras and nadis can carry the kundalini Shakti up the spine to its’ goal-the bindu point on the top of the chakra system.  This process cannot be completed unless the physical, energy, and mental sheaths are balanced, stable, and functioning in harmony.   Shirodhara works mainly in the manomaya kosha, or the mental sheath.  If the mental sheath is not balanced, then the pull of the old vasanas and samskaras will distract the mind in the discernment sheath from being able to choose wisely in the direction of spirituality.   These impressions are held captive in the limbic system or the emotional cortex of the brain.  With an unpurified mental sheath, choices will be in the direction of supporting the status quo set up by the old, deep-seated patterns of behavior.  Once the mental sheath is cleared, the individual mind can choose, without distraction, to move into the bliss sheath or anandamaya kosha.  Once the bliss sheath is activated, the flow of Shakti and consciousness can freely move through each kosha creating better health, peace of mind, and spiritual progress through one’s life.  As you can see, if the subtle bodies, doshas, vayus, nadis, chakras, and srotas are blocked, then physical imbalance, emotional disturbance, and mental unrest will be the accepted human condition (which it is in our current society). 11    A standardized Shirodhara leads to a state of alert calmness similar to the relaxation response observed in meditation.  The clinical benefits observed with Shirodhara in anxiety neurosis, hypertension, and stress aggravation due to chronic degenerative diseases could be mediated through these adaptive physiological effects.  A total feeling of wellness, mental clarity, and comprehension is experienced in this process. 2    Shirodhara stimulates the pineal gland which produces the hormone melatonin.  Melatonin regulates the wake and sleep cycles of the body. 6    In the procedure of Shirodhara, a particular pressure and vibration is created over the forehead.  The vibration is amplified by the hollow sinus present in the frontal bone.  The vibration is then transmitted inwards through the fluid medium of cerebrospinal fluid (CSF).  This vibration along with little temperature may activate the functions of thalamus and the basal fore brain which then brings the amount of serotonin and catecholamine to the normal stage inducing the sleep.  The procedure of Shirodhara brings the Sanjnavaha Srotas in peaceful state of rest which helps in inducing sleep.   The process of Shirodhara also produces a meditation effect which helps to overcome the complaint of insomnia.  The method Shirodhara produces almost similar effects as that of Yoganidra technique in yogic science. 4

Conclusion

Shirodhara is becoming increasingly popular in day spas, especially in North America, where it is used to relieve fatigue and promote relaxation. 14 As oil is poured on the forehead, the nervous system is deeply stilled.  The brain waves slow down and become coherent.  Once the brain is quieted, the pranavaha and manovaha srotas begin to transport prana, oxygen, and other necessary nutrients to the brain.  When the brain is quieted and the srotas are activated, the cerebral circulation is greatly improved, and access to these mood stabilizing receptors is enhanced.  The result: better brain function, mood stability, and improved stress handling ability. 11 Shirodhara may be the oldest but the most skillful healing technique that manipulates cerebral circulation, cerebral function, and the state of consciousness.  It may provide a new tool and new knowledge for modern brain research into consciousness.  Furthermore, it may open new paradigms for exploring what we refer to as spiritual biotechnology. 9 In India, Shirodhara is a common and age-old Ayurvedic practice, and the clinical benefits are being observed by vaidyas in thousands of patients.2 Shubham bhavatu!  God Bless You! 14

References

1.  Vinjamury, Sivarama Prasad et al. “Ayurvedic Therapy (Shirodhara) for Insomnia: A Case Series.” Global Advances in Health and Medicine 3.1 (2014): 75–80. http://www.ncbi.nlm.nih.gov/pubmed/24753997 PMC. Web. 21 Feb. 2015.

2.  Dhuri, Kalpana D., Prashant V. Bodhe, and Ashok B. Vaidya. “Shirodhara: A Psycho-Physiological Profile in Healthy Volunteers.” Journal of Ayurveda and Integrative Medicine 4.1 (2013): 40–44. http://www.ncbi.nlm.nih.gov/pubmed/23741161 PMC. Web. 21 Feb. 2015.

3.  Kundu, Chittaranjan et al. “The Role of Psychic Factors in Pathogenesis of Essential Hypertension and Its Management by Shirodhara and Sarpagandha Vati.” Ayu 31.4 (2010): 436–441. http://www.ncbi.nlm.nih.gov/pubmed/22048535 PMC. Web. 22 Feb. 2015.

4.  Pokharel, Sanjay, and Ajay Kumar Sharma. “Evaluation of Insomrid Tablet andShirodhara in the Management of Anidra (Insomnia).” Ayu 31.1 (2010): 40–47. http://www.ncbi.nlm.nih.gov/pubmed/22131683  PMC. Web. 22 Feb. 2015.

5.  Fenghao Xu, Kazuo Uebaba, Hiroko Ogawa, Takeshi Tatsuse, Bing-Hong Wang, Tatsuya Hisajima, and Sonia Venkatraman.  “Pharmaco-Physio-Psychologic  Effect of Ayurvedic Oil-Dripping Treatment Using an Essential Oil from Lavendula angustifolia”, The Journal of Alternative and Complementary Medicine. October 2008, 14(8): 947-956. doi:10.1089/acm.2008.0240. http://www.ncbi.nlm.nih.gov/pubmed/18990044, http://online.liebertpub.com/doi/abs/10.1089/acm.2008.0240

6.  Gotmare Ashish, Tawalare Kiran, Nanote Kalpana, Dehankar Manisha.  “Godugdha Shirodhara: A Non Pharmacological Treatment of Nidranash (Insomnia).  (Moksha Publishing House, 2013) doi:10.7897/2277-4343.04417 http://www.ijrap.net/admin/php/uploads/1058_pdf.pdf

7.   RK Sharma and Bhagwan Dah, Charaka Samhita (Varanasi: Chowkhamba Sanskrit Series Office, 2014) vol. V, preface.

8.   RK Sharma and Bhagwan Dah, Charaka Samhita (Varanasi: Chowkhamba Sanskrit Series Office, 2014) vol. VI, ch. 1, verses 7-8.

9.   Uebaba K, Xu FH, Tagawa M, Asakura R, Itou T, Tatsuse T, Taguchi Y, Ogawa H, Shimabayashi M, Hisajima T.   “Using a Healing Robot for the Scientific Study of Shirodhara”   http://www.ncbi.nlm.nih.gov/pubmed/?term=shirodhara+healing+robot  PMID: 15825848 [PubMed - indexed for MEDLINE] March/April 2005

10.   Maya Tiwari, Secrets of Healing, (Twin Lakes Wisconsin, Lotus Press, 1995), 150-156.

11.  Dr. John Douillard, The Encyclopedia of Ayurvedic Massage, (North Atlantic Books, Berkeley, California, 2004), 14-15, 19-20, 36, 51, 89-90, 271-279.

12.   Brahmi: “Herb of Grace“, 1, 3. http://www.ayurvedacollege.com/articles/students/Brahmi

13.   Sunil V. Joshi, Ayurveda & Pancha Karma, (Twin Lakes Wisconsin, Lotus Press, 1997), 281

14.  WebMD http://www.webmd.com/vitamins-supplements/ingredientmono-1215-shirodhara.aspxactiveingredientid=1215&activeingredientname=shirodhara