Tuesday, November 18, 2014

The Buddhist Jataka Stories and the DSM based Mental Disorders

Ruwan M Jayatunge M.D. 

The Jātaka Stories
The Jātaka stories or Jātaka tales are a voluminous body of folklore concerned with previous births of the Buddha which is based as a collection of five hundred and fifty stories. Originally it comprise of 547 poems, arranged roughly by increasing number of verses. There are 547 stories in the Jātaka collection. Some experts say that 550 stories were translated from Sinhalese into Pāli by Rev Buddhaghosa in Sri Lanka (Bunnary, 2004). According to archaeological and literary evidence the Jātaka stories were compiled in the period, the 3rd Century B.C. to the 5th Century A.D. As Professor Rhys Davids indicated Jātaka stories are one of the oldest fables.

Rev Buddhaghosa who was a 5th century Indian Theravadin Buddhist commentator and a scholar translated most of the Jātaka stories into Pāli about 430 A.D. Between 399 and 414 A.D. the Chinese monk Fa Hien (Fa-Hsien, Faxian) undertook a trip via Central Asia to India seeking Buddhist texts.  He visited Ceylon (Sri Lanka) in 400 A.D and stayed in the Abhayagiri Viharaya -a major monastery site of Theravada and Mahayana Buddhism in Anuradhapura - Sri Lanka. The Bhikkhu Fa Hien translated Jātaka stories in to Chinese.  

Jātaka scenes are found sculptured in the carvings on the railings round the relic shrines of Sanchi and Amaravati and especially those of Bharhut where the titles of several Jātaka are clearly inscribed over some of the carvings. These bas-reliefs prove that the birth- legends were widely known in the third century B.C (Chalmers, 2012).

The Khuddaka Nikāya (Minor Collection) contains 550 stories the Buddha told of his previous lifetimes as an aspiring Bodhisattva or a person who is compassionately refrains from entering nirvana in order to save others and is worshipped as a deity in Mahayana Buddhism. The stories of his lives, the Jātakasportray the efforts of the bodhisattva to cultivate the qualities, including morality, self-sacrifice, and wisdom, which will define him as a Buddha (Encyclopedia Britannica).
The history of the word “Jātaka” may come from Buddhism. The earliest use of the word “Jātaka” is found on a stone carving of a relic-shrine at Bharhut (Wray et al. 1996; Bunnary, 2004).  The word has a literary meaning of a collection of fables, many concerning former lives of the Buddha.

The Jātakas themselves are of course interesting as specimens  of Buddhist literature ; but their foremost interest consists in  their relation to folk-lore and the light which they often throw on  those popular stories which illustrate so vividly the ideas and  superstitions of the early times of civilization. In this respect they possess a special value, as, although much of their matter is peculiar to Buddhism, they contain embedded with it an unrivalled collection of Folk-lore. They are also full of interest as giving a vivid picture of the social life and customs of ancient India (Chalmers, 2012).

Jātaka stories mostly reflect the Bodhisattva period. It gave a   kaleidoscopic view of the journey of the   Bodhisattva.  Every aspirant to Buddhahood passes through the Bodhisattva Period – a period of intensive exercise and development of the qualities of generosity, discipline, renunciation, wisdom, energy, endurance, truthfulness, determination, benevolence and perfect equanimity (Narada, 1998). The Jātaka stories illustrate the development of the Buddha wandering in the cycle of birth and death (samsara) by behaving in various good ways with acts of charity, renunciation, compassion, gratitude and so forth. All his actions lead to his achieving a good result in his future life or becoming a greater person in the next life (Bunnary, 2004).

Jataka stories deal with issues of everyday life and their resolution. The problems faced by the Bodhisattva are universal. Despite the culturally specific contexts in which the stories are cast, the basic themes underlying most of these stories transcend both history and culture. The challenge for each cultural ethos is to identify and interpret the stories that best reflect the demands of its times (Hewapathirane, 2006). The Jataka stories, over millennia, have been seminal to the development of many civilizations, the cultivation of moral conduct and good behaviour, the growth of a rich and varied literature in diverse parts of the world and the inspiration for painting, sculpture and architecture of enduring aesthetic value. (Piyatissa, 1996).

The Jātaka gives its core meaning as a form of teaching. It advises people on good behaviour, merit, alms giving, charity, gratitude, renunciation, helpfulness and forbearance (Narasu, 1993). Jātaka narrative provides much didactic meaning particularly about moral conduct through literature (Bunnary, 2004). The jataka stories, being full of wit and humour, worldly wisdom, moral lessons, and pious legends of semi-historical nature, were very helpful in popularizing the Dhamma amongst the masses (Ahir, 2000).

Jātaka stories made a profound influence on art and literature in India, in South-East Asia, and in Europe (Ahir , 2000). In addition parts of the Old Testament, Aesop's fables and other western stories are somewhat similar to the Jātaka (Wray et al. 1996) and the Jātaka may therefore reflect an earlier stratum of narrative, perhaps predating Buddhism itself (Bunnary, 2004).

Kulasuriya (1996) points out that some stories of the Jātaka Book occur in the Pañcatantra, Kathāsaritsāgara and other Indian story books.   Some stories have parallels in the Mahābhārata and in the Rāmāyaṇa. According to Winternitz (1968) the tendency of turning popular tales into jātakas had the result that at times rather worldly narrations became 'Buddhist' even though they may have had little in common with Buddhist. The Dasaratha-Jātaka identifies Rāma with the Bodhisattva.

The Panchatantra shares many stories in common with the Buddhist Jātaka tales purportedly told by the historical Buddha before his death around 400 BCE. The Panchatantra (Five Principles) is an ancient Indian inter-related collection of animal fables in verse and prose, in a frame story format. The original Sanskrit work, which some scholars believe was composed in the 3rd century BCE, is attributed to Vishnu Sharma (Nadwi, 2013).

Jātaka stories are moral and spiritual stories and it can be considered as case studies of the Buddhist philosophy. These spiritually evoking case studies converse about the dynamics of the human mind and human behavior in different circumstances. Jātaka stories contain a reflective psychological premise. The Jātaka stories represent a broad structure of mental phenomena. It represents existential and moralistic dimensions of human nature.  Jātaka stories profoundly discuss thoughts and actions of the Akusal (sinful) or pathological mind as well as non pathological Kusala (healthy and pure) mind. 

Jātaka Stories and the Western World

The Jātaka stories entered European ground at the end of the medieval period via Arabs and were translated and spread into all the main languages, viz; Greek, Spanish, German, Italian, French and English  (Janné, 2014).  T.W. Davids – a British scholar and the Pāli language, Indologist stated that Buddhist Jātaka Stories impacted the Western fables and stories. The prominent novelist Martin Wicramasinghe D.Lit indicated similarities between Dostoyevsky’s Brothers Karamazov and Asathamanthra Jātakaya of the Jātaka story book. Moreover he saw similarities in French writer Jean Baptiste Poquelin Moliere’s Tartuffe and Somanassa Jātakaya.

Among the Western intellectuals Professor Rhys Davids Ph.D., LL. D., of London, Secretary of the Asiatic Society studied the historical and cultural context of the Jātaka stories and he translated a large number of stories in 1880. Rhys-Davids described Jātaka stories as ‘full of information on the daily habits and customs and beliefs of the people of India, and on every variety of the numerous questions that arise as to their economic and social conditions (Appleton, 2007).  Beginning 1877, the Danish scholar Victor Fausboll published the Pali compilation in Roman script. 

Sir Edwin Arnold – an English poet and the celebrated author of The Light of Asia gracefully wrote poems about Jātaka stories. Professor E. B. Cowell, Professor of Sanskrit in the University of Cambridge, brought out the complete edition of the Jātaka stories between 1895 and 1907. Also Oskar von Hinüber- Professor of Indology at Albert-Ludwigs-Universität Freiburg did a vast study on Jātaka stories. Dr. Felix Adler a German American professor and the founder of the Ethical Culture movement studied the Jataka tales and stated that it contains deep truths. Professor Roderick Ninian Smart (the University of California, Santa Barbara) introduced the seven-part definition of religion and thoroughly researched on the Buddhist philosophy including Jātaka stories. Naomi Appleton - British Academy Postdoctoral Fellow in the Centre for the History of Religion in Asia, Cardiff University- Wales has done valuable surveys on Jātaka tales.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) and Jātaka Stories

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is published by the APA or the American Psychiatric Association and it provides broad symptomatology and standard criteria for the classification of mental disorders. It has been considered as the Bible of psychiatry.

With the DSM mental illnesses were transformed from broad, etiologically defined entities that were continuous with normality to symptom-based, categorical diseases (Mayes & Horwitz, 2005). The first version of DSM was published in 1952. The current version of the Diagnostic and Statistical Manual of Mental Disorders is known as DSM-IV-TR (Text Revision) and it was published in 2000. DSM-IV-TR recognizes the impact of culture on psychological health within a biopsychosocial framework. The diagnostic criteria now reflect a focus on behavioral symptomatology and suggest the importance of drug-management in therapy over psychotherapy (Shorter, 1997). The fifth edition of Diagnostic and Statistical Manual, the DSM-5 appeared officially in May 2013 during the development of the 166th Annual Meeting of the American Psychiatric Association (APA) in San Francisco (Márquez, 2014). The DSM triggered a paradigm shift in how society came to view mental health (Mayes & Horwitz, 2005).

The Buddhist Jathaka story book deeply touches the DSM (Diagnostic and Statistical Manual of Mental Disorders) based mental illnesses (Jayatunge, 2013) and these mental ailments could be identified in many Jātaka stories. The Buddhist Jathaka story book discusses deep psychological themes and analyses the human mind. The Jātaka stories were a form of teaching approach which used the case method. This method consists in presenting the disciples with a case and did descriptive, exploratory analysis of a person, his mental state, actions and consequences. The Buddha knew the power of storytelling. The Buddha used such stories to heal people with emotional and spiritual problems. These stories gave insight and created Aha moments. 

The Consultant Psychiatrist Dr D.V.J Harischandra FRCP (Psych) in his famous book Psychiatric Aspects of Jātaka Stories that was published in 1996, points out that the Western Psychologists and Psychiatrists should get acquainted with this ancient DSM which is called the Jātaka Story Book.

The Buddhist Psychiatric Nosology
The ancient classification of mental disorders, also known as the Buddhist psychiatric nosology indicated in Darimukha Jathakaya. The Darimukha Jathakaya classifies mental ailments in to eight sub divisions. Those are Kama Unmada (sexually deviant behaviors) , Krodha Unmadha ( anger related mood disorders), Darshana Unmada (mental ailments with visual hallucinations) Moha Unmadha (mental retardation), Yaksha Unmada (dissociation and possession disorders ) Pittha Unmada (Melancholia) and Viyasana Unmada (psycho-trauma).

Jātaka Stories and Positive Mental Health

The World Health Organization (WHO) defines mental health as “a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community. The WHO definition emphasizes that mental health is more than the absence of mental illness (Gilmour, 2014). However mental health has long been defined as the absence of psychopathologies, such as depression and anxiety (Westerhof & Keyes, 2010). 

According to the Public Health Agency of Canada (PHAC) mental health is the capacity of each and all of us to feel, think, and act in ways that enhance our ability to enjoy life and deal with the challenges we face. It is a positive sense of emotional and spiritual well-being that respects the importance of culture, equity, social justice, interconnections and personal dignity.

Provencher and Keyes (2011) define positive mental health as feeling well, functioning well, and being resilient in the face of life’s challenges — improves quality of life and is integral to overall health and well-being, even when there are on-going limitations caused by mental health problems and illnesses. According to Buddhism mental suffering is due in large part to imbalances of the mind (Gunaratana, 1985; Wallace & Shapiro, 2006). Numerous Jātaka stories indicate the mental imbalance caused by Akusal Chitta (or pathological mind). These pathological elements impact the mental wellbeing. 

Dr. Yukio Ishizuka, a Harvard trained Japanese psychiatrist hypothesized that there are three basic psychological needs or spheres that determined psychological health such as  the search for self, the need for intimacy, and the quest for achievement. As described by  Westerhof & Keyes, (2010) there are three core components of positive mental health: feelings of happiness and satisfaction with life (emotional well-being), positive individual functioning in terms of self-realization (psychological well-being), and positive societal functioning in terms of being of social value (social well-being) The Jātaka Stories highlight the importance of positive mental health by spiritual enhancement. These stories help to promote spiritual wellbeing. 

Having a sense of spiritual well-being is an important component of positive mental health. Spirituality is something holistic, beyond religious practices and beliefs, which includes broader values and principles that give meaning to life. Coyle (2002) describes spiritual well-being as a feeling connected to something larger than oneself and having a sense of purpose and meaning in life. The Jātaka stories encourage finding the purpose and meaning in life thus promoting positive mental health.

Search for self or know thy self is one of the dictums in Jātaka stories. Dr. Yukio Ishizuka as well as Eric Fromm strongly believed that “Know thyself” is one of the fundamental commands that aim at human strength and happiness. Fromm’s notion “Know thyself” was stated by the Buddha over 2600 years ago.

The story of Bhaddawaggiya Princes reveals the importance of knowing thyself. The Bhaddawaggiya Princes where looking for a woman who stole their valuable possessions. When they met the Buddha the princes asked “Venerable Sir, did you see a woman? The Buddha answered “What is more important whether look for a woman or to look for thy self? (i.e. know thyself). The princes replied that more important is to know thy self. 

The Buddhist tradition has focused for over 2,500 years on cultivating exceptional states of mental well-being as well as identifying and treating psychological problems (Wallace & Shapiro, 2006). The Jātaka stories encourage self-perceived positive mental health. Perceived mental health is a subjective measure of overall mental health status. Jātaka stories reveal how virtuous people attained positive well-being through the cultivation of optimum mental balance.
Buddhism promotes an ideal state of well-being that results from freeing the mind of its afflictive tendencies and obscurations and from realizing one’s fullest potential in terms of wisdom, compassion, and creativity (Wallace & Shapiro, 2006).

Mental Disorders and the Influence of Buddhist Jātaka Stories
In general terms a mental disorder is a psychological or behavioral pattern that is associated with subjective distress or disability that occurs in an individual and which are not a part of normal development or culture. The mental disorder is characterized by impairment of an individual’s normal cognitive, emotional, or behavioral functioning, and caused by social, psychological, biochemical, genetic, or other factors, such as infection or head trauma.

The DSM- IV defines Mental Disorders as thus.

A clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress (i.e., a painful symptom) or disability (i.e.,  an impairment in one or more important areas of functioning) or with a significantly increased  risk of suffering death, pain, disability, or an important loss of freedom. The syndrome or pattern must not be merely an expectable and culturally sanctioned response to a particular event. It must currently be considered a manifestation of a behavioral, psychological, or biological dysfunction in the individual. No definition adequately specifies precise boundaries for the concept of mental disorder. Also known as mental health, mental impairment, mental illness, brain illness, and serious brain disorder. 

A mental disorder is an undesirable (e.g. harmful) condition caused by a dysfunction in a mental Cummins-function (Brülde, 2003). Cultures differ in what is considered normal and what is considered abnormal (Hall, 2009). Psychiatry itself, like most of the rest of medicine, is a product of Western culture. As such, it embodies ideas of illness and wellness, of normal and abnormal, of well-functioning and malfunctioning, of adaption and maladaptation which have their roots in our own shared sentiments regarding the character of reality, of what is desirable, and of what ought to be desired (Leighton & Hughes, 2005).

In traditional societies human distress is more likely to be seen as an indicator of the need to address important life problems than as a mental disorder requiring treatment (Burton, 2012). As described by Dube (1979) Ayurveda, the ancient Indian system of medicine is described in Atharva Veda and in subsequent treatises by Charak, Susrut, and Vagbhatt, containing the details of etiology, symptoms, diagnosis, and therapy of afflictions in humans and animals.  The Buddhist literature also possesses the esoteric material of Medical Science, which is practiced and conserved in India since centuries. It refers to the fundamentals of medicine, rules of good living, which lay considerable emphasis on the hygiene of body, mind (Narayana & Lavekar, 2005).

In ancient India, two branches of knowledge are concerned with human suffering, trying to theoretically explain as well as to practically overcome its reasons: (practical) philosophy and medicine. Buddhism was regarded as a medical discipline (Butzenberger & Fedorova, 1989).

The Buddhist philosophy talks about the human mind and its pathological and non-pathological portions. Jātaka stories describe extensively conditions from mild neurosis to severe psychoses.

Stigma and discriminations are often associated with mental illness. Mental illness stigma is defined as the “devaluing, disgracing, and disfavoring by the general public of individuals with mental illnesses.(Abdullah & Brown,  2011) Stigma often leads to discrimination. Public stigma and discrimination have pernicious effects on the lives of people with serious mental illnesses (Corrigan et al., 2012).

The Buddhist Jātaka stories describe various types of mental disorders and how it affects the individual as well as the society. For centuries these stories helped the people to treat individuals affected by mental illnesses with utmost compassion. There is no evidence of persecution of psychiatric patients in the ancient Buddhist societies.

In the Medieval Europe, psychiatric patients were often targeted as the agents of Satan and subjected to torture and execution.  Mentally ill women were often burnt at the stake as witches. As indicated by Schoeneman (1982) the psychopathological interpretation of the European witch hunts of the 16th and 17th centuries, which has been prominent in histories of psychiatry, contends that demonology overwhelmed psychiatry in the late middle Ages, with the result that the mentally ill were executed by the thousands as witches. The witch hunts of sixteenth and seventeenth-century Europe impeded psychiatric progress for centuries (Schoeneman, 1977).

In his famous book Gendercide and Genocide by Prof Adam Jones of the international studies at the Center for Research and Teaching in Economics (CIDE) in Mexico City writes thus.

…….. for three centuries of early modern European history, diverse societies were consumed by a panic over alleged witches in their midst. Witch-hunts, especially in Central Europe, resulted in the trial, torture, and execution of tens of thousands of victims; about three-quarters of victims were women. Arguably, neither before nor since have adult European women been selectively targeted for such largescale atrocities. Modern estimates suggest perhaps 100,000 trials between 1450 and 1750, with something between 40,000 and 50,000 executions, of which 20 to 25 per cent were men. (Gendercide and Genocide – Adam Jones).

In 1247 London’s Bethlem asylum was found and the term “bedlam” became associated with chaos, confusion, and poor treatment, which reflected the general attitude toward mental illness. The mentally ill received harsh treatments. The 17th century English physician Thomas Willis declared that: “discipline, threats, fetters, and blows are needed as much as medical treatment for the mentally ill.

Institutions for the mentally ill were established beginning in the 14th century. Institutionalization is a deliberate process whereby a person entering the institution is reprogrammed to accept and conform to strict controls that enables the institution to manage a large number of people with a minimum of necessary staff. Until the end of 1960 s Institutionalization was considered as the viable option to treat psychiatric patients. In these institutions psychiatric patients were often subjected to humiliations and maltreatment. Prolonged years of Institutionalization diminished the social and life skills of the patients. This condition was identified as Institutionalization Syndrome which had the features of loss of independence, loss of self-confidence, erosion of desire and skills for social interaction, excessive reliance on institutions and fear of authority.

The humane way of treating mental patients started in Europe mainly with the reformations introduced by Dr Philippe Pinel (1745- 1826) and he initiated moral treatment for the psychiatric patients.  In 1793 he was appointed the director of the Bicêtre Insane Asylum and took numerous revolutionary decisions. He unchained the mental patients and stopped ill treatments.   Dr.  Pinel treated the patient as well as his surrounding environment. His innovations in treating mentally ill patients are still used by the modern psychiatry.

Conversely many centuries before Philippe Pinel the Buddhist societies in Asia treated psychiatric patients with empathy. The King Buddhadasa of Sri Lanka (398 AD) treated psychiatric patients with compassion.  The King Buddhadasa used herbals, empathetic words and healthy community atmosphere to treat the mentally ill.  
It is important to note that in the ancient Buddhist societies the mentally ill were never mistreated or excommunicated.  The Jātaka stories may have had a weighty effect on de-stigmatizing metal disorders.  For centuries, these stories helped people to view individuals with mental illnesses with a compassionate eye.

Psychoanalysis and Jātaka Stories
Psychoanalysis was introduced by Sigmund Freud in which free association, dream interpretation, and analysis of resistance and transference are used to explore repressed or unconscious impulses, anxieties, and internal conflicts. To Freud, psychoanalysis was clearly a social theory as well as a psychological theory (Stea, ‎2012)
 Some experts view that the Freudian Psychoanalysis as a subject which is incomplete. According to Wax (1983) the scientific status of psychoanalysis has been the subject of continual debate. Influential philosophers of science have challenged the form of its theories and the nature of the evidence offered on their behalf. Some have concluded that the theories are beyond testing. Bogousslavsky and  Dieguez (2014) state that Freud did not follow a scientific process of verified experiments, but rather adapted his theories to the evolution of his own beliefs on psychological conditions, selectively emphasizing the aspects of his 'therapies' with patients which supported his emerging ideas, with often abrupt changes in theoretical interpretations.

The renowned Sri Lankan Literary genius Martin Wicramasinghe D.Lit. argues that the Psychoanalysis was initiated not by Freud but by the Jātaka Storyteller. Martin Wicramasinghe gives solid examples to qualify his opinion. Wicramasinghe intensely wrote on Buddhist Jātaka stories. In his books The Buddhist Jataka Stories and the Russian Novel (published in 1952) and Jataka Katha Vimasuma (The Literary Aspects of Buddhist Jātaka Stories) published in 1968 Martin Wicramasinghe explained the mind analysis that shown in the Jātaka stories. The Jātaka storyteller revealed and analyzed the noble to ignoble characteristics of the human psyche. The Jātaka storyteller knew the complexity of the human mind. He described the human behavior in vivid situations. He knew the internal mental conflicts, repressions and hysteria type of behavior that people exhibited. A vast amount of abnormal behaviors were recorded in form of stories by the Jātaka storyteller. The Jātaka stories represent a broad structure of mental phenomena.

The Late Professor K. N. Jayatilleke stated that Buddhist psychology does not share with Freud his psychic determinism and his consequent pessimism about the possibility of transforming human nature, but the Buddhist’ theory of motivation outlined above shows a marked similarity with that of Freud’s.

The similarity, as we may observe, even extends to the classification of desires and the use of terminology.. In a later phase of Freud’s thought there was a division of drives into eros (lust) or the life instinct and thanatos or the death instinct. At this stage eros comprehended both libido, the sex instinct, as well as the egoistic instincts. In Buddhism we find rāga (eros) subdivided into sex (kāma-rāga) and ego-instincts (bhava-rāga). Vibhavataṇhā is the desire for destruction or annihilation since vibhava and vināsa are synonyms, in the Pali texts (cp. ... ucchedavādā sattassa ucchedaṃ vināsaṃ vibhavaṃ paññapenti, i.e. annihilationists posit the annihilation, destruction and extermination of a being). This is what Freud calls the death instinct, sometimes (mistakenly) referring to it as the Nirvana principle. In view of the close similarity of concepts the question as to whether Freud was influenced by Buddhism should be carefully examined especially since Freud had made a thorough study of Schopenhauer, who claimed to be a Buddhist deeply influenced by Buddhist and Upaniṣadic literature (Jayatilleke, 1978).

According to Dr. D V J Harischandra (1996) in Ummagga Jatakaya and Mahasupina Jatakaya there exist almost all the unconscious mechanisms that Freud described over six centuries later – including symbolisation, condensation, displacement and secondary elaboration.

Buddhist psychology espouses several competing topological theories of mind all of which include some form of an unconscious. The Abhidharmic model conceptualizes the unconscious as bhavanga-citta, a ground consciousness that is conditioned by karma and acts as a conditioning factor for current life habitual tendencies. Later revisions of that model view the unconscious as ālaya-vijñāna, a store consciousness containing the individual’s karmic seeds of suffering. Like Freud’s unconscious, bhavanga-citta and ālaya-vijñāna are thought to motivate the mind to produce destructive habitual mind states (Waldron, 2003).

Nichol (2006) sees some parallels between the Buddhistic Psychoanalysis and Freudian Psychoanalysis. He further states that around 600 BC Siddhartha Gotama practiced intensive meditation for several years and found a way for people to cultivate a sense of equanimity, wisdom, and compassion in their lives. Around 1900 AD Sigmund Freud undertook several years of intensive self-analysis and developed theories and therapeutic techniques for understanding how the unconscious operates in our lives to perpetuate neurotic suffering, and how we might gain insight and relief from that suffering and be more free to move toward our potential in this life.

Mid-twentieth century saw the collaborations between many psychoanalysts and Buddhist scholars as a meeting between “two of the most powerful forces” operating in the Western mind (Tapas Kumar Aich, 2013). Schopenhauer is a link between Freud and Buddhism. The Buddhist axiom: "sabbe sattd ummattakd" (all worldlings are deranged) shows that both systems looked upon the neurosis of mankind as a problem with which to deal, but Freud saw the solution as a rational insight into one's own condition; whereas Buddha was concerned with a man's emotions and whole being. Both systems had a dynamic quality and not a static one; however, in de Silva's view Buddhism goes further than does Freud. Freud claims that man must live with the best adaptation to the human condition that one can have and Buddhism's araliat professes to transcend this condition entirely (de Silva, 1978)

The Psychoanalysts such as Erich Fromm and Karen Horney studied the Psychoanalytic component in the Buddhist philosophy. According to Erich Fromm psychoanalysis is not a therapy of commitment but rather an approach that liberates people from the type of commitment required by traditional religion and other social institutions. Fromm once stated: “Psychoanalysis is a characteristic expression of the Western man's spiritual crisis, and an attempt to find a solution. The common suffering is the alienation from oneself, from one's fellow men, and from nature; the awareness that life runs out of one's hand like sand, and that one will die without having lived; that one lives in the midst of plenty and yet is joyless”  (Fromm , Suzuki & Martino, 1960).
The Buddha helped to liberate people from emotional bondages and oppressed social conditions two millennia ago. Unlike the Freudian psychoanalysis the Buddhist psychoanalysis has a profound spiritual dimension and it extensively focuses on the deeper existential questions. Buddhist psychoanalysis brings unconscious and consciousness to a dialectical relation.

According to Mark Epstein- psychiatrist and the author, Both the Buddha and Freud came to appreciate that the source of self-generated misery is an exaggerated sense of self’s absolute reality. Nonetheless Freud believed that the inner layers of the human personality consist of irrational and savagery wishes. In contrast the Buddha believed in the positive aspects of the human personality and its capabilities. The Buddha preached that the human have the capacity for self growth and achieve higher spiritual level (Jayatunge, 2014).

Hysteria Types of Reactions Described in the Jātaka Stories
The history of hysteria stretches over several millennia and contains a plethora of different understandings and interpretations.(Møllerhøj , 2009). Hippocrates (5th century BC) is the first to use the term hysteria. He believed that the cause of this disease lies in the movement of the uterus (Sigerist, 1951).

Paul Briquet's Traité de l'Hystérie was published in 1859 and is a comprehensive clinical and epidemiological study of 430 patients with hysteria (Mai & Merskey, 1981). Up till 1870 hysteria had been regarded as a gynaecological illness that affected almost exclusively women; as a result of Charcot's work the illness was transformed into a neurological disorder. However, shortly before his death Charcot had to acknowledge that he had been mistaken and that hysteria was in fact a psychiatric disorder (Gilson, 2010).

The Webster’s dictionary defines Hysteria as a psychiatric condition variously characterized by emotional excitability, excessive anxiety, sensory and motor disturbances, or the unconscious simulation of organic disorders. Jean Martin Charcot, Pierre Janet, Freud, and Joseph Breuer comprehensively wrote on hysteria.

 Sigmund Freud provided a contribution that leads to the psychological theory of hysteria and the assertion of a male hysteria (Tasca, 2012). Sigmund Freud saw a traumatic experience in childhood that is uniformly of a sexual nature as general aetiology of hysteria. Freud’s famous case study of Anna O (Bertha Pappenheim) suffered from a rigid paralysis, accompanied by loss of sensation, of both extremities on the right side of her body over two years. Anna O was the classic study of Hysteria.

Hysteria' (conversion disorder) remains in modern humanity and across cultures, as it has for millennia (LaFrance, 2014). Hysteria was largely considered to be a neurological problem in the 19th century, but without a neuropathological explanation it was commonly assimilated with malingering (Kanaan et al., 2009).

The DSM- IV -TR distinguishes hysteria under Somatoform Disorders and the Dissociative Disorders. Somatoform disorders are psychological ailments that cause bodily symptoms, including pain and numbness. The symptoms can't be traced back to any physical cause. And they are not the result of substance abuse or another mental illness. Dissociative disorders (DD) are conditions that involve disruptions or breakdowns of memory, awareness, identity or perception. There are numerous Somatoform and Dissociative Disorders are discussed in the Jātaka stories.

The Vibhanga Atuwawa – a Buddhist scripture part of the Pali Canon of Theravada Buddhism describes vibrant neurotic features that are perceptible in laymen. The Abhidhamma model implies that neuroses, psychoses and an armored personality are natural phenomena, but also that there is a systematic training to go beyond these modes of living (Barendregt , 2006). 

The Jātaka stories give numerous case examples of neurotic behavior in people. The story of Prince Asanaga is one of the special case studies of phobias. The Prince Asanaga – a character that is described in Chula Phalobhana Jātaka Story suffers from Gynophobia or an abnormal, irrational and persistent fear of women. He fears and avoids women from childhood. From birth to the adulthood, he was in the company of males and never had a chance to associate women. Accidentally he got acquainted with a woman and experiences an erotic relationship with her. His suppressed sexual desires emerge like a volcano and the Prince Asanaga goes in to an acute stress reaction. He becomes violent and attacks the men on the street with his sword. The Jathaka storyteller colorfully describes the inner mental conflict of the Prince Asanaga and his fears, anxiety, sudden desire and the acute emotional reaction.

Psychogenic diseases
Psychogenic disease is a broader category than psychosomatic disease, in that it can include the hysterical form, where there is no physiologic change in peripheral tissues, as well as the psychosomatic form, where there is some physiologic alteration (Sarno, 2006). The Jātaka Storyteller narrates numerous stories of psycho- physiological manifestations (psychogenic skin rashes, psychogenic sexual dysfunctions, and psychogenic paralyses) found in men and women. According to these Jātaka stories the Akusal or the guilty based mind is responsible for such manifestations.  In one of the stories a guilty ridden Count experiences sexual impotence and subsequently a sex change.

Psychogenic Nonepileptic Seizures
Psychogenic nonepileptic seizures have long been known by many names. A short list includes hysteroepilepsy, hysterical seizures, pseudoseizures, nonepileptic events, nonepileptic spells, nonepileptic seizures, and psychogenic nonepileptic attacks (Gedzelman & LaRoche, 2014). Psychogenic nonepileptic seizures are episodes of movement, sensation, or behaviors that are similar to epileptic seizures but do not have a neurologic origin; rather, they are somatic manifestations of psychologic distress (Alsaadi & Marquez, 2005). These seizures are triggered by psychological problems. 

In Illisa Jātakaya the miserly count Illisa goes in to a psychogenic fits when he found his wealth had been distributed among the poor people. He lost his consciousness and then his body shakes violently. After a while he gains consciousness and then demands his property. According to the storyline after he gained consciousness there was no postictal period described in count Illisa. He was not under sedated state and he walks up and actively cries for his possessions.

Psychogenic Itch
Itch (or pruritus) is defined as an unpleasant sensation inducing the desire of scratch. Psychogenic itch is related to psychologic abnormalities e.g., itch in obsessive compulsive disorders, depression, and delusions of parasitosis (Yosipovitch & Samuel, 2008).  As indicated by Gupta & Gupta (1996) it has been estimated that in at least one third of dermatology patients, effective management of the skin disorder involves consideration of associated emotional factors.
The Ghata Jātakaya is one of the best case studies of Psychogenic Itch. In Ghata Jātaka (also called Ghatakumara). The king Ghata was a righteous monarch who ruled his kingdom according to humane laws. Once he found his chief minister committed adultery with a noblewoman of his royal harem. Instead of condemning him to death the King Ghata expelled him from the position that he held.

The expelled minister went to the neighboring kingdom and met the monarch Vanka who was greedy for power and who had a desire to extend the borders of his kingdom. The ex minister persuaded king Vanka to attack his native land.  The king Vanka invaded king Ghata’s kingdom.

Being a virtuous person the king Ghata did not want to see any bloodshed or to send his men to a slaughtering noxious battle. He renounced the throne. Hence the king Vanka became the new ruler and sent king Ghata to the prison. At the prison the king Ghata practiced the meditation of loving-kindness. He had no anger or ill feelings towards the king Vanka who seized his kingdom. Knowing the extraordinary and compassionate qualities of the king Ghata and his innocence Vanka had severe guilty feelings. Within a several days he had a skin rash and an excruciating itch which made him extremely uncomfortable.  The royal physicians gave him profuse medicine, but his condition became worst. Finally the king Vanka freed king Ghata from the prison and restored his kingdom. After these reconciliations the king Vanka had a spontaneous recovery. 

Psychotic Disorders

Psychosis is a condition characterized by loss of contact with reality and may involve severe disturbances in perception, cognition, behavior, and feeling. Positive symptoms of psychosis include delusions, hallucinations and/or thought disorder (MHECCU).  Hallucinations are perceptions without stimuli.  Delusions are fixed, idiosyncratic, or false perceptions or beliefs with little if any basis in reality and are not the result of religious or cultural norms.

Disordered thinking is a symptom found in many mental disorders, including schizophrenia, mania, depression, obsessive–compulsive disorder, and others (Waring et al., 2003).

The term psychotic has historically received a number of different definitions, none of which has achieved universal acceptance. Schizophrenia is a chronic psychotic disorder characterized by disturbed behavior, thinking, emotions, and perceptions. To the best of present knowledge schizophrenia is a disorder with variable phenotypic expression and poorly understood, complex etiology, involving a major genetic contribution, as well as environmental factors interacting with the genetic susceptibility (Jablensky, 2010).

The term ‘schizophrenia’ was coined in 1910 by the Swiss psychiatrist Paul Eugen Bleuler, and is derived from the Greek words ‘schizo’ (split) and ‘phren’ (mind). The disease concept of schizophrenia is of a relatively recent origin, as compared with disorders such as melancholia, mania, or generic “insanity,” all known since antiquity (Jablensky, 2010). Schizophrenia is a classic psychiatric diagnosis. The defining features have remained unchanged for more than 100 years (Heckers, 2011).

The Jātaka Stores describe several individuals with a variety of psychotic manifestations. The Labha- Garu Jatahakya is one of the examples that describe a person with insane behavior. For insanity the Jathaka storyteller uses the term “Umathu” Umathu illustrates abnormal behavior, divergence from reality, erroneous thinking and decision making. The Jātaka Stores illustrate confirmatory examples of psychotic behavior.

An ancient textbook of Ayurvedic medicine, Therapeutics and Surgical Practice by Charaka and Susrutha, has a vivid description of schizophrenia (Thara et al, 2004). According to Nizamie and Goyal (2010) descriptions of conditions similar to schizophrenia and bipolar disorder appear in the Vedic texts. A vivid description of schizophrenia is also found in Atharva-Veda.  Ancient Ayurvedic’s physicians described schizophrenia as a disorder of the mind caused by the doshas (vata, kapha, and vata) moving in the wrong paths due to increased toxicity (Vega, 2013).

According to the historical records the King Buddhadasa (398 AD) of ancient Sri Lanka successfully treated an insane man who insulted him publicly. As the ancient texts describe this individual showed grandiose ideas, verbal aggression and socially inappropriate behavior with marked arrogance. This story further elucidate that instead of punishing the individual the King approached him humanly. He used empathy, talk therapy and positive reinforcements to treat this individual.

The "Daha Ata Sanniya" is an ancient healing dance ritual held to exorcise 18 types of diseases from the human body. The Exorcists wear masks depicting the demons thought to be responsible for a person's ailments (Bailey & de Silva, 2006). There are several dances depicting mental illnesses. For non spirit related insanity such as psychotic conditions the ancient healers used Abutha Sanniya and for spirit related insanity (in Possession states) used Butha Sanniya. In temporary insanity (in Acute Transient Psychotic Disorders) Pissu Sanniya was used. For sleep disorders Naga Sanniya was recommended.

These traditional healing methods concur that the ancient Budhistic societies were aware of various types of mental illnesses and its psychosocial impact. The Jātaka Stores gave the public a great awareness of such mental ailments and to view the suffers with empathy.

Depressive Disorder

Depression is a mood disorder associated with specific symptoms such as depressed mood, decreased interest or pleasure in most activities, most of each day , significant weight change, change in sleep, fatigue or loss of energy, feelings of worthlessness or excessive or inappropriate guilt, diminished ability to think or concentrate, or more indecisiveness and thoughts of death or suicide. According to Assaka Jātakaya a King goes in to depression after his Queen’s death. The Jātaka Storyteller vividly describes the King’s depressive reaction that is equivalent to the DSM description.

Following the queen’s death the king experiences utter misery. His despair is not ending. He is not interested in ruling the country. In Panditha Jātakaya King Vasudeva becomes depressed following the death of his son.

Pathological Grief

Grief is an intense sorrow caused by loss of a loved one (especially by death) something that causes great unhappiness and it has multi-faceted responses. Grief is an overwhelming emotion. Individual experiences of grief vary and are influenced by the nature of the loss. Sometimes grief reactions are prolonged and the affected person is unable to come to terms with the loss. Pathological grief deserves a place in the diagnostic nomenclature (Horowitz 1993).

The field of grief counseling has yet to see an integration of Buddhist psychology (Wada & Park, 2009). The Sujatha Jātaka story explains a pathological grief reaction experienced by a person following the death of his father. His emotional pain does not heal with time and lasted for a long period. Most of the day his mind was preoccupied with the memories of his dead father and he used to weep relentlessly.  He was emotionally overwhelmed and prolonged grief impacted his social and private life. According to the story the sufferer’s pathological grief reaction was healed by using an existential mode of intervention by his young son. 

Disruptive Mood Dysregulation Disorder (DMDD)

Disruptive mood dysregulation disorder (DMDD) is a new disorder for DSM-5 that is uncommon and frequently co-occurs with other psychiatric disorders (Copeland et al., 2014). DMDD is a newcomer to psychiatric nosology, addresses the need for improved classification and treatment of children exhibiting chronic nonepisodic irritability and severe temper outbursts (Roy, Lopes & Klein, 2014). The children with DMDD show severe recurrent temper outbursts manifested verbally and behaviorally that are grossly out of proportion in intensity or duration to the situation or provocation. The temper outbursts are inconsistent with developmental level.

The Virochana Jātakaya of the Jātaka storybook gives details of a Prince who had positive features of DMDD. The Prince has aggressive impulsive behavior, temper tantrums, temper outbursts, property destruction, rule violation etc. The King sends the young Prince to a hermit who has knowledge and wisdom. The hermit uses a form of behavior modification therapy to treat the child. After series of interventions the hermit gives an insight to the child by using a Kohomba plant (Azadirachta indica) which bears leaves with a bitter taste. The hermit says that the children with aggressive behavior often harms others are like these leaves and no one likes them. The child gains insight and refrains from aggressive behavior.

Intermittent Explosive Disorder (IED)

The term “intermittent explosive disorder” did not appear in DSM until publication of the third edition in 1980 (Coccaro, 2012). According to McElroy (1999) Intermittent explosive disorder (IED) is a behavioral disorder characterized by explosive outbursts of anger, often to the point of rage, that are disproportionate to the situation at hand (i.e., impulsive screaming triggered by relatively inconsequential events). Impulsive aggression is unpremeditated, and is defined by a disproportionate reaction to any provocation, real or perceived. Some individuals have reported affective changes prior to an outburst (e.g., tension, mood changes, energy changes, etc.) Intermittent Explosive Disorder is a relatively common disorder of impulsive aggression that typically emerges by adulthood (Fanning et al., 2014).

Intermittent Explosive Disorder falls in the category of Impulse-Control Disorders. The condition is characterized by failure to resist aggressive impulses, resulting in serious assaults or property destruction.

Recent studies have shown IED to be a common and under-diagnosed disorder existing in over 6% of the population (Coccaro, Posternak, & Zimmerman, 2005; Kessler et al., 2006; McCloskeyet al., 2008). IED is associated with a high degree of social impairment (Blankenship, 2008).

Coccaro (2012) indicates that human aggression constitutes a multidetermined act that results in physical or verbal injury to self, others, or objects. It appears in several forms and may be defensive, premeditated (e.g., predatory), or impulsive (nonpremeditated) in nature.

The Chethiya Daddara Jātakaya reveals a monk with an Intermittent Explosive Disorder and this monk is easily provoked and goes into violent impulsive tantrums. He is abusing other monks verbally and physically. His destructive anger causes huge problems to the fellow monks. Later this monk was reformed by the Buddha.

Mental Retardation (Intellectual Disability)
According to Luckasson et al (1992) Mental retardation refers to substantial limitations in present functioning. It is characterized by significantly subaverage intellectual functioning, existing concurrently with related limitations in two or more of the following applicable adaptive skill areas: communication, self-care, home living, social skills, community use, self-direction health and safety, functional academics, leisure, and work. Mental retardation manifests before age 18.
The Ummaga Jātakaya narrates of a Count named Gorimannda who suffers from a Mental Retardation. According to the description the Count Gorimannda has lack of social or emotional reciprocity, poor motor coordination, Sialorrhea (drooling or excessive salivation) and abnormal speech. In addition Achari Jātakaya and Nangulisa Jātakaya present individuals with Mental Retardation.  The individuals in these Jātaka stories have cognitive delays, intellectual abilities and poor social adaptation.  

Autism Spectrum Disorder (ASD)
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that is clinically defined by abnormalities in reciprocal social and communicative behaviors and an inflexible adherence to routinised patterns of thought and behavior. Laboratory studies repeatedly demonstrate that autistic individuals experience difficulties in recognizing and understanding the emotional expressions of others and naturalistic observations show that they use such expressions infrequently and inappropriately to regulate social exchanges (Gaigg, 2012).

The Jātaka story book discloses extraordinary narrative of a Prince who displays Autism related symptoms to deceive the King and the Royal healers. The little Prince Themiya becomes disgusted with the way his father rules the country tormenting his subjects. He does not want to be a part of the kingdom. Therefore the little Prince Themiya exhibits autistic behavior pattern disregarding his surroundings. He shows no eye contact, does not respond to social interactions and does not acknowledge to others. By demonstrating these autistic features the little Prince Themiya intends to run away from the kingdom.

The King makes numerous efforts to heal the prince. But his condition remains the same. Eventually the King orders to kill the Prince who has no value to the kingdom. When the executioner takes the Prince to the forest to kill him, unexpectedly the Prince Themiya talks to the executioner. The Prince states that it was an act and he needed to escape from the palace. The executioner releases the Prince and he goes to Himalayan forest and becomes a hermit.
Also in Padangali Jātakaya the Prince Padanjali shows a number of Autistic traits with poor social skills, difficulty understanding linguistic terms, and lack of sensitivity to outer environment. These clinical features suggest that the Prince Padanjali was an autistic child.

Conduct Disorder

Children with conduct disorder repeatedly violate the personal or property rights of others and age-appropriate social standards and rules. Associated features of conduct disorder include an inability to appreciate the importance of others’ welfare and little guilt or remorse about harming others. Children with Conduct Disorder often view the world as a hostile and threatening place and they have difficulty maintaining friendships. They often have low self-esteem and low frustration tolerance. Peers and family members become negative and irritated with their misbehaviour, which leads to a vicious cycle.

Thila Mutti Jātakaya of the Jātaka storybook gives details of a Prince who had positive features of a Conduct Disorder. He violates social rules and shows temper outbursts and aggressive behavior. When his mentor punishes him for his socially unacceptable behavior (for stealing) the Prince becomes extremely angry and determined to take revenge from the teacher.

After he becomes the king he invites his former tutor to visit him. But he has different intentions. He wants to arrest the tutor and then torture him for the punishment that he gave long time ago. Knowing the former students intentions the teacher deliberately takes time to visit him. When the king is emotionally matured he visits the king. By seeing his mentor the king recalls his punishment and humiliation. The king orders to arrest his teacher. But the wise teacher explains the king why he punished him. He states that he did punish the prince not with a bad intention but to reform him. Hence he could be the king and rule the kingdom. After listening to his teacher’s explanation the king gives up the idea of punishing his teacher. Instead of punishing the king rewards him.

Separation Anxiety Disorder

 Separation Anxiety Disorder is characterized by an abnormal reactivity to real or imagined separation from attachment figures that significantly interferes with daily activities and developmental tasks. To meet DSM-IV-R diagnostic criteria, the anxiety must be beyond what is expected for the child's developmental level, last longer than four weeks, begin before age 18 and cause significant distress or impairment (American Psychiatric Association, 2000). The fear of separation is associated with leaving the safety of parents and home may escalate into tantrums or panic attacks and cause significant interference with academic, social, or emotional development (Hanna, 2006).

Mahajana Jātaka story describes separation anxiety in a child following Paternal Derivation.   According to the Mahajana Jātaka story the child manifests numerous emotional and behavioural problems. The child becomes anxious and it affects his functionality. He becomes withdrawn and relentlessly asking about his father. He is forcing his mother to take him to his father. Finally his mother makes arrangements to meet the child with his father and hence the anxiety comes to an end.

Learning disabilities Described in Jātaka Stories

Learning disability is an umbrella term covering many different intellectual disabilities. It   is not a single disorder, but is a general category of disabilities in any of seven specific areas :(1) receptive language (listening), (2) expressive language (speaking),(3) basic reading skills, (4) reading comprehension, (5) written expression, (6) mathematics calculation, and (7) mathematical reasoning. These separate types of learning disabilities frequently co-occur with one another and also with certain social skill deficits and emotional or behavioral disorders such as attention deficit disorder (Lyon, 1996)

Samanera Chula Panthaka (of the ChullaSetti Jātakaya) was significantly affected by learning disabilities. He could not memorize even a line of a stanza although he made laborious efforts. He was ridiculed by his elder brother Samanera Maha Panthaka for his learning difficulties. Samanera Chula Panthaka became overwhelmed and decided to give-up his monkhood. Finally the Buddha intervened and helped him to overcome his difficulty. The Buddha used mind evoking but a simple technique that gave him insight. Following this intervention Samanera Chula Panthaka not only overcame his learning difficulty but attained Nibbana.

Child Abuse

Some of the Jātaka tales reveal the true nature of child abuse. For instance Vessanthara Jātakaya divulges a Brahmin named Juthaka who was highly cruel to children. Vessanthara Jātakaya narrates how Juthaka Brahmin physically and emotionally abused two children- Jaliya and Krishnajina. They were beaten and dragged to his house to serve as domestic servants. However Juthaka Brahmin attempt was failed and the grandparents of the children rescued them.

Child abuse is the physical, sexual or emotional maltreatment or neglect of a child or children. Child abuse and neglect consists of any acts of commission or omission by a parent or other caregiver that results in harm, potential for harm, or the threat of harm to a child even if the harm is unintentional (Gilbert et al., 2009). There are five main types of child maltreatment: physical abuse, sexual abuse, emotional maltreatment, neglect, and witnessing domestic violence.
Physical abuse results in actual or potential physical harm from an interaction or lack of an interaction, which is reasonably within the control of a parent or person in a position of responsibility, power or trust. There may be single or repeated incidents” (Krug et al., 2002).

Infanticide or infant homicide has been narrated in the Jātaka stories. In Chulla Dharmapala Jātakaya the King Maha Prathapa orders the executioner to decapitate his infant son.

Jeevaka was the son of a sex worker –Salavati. When he was born his mother ordered a servant to kill him. The infant was thrown into garbage. Somehow he survived and later rescued by a prince. The prince adopted him. Jeevaka became a legendry physician.  He even treated Gautama Buddha.

Little Sopaka was physically and emotionally abused by his stepfather. Once his stepfather took him to a cemetery and tied Sopaka to a dead body. The child was crying in extreme fear and the Buddha rescued him.

Child abuse and neglect can have a multitude of long-term effects on physical health. There are immediate and long-term effects of child abuse. The immediate emotional effects of abuse and neglect are isolation, fear, and an inability to trust.  The long term psychological consequences include low self-esteem, depression, and relationship difficulties.

Neglect is frequently defined as the failure of a parent or other person with responsibility for the child to provide needed food, clothing, shelter, medical care, or supervision to the degree that the child’s health, safety, and well-being are threatened with harm. 

In Mattakundali Jātakaya a stingy father neglects the health requirements of his own son. When his son was ill he does not provide medical treatment fearing it would cost him money. As a result of the neglect the child dies.

Obsessive–Compulsive Disorder (OCD)

Obsessive–compulsive disorder (OCD) is an anxiety disorder. Obsessions are recurrent and persistent thoughts, impulses, or images that are experienced as intrusive and that cause anxiety and/or distress to the patient, who tries to ignore them or neutralize them with some other thought or action.  Compulsions are repetitive behaviors or mental acts aimed at preventing or reducing distress and/or anxiety caused by obsessions or by discomforting sensations (APA).

Ritualistic behaviors are common to the human experience. These behaviors allow individuals in the same group to establish complex communication with each other, which facilitates and standardizes their relationships (Mercadante et al., 2004). Many patients with obsessive-compulsive disorder have covert, or internal, compulsions (de Silva et al., 2003).

According to Harischandra (1998) several cases of compulsive urges and obsessive ideas are described in the Jātaka stories. Kudhala Jātakaya is a story about an individual who had an obsessive fixation to an inanimate object (a mammoty). Although he became a monk renouncing everything when he was deprived of fixated inanimate object he could not control the compulsive urge. Then he disrobed himself and went seeking the mammoty. After sometime he again wanted to become a monk leaving the fixated inanimate object. Again the obsessive fixation and anxiety caused him to give-up his monkhood. When it occurred for the third time he decided to fight back vigorously. Then he threw the mammoty to a river and yelled; I am free at last. He was free from the obsessive fixation (the original fixation became a transference fixation?). His apprehension and anxiety was ceased. He was able to concentrate on meditation. He achieved spiritual success.

Body Dysmorphic Disorder

Body Dysmorphic Disorder is considered as a body-image disorder. Body Dysmorphic Disorder (BDD), a distressing or impairing preoccupation with an imagined or slight defect in appearance, has been described for more than a century and increasingly studied over the past several decades (Phillips, 2010). In DSM-IV, BDD is classified as a separate disorder in the somatoform section (APA). Individuals with BDD have intense preoccupation with an imagined defect in appearance and if a slight physical anomaly is present, the person's concern is markedly excessive. This preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.  BDD is associated with substantial impairment in psychosocial functioning and markedly poor quality of life (Bjornsson, 2010). 
In Kusa Jātakaya the King Kusa is overly anxious about the size of his nose.  He got married to a beautiful queen named Pabhavati. Fearing his appearance King Kusa visited his wife only in the dark nights. After the marriage for a long period Pabhavati never saw her husband’s face. She felt her body in the darkness.Pabhavati was curious of her husband’s strange behavior. Although she pleaded him to visit during day time to see his face he never came to meet her at day time.His preoccupation with his facial image causes him immense distress and impairment in social functioning as a king and as a husband.

Adjustment Disorder
The ICD-1 and DSM-IV define adjustment disorders as transient states of distress and emotional disturbance, which arise in the course of adapting to a significant life change, stressful life event, serious physical illness, or possibility of serious illness. The symptoms can include depressed mood, anxiety, worry, a feeling of inability to cope, plan ahead, or continue in the present situation, and a degree of difficulty in day-to-day living. The individual may feel liable to dramatic behaviour or outbursts of violence.  Adjustment Disorder is a condition strongly tied to acute and chronic stress (Carta, te al., 2009).  .
A hermit in the Muva Pothaka Jātakaya was closely attached to his pet deer.  His pet had become his beloved friend. They were inseparable. After some years the deer dies and the pet loss causes severe adjustment disorder in the hermit.
Kesava Jataka is about a psycho physiological reaction following separation and this reaction is much similar to the adjustment disorder that has been illustrated in the DSM.  According to the story the ascetic Kesava lived in Himalaya forest with five hundred pupils. A Brahmin student of Kasi was his senior pupil. Once Kesava went to Benares and the King invited him to live in the royal park as his guest. He was given all the comforts by the King. Although he had all the facilities at the royal park Kesava became nostalgic. He missed the Himalaya forest and his students. Kesava fell ill of loneliness, and the five physicians of the king could not cure him.  Kesava looked depressed and he neglected his mediations and self care. His appetite was changed and he ate very little. He could not sleep at nights. At his own request he was taken to the Himalaya forest by the king’s minister. When he went to his familiar surrounding and met his students Kesava had a spontaneous recovery.  Again Kesava started his teaching practice.

Posttraumatic Stress Disorder

PTSD is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. People with PTSD have persistent frightening thoughts and memories of their ordeal and feel emotionally numb. They may experience sleep problems, feel detached or numb, or be easily startled.

The Jātaka storyteller elegantly portrays the clinical picture of a monk (in Dummbala Katta Jathakaya) who had fear feelings, flashbacks, hyperaousal, avoidance and startling reactions. The monk who was described in this Jātaka story   fits in to the DSM criteria of PTSD.

The said monk had fear feelings, being panicked for a slightest sound (the ancient text describes that the monk was terrified even hearing a sound such as a drop of a leaf from a tree - which is modern day viewed as hyper-arousal), fearing the places where he received terrible experiences and reluctant to visit them (avoidance), troubled by the fearful mental images (flashbacks?), morbid fear, unable to meditate (lack of concentration), sweating and heart pounding (activation of the sympathetic nervous system), lack of happiness (depressive feelings), mental worry etc.  The clinical picture, which is given in the Maranabheruka Jātaka much similar to the present day DSM description of PTSD. The word Maranabheruka roughly translates into English as fear of death (Jayatunge, 2014).

Survivor Guilt

Guilt is a common response following loss and/or traumatic experiences with significant victimization (Nader, 2001). Guilt is usually defined as an affective state that occurs when an  individual believes that he or she has violated a moral standard either by  having done something that one believes one should not have done, or  conversely, by not having done something one believes one should have  done, and that one is responsible for that violation (Strickland, 2001).

Vedhammba Jātakaya could be viewed as a story that recounts survival guilt. According to the Vedhammba Jātakaya once a Brahamin travels with his student in a thick jungle, unexpectedly they encounter a gang of thieves who were desperate for money. They demand money from the Brahamin and the student. Neither of them had the money to pay for the bandits. Then the bandits kidnap them. The student pleaded the thieves not to harm his mentor and he agreed to bring money. Then the thieves keep the Brahamin and release the student. When the student went in search of money for the ransom the Brahamin was impatient and he tells the bandits that he has a Veda mantra that can convert rain water in to gold coins. The Brahamin’s inappropriate statement leads to a tragedy and the greedy thieves kill him. When the student returns with the ransom he sees the dead body of his mentorHe mourns and finally buries the dead body. He feels guilty for leaving the mentor which caused a catastrophic end.

Sleep Terror Disorder

According to the DSM IV -TR Sleep Terror Disorder ( pavor nocturnus ) is characterized as having recurrent episodes of abrupt awakening from sleep, usually occurring during the first third of the major sleep episode and beginning with a panicky scream , intense fear and signs of autonomic arousal, relative unresponsiveness to efforts of others to comfort the person during the episode ,  no detailed dream is recalled and there is amnesia for the episode and  the episodes cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The DSM highlights that the disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Maha Supina Jātakaya gives an unambiguous case study of Sleep terror disorder. This Jātak story is also known as the sixteen dreams of King Pasenadi Kosol.

This was the first dream that the king saw: Four black bulls came roaring, raising dust with great thunder from four main directions, with every intention to fight, to the royal courtyard. Spectators were eagerly waiting to see their fight with jubilation clapping their hands. But, they only made a show of fighting by pawing and bellowing and finally left without fighting at all. The people were very sad that they couldn’t see a good bullfight. 

In the second dream the king saw tiny plants and shrubs burst from the soil. When they grew no more than few inches, they flowered and bore lot of large fruit.

In the third dream he saw cows suckling milk from their very own newborn calves.    

In the fourth dream he saw some men replaced the strong adult bulls that were pulling the first carts in a caravan with weak young calves. Since the young ones were too weak to haul the load they refused to pull the carts. So, the caravan was unmoving.

In the fifth dream the king saw an extraordinary horse which had two mouths on either side of its head being fed on both sides at once and it was eating greedily.

In the sixth dream he saw some people were holding a golden bowl which was worth a fortune. They were begging an old fox to urinate in it, and the horrible beast did just that.

In the seventh dream - a man was plaiting a rope and putting the finished end at his feet. An old hungry vixen, which was hiding under his bench, was eating the finished rope as fast as the man was plaiting it without his knowledge. 

The eighth dream - At the palace gates, stood a big pitcher full to the brim. There were empty pitchers all around it. People came from all the directions with containers full of water and poured them into the pitcher that was already full, not giving a single glance to the empty ones standing nearby. Water overflowed in vain and soaked into the earth. Yet, they came in thousands and poured water to the same vessel.

Ninth Dream - There was a deep pool with slanting banks dense with lotus flowers to which wild animals came from all directions to drink water. Surprisingly, the water in the middle of the pool was muddy while the edges, from where the wild beasts have got into the pool were crystal clear.

Tenth Dream -Rice was boiling in a pot without being properly cooked. One part of the rice looked sopping wet, one part looked hard and raw, and the other part looked perfectly cooked.

Eleventh Dream -Sour buttermilk was traded for expensive sandalwood worth a fortune in gold.

Twelfth Dream - Dried gourds which usually float on water sank in the water.

Thirteenth Dream - Huge rock boulders floated in the water like dried gourds

Fourteenth Dream -Tiny frogs, no bigger than miniature flowerets were perusing huge snakes and devouring them.

Fifteenth Dream - A disgusting, vulgar village crow was being escorted wherever it went by an entourage of mandarin ducks which had feathers with a golden sheen.

Sixteenth Dream - Goats chased wolves and ate them. At the sight of the goats, wolves would runaway and hide themselves in the wood, screaming with fear. (thebuddism.net, 2012)

After seeing these dreams the King Pasenadi Kosol was terrified. He was highly distressed and went to Buddha asking some explanations. The Buddha analyzed these dreams and reduced the king’s agony. 

Pain Disorder

Pain is defined as an unpleasant sensory and emotional experience associated with real or potential tissue damage. Pain experience is therefore mainly a subjective experience mediated in part by beliefs or emotions (Martelli et al., 2004). Pain disorder is chronic pain experienced by a patient in one or more areas. Often the pain does not subside for medications and it has a psychological origin.

According to the Ummaga Jatakaya the Count Sirriwaddana was suffering from a headache for over seven years. The pain causes clinically significant distress in him. No remedy helped him to sooth the pain. His prolonged pain was headed by his infant son Mahosadha with a piece of sandalwood.

Alcohol Abuse and Dependence

According to the  DSM-IV-TR Alcohol Abuse  and Dependence are describe as  maladaptive pattern of drinking, leading to clinically significant impairment or distress.  DSM–5 integrates the two DSM–IV disorders, alcohol abuse and alcohol dependence, into a single disorder called alcohol use disorder (AUD) with mild, moderate, and severe sub-classifications.

Chronic use of alcohol results in progressive changes to brain and behavior that often lead to the development of alcohol dependence and alcoholism (Vetreno & Crews, 2014). Butterworth (1995) indicate that chronic alcoholism results in brain damage and dysfunction leading to a constellation of neuropsychiatric symptoms including cognitive dysfunction, the Wernicke-Korsakoff Syndrome, alcoholic cerebellar degeneration and alcoholic dementia.

Chronic alcoholism is associated with impaired cognitive functioning (Vetreno et al., 2011). A number of Jātaka stories recount the ill effects of alcohol usage. For instance Surapana Jātakaya, Punna Pathi Jātakaya and Bddraghataka Jātakaya point out health and behaviour related problems associated with alcoholism. According these Jātaka stories the persons who abuses alcohol lose their rational judgment. Dubbaca Jātakaya narrates an intoxicated acrobat accidently kills himself while performing a stunt. 

Alcohol-Induced Psychotic Disorder
Alcohol-Induced Psychotic Disorder has been revealed in the Darmadavaja Jātaka story. According to the story a King with alcohol induced psychosis kills his infant son and forces the Royal Chef to cook the dead infant’s meat. This horrendous narrative is dramatically presented by the Jātaka storyteller.
Alcohol-related psychosis is a secondary psychosis that manifests as prominent hallucinations and delusions occurring in a variety of alcohol-related conditions. For patients with alcohol use disorder, previously known as alcohol abuse and alcohol dependence, psychosis can occur during phases of acute intoxication or withdrawal, with or without delirium tremens (Medspace).

As described by Perälä and colleagues (2010) Alcohol-Induced Psychotic Disorder is a severe mental disorder with poor outcome.  Also they specify that psychotic symptoms can occur in several clinical conditions related to alcohol such as intoxication, withdrawal, alcohol-induced psychotic disorder and delirium. The association between alcohol and homicide is well documented and according to a study done by Razvodovsky (2008) showed that homicide and alcohol are closely connected in the prevailing culture with its intoxication-oriented drinking pattern.

Cannabis Induced Psychosis

Cannabis intoxication, a cannabis-related disorder coded as 292.89, is defined by DSM-5, as clinically significant problematic behavioral or psychological changes (eg, impaired motor coordination, euphoria, anxiety, and sensation of slowed time, impaired judgment, and social withdrawal) that developed during, or shortly after, cannabis use. Cannabis-induced psychotic disorder (CIPD) refers to psychotic symptoms that arise in the context of cannabis intoxication (Morales-Muñoz et al., 2014).

Cannabis use may increase the risk of psychotic disorders (Van Os, 2002). In addition chronic cannabis use is associated with reduced dopamine synthesis capacity users are at increased risk of schizophrenia (Bloomfield, 2014).  The 27-year follow-up of the Swedish cohort by Zammit et al. (2002) found a dose–response relationship between frequency of cannabis use at baseline and risk of schizophrenia during the follow-up (Parakh & Basu, 2013). Cannabis use could lead to psychosis ((Griffith-Lendering et al ., 2013)  and associated with a range of adverse outcomes in later life (Fergusson & Boden , 2008).

Cannabis sativa and cannabis indica are members of the nettle family that have grown wild throughout the world for centuries. Cannabis use can cause acute adverse mental effects that mimic psychiatric disorders (Khan, 2009). Cannabis use also causes symptoms of depersonalization, fear of dying, irrational panic, and paranoid ideas (Thomas, 1993).

Cannabis has a long history in India, veiled in legends and religion. The earliest mention of cannabis has been found in The Vedas, or sacred Hindu texts. These writings may have been compiled as early as 2000 to 1400 B.C (Gumbiner, 2011). The earliest written reference to cannabis in India may occur in the Atharvaveda, dating to about 1500 BCE (Russo, 2005).

During Buddha’s time some mystics used cannabis as an aid to spiritual experience. In early Buddhism there appears to have been an awareness of some of the dangers of addictive behavior. Principally the Buddha seems to have exhorted his followers to avoid addictive substances and behaviors by drawing attention to their unwanted consequences (Groves, 2014). Buddhist teachings constitute a rich source of aetiological models and possible therapies for addictions (Groves, 1994).

Some of the Jātaka stories point out abnormal and immoral behavior after substance misuse. These Jātaka stories indicate that substance misuse affects mind, body, emotional and spiritual wellbeing.  The Buddhism identifies substance abuse as a severe type of attachment and it leads to suffering. Gray (2003) elucidate that drug addiction is a lifestyle accompanied by physical, mental and spiritual suffering for the addicts, their families and society.

The Buddha recognized addiction problems and advised his followers accordingly and made an emphasis on craving and attachment, an understanding of the workings of the mind, as well as practices to work with the mind to assist addiction recovery. (Groves, 2014).

From a Buddhist perspective addictive behaviour may be seen as a false refuge and a source of attachment which unwittingly, but inevitably, leads to suffering. Since the root of this is ignorance, there is no question of disapprobation for sinful behaviour, unlike early Western moral or religious views of addiction (Groves, 1994).

Most of the Jātaka stories highlight importance of five precepts that could be used as a buffer against substance abuse. As indicated by Bayles (2014) human beings commonly have many negative mental traits, observing the five precepts is one of the very basic ways to counteract the negative traits. The five precepts are: (1) refrain from harming self or others, (2) do not steal, (3) do not practice sexual misconduct, (4) speak truthfully, and (5) do not use drugs / alcohol that cause carelessness and loss of awareness (Faxun, 2011). As such, the five precepts help guide physical actions, speech, and mental attitude via a systematic means aimed at actualizing the purification of the body, speech, and mind.  

Pathological Gambling

Pathological gambling (PG) is a non-substance based addiction that shares many behavioral and neural features with substance based addictions (Wiehler & Peters, 2014). Ochoa (2013) states that decision-making deficits are observed in pathological gambling. In addition the individuals with PG have impairments in self-regulatory behavior (Alvarez-Moya et al. , 2011)

According to the American Psychiatric Association Pathological gambling (PG) is classified in the DSM-IV as a disorder of impulse control with the essential feature being recurrent and maladaptive gambling behaviour. The individual has a preoccupation with gambling, needs to gamble with increasing amounts of money in order to achieve the desired level of excitement, repeated, unsuccessful efforts to control, cut back or stop gambling, feels restless or irritable when attempting to cut down or stop gambling, uses gambling as a way of escaping from problems or of relieving a dysphoric mood, has jeopardized or lost a significant relationship, job or educational or career opportunity because of gambling etc.

In his paper “Dostoyevski and Parricide”, Freud (1928) suggests that pathological gambling is a form of addiction related to the Oedipus complex. The individual gambles as a substitute for masturbation. Also gambling constitutes a way of punishment that secondarily becomes a pleasurable activity. Thus, Freud suggests masochistic component to pathological gambling (Moreyra et al., 2000). Pathological gambling is proposed as a participant of an impulsive-compulsive spectrum related to obsessive-compulsive disorder (Tavares & Gentil , 2007)

The Jātaka storyteller narrates of a pathological gambler named Thundila in the Thakari Jātaka story. Thundila whose sister Kali a sex worker lived in the city of Benares. He was addicted to gambling and lost his entire wealth. He used to demand money from his sister Kali. Once Kali became annoyed due to her brother’s wild behavior and chased Thundila from her house.

Tundila was described as a person who was preoccupied with gambling and had loss of control.  Tundila was spending an excessive amount of time gambling often the entire day.  He borrowed money from his sister, relatives and friends to gamble.  When failed he was lying and pleading to get money. He had jeopardized and lost his relationship with his sister due to gambling behaviour. The behavioral features of the gambler Thundila is very much similar to the behavioral symptomatology that has been described in the Diagnostic and Statistical Manual of Mental Disorders

Dissociative Trance Disorders (Possession Disorder)

Pathological Possession Trance (PPT) was formerly known as dissociative trance disorder in the DSM psychiatric manual, and became included within the dissociative identity disorder criteria in the DSM-5. The experience of being "possessed" by another entity, such as a person, god, demon, animal, or inanimate object, holds different meanings in different cultures. Yet the phenomenon of possession states has been reported worldwide (Gaw et al., 1998). Although dissociative trance disorders, especially possession disorder are probably more common than is usually though, precise clinical data are lacking (Ferracuti, Sacco & Lazzari, 1996).

Spirit possession is a common, worldwide phenomenon with dissociative features and studies in Europe and the United States have revealed associations among psychoform and somatoform dissociation and (reported) potential traumatic events (van Duijl et al., 2010). Spirit possession little attention from mental health care systems, possibly due to the cultural complexity of defining pathological trance syndromes and its diagnosis and treatment (Cardeña et al. 2008; Castillo 1992, 1998; Marjolein van Duijl, 2010). 

Aspects of possession are reviewed in historical, cultural and clinical contexts (Prins, 1992). Possession disorder is basically an illness of attribution that has intrinsic meaning to the individuals suffering from it. Illnesses of attribution are defined not so much by their signs and symptoms as by their presumed etiologic mechanisms (Gaw et al., 1998). 

The Pandit Kavinda (in the Ummaga Jātakaya storyline) seems to be suffering from Dissociative Trance Disorder- Possession state. As the Pandit describes it is a transient monthly occurrence on full moon days. When he is under the trance he loses control of his body as well as the control over his consciousness.  His behavior changes rapidly.  There is a change in tone of voice and he barks like a dog. He loses the awareness of surrounding and there is a loss of personal identity. The Pandit Kavinda believes that he is under a possession by a demon.

The Asilakkhana Jātakaya gives some clues about Possession state that was known to the ancient people in India. In this Jātaka story a young princess pretends that she is under a demonic influence in order to refuse the marriage proposals and to be with her lover. The king became convinced thatshe was possessed by demons.


Malingering has been said to be synonymous with faking, lying and fraud (Lo Piccolo et al, 1999; Avasthi et al, 2007) and these have been integral parts of human behaviour since the earliest times. Malingering was documented in biblical times. David "feigned insanity and acted like a madman" to avoid a king's wrath (Lebourgeois, 2007). The DSM-IV-TR defines Malingering as the intentional production of false or grossly exaggerated physical or psychological symptoms, motivated by external incentives. Although malingering is not considered a mental disorder, it is recognized by the DSM   as something that warrants clinical attention. The difference between malingering and simple unreliable reporting is a matter of the individual’s intent. Malingering, by definition, is deliberate (Conroy & Kwartner, 2006).

Many Jātaka stories describe malingerers who were interested in secondary gain. For instance Nigrodha-jātakaya indicates a case study of false pregnancy. However this story is not about pseudocyesis which is a rare psychiatric syndrome. In the Nigrodha-jātaka the Bodhisattva is abandoned at birth by his mother and adopted by a woman who had been feigning pregnancy.  According to the story her pregnancy was found to be a fake made-up.  

In Themiya Jātakaya the Prince Themiya is malingering as an autistic child. This case can be viewed as cognitive malingering. Cognitive malingering refers to feigning a deficit, pretending to be less intelligent or less able than one actually is. Typical examples include someone attempting to appear to have mental retardation or a significant brain injury or severe memory problems (Conroy & Kwartner, 2006).

In Bandhanamokkha Jātakaya a queen with adulterous behavior fakes illness to trick the king. She pretends that she became a victim of an attempted rape. She presents self with inflicted bruisers and bogus emotional complaints to prove the rape. But the truth was revealed and the queen was punished. 

No comments:

Post a Comment

Appreciate your constructive and meaningful comments

Find Us On Facebook