Sunday, April 7, 2024

Attention-Deficit Hyperactivity Disorder (ADHD)

Ruwan M Jayatunge M.D. 

Attention-Deficit Hyperactivity Disorder (ADHD) is a neurobehavioral developmental disorder affecting about 3–5% of the world’s population. ADHD was first described by Dr. Heinrich Hoffman in 1845. He eloquently wrote about children with ADHD and their characteristics. Contemporary studies concur that the symptoms of ADHD are caused by a neurological dysfunction within the brain, mostly due to a deficiency in a specific neurotransmitter in the lower area of the brain. The principle characteristics of ADHD are inattention, hyperactivity, and impulsivity.

Attention-Deficit Hyperactivity Disorder is a condition that becomes apparent in some children in the preschool and early school years. Sometimes it may persist into adulthood. About 60 percent of children diagnosed with ADHD retain the condition as adults. These children need care and attention. When hyperactivity, distractibility, poor concentration, or impulsivity begin to affect performance in school, social relationships, or the ability to accomplish day-to-day activities, therefore, they need treatment.

According to the US-based statistics, an estimated three to five percent of school-age children suffer from ADHD. Although there are no statistics available in Sri Lanka, a considerable number of children are affected by ADHD, and many do not receive any treatment. In our school system, ADHD children are considered bad students who are disobedient. But the fact is, their behavior is caused by complex etiological factors, and they are not bad by nature.

They have a poor attention span. They have difficulty organizing tasks and activities. Furthermore, they act as if “driven by a motor” and cannot remain still. Difficulty remaining seated; Easily distracted; Gives answers to questions before they are completed; Difficulty following instructions from others. Difficulty sustaining attention in tasks or play activities shifts from one uncompleted task to another; Talks excessively; Interrupts others; does not seem to listen; Engages in physically dangerous activities without considering the possible consequences; is restless and does not follow the commands.

There are a number of risk factors associated with ADHD. Major etiologic contributors include adverse responses to food additives and intolerances to foods. Too much refined sugar, Chocolate and Genetically Modified Food can increase hyperativity in some children. Common food additives and colorings can increase hyperactive behavior; some artificial additives increase hyperactivity and decrease attention span in a wide range of children. Some have sensitivities to environmental chemicals, molds and fungi. Exposures to neurodevelopmental toxins, such as heavy metals and organohalide pollutants can precipitate the condition. 

General Strategies to combat ADHD are important. Parental Education is vital. The parents must be taught how to handle the children. Some parents use corporal punishment, which can lead to the damage the personality. Parent-coached social skill training gives insight and handiness to manage an ADHD child more effectively.  Medications are necessary since there is an imbalance in brain chemistry. The medications must be prescribed by a qualified medical professional. Ritalin (methylpenidate) is widely used to treat ADHD. Medications must be prescribed by a qualified Physician. 

Apart from drug therapy, special Psychotherapeutic approaches are essential. Behavior Modification Programs for Home and School can be used to minimize inattentiveness and improve concentration. Relaxation training advances emotional control and the child is able to face day-to-day activities without much tension. CBT, or Cognitive Behavioral Therapy is important to improve motivation, problem-solving skills, and self-esteem. Some experts recommend Fun Cognitive Rehabilitation Exercises (Brain Training) to improve attention span. 

Cybertherapy is another mode of treatment that can be used for ADHD. In cyber therapy especially designed computer animation programs are used to enhance attention, concentration, eye contact and fine motor movements.  The therapist should allow the child to change work sites frequently while completing homework or studying. Behavioral approaches can be attempted to help the child concentrate on sitting still, staying on task or thinking before acting. Many ADHD children can be managed via music therapy.  Music therapy reduces their excessive stress factors. In order to enhance their productivity, guidance must be given to the students to verbalize a plan before solving problems or undertaking a task. 

The therapist should provide opportunities for students to show divergent, creative, and imaginary thinking. On most occasions, ADHD children have a good IQ, and if their massive energy is used prolifically a good results can be expected. Art Benjamin, the famous Professor in Mathematics was an ADHD child and he was able to conquer the illness. Therefore, ADHD is not a paralyzing condition. If positive guidance is given to the child, he/she can be a productive person.

Saturday, March 30, 2024

Motivational Interviewing (MI) in the Field of Addiction Medicine


Ruwan M Jayatunge M.D. PhD 

Motivational interviewing (MI) helps to change longstanding behaviors that pose significant health risks, and MI is considered an important tool in addiction treatment. Moreover, MI is a tool designed to facilitate behavioral change in the patient by resolving the ambivalence to change (Miller & Rollnick, 2002). MI is facilitating health-related behavioral change in substance abuse, such as tobacco, alcohol and others (Dunn et al., 2001). Sim and team (2009) state that MI is about creating a climate that facilitates change, and can help build motivation, commitment and confidence to change.  

As described by Hall and colleagues (2012), Motivational interviewing is a patient-centered counseling method that involves enhancing a patient’s motivation to change by means of four guiding principles, represented by the acronym RULE: Resist the righting reflex; Understand the patient’s own motivations; Listen with empathy; and empower the patient. MI can be described as a collaborative and evocative process that honors patient autonomy (Miller & Rollnick, 2002). It is focused on patient coaching rather than instructing the patient and is described as a non-confrontational, non-judgmental and supportive type of counseling (Al Ubaidi ,2017). MI helps to promote and increase patient motivation towards positive behavioral change, as well as to explore and then resolve any negative issue(s) or experience(s) of conflict. 


MI focuses on client desires, thoughts and feelings as a way to encourage clients to express their own barriers to change and to explore and resolve ambivalence toward behavioral change (Wu & Lin 2009). The patient's motivation cannot be imposed by an external entity; it is the patient's task to resolve their ambivalence, and the counselor should not concentrate on persuading the patient to change their behavior.  (Al Ubaidi ,2017). Readiness to change is a dynamic process, and ambivalence is hindering positive change. Ambivalence is a conflicted state where opposing attitudes or feelings coexist in an individual. Ambivalence is evident in substance abuse.


MI strategies reduce the paternalistic therapeutic style, and the practitioner avoids an authoritarian stance. During the sessions, a partnership between the patient and practitioner is formed. Joint decision-making occurs. The practitioner acknowledges the patient’s expertise about themselves. The practitioner activates the patient’s own motivation for change by evoking their reasons for change. It is the patient’s own reasons for change, rather than the practitioner’s, that will ultimately result in behavior change. The therapist is using reflective listening skills and accurate empathy, where the practitioner seeks to understand the patient’s perspective, thoughts and feelings without judging, criticizing or blaming. Assisting patients to identify discrepancies between their current behavior and future goals or values about themselves as a person, partner, parent, or worker is a powerful motivator that helps ‘tip the balance’ toward change.


MI activates motivation for change. It uses a guiding communication style that invites people to consider their own situation and find their own solutions to situations that they identify as problematic and that are preventing change (Christie & Channon, 2014). The counselor adopts a "goal-directed approach" with a "patient-centered counseling style" that may enhance the patient's desire to change and decrease resistance (Miller & Rollnick ,2002). Research indicates that MI is equivalent to or better than other treatments such as cognitive behavioral therapy (CBT) or pharmacotherapy (Burke et al., 2003).


Al Ubaidi BA (2017) Motivational Interviewing Skills: A Tool for Healthy Behavioral Changes. J Fam Med Dis Prev 3:069.

Burke BL, Arkowitz H, Menchola M. The efficacy of motivational interviewing: a meta-analysis of controlled trials. J Consult Clin Psychol 2003;71:843–61.

Christie D, Channon S. The potential for motivational interviewing to improve outcomes in the management of diabetes and obesity in paediatric and adult populations: a clinical review. Diabetes Obes Metab. 2014 May;16(5):381-7. doi: 10.1111/dom.12195. Epub 2013 Sep 1. PMID: 23927612; PMCID: PMC4237607.

Dunn, C,. Deroo ,L., Rivara, F.P.(2001). Addiction. 96(12):1725-42.

Hall K, Gibbie T, Lubman DI. Motivational interviewing techniques - facilitating behaviour change in the general practice setting. Aust Fam Physician. 2012 Sep;41(9):660-7. PMID: 22962639.

Miller, W.R., Rollnick, S. (2002).Motivational Interviewing: Preparing People for Change. 2nd ed. New York: Guilford Press.

Sim MG, Wain T, Khong E. Influencing behaviour change in general practice - Part 2 - motivational interviewing approaches. Aust Fam Physician. 2009 Dec;38(12):986-9. PMID: 20369152.

Wu CC, Lin CC. [The application of motivational interviewing in nursing practice]. Hu Li Za Zhi. 2009 Apr;56(2):89-93. Chinese. PMID: 1931

Thursday, March 28, 2024

Alexander Pushkin and Mikhail Lermontov - Who Shared a Common Fate


Ruwan M Jayatunge M.D. 

Alexander Pushkin and Mikhail Lermontov were Great Russian romantic poets who lived in the 19th century. They knew each other and adored each other’s work. Both were rebellious in nature. Alexander Pushkin was the pioneer of Russian literature. Among his major works Ruslan and Ludmila  , Evgenii Onegin, and Boris Godunov can be considered the greatest masterpieces of Russian literature. Although Pushkin was a genius in literature, the Russian Czar did not tolerate his poems, which carried elements of protests. Pushkin was a daring activist who was secretly involved with an underground revolutionary group and also publicly expressed his support for the Decembrist uprising, which demeaned feudal reforms. As a result of his rebellious attitude, Pushkin was banished from St Petersburg.
In 1827, he composed the ode titled The Poet
Until he hears Apollo's call
To make a hallowed sacrifice,
A Poet lives in feeble thrall
To people's empty vanities;
And silent is his sacred lyre,
His soul partakes of chilly sleep,
And of the world's unworthy sons
He is, perhaps, the very least.
Pushkin knew the suffering of the peasants under the Czar’s regime. As a member of the upper Russian social class, Pushkin was never fascinated by its glory. He had a mission in life. Pushkin often used his writing to express the agony and suppression of the Russian people. Hence, he was hated by the regime. But, the general public recognized Pushkin as a great poet and respected him. Gradually he became the envy of the Royal Palace.
Many conspiracies were launched against Pushkin, and finally, he was provoked to engage in a dual. In the ill-fated dual, he was fatally wounded and later succumbed to the injuries. After Alexander Pushkin’s tragic death, Lermontov published an elegy titled Smerta Poeta or The Death of a Poet, which criticized the conspiracy involved in Pushkin’s untimely death.
Alexander Pushkin and Mikhail Lermontov shared many things in common.  
Both were inspired by the novels of Sir Walter Scott. Both demanded social reforms and emerged as spokesmen for literary radicals. Their work provided fertile ground for Russian poets and novelists.  Both had a great influence on later Russian writers. From Gogol to Dostoevsky and from Dostoevsky to Boris Pasternak, their unique influence remained unchanged.
Ironically, Pushkin and Lermontov led reckless and generally cynical lives, but they expressed their inner feelings via prose and verse. Mikhail Lermontov had an influence on Lord Byron, and as a matter of fact, he adopted the Byronic cult of personality. Lermontov’s psychological novel A Hero of Our Time describes a reckless and a cynical character named Grigorii Pechorin.
The central character, Pechorin, is complex in nature. Pechorin is an impulsive, emotionally numbed and manipulative, capable of extreme bravery but generally bored by his life. Pechorin was a hero as well as a renegade, and according to some critics, the central character in A Hero of Our Time could really have been applied to Lermontov himself. Lermontov's best-known poem, The Demon a self-accusing poem,   exemplifies a fallen angel who loves a mortal woman reflecting the poet's self-image as a demonic creature.
Lermontov loved the Caucasus region and admired its natural beauty. The Caucasus had also inspired Pushkin. Their characters were somewhat similar. Both were sensitive, cynical, nihilistic, and possessed extreme arrogance. They stood against social injustice. Like Pushkin, Lermontov was killed in a duel in the Caucasus. Both died at a young age, leaving a deep void in the field of literature. Alexander Pushkin’s and Leonardo's lives can be viewed as some of the most epic and dramatic in the history of literature.

Tuesday, March 19, 2024

Tim Hortons-Double -Double


A KKK Member
A Black Panther 
A Jihad Fighter 
All three came to Toronto
They met near the CN Tower
Decided to challenge each other   
They all went to Tim Hortons
Before starting their violent debate 
They ordered three  medium coffee 
Specifically said  - Double -double 
They enjoyed their coffee 
With Boston Cream Donuts
After finishing their coffee   
They instantly became friends 
They embraced each other 
Then agreed to renounce violence 

Saturday, March 16, 2024

Hey Dorothy where are you


Hey Dorothy where are you 
Where is Toto - the dog that you loved 
Have you been to the magical Land of Oz
How did you escape from the wicked Witch of the East 
Whose hand savaged the  Munchkins

Your  magical Silver Shoes are shining 
You may be heading to the Emerald City 
Wanna meet the great and powerful Wizard of Oz 
Then walk on the yellow brick road

I see you walk with the Scarecrow  
When you meet the Tin Woodman
Pour some oil on him 
He would walk with you 

Do you hear the Lion's roar
He is harmless -a cowardly Lion
He needs confidence and care 
Join hand in hand with him 

The  Scarecrow wants a brain
The Tin Woodman wants a heart
The Cowardly Lion wants courage
What do you need Dorothy
Anything special 

Be cautious-  you are being watched 
The wicked Witch of the West sees you
She might send the Winkie soldiers 
Ask the  Cowardly Lion to strike 

Dorothy your bucket of water 
Melted the Witch
She said What a world 
What a world 
It was an end of an era 
An era of tyranny
Ruwan M Jayatunge 

Friday, March 1, 2024

නිහාල් සිල්වා ගේ මරණය ඝාතනයක් ද ?


කොන්ස්පිරසි තියරි සඳහා මිනිසුන් තුල අභ්‍යන්තර ආශාවක් පවතියි. නිහාල් සිල්වා ගේ මරණය එලෙස කොන්ස්පිරසි තියරියක් ගොඩ නැංවීය​. නිහාල් සිල්වා  1989 දෙසැම්බර් 03 වෙනිදා රාත්‍රියේ දෙහිවල, ගාලු පාරේ, විලියම්ස් හංදියේ දී හමුදා මුර පොළකදී අණ නොතකා ධාවනය කිරීම නිසා වෙඩි වැදී මිය ගියේය​. මිය යාමට ප්‍රථම නිහාල් ජනාධිපති ප්‍රේමදාස ගේ සමීපතයෙක් විය​. මේ නිසා නිහාල් ගේ මරණය සමග බොහෝ කතා කරළියට පැමිනියේය​. 

 නිහාල් සිල්වා පැමිණියේ කොලඹ අඩු ආදායම් වත්තකිනි. ගෙන්දගම් පොළවේ සමාජ ආශරයෙන් ඔහු චරිත පිලිබඳව ඉගන ගත්තේය​. ඕනෑම ලූම්පන් චරිතයක් , සුළු ජාතික චරිත ( සාජන්ට් නල්ලතම්බි - ද්‍රවිඩ / හිරු නොසැලී සිටියේය නාට්‍යයේ මුස්ලිම් මුදලාලි ) රඟපෑම​ට ඔහුට හැකි විය​. එකී සෑම චරිතයකම සියුම් අන්තර්ගතයන් , ගතිකයන් , කථන විලාස ඔහු අති දක්‍ෂ ලෙස ග්‍රහනය කරගෙන සිටියේය​. එසේම පුන්තිලා වැනි නාට්‍ය වල බැරෑරුම් චරිතද ඔහු දක්‍ෂ ලෙස  රඟපෑවේය​. මිය යන විට ඔහු සිටියේ ජනප්‍රියතාවයේ හිණි පෙත්තේය​.

බොහෝ නළුවෝ දේශපාලකයා පසුපස බළු කුක්කන් මෙන් යන විට දේශපාලකයා කෙලින්ම නිහාල්ව තමන් වෙත කැඳවා ගත්තේය​. නිහාල් ගේ සමාජ ප්‍රාග්ධනයේ වටිනාකම ඔහුගේ සන්නිවේදන හැකියාවන් ඔවුන් අවබෝධ කර ගෙන සිටියහ​. මාධ්‍යවේදී නන්දන වීරරත්න පවසන අන්දමට නිහාල් සිල්වා ගේ මරණය ඝාතනයකි. එය පසු පස සිටින්නේ ජනාධිපති ප්‍රේමදාසය​. ජනාධිපති ප්‍රේමදාස බොහෝ දෙනෙකු ස්වර්ගස්ථ කල බව සැබවි. එහෙත් නිහාල් සිල්වා ගේ මරණය කොන්ස්පිරසි තියරියක් හරහා ජනාධිපති ප්‍රේමදාසට බැර කල හැකිද ?

නිහාල් සිල්වා ගේ මරණය පිලිබඳව මම බොහෝ දෙනෙකු ගෙන් විස්තර විමසුවෙමි. අවසානයේදී තර්කානුකූල විස්තරයක් මට ලැබුනේ අදාල මුර පොල භාරව ක්‍රියා කල මේජර් මහින්දන් සීවරත්නම් ගෙනි . මේජර් මහින්දන් සීවරත්නම් වර්තමානයේ කැනඩාවේ ජීවත් වන අතර එවකට ඔහු ලුතිනන්වරයෙකි. භීෂණ කාලය නිසා මුළු ජන ජීවිත විපරීතව තිබුනේය​. සාමාන්‍ය ජනයා ගේ සිට සාමාන්‍ය සොල්දාදුවා දක්වා පිරිස් සිටියේ ආතතියකිනි. මේ මුරපොලේ සිටි සොල්දාදුවෝ පිරිස් බලය අඩු නිසා දින ගනන් එක දිගට රාජකාරී කිරීමෙන් හෙම්බත්ව සිටියහ​. ඒ කාලයේ ජවිපේ ක්‍රියාකාරකම් උත්සන්නව තිබූ නිසා ඔවුන් සිටියේ සැකයෙනි.

ජනාධිපති ගේ සමීපතයෙකු නිසා නිහාල් සිල්වා සිටින්නට ඇත්තේ ගැම්මකිනි. එය ස්වභාවිකව ඕනෑම පුහුදුන් මිනිසෙකුට ඇති වන මාන්නයකි. ඒ නිසා ඔහු හමුදා මුරපොලවල් පිලිබඳව එතරම් තැකීමක් නොකරන්නට ඇත​. අණ නොතකා ධාවනය කිරීම නිසා හමුදා සෙබලා එම රථයට වෙඩි තැබුවේය​. එහි ප්‍රතිඑලය වූයේ නිහාල් ගේ මරණයයි.

මේ මරණය සිදුවූ වහාම ලුතිනන් මහින්දන් සීවරත්නම් එතැනට ගොස් පොලිසිය සමග ස්ථානීය විමර්ශණයක් කරන ලදි. මහින්දන් සීවරත්නම් පවසන අන්දමට එය විඩාබර සහ ජවිපෙ ප්‍රහාර පිලිබඳ නිරන්තර සැකයෙන් සිටි සොල්දාදුවෙකුගේ වෙඩි පහරකි. ඔහු මෙය ඝාතන සැලැස්මක් යන අදහස ඔහු බැහැර කරයි. නන්දන වීරරත්න පවසන පරිදි එම රථයට වෙඩි තැබීමෙන් පසු  සමඟ එම රියේ ගමන් කරමින් සිටි තවත් මගීන් තිදෙනෙකු වූහ​. මොවුන් තිදෙනාම තවමත් ජීවතුන් අතර සිටිති. කොන්ස්පිරසියක් අනුව වෙඩි තැබුවේ නම් ඝාතකයන්  සාක්‍ෂිකරුවන් තිදෙනෙකු ඉතිරි කරන්නේද නැත​.

ජවිපේ මිනිස් ඝාතන , ප්‍රේමදාසගේ ඝාතන සපිරි යුගයක නිහාල් සිල්වාගේ මරණය කාගේ හෝ ගිණුමකට බැර කිරීම අපහසු කාර්‍යක් නොවේ. එහෙත් අප එදා සිදු වූයේ කුමක් ද යන්න අනාගත පරම්පරාවට දැන ගැනීමට සහ ඔවුන්ට විචාර බුද්ධියෙන් කරුණු තේරුම් ගැනීමට අප සත්‍ය සාක්‍ෂි ඉතිරි කල යුතුය​. 

 වෛද්‍ය රුවන් එම් ජයතුංග 

Wednesday, February 28, 2024

Let's Just Pathologize All


They were not perfect indeed 
They all had their weaknesses 
They had their flaws 
Suffered from various pathologies 
They were not so sweet as we were told 
Lets analyze these great characters   
Little miss Muffet suffered from Arachnophobia
Rapunzel was known for Trichotillomania
Prince Charming turns out to be a Toxic Narcissist
Pinocchio was a compulsive liar
Alice   Liddell had a sensory perception disorder
Tom Thumb  had a pituitary tumor
The Gingerbread man suffered from Thanatophobia
Wee Willie Winkie was a Pedophile
Humpty Dumpty was pushed
On the contrary
No one never lived happily ever after

Monday, February 26, 2024

කාන්තා ලිංගික අවයව විකෘති කිරීම (Female genital mutilation (FGM) ලංකාවේ හිස ඔසවයි

කාන්තා ලිංගික අවයව විකෘති කිරීම Female genital mutilation (FGM)  ක්‍රමක් ක්‍රමයෙන් ලංකාවේ  හිස ඔසවන අතර මෙය වෛද්‍ය සේවාවක් දක්වා පැතිර යමින් පවතියි. මෙය කාන්තා  කායික මානසික සෞඛ්‍ය කෙරෙහි දුර්විපාක ඇති කල හැකිය.

කාන්තා ලිංගික අවයව විකෘති කිරීම Female genital mutilation (FGM) යනු ආගමික සහ සංස්කෘතික හේතූන් මත භගමනිය ඉවත් කිරීමයි. මෙය කාන්තා චර්ම චේදනය ලෙස හැඳින් වේ. සෝමාලියාවේ වාරිස් ඩයරි ලෝකයේ නොම්බර එකේ මෝස්තර නිරූපිකාවක් වන අතර ඇය  මේ කටුක අද්දැකීම ලැබුවාය​.  මෙම ක්‍රියාවලියේදී  ඔවුන්ගේ ජනනේඳ්‍රියේ කොටස් කපා දමන අතර ඉන්පසුව, ජනනේන්දිය මුත්‍රා කිරීමට කුඩා සිදුරක් ඉතුරුකොට තබා මසා දමනවා. 

මා සමග වෛද්‍ය පීඨයේ ඉගෙනුම ලැබූ සුඩාන ජාතික වෝෆා තමා කුඩා කාලයේ කාන්තා චර්ම චේදනයට ලක් වූ බව වරක් මා සමග පැවසුවා. කාන්තා චර්ම චේදනය සෞඛ්‍ය සංකූලතා ඇතිවීමේ වැඩි අවදානමක් ඇති කරයි. මෙමගින් කල් පවත්නා මුත්‍රා ආසාදන, සංසර්ගයේදී වේදනාව, තෘප්තිය අඩු වීම, ලිංගික භීතිය, දරු ප්‍රසූතියේ සංකූලතා ඇතිවීම, මානසික අවපීඩනය, කාංසාව, පශ්චාත් කම්පන ආතති ආබාධ, අඩු ආත්ම අභිමානය ඇති විය හැක. අප්‍රිකාවේ, මැදපෙරදිග සහ ආසියාවේ රටවල් 30 ක  ජීවත්ව සිටින ගැහැණු ළමයින් සහ කාන්තාවන් මිලියන 200 කට වැඩි ප්‍රමාණයක් කාන්තා ලිංගික ඡේදනයට (FGM) භාජනය වී ඇත. 

පහත දැක්වෙන්නේ බලහත්කාර කාන්තා චර්ම චේදනයට ලක් කල යුතු බවට ඥාතීන් ගේ බලපෑමට ලක්ව නයිජීරියාවෙන් කැනඩාවට පලා ආ කාන්තාවක් සම් බන් ධයෙන් මා විසින් කැනේඩියානු ඉමිග්‍රේෂන් එකට ඉදිරිපත් කරන ලද මනෝ විද්‍යාත්මක වාර්තාවක කොටසක්.....

Ms. xxxxx  stated that she faced a threatening situation while living in Nigeria. As she indicated, her husband’s relatives and the Tribal elders forced her daughter to undergo female circumcision which is known as Female genital mutilation (FGM). According to Ms. xxxxxx, FGM is a painful procedure that was done without any anesthesia and under aseptic conditions. Moreover, excess deaths attributable to FGM. Therefore she declined their demand. Her relatives became furious and relentlessly harassed her. Moreover, the Tribal elders put immense pressure on Ms. xxxxx They emphasized that it was a tribal, religious and cultural obligation and her daughter must undergo FGM. As a result of domestic abuse and continuous pressure Ms.xxxxx decided to leave Nigeria with her children. She came to Canada in December 2019 and filed her refugee claim. At present, Ms. xxxxx is having fear and apprehension. She is experiencing intrusive memories of her past distressing events. She is worried about her well-being and has low mood and sleep disturbances with Insomnia. She reports fatigability and decreased energy. As a result of these distressful symptoms, Ms. xxxxxxxxdecided to seek medical assistance and visited the office of Dr. AV , who diagnosed her with Anxiety, Post-Traumatic Stress Disorder (PTSD) and Adjustment Disorder.

කාන්තා ලිංගික අවයව විකෘති කිරීම සාධාරණීකරනය කිරීම සඳහා අන්තවාදීන් බොහෝ විට අසන්නේ පිරිමි සුන්නත් කිරීම හරිද යන්නයි. මාගේ පුද්ගලික අදහස අනුව පිරිමි සුන්නත් කිරීමද පිරිමි දරුවාට වේදනාකාරී අත්දැකීමක් බවයි. මෙහිදී විද්වතුන් විසින් පෙන්වා දෙන්නේ කාන්තා චර්ම චේදනය මෙන් නොව පිරිමි සුන්නත් කිරීම පිරිමියාගේ අනාගත ලිංගික හැසිරීම් වලට බලපෑම් කිරීමට ඇති අවකාශය අවම යන්නයි.  කෙසේ නමුත් ආගමික අන්තවාදීන් පිරිසක් සහ මුදල් උපයා ගැනීමේ අභිලාශයෙන් යුතු වෛද්‍ය කණ්ඩායමක් විසින් ලංකාවේ  කාන්තා චර්ම චේදනය ප්‍රවර්ධනය කරමින් සිටින අතර එය කාන්තාවන් ගේ කායික මානසික සෞඛ්‍යට අහිතකර බලපෑම් ඇති කල හැකිය. මේ නිසා ශ්‍රී ලංකාවේ සෞඛ්‍ය අංශ මේ පිලිබඳව අවධානය යොමු කල යුතුය.

වෛද්‍ය රුවන් එම් ජයතුංග M.D. BA Psych (Canada) , MCP (USA) PhD (in Progress) 
(මීගමුව මූලික රෝහලේ හිටපු නාරි  හා ප්‍රසව ජේෂ්ඨ වෛද්‍ය නිලධාරී  ) 

Thursday, February 22, 2024

1982 අනුරාධපුර පැවති ලෝක ජම්බෝරිය

1982 අනුරාධපුර පැවති ලෝක ජම්බෝරියේදී අපගේ බාලදක්‍ෂ නායක සමන් කුරේට පාසල් කීපයක නායකයා වශයෙන් යාමට සිදු විය​. මේ නිසා මා ඇතුළු දඟයන් මෙම ජම්බෝරියේදී කුමන විගඩමක් නටත් දැයි විස්සෝප වූ සමන් අයියා අනුරාධපුර යාමට දවස් දෙකකට උඩදී මා කැටුව පාසල අසල සාන්ත සිරි හෝටලයට ගොස් මට රෝල්ස් , පැටිස් , මාළු පාන් අරගෙන දී අනුරාධපුරයේදී නාලන්ද , ආනන්ද යනාදී පාසල් ගනනාවක බාලදක්‍ෂයන් ඔහු යටතේ ජම්බෝරියට යන බවත් එම නිසා විජ්ජා පෙන්වන්නේ නැතිව හොඳට හැසිරිය යුතු බව කීවේය​. ජම්බෝරියේදී හොඳට හැසිරෙන බව සමන් අයියාට පොරොන්දු වෙමින් මම තව පැටිස් එකක් ද කෑවෙමි. 

 නියමිත දිනයේදී අප මරදාන දුම්රිය පළට ගියේ අනුරාධපුරයට යන රාත්‍රී දුම්රිය අල්ලා ගැනීමටය​. දුම්රියේදී අපට ආනන්ද සහ රාජකීය විද්‍යාල වල බාලදක්‍ෂයන් පිරිසක් ද හමු විය​. අප ගීත ගයමින් ගමන් කලෙමු. ආනන්ද විද්‍යාලයේ අපටම ගැලපෙන පිරිසක් සිටි හෙයින් අප දුම්රිය දෙවනත් කෙරුවෙමු. අපගේ පිරිස දුම්රියේ දොරක් ඇරගෙන සිට අතර ගාඩ්වරයා පැමිණ අපට බැන වැදී දොර වසා දැමුයේය​. අප ගාඩ්වරයා මඩ් ගාඩ් ලෙස නම් කලෙමු. 

 අනුරාධපුරයට ආ අප හරිස්චන්ද්‍ර පිටියට විත් කඳවුරු බැන්දෙමු. අනුරාධපුර පැවති ලෝක ජම්බෝරියේදී අප ඉතා ආකර්ශනීය කඳවුරු සංකීර්ණයක් නිර්මානය කලෙමු. මෙම කඳවුරු සංකීර්ණය නැරඹීමට බොහෝ පිරිස ආහ​. ජම්බෝරියේදී මම සමන් අයියාට පොරොන් දු වූ පරිදි විජ්ජා නොපෙන්වූ නමුත් අප ලුවී ඔකස් යන බාලදක්‍ෂ නායකයාව බයිට් කලෙමු. ලුවී ඔකස් අවසන් දිනයේදී අපගේ සෙට් එකත් සමග මිතුරු විය​. 1

983 අනුරාධපුරයේ පැවති ලෝක බාලදක්‍ෂ ජම්බෝරියට චීනයෙන් , නේපාලයෙන් , ඉන්දියාවෙන් බාලදක්‍ෂයන් සහභාගි වූහ​. 1983 අනුරාධපුරයේ ලෝක ජම්බෝරිය රස ගුලාවක් වූයේ මට තකට තක ලෙස ගැලපුනු ආනන්ද විද්‍යාලයේ කුසල් මෙන්ඩිස් හමු වීමෙනි. අප දෙදෙනා එකතුව බොහෝ විනෝද වැඩ කලෙමු. එසේම කවට නාට්‍ය අප ගිනිමැළ සංදර්ශන වලදී ඉදිරිපත් කොට පිරිස කුල්මත් කලෙමු. වෙනත් දිස්ත්‍රික්වල බාලදක්‍ෂයන් ද අපගේ නාට්‍ය බැලීමට ආවෝය​. ඒ කාලයේ දී අප කුසල් මෙන්ඩිස් දකුණු අප්‍රිකාවෙන් පැමිණි බාලදක්‍ෂයෙකු ලෙස හඳුන්වා දුන්නෙමු. කුසල් ගේ කාල වර්ණ බවත් බොකුටු කොණ්ඩයත් නිසා ඔහු දකුණු අප්‍රිකාවෙන් කියා බොහෝ දෙනෙකු සිතූහ​. පසුව කුසල් සිංහලෙන් කතා කොට තම අනන්‍යතාව ඔප්පු කරන ලදි. කුසල් වර්තමානයේ බැංකු නිලධාරියෙකි. ඔහු මෑතකදී සම්පත් බැංකුවේ නාට්‍යකද රඟපාන ලදි. 

 මේ ජම්බෝරියට කිලිනොච්චියෙන් පැමිණි ද්‍රවිඩ බාලදක්‍ෂයන් පිරිසක් හමුවූ අතර ඔවුන් දැන සිටියේ දෙමල පමණි. එම නිසා අප ඔවුන්ට වනක්කම් කීවෙමු. අප දැන සිටි දෙමල එපමනකි. මේ 1982 වසර් විය . තව වසරක් තුලදී කළු ජූලියක් එන බවත් , ඉන්පසු රට තුල තිස් වසරක් ලේ හලා ගැනීම් සිදු වන බවත් අප දැනගෙන සිටියේ නැත​. මේ ජම්බෝරියට කිලිනොච්චියෙන් පැමිණි ද්‍රවිඩ බාලදක්‍ෂයන් අතරින් කොපමණ දෙනෙකු එල් ටී ටී ඊ යට බැඳුනේද , කී දෙනෙක් යුද්දයේදී මිය ගියේද කියා දන්නේ උඩ සිටින දෙවියන් පමණි. ජම්බෝරියෙන් පසු මම බාලදක්‍ෂ ව්‍යාපාරයෙන් සමුගත්තෙමි. ඉන්පසු සියල්ල අතීත සිහිවටනයන් විය​.

Wednesday, February 14, 2024

වැලැන්ටයින්ස් ඩේ ආදර කතාව

මචං අර කෙල්ලව යාළු කර ගත්ත නම් නියමයි කියා වජිරාරාම දහම් පාසලේ අපේ පන්තියේ කොල්ලෙක් කීවේය. ඒ කාලය අප සිටියේ 1980 දහම් පාසලේ 7 පන්තියේ ය. ඉස්කෝලේ 8 පන්තියේය.

කෙල්ල කොලඹ විශාකා එකේ සිසුවියකි. කෙල්ලගේ නමත් මට මතකය . ප්රභා කුමාරී විජේරත්න ය. දැන් කොහේ ඉන්නවාද කියා දන්නේ නැත.

අපේ පන්තියේ ට්රයි එක දෙන කොල්ලා සෙන්ට් තෝමස් එකේය. මුගේ සපෝටර්ස් ලා වූයේ මා සහ බැස්ටියා ( නිලන්ත බැස්ටියන් ) ය. නිලන්ත බැස්ටියන් රෝයල් එකේ නිසා ඌට සෙන්ට් තෝමස් එකේ කොල්ලා එච්චර දිරවූයේ නැත. නමුත් කොල්ලාගේ ප්රේමය නිසා උපකාර නොකරත් බැරිය.

" හරි අපි උඹට කෙල්ලව යාළු කරලා දෙන්නම් අපිට කීයක් දෙනවාද කියා මම ඇසුවෙමි. ප්රේමය නිසා කොල්ලා සාක්කුවට අත දමා අළුත්ම පහේ නෝට්ටුවක් මගේ අතේ තැබුවේය. පහේ නෝට්ටුවක් අතේ ගුලි කරගත් මා විශාකා එකේ කෙල්ලව යාළු කර දෙන බවට පොරොන්දු වූයෙමි. ඉන් පසුව අපගේ පන්ති භාර ටීච වූ මඩවල මිස්ට, ලොකු සර් (සුවාරිස් මයා ) අපිට හැන්දෑවේ පින්කමට දානෝපකරණ ගේන්නට නියම කල බව පවසා මමත් බැස්ටියාත් දහම් පාසලින් මාරුවී කෙලින්ම ගියේ සැවෝයි එකටය.

සැවෝයි එකේ Grease චිත්රපටය තිබුණි. අපි ගියේ සෙකන්ඩ් ක්ලාස් ය. ටිකට් එකක් 2.75 විය. අපි දෙදෙනා ෆිල්ම් එක බලා ලබන ඉරිදා දහම් පාසලේදී හමු වෙමු කියා විසිර ගියෙමු.

ඊලඟ සුමානේ කොල්ලාට දුන් පොරොන්දුව මතක් විය. කොල්ලාගේ සල්ලි ගත් නිසා ශේප්මන්ට් එකක් දැමිය යුතුය. කෙසේ නමුත් මාත් බැස්ටියාත් කොල්ලාගේ කනට කර " අප කෙල්ලට කතා කල බවත් , කෙල්ල ඔහුට කැමති බවත් නමුත් ඕලෙවල් විභාගය ඉවර වෙන තෙක් කිසිම සම්බන්ධතාවකට නොඑන බව කෙල්ල අපට කී බව කීවෙමු. අප දෙදෙනා කිව්වේ බොරුවකි. අපට කෙල්ල හමු වූයේද නැත. නමුත් ඕලෙවල් වලට තව වසර දෙකක් තිබෙන නිසා කොල්ලාට ඉවසගෙන සිටින ලෙස අප ඔහුට අවවාද කලෙමු.

මචං කමක් නෑ මම කොහොම හරි හිත හදාගෙන තව අවුරුදු දෙකක් එයා වෙනුවෙන් බලා ඉන්නම් කියා කොල්ලා කීවේය

Tuesday, February 13, 2024

Leonardo da Vinci’s Art in a Psychoanalytic Perspective


Ruwan M Jayatunge M.D. 

"Leonardo da Vinci was like a man who awoke too early in the darkness, while the others were all still asleep" - Sigmund Freud  

The renaissance painter Leonardo da Vinci was a man well beyond his time. He was a genius who demonstrated skills as an architect, engineer, mathematician and a philosopher. What is so special about Leonardo da Vinci’s art? He studied nature in its finest detail. He made enormous attempts to make his art as true to life as possible. He was a passionate painter who was dedicated to his work, sometimes driven by obsessions. His art is everlasting and he expressed motions of the mind in his art. 

Leonardo's paintings are full of spiritual reflections.  For centuries da Vinci’s some of the art work has become a mystifying riddle to the people. According to connoisseur opinion there are hidden messages associated with his art and the speculation led to the birth of the term da vinci code. His paintings can be called “Pictures within Pictures. He used art as a mode of communication. Perhaps some of the puzzles were not known to da Vinci himself since he depicted his art following unconsciously driven motives. 

A large portion of these distinctive characteristics steamed from his unconscious mind that was deeply analyzed by Dr Sigmund Freud.  The impressive essay written by Sigmund Freud in 1910 titled Leonardo da Vinci, A Memory of His Childhood reveals the inner psyche of this great artist. Freud's essay on Leonardo was stupendous and he reconstructed the psychology of a man who was considered as the archetype of the Renaissance period. 

Freud had speculated on various aspects of Leonardo's personality. His life has been the subject of study, analysis and speculation. Freud has written the connection between Leonardo’s inner psyche and its role in his art. Freud examined Leonardo's life and works closely from a psychological perspective. Freud largely depicted Leonardo's life by factual references he had found. He mainly speculated on the two paintings of Leonardo da Vinci the Monna Lisa and Sant'Anna and the Madonna with the child. This analysis gives a detailed reconstruction of Leonardo's emotional life from his earliest years.  

Leonardo da Vinci was born as the illegitimate son of a notary in 1452. He had an anxious childhood. Frequently little Leonardo was disturbed by a nightmare. He saw a kite dropped from the sky and hovered over his cradle, its tail feathers brushing his face. Although little is known about Leonardo's early life there are facts which concur that he was very much attached to his father’s young legal wife Anchiano. Young Leonardo was devastated over the untimely death of Anchiano and suffered derivational symptoms. 

Freud examined the childhood of Leonardo da Vinci, to explain his psychological inclinations toward people who took care of him.  Young Leonardo was doted on by his mother, neglected by his father; hence Freud suggested that he was subjected to so called inordinate Oedipal development in which the subject took his father's domination of the mother as a "de facto" domination (therefore prohibition on the father's part). 

Freud applied theory on Leonardo’s prodigious genius, his scientific pursuits and the fact that he left so many works unfinished. For instance one of his magnificent paintings, the Madonna Litta was not completed by Leonardo da Vinci and later one of his pupils did the completion. Freud attributed that partial completion of Madonna is symbolic and it was the unconscious expression of childhood anxiety that was experienced by da Vinci following the deprivation of his mother.  Sigmund Freud interpreted Leonardo’s childhood memories as fantasies and compares it with mythological information. He stated that Leonardo identified with his mother unconsciously as an object so he could experience self-love (narcissism) and his antagonism toward his father was specifically described in his art. 

Freud continues his discussion of the memory of Leonardo's mother in his analysis of Mona Lisa's smile. This ambiguous half smile is one of the striking features of the painting. Enigmatic portrait Mona Lisa which is an open text painted during the Italian Renaissance and it could be considered as the most celebrated work of Leonardo.  

Freud theorized that Leonardo’s fondness of depicting the Virgin Mary with St Anne which represents two mothers. Leonardo was raised by his blood mother and later adopted by the wife of his father hence he had two mothers. This very idea was represented in his art. Freud explained that depicting the Virgin Mary with St Anne represents protection under two mothers.  

Experts claim that androgyny and eroticism manifested in a number of drawings of Leonardo da Vinci and his famous painting Virgin of the Rocks demonstrates Leonardo's interest in nature. Leonardo's most legendary painting, the Last Supper represents the last meal shared by Jesus with his disciples before his capture and death. His ability to adequately depict the faces of Christ and Judas were marvelous. The Last Supper specifically portrays the reaction given by Judas Iscariot who betrayed Christ.  

Freudian psychobiography of Leonardo da Vinci scrutinizes the life and work of one of the exceptional artists of human history and for a considerable extent it helps to resolve the mystery of Leonardo da Vinci.  

Thursday, February 8, 2024

Can Reincarnation be Explained with Quantum Theory?



 Ruwan M Jayatunge M.D. PhD (in progress) 

Recently Dr Mahinda Pathirana of the Sabaragamuwa University of Sri Lanka, made an attempt to explain reincarnation via quantum mechanics. He uses the Buddhist teachings, Milinda / Nagasena debate and some of the ideas of the 2nd Century Buddhist Philosopher Nagarjuna.  He is bringing Quantum entanglement to explain the method of transferring consciousness and how the birth of a consciousness in another body.  

A complex and philosophical question is why we are born into a particular body and life. Is it something random? or predetermined? According to the current understanding of quantum mechanics things happening in the universe are probabilistic rather than deterministic. We know that Brownian motion is a random motion. Is it possible for the universe to be deterministic at certain levels?  Remember Albert Einstein stated, “God does not play dice”. Therefore, some people say nothing is "random" in the real world.

Those who agree with reincarnation try to highlight the connections between reincarnation and quantum mechanics and quantum entanglement. Quantum entanglement explains how two subatomic particles can be intimately linked to each other even if separated by billions of light-years of space. These particles communicate faster than the speed of light. Neuro-experts point out quantum effects in neural processes. Quantum entanglement links everything in the Universe. Deepak Chopra says that quantum entanglement links everything in the Universe, and therefore it must create consciousness. But I must say that the scientific community does not regard Deepak Chopra to be a credible scientist and his theories lack empirical evidence and they are not supported by mainstream scientific research. Moreover, Art Hobson Prof of Physics, University of Arkansas specifies that quantum entanglement has nothing directly to do with consciousness.

Despite these skeptical ideas can we say consciousness operates on a quantum level? Some claim that consciousness is a manifestation of quantum processes in the brain. The British molecular biologist Francis Crick and neurophysiologist Christof Koch proposed that consciousness is generated by networks of neurons oscillating in synchrony. Crick and Koch (2005) indicated that the “claustrum” which is a thin, irregular, sheet-like neuronal grey matter structure that lies beside the insular cortex, may be involved in the processing of consciousness.

Consciousness is a complex and multifaceted phenomenon. However, so far, physicists have explained that quantum entanglement is a physical reality.


Quantum Theory and Consciousness

Consciousness implies awareness: subjective, phenomenal experience of the internal and external worlds. Consciousness creates the physical world moment by moment. Consciousness emerged as a property of complex biological computation during the course of evolution. Some suggest that consciousness is a quantum phenomenon. Connections between neurons alone cannot explain consciousness. Therefore, as an alternative theory some propose the quantum mind or quantum consciousness. Does the human brain use quantum computation? Can quantum theory help us to understand consciousness?

Quantum theory is characterized by the acknowledgment of a fundamental limitation in the classical physical ideas when applied to atomic phenomena. Niels Bohr's philosophy of quantum mechanics helps us to understand physical realities.  We know that Bohr was inspired by Immanuel Kant. Kant stated that without any consciousness we would make no distinction. For Kant, consciousness results from differentiation.

Bohr believed that the discovery of quantum mechanics could and should inform philosophy about new ways of understanding human knowledge. It would replace causal-space-time description of classical physics in order to preserve objectivity. Einstein's theory is also central to quantum mechanics.

Scientists use string theory to describe the fundamental forces and particles in the universe. Can string theory explain consciousness? String theory highlights that reality is made up of infinitesimal vibrating strings. As string theory describes everything consists of quantum strings. Some experts postulate that the idea of consciousness being directly related to the position and configuration of strings. They think that string theory and consciousness are two sides of the same coin.

Some Neurologists speculate that the functioning of the brain is quantum. Quantum fields have holographic nature (every component already contains all the information of the whole) This indicates the multidimensional nature of reality.

Consciousness is the sensory awareness of the body, the self, and the world.  Human consciousness arises from quantum fields. Still, we don’t have an accurate picture of quantum dimensions of reality. We cannot focus on consciousness from the perception of the physical senses. Consciousness goes far beyond the limitations of mechanistic materialism.

Having said that, we know that neurons alone cannot explain consciousness. Can we use quantum mechanics to explain the function of consciousness?  Quantum mechanics allows the calculation of properties and behavior of physical systems. Quantum physics suggests that two particles will respond simultaneously to an active agent, regardless of distance. There is a deeper connection between consciousness and quantum mechanics. The mathematics of quantum mechanics might show us how consciousness works. We as humans live in a fundamental nondeterministic world. Quantum interaction remains indeterministic. The universe operates according to deterministic laws of physics such as consciousness. Consciousness belongs to the subatomic world which is fundamentally inscrutable.

Can we conclude that consciousness is based in the brain? Neuropsychologists believe that consciousness may arise from the complex interactions of neural networks in the brain. Conceivably Brain is a quantum processor.  Kodukula (2009) theorized that the conscious brain works like a projector.

Here I want to bring an illustration. Most likely you may have seen how Jimi Hendrix played his guitar. Where does that electronic melody come from? Did it come from his Fender Stratocaster guitar itself or from Jimi Hendrix’s fingers? That innovative, powerful, and expressive sound came from the combination of his fingers and Fender Stratocaster guitar. Consciousness too comes as a series of combinations. 

Hiroomi Umezawa - Physicist and Distinguished Professor in the Department of Physics at the University of Wisconsin interpreted memory and other conscious phenomena as the result of the energy exchange of energy particles in the cerebral cortical field. Is there a quantum-level substance that can be transmitted between neurons, such as a neurotransmitter, which conveys consciousness-related information? Hameroff and team (2014) proposed that consciousness depends on biologically ‘orchestrated’ coherent quantum processes in collections of microtubules within brain neurons.

Javier García-Castro and Prasad Kodukula Siva state that a fundamental property of the entire universe and that conscious experience emerges by transformation from mind (‘‘jeeton’’) to matter (‘graviton’). Graviton is a postulated quantum that is thought to be the carrier of the gravitational field and jeeton is a quantum particle.  Kodukula (2019) hypothesized that the interaction between ‘jeeton’ and ‘graviton’ gives rise to consciousness. This model emphasizes that ‘mind’ is a consequence of ‘jeeton’ and the ‘matter’ is a consequence of ‘graviton’. Their entanglement gives rise to consciousness. However, it’s important to mention that jeeton / graviton theory is a hypothesis and still there is no empirical evidence to prove this fact.  


The Concept of Reincarnation and Quantum Physics

The concept of reincarnation cannot be explained through classical Newtonian physics. There is no empirical evidence to prove reincarnation using mathematics or cell biology. However, some experts use Quantum physics to explain the reincarnation process.

Can we use quantum physics to explain metaphysical theories of reincarnation?  Quantum physics, as a branch of science, primarily deals with the behavior of matter and energy at the smallest scales. We all agree that Quantum physics opens a totally new world view and provides a new understanding of spiritual philosophy. Quantum physics gives a new cosmovision. Newtonian physics was deterministic and Quantum science is probabilistic. Quantum science is holistic, acknowledging a multi-dimensional universe. Through Newtonian physics we can understand the objective world scientifically through the senses. But Quantum physics can explain things beyond our sensors.

According to quantum theory energy is not continuous but comes in discrete units and the elementary particles behave both like particles and like waves. Quantum physics has evidenced that one particle can be in more than one place at the same time. Subatomic particles communicate instantaneously and travel faster than the speed of light. At the subatomic level, matter does not exist with certainty in definite places. Sometimes a particle acts like a particle, sometimes like a wave. Therefore, the quantum world evolves beyond the common parameters of the space-time characteristic of the macroscopic realm.

Can consciousness exist without or beyond the human brain? Can consciousness open to other dimensions? Human consciousness has multidimensional, holistic and holographic properties. Some physicists conclude that consciousness is primary and the creative basis for the material world. The entire humankind may be living in a universe of consciousness.  Consciousness is a great part of the cosmic ocean. consciousness cannot be reduced to matter.  Can we detect transmigration of consciousness using quantum physics? Perhaps reincarnation resides quantum definition of physical reality? Those who agree with reincarnation suggest that quantum memory remains after biological death and it transmigrate to another plains as a special type of consciousness and continues, through to another incarnation. This is universal interconnectedness. May be reincarnation is a quantum reality.

Can consciousness move to another reality after death? Jerzy Zbigniew Achimowicz of the Warsaw Medical Academy state that when a human being dies, the seat of mind, generates a quantum solitary electromagnetic wave packet and then reincarnation may happen if given seat of mind (consciousness) finds a brain of a newborn with similar genotype. (consciousness attaches to a new brain?)


Reincarnation Explained in the Buddhist Doctrine

As described by Ṭhānissaro Bhikkhu who is an American Buddhist monk and author, rebirth has always been a central teaching in the Buddhist tradition.  The Buddha did not believe in a transmigration of soul and replaced the soul by the theory of mind-continuum (Thupten Tenzlng - Karma and Rebirth in Buddhism). There is a causal link between a subtle form of consciousness present at the time of death and the first moment of consciousness in the next life (Finnigan, 2023).

According to Buddhist doctrine a thought moment occurs when a person dies. It is the mind set during death in the current existence and then grasping the next life. A dying person has exit consciousness. This consciousness is a form of transitory energy. Exit consciousness transforms into another level of consciousness and it can enter another womb when a matching one becomes available. Hence rebirth occurs. Three conditions are essential for conception: “the union of mother and father, the mother in season, and the presence of a transformed level of exit consciousness.

The Buddhist concept denies the existence of an eternal soul.  Instead of an eternal soul, they believe in transforming consciousness which is not static. These processes are governed by the Karmic force or karmic retribution. Here the analogy is the flame of a dying candle can serve to light the flame of another. A flame is transferred from one candle to another. Hence consciousness is a continuous birth and death of mind-states. It is linking an individual to past and future existences. The person who dies here and is reborn elsewhere is neither the same person, nor another.

Milinda was the King of the Indo-Greek Kingdom who probably reigned from about 155 to 130 BCE. King Milinda had a debate with Bhikkhu Nagasena about rebirth.   

In the Milinda / Nagasena debate the king asked: 

"When someone is reborn, Venerable Nagasena, is he the same as the one who just died or is he another?" 

Ven Nagasena replied: "He is neither the same nor another." 

"Give me an illustration!" 

 "Milk, once the milking is done, turns after sometimes into curds; from curds it turns into fresh butter; and from fresh butter into ghee. Would it now be correct to say that the milk is the same thing as the curds, or the fresh butter, or the ghee?

"No, it would not. But they have been produced because of it."

All Buddhist schools agree that there is no enduring, substantial, or independently existing entity that continues from life to life. Instead, there is simply an apparent continuity of momentary consciousness from one lifetime to the next that is imbued with the impressions or traces of the actions one has done in the past. One moment gives rise to the next, in a continuity of causally connected conscious events, but nothing solid or substantial continues from one existence to the next. (Lekshe Tsomo - University of San Diego).

Ven Buddhaghosa - a 5th-century Indian Theravada Buddhist monk states that conception occurs immediately after death, that is, the continuity of consciousness enters a new state of existence without any interval in-between.

If we think consciousness is simply energy and it cannot be destroyed and it transforms. Can we say in Buddhist teaching rebirth occurs due to the transmigration of consciousness?  A living being starts a new life in a different physical body   form after each biological death.

The Buddhist notion of the mental continuum of an individual is difficult to explain via neuropsychology. I communicated with several world-renowned Psychologists and Psychiatrists.  I spoke with Professor Judith Herman of Harvard University, Professor Mary Seeman of University of Toronto, and Professor Philip Zimbardo of Stanford University. Many of these intellectuals expressed their doubt about the said process. Professor Zimbardo was explicit and stated, “This process is Not possible in reality It can only be a religious belief with no scientific evidence”. However, Professor Daya Somasundaram- a senior professor of psychiatry at the Faculty of Medicine, University of Jaffna expressed his thoughts thus.  

“I feel that these beliefs and descriptions are metaphysical or subtle phenomena which are beyond current neuropsychological knowledge or theories. Most scientific and neuropsychological knowledge or speculations tend to confine themselves to very basic and objective, materialistic phenomena as the hard facts of life. They even have problems with admitting subjective phenomena such as consciousness. They would consider the Buddhist descriptions as mere speculations with no objective evidence. But some psychologists and others do go beyond the hard or materialistic views and frontiers to entertain such beliefs and descriptions”.


How Did Consciousness Evolve?

According to Salama, (2008) life began as lipid molecules originating in deep space and fell into the surface of the primordial ocean and then went into numerous changes and transformed into a cell then through the evaluation multicellular beings emerged. Cells have memory and it’s called cellular “memory. Based on Darwinian evolution, the scientists surmise that consciousness would have occurred initially some 200 million years ago. They think that consciousness was built upon the mammalian neocortex. The core of human consciousness appears to be associated primarily with phylogenetically ancient structures mediating arousal and activated by primitive emotions (Denton et al., 2009).

Living cells constitute a new class of matter. Cells literally construct themselves. Through consciousness we create the physical world. We cannot explain consciousness through mainstream science.  Living things are Kantian wholes where the parts exist for and by means of the whole. The link between the lifeworld and the quantum world should already be broadly evident. Quantum mechanics points to the end result of what consciousness does. Is there a quantum mind, resides in the space between quantum events?


Can Consciousness Continue After Death?

Consciousness is the most important function of the organism. According to William James, consciousness is not a static thing but a process. Neuroscientists believe that consciousness is generated by the brain. They highlight that consciousness must be the product of neural activity. Substantial interconnections among the brainstem, subcortical structures, and the neocortex are essential integrating components of human consciousness.

Different levels of consciousness are distinguished: 1. hyperalertness, 2. alertness (normal state of wakefulness), 3. somnolence or lethargy, 4. obtundation with tendency to fall asleep, 5. stupor, 6. coma and its subtypes, like akinetic mutism, apallic syndrome or persistent vegative state, locked-in syndrome, delirium, and catatonia.

Following a coma, some patients may "awaken" without voluntary interaction or communication with the environment. The patients who are in "persistent vegetative state” show some degree of consciousness--a condition called "minimally conscious state". Using neuroimaging techniques Neurologists are able to measure the fading consciousness in the human brain.

Is there an irreversible loss of consciousness? There may be consciousness in the dying brain. The brain is assumed to be hypoactive during cardiac arrest. Gang Xu and team analyzed electroencephalogram and electrocardiogram signals in four comatose dying patients before and after the withdrawal of ventilatory support. Two of the four patients exhibited a rapid and marked surge of gamma power, surge of cross-frequency coupling of gamma waves with slower oscillations and increased interhemispheric functional and directed connectivity in gamma bands.

These data demonstrate that the dying brain can still be active. Some researchers have found a surge in brain activity at the time of death. The question remains; is there a survival of consciousness after death? Dr. Sam Parnia a British associate Professor of Medicine at the NYU Langone Medical Center is of the view that human consciousness does not become annihilated after death. What happens to this consciousness? Does it enter a living fetus? 

Dr. Robert Lanza is a scientist and author, and a professor at Wake Forest University coined the phrase ‘biocentrism’ which is a theory that the consciousness is released into the universe through sub-atomic particles According to this notion    consciousness would not necessarily be dependent on a physical brain in order to survive. Therefore, consciousness is more than an abstract concept.  


Consciousness in a Human Fetus

The emergence of consciousness or the mind can be regarded as defining human viability. Development of the embryo begins at Stage one when sperm fertilizes an oocyte and together, they form a zygote. The zygote is a large diploid cell that is the beginning, or primordium, of a human being. The fetus may be having a consciousness, and it reacts to pain and other stimulations.

The fetus reacts to nociceptive stimulations through different motor, autonomic, vegetative, hormonal, and metabolic changes relatively early in the gestation period.  The fetus may be aware of the body. But the fetus is almost continuously asleep and unconscious partially due to endogenous sedation.

The newborn infant can be awake, exhibit sensory awareness, and process memorized mental representations. However, Falsaperla and team (2022) state that neuroanatomical point of view, it is rather unlikely that the infant can be seen as a conscious human before 24 weeks of gestational age. (This hypothesis assumes that consciousness is mainly localized in the cortex, consciousness cannot emerge before 24 gestational weeks when the thalamocortical connections from the sense organs are established).


Concluding Thoughts

Is there a mechanism within quantum physics that can be used to validate or explain the notion of reincarnation?  Quantum physics indicates the possibility of higher-dimensional spacetimes.  The quantum effects are evident in photosynthesis and during the process remarkable efficiency of energy is transferred.  

Dr. Maher Abdelsamie proposed 5 dimension aka Meta-Dimension which is believed to mediate the entanglement between quantum particles regardless of their physical separation in the conventional three-dimensional space. Using Meta-Dimension, we can explain the nature of consciousness. The mind set during death or in other words exit consciousness can be redefined as a complex network of entangled quantum states. Can the exit consciousness remain after death and go to another realm?

However, reincarnation is a metaphysical concept. It falls outside the scope of quantum physics and mainstream science. There is currently no scientific evidence to support the idea that quantum mechanics can explain reincarnation.



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