A Proposed Neurophysiological Model for
Sudarshan Kriya® and Consideration
of How to Bring It into
Mainstream Medical Modalities
Vipin Kalia, MD
20 October 2009
Executive Summary
This paper examines a proposed research and development program involving sudarshan kriya® (a Sanskrit terminology meaning “proper vision, purified action”), a revived ancient technique for purifying the human bodymind of various disorders. Sudarshan kriya accomplishes this through a systematic daily practice of specifically altered breathing, as developed by Sri Sri Ravi Shankar and Art of Living Foundation.
The author suggests a neurophysiological hypothesis for the mechanism of sudarshan kriya, with adequate empirical content to enable testing. He then suggests individual and social benefits that could come from widespread use of sudarshan kriya in medical protocols.
To collaborate with the author on this proposed research and development, please contact Vipin Kalia at (317) 414-4439, kalia_vipin@hotmail.com.
Vipin Kalia, MD, has a BA in chemistry from Purdue University and studied medicine at Indiana University School of Medicine. He did his post-graduate training in internal medicine at Indiana University Medical Center at Indianapolis. He is assistant professor of medicine at Indiana University and general internist at the VA Hospital in Indianapolis.
Introduction to pH Chemistry
pH is a measure of acidity or alkalinity (an alkaline substance is also referred to as “basic”). A pH from 0 to 7 is acid (e.g., soda pop or vinegar), a pH of 7 is neutral (pure water), and a pH from 7 to 14 is alkaline (baking soda or soap) (see Figure 1).
The human physiology has various pH levels in different areas. Blood pH is influenced, to some degree, by our activities. For example, when we breathe out, we expel carbon dioxide; we breathe in oxygen. Breathing more quickly than normal (hyperventilation) releases excess carbon dioxide. This causes our blood pH to rise, and our blood becomes more alkaline. The normal pH of blood is around 7.4. Hyperventilation raises the pH to 7.45–7.5. Slow breathing (hypoventilation) creates more acidic blood.
The same pH is transferred to the brain and cerebrospinal fluid during hyper-/hypoventilation. In certain psychiatric disturbances such as panic disorder, patients can spontaneously hyperventilate, with breath rates of 25–30/minute. This excretes excess carbon dioxide, and they become more alkaline and quickly settle down and become numb. A physician can slow the process by having the patient breathe into a paper bag. This spontaneous hyperventilation doesn’t really injure the patient, however.
“Intracranial bleeding” means bleeding into the brain, either outside the brain as epidural hematoma or inside the brain as intracerebral bleeding. Either way, such bleeding increases pressure inside the brain cavity. This is known as increased intracranial pressure, and it causes the brain to exit the skull cavity (herniation) through the bottom, slowing breathing and possibly causing death. To prevent that, neurosurgeons usually put patients on a breathing machine and hyperventilate them, pushing them into a more alkaline state. This decreases intracranial pressure. Modern medical science has not examined or explored other medical or psychiatric therapeutic modalities stemming from hyper- and hypoventilation. However, in panic disorder and intracerebral hemorrhage, the role of hyperventilation is well-known to modern medical science.
Neuron Functioning
Neurons are brain cells. Each brain has 100 billion neurons, responsible for transmitting information from one part of the brain to another. A neuron initiating information transfer is called a pre-synaptic neuron, and the immediate destination is called a post-synaptic neuron (see Figure 2).
Figure 2: The pre- and post-synaptic neurons.
All biological information transfer between cells, throughout the body, happens via a so-called “lock-and-key” mechanism. Pre-synaptic neurons release neurotransmitter chemicals that lodge themselves into post-synaptic neurons through this mechanism. This action opens a certain gate or channel, wherein the information is transmitted further to the next level. A problem can arise when certain medications that mimic neurotransmitters cause the locks, i.e., receptors, to “down-regulate,” which means to decrease in number, or “up-regulate,” which means to increase in number. This curtails the effectiveness of the medication after a few weeks or months of use. Also, because the same locks and keys are used in analogues in multiple parts of the brain, medications fail to travel precisely to a desired location. They open multiple locks and, hence, produce side effects.
Modern psychiatric theory is based on the concept of chemical balance/imbalance. Most psychiatric disorders are explained on the basis of neurotransmitters not being in the right quantity in the right location. The medications are intended to help in that area. Due to the above-mentioned problems, patients are usually not happy with the long-term efficacy of the medications.
Why do these medications come into and stay in the market? The FDA standard for admission to the market is a 5% greater benefit compared to placebos. The measurements involved in this assessment are sometimes as short as six months and often less than two years. Any testing after six to twenty-four months ordinarily lacks the rigor of shorter trials. This can mask the reduced benefits of the drugs over time. In the end, modern medical science has limited useful treatments for psychiatric disorders, chronic pain, arthritis, and so on.
A brain looks like squiggly lines on the outside, but a PET, CT, or MRI scan exposes different parts of the brain. These internal structures are in constant contact, via neuronal connections. Each cell, on its own level, generates electrical activity, some of which is pure “noise,” like a bubble machine, of sorts. However, combined, the cells form tissues and build up to named parts of the brain, where their electrical output can be measured, including visually on PET scans. The amygdala, for example, controls mood. Other centers join together to control impulses such as hunger and satiety. Certain of these electrical currents are perceived consciously as thoughts. The brain produces this symphony of electrical currents, large and small, all the time.
Hunger is something we all commonly experience. When multiple mechanisms in the body combine functions and send signals to the brain, such as “stomach empty/low glucose,” the brain interprets this as hunger and a need for food. Once the food is obtained, those electrical signals are suppressed by the brain’s satiety center, which also produces “feel-good” chemicals—enkephalins and endorphins—and sends them to the hunger center. Eventually, the body coaxes the brain back into hunger, and the process of seeking food starts afresh (see Figure 3).
Figure 3: The hunger/satiety feedback loop.
A similar feedback loop works in multiple mechanisms in the brain and other biological functions in the body. In a condition such as obsessive–compulsive disorder (OCD), some part of the brain generates the obsession or the compulsion to, for example, wash hands. Once the hands are washed, a certain amount of anxiety is relieved. When this particular circuit is in overdrive, this ritual can itself become a clinical problem.
Psychiatric disorders fall across a two-part spectrum, from simple stress to post-traumatic stress disorder as a mild range and from psychosis to schizophrenia as a major range (see Figure 4).
Figure 4: The spectrum of psychiatric disorders.
In all aspects of this spectrum, the underlying problem remains constant. Some parts of the brain are generating signals that are not being controlled by other inhibitory cycles of the brain. In normal people, similar thoughts do occur at a lower frequency, and inhibitory cycles can usually stem those thoughts and prevent their being carried out to the extreme. In clinical disorders, these thoughts are not well-controlled. The same neurons mentioned above functioning as a bubble machine, generating impulses not modulated by the inhibitory neurons, lead to some of these psychiatric maladies. In post-traumatic stress disorder, for example, thoughts of past trauma are recycled excessively, leading to impairment of normal functioning.
In the cortical regions of the brain, our higher discriminatory mentation occurs. The primitive parts of the brain, such as the so-called reptilian complex lying atop the brainstem, control our moods, hunger and satiety, sexual urges, and so on. They coexist in uneasy truce with our cortical, mammalian levels in which our “smarts” reside. People with a well-balanced personality manage to control the lower urges to a large extent. In pathological, psychiatric conditions, moods, obsessions, compulsions, and addictions are difficult to control. A bubble machine generating continuous anxiety and sending it to a higher cortical function unable to properly suppress it will result in a disturbed affect and a lack of feeling of wellness. A medication capable of suppressing the bubbles could, in theory, control some of these psychiatric disorders. Traditional medications and psychotherapy have tried to operate in this realm (see Figure 5). Psychotherapy goes through the ears and eyes and into one’s higher cortical function in hopes of sending suppressive signals downward, into the primitive parts of the brain. Medications go everywhere in the brain, and are supposed to control neuronal impulses on an individual basis.
Figure 5: Mode of action of psychotherapy versus medications.
Medications, as previously discussed, are not adequately selective as they go about opening locks throughout the brain, resulting in side effects and up- and down-regulation of the receptors, including in other areas of the body, such as the heart, lungs, and GI tract. Side effects of these psychoactive drugs can therefore include problems such as diarrhea, bladder outlet obstruction, fast heart rate, dizziness, and so on. Psychotherapy is also not selective because some of the primitive parts of the brain are on an automated cycle and usually do not receive the inhibitory responses from the higher cortical function in a particularly receptive fashion.
In an ideal world, a new mechanism would turn the bubble machine switch off in the primitive brain. Could a mechanism from thousands of years ago possibly incorporate a complete understanding of all these biochemical, neurophysiological processes? Could it provide a treatment option helpful for people looking for just general peace of mind, as well as for large psychiatric disorders?
Hypothesized Mechanism of Sudarshan Kriya®
From a milieu of Vedic culture from India, stretching back 5000–8000 years, multiple systems have emerged to normalize brain activity. One such technique is known as sudarshan kriya, a series of hyper- and hypoventilations wherein the pH of blood and cerebrospinal fluid is altered. This alteration ultimately results in release in the brain of chemicals that produce an inhibitory response. Easy-to-measure stress-related chemicals, such as blood cortisol, decrease with sudarshan kriya, as substantiated in laboratories throughout the world.(1) Other psychological characteristics, such as concentration, mood, and depression, have been shown, through psychometric testing, to improve as well. To the author’s knowledge, no one has directly measured nano-concentrations, within the cerebrospinal fluid, of enkephalins, endorphins, seratonin, dopamine, epinephrine, or norepinephrine. Perhaps the ultimate research on sudarshan kriya would lie in just such research.
The hypothesized mechanism is that, once these chemicals are selectively released in the centers of the brain creating pathological impulses, such as affective disorders, these impulses are suppressed selectively, within only that particular tissue, with no collateral side effects. This would be similar to rebooting a computer (tried in a crude manner with electroconvulsive therapy). These neurotransmitters, though available in pre- and post-synaptic neurons of the pathological impulse-generating sections of the brain, are not released with appropriate quantities or timing to suppress the pathological impulses. Similarly, the inhibitory neurons are not capable of releasing enough neurotransmitters to suppress the pathological impulse-generating signals. Most medications do not work exceedingly well, nor are they extremely selective. In modern medical science, it is well-known that proteins bind with varying amounts of strength, based on temperature or pH. What has not been explored is that, by systematically altering pH from acidic to alkaline (or vice versa), one could release inhibitory neurotransmitters at selected locations and times, selectively (without any side-effects) producing a range of desired effects. These include “peace of mind, state of calmness,” suppressed obsessions in OCD, and reductions in both criminal tendencies and the playing out of traumas to the brain in disorders like PTSD. In major psychotic disorders, delusions created by the brain could also be suppressed by selectively altering the pH. Sudarshan kriya does all that!
The Useful Role of Sudarshan Kriya in Society
There are clear social implications to sudarshan kriya’s ability to reduce pathological impulses and increase well-being: lowered crime, improved educational outcomes, and treatment of psychiatric, psychosomatic, and behavioral disorders resistant to current therapies. In order to bring this powerful tool into the conventional medical arsenal, a number of hurdles must be overcome. There are, for instance, no patents available on something like sudarshan kriya. Hence, no drug company is going to invest millions moving it through research protocols and into doctors’ offices. Sudarshan kriya lacks extensive, rigorous research, for all the shortcomings of such research mentioned at the beginning of this paper. What research exists on sudarshan kriya involves small populations and does not have much money behind it to generate widespread publicity. Even when patients are willing to explore this option, no large medical centers offer necessary expertise to provide it.
All types of psychiatric disorders will need to be tried with various mechanisms of sudarshan kriya and will have to pass scientific standards. The benefits—social, psychological, crime-related, productivity-related, medical—will have to be demonstrated on an individual basis. These techniques would have a particularly significant role in management of behavioral disorders, especially in inner cities where there is a high rate of crime and violence. A lot of money would be needed to create this research. Then, established medical establishments could offer sudarshan kriya in tandem with conventional treatments. Much advertising would be necessary to bring this into the mainstream.
Individual Benefits
Individuals practicing sudarshan kriya would have a happier, more useful life, with reduced costly medical/psychiatric disorders and with lower exposure to crime from themselves and others.
Social Benefits
The proposed use of sudarshan kriya would result in reduced individual and social stress, and reduced stress-related diseases such as hypertension and diabetes, and their complications such as heart disease, stroke, and so on. At the social level, this would create a calmer, more peaceable society, with less crime and intra-species pressure. Savings would accrue from reduced psychiatric disorders and less crime. Productivity would improve on the basis of improved educational outcomes. The program would pay for itself in terms of medical, psychiatric, and criminal justice savings. Eventually, additional savings would come about from the replacement of expensive psychiatric medications and hospitalizations with sudarshan kriya. From the business standpoint, the program would also pay for itself, from revenues associated with training programs.
Financials
The staff to deliver this program must be trained both in modern medical science and in sudarshan kriya. The staff would conduct scientific trials while using sudarshan kriya as an adjunct therapy, with the studies being published in refereed journals. As soon as benefits would be shown for each of the psychiatric problems mentioned above, infrastructure and advertising would have to be paid for, in order to popularize the program.
psychiatrists with research experience (2) @ $300K $600K
psychologists with research experience (6) @ $125K $750K
masters-level research assistants (6) @ $75K $450K
social psychologists (4) @ $75K $300K
secretaries/receptionists (4) @ $50K $200K
MBA @ $125K $125K
computer technicians (2) @ $75K $150K
internal medicine MDs (2) @ $250K $500K
public relations (2) @ $75K $150K
miscellaneous/accounting/administration/
maintenance (2) @ $62.5K $125K
35 people on staff total $3,350K
300 sq. ft x 35 = 10,500 sq. ft
+ lobby
+ exam rooms, 5000 sq. ft
+ conference room
15,500 sq. ft
15,500 x $150 sq. ft = $2,325,000 rounded to $2,250K
total ~ $5,600K
advertising costs, 25% $1,400K
total $7,000K
second-year labor cost $3,350K
grand total $10.35 million
revenue
psychiatrist, $750K x 2 $1.5 million
psychologist, $200K x 6 $1.2 million
masters/counselor, $150K x 4 $0.6 million
medical doctors, $750K x 2 $1.5 million
masters-level research assistants $250K x 6 $1.5 million
total $6.3 million
profitability achieved in one year
second-year revenue $7.5 million
providing expansion potential
Clearly, the early-phase seed money of approximately $10.35 million can come from a wealthy donor, who has benefited first-hand from such a program. Other sources of funding could include government and philanthropic grants and endowments, however the concentrated efforts of multiple people and several hundred thousand dollars would be required to bring such levels of funding to fruition.
To collaborate with the author on this proposed research and development, please contact Vipin Kalia at (317) 414-4439, kalia_vipin@hotmail.com.
Vipin Kalia, MD, has a BA in chemistry from Purdue University and studied medicine at Indiana University School of Medicine. He did his post-graduate training in internal medicine at Indiana University Medical Center at Indianapolis. He is assistant professor of medicine at Indiana University and general internist at the VA Hospital in Indianapolis.
Endnotes:
(1) www.mindandbodyhealth.org/National%20Symposium%20-%202006/Proc%20pages/
CMB/CMB6.pdf
