Panchakarma – the deep healing and detoxification process of Ayurveda

By Jamila Colozzi 06 December 2018

Ayurveda, the ancient “science of life,” is one of the oldest documented forms of health care in the world. It is a holistic science that places great emphasis on prevention in health through maintaining harmony of body, mind and spirit, or consciousness. Its healing interventions include diet and lifestyle guidelines, herbal remedies, Yoga and meditation practices, as well as various therapies known as Panchakarma to support and enhance individual Ayurvedic programs.

A holistic definition of “health” based on balance

To understand how Panchakarma works, it is important to learn some Ayurveda basics. Ayurveda defines health as the state where every aspect of our being is working properly and in harmony with all its other aspects.

Balance in the mind-body system requires:

  • The digestive fire (Agni) is in a balanced condition
  • The three Doshas (the three humors, or energetic qualities) — Vata, Pitta and Kapha — are in equilibrium according to the individual constitution
  • Waste products (Malas) are produced and eliminated normally
  • Mind, senses and consciousness are working harmoniously together

The first goal of Ayurveda is “to preserve the health of the healthy,” or to maintain balance. When harmony exists in the system, disease cannot enter.

When balance in the primary functional systems is disturbed, the disease process begins

Any aggravation of the Doshas will affect Agni (the digestive fire) and produces toxins, or Ama. Ama is also produced when there is poor digestion of food, improper food combinations and choices, poor drinking water, pollution, pesticides in food, emotional and physical stress or trauma. As these toxins accumulate, they spread throughout the body and eventually deposit themselves into the deeper tissues, organs or channels, creating dysfunction and disease.

When we talk about detoxification in Ayurveda, we are referring to the loosening and elimination of these toxins, or Ama in the body. Removing the Ama is the first step of the healing process, though Ayurveda also recognizes the importance of rejuvenating the systems and bringing them back into balance.

Personalization, detoxification and rejuvenation

Panch means “five” and karma means “action.” Panchakarma consists of five therapeutic actions or therapies to safely and effectively remove Ama (toxins) from different areas of the body without damaging or weakening the system. The goal of Panchakarma is not to remove physical toxins alone, but truly restore the mind-body system back to a healthy state of balance on all levels – including the mind and emotions.

Panchakarma is unique in that it is tailored to meet each individual’s needs according to their constitution and Doshic imbalances. Ayurvedic philosophy provides the framework for assessing the individual’s constitution and imbalances, which dictate the necessary Panchakarma protocol for an individual. Before entering the process of Panchakarma, a skilled Ayurvedic clinician must assess one’s imbalances and determine the individual’s constitution and current state of Doshas, as well as which tissues, channels and organs are involved in the imbalance and need to be addressed.

A personalized Panchakarma plan is then designed by the clinician, which is a comprehensive process involving diet, nutrition, herbal formulations and supplements, bodywork therapies and lifestyle guidelines. The bodywork therapies performed by a Panchakarma technician include customized herbs and oils to loosen Ama (toxins) from the deep tissues in order to be removed through the body’s natural channels of elimination.

The three phases of Panchakarma

Individual Panchakarma programs can be as short as a week and as long as a month, or even longer in some cases. During this time, it is advised to minimize stress, put aside as much of the regular daily preoccupations as possible, and adopt a more Sattvic, or pure lifestyle.  Surrounding oneself with a pleasant environment, reducing sensory input and avoiding experiences which provoke strong emotions are conducive to the healing process. It is also advised to meditate and practice Yoga asana and breathwork. Regulating the environment and daily practices helps to deepen the detoxification process.

The recommended diet during and after program is also a key element. Heavy food interferes with the cleansing process, so it is advised to eat small amounts of khichadi (or kitchari, a nourishing and cleansing porridge made with mung beans, basmati rice, spices and clarified butter, or ghee) to provide the body with enough nutrition to keep it strong, as well as to keep the digestive fire kindled throughout the process.

Preliminary therapies: Purvakarma to loosen and move toxins

Purvakarma therapies serve to prepare the body by removing stored Ama (toxins) from the tissues. Snehana (oleation) is the first step of Purvakarma and it consists of saturating the body with herbal or medicated oils, or internal oleation through ingesting ghee or medicated oil. External oleation through Abhyanga (or Bahya Snehana) consists of vigorous massage over the whole body with herbalized oils. The choice of oils depends on the particular needs and Doshic imbalance of the individual. Oleation helps loosen Ama and move it from the deeper tissues into the GI tract, where Panchakarma’s main therapies can eliminate it.

Once the massage is completed, Swedana (literally, “sweat”) is performed. The main objective of this therapy is to dilate the channels so that the removal of Ama can be more easily achieved. There are several Swedana treatments that can also be used as adjunct therapies during Panchakarma, but the two most commonly used are Nadi Swedana and Bashpa Swedana. Nadi Swedana is a localized application of steam with herbal decoctions and oils. It usually focuses on specific areas of the body, such as sore joints or muscles, to improve mobility and reduce pain. Bashpa Swedana applies steam evenly to the whole body (with the exception of the head) with the use of a sweatbox. This method is used to further detoxify the body after Abhyanga. It is usually followed by herbal plasters and poultices called Lepa to help draw toxins out of the pores of the skin.

Lastly, Purvakarma involves Shirodhara. It is thought in Ayurveda that steep relaxation provides an environment where deeply rooted imbalances can be overcome, and where it is easier to restore the harmony and functional integrity of the Doshas. Shirodhara is a subtle and profound treatment that consists of pouring warm oil in a slow, steady stream on the forehead. It pacifies Vata Dosha, calms and nourishes the central nervous system, promoting relaxation and tranquility, and improves mental clarity and comprehension.

The basic idea behind the function of Purvakarma therapies can be understood with the following analogy: suppose you oil a bowl thoroughly and then pour honey into it. The honey cannot stick to the bowl because the slippery quality of the oil does not allow it to. So the honey can be poured out of the bowl much more easily than if the bowl hadn’t been oiled. Ama has the same sticky quality as honey, and so it moves easily after the body has been thoroughly oiled and relaxed with Purvakarma therapies.

The main process of Panchakarma: elimination of toxins

After Snehana, Swedana and Shirodhara have been performed, Ama has moved into the GI tract and can be eliminated with the main Panchakarma therapies: Vamana, Nasya, Virechan, Raktamokshana and Basti. Each of these therapies promote the removal of Ama through the normal channels of elimination, either moving it upward, downward or through the periphery (skin). The Ayurvedic clinician will assess the imbalances and decide which therapies should be emphasized, depending on which Doshas, tissues and organs are involved and where has Ama lodged in the body.

Vamana (therapeutic emesis) and Nasya (nasal administration of medicated oils and herbal preparations) usually relate to Kapha Dosha; Virechan (therapeutic purgation) relates to Pitta Dosha, and Basti (therapeutic herbal enema) relates to Vata Dosha. So, for example, in the case of a person with a Kapha imbalance, or excess Ama in a Kapha site, Vamana and Nasya will be emphasized to remove excess Kapha.

Vamana and Nasya

Vamana should not be associated with nausea and sickness. The preparation for Vamana with the use of natural ingredients and herbs makes it a smooth and painless process that can restore balance and help with serious Kapha conditions, such as lung problems and metabolic imbalances. Nasya removes Ama from the nasal passages, ears and eyes, and cleanses and opens the channels of the head, improving oxygenation of the brain.

Virechan

Virechan is a natural, herb-induced purging process that mainly cleanses the small intestine and Pitta-related organs (such as the liver and gall bladder), and removes Ama and excess Pitta from the body, balancing all metabolic functions.

Basti

Basti is probably the most powerful of all five karmas. It consists of introducing medicated oily substances into the colon to be retained and absorbed by the whole body. Its goal is the purification and rejuvenation of the colon, as the colon is linked to all the other organs and tissues of the body. The colon is an important organ for the absorption of nutrients; it is the primary receptacle for waste elimination; and it is the seat of Vata Dosha, which is the mover of the other Doshas and thus of all physiological activity. Therefore, since it balances and nurtures Vata Dosha, Basti Karma has a wide-ranging influence in the body and affects all the Doshas, channels and tissues.

Common enemas and colonics can help cleanse the colon, but these procedures do not nourish the tissues; furthermore, they only remove what is present in the colon. Enemas are temporary and localized, and according to Ayurveda, repeated flushing of water with colonic therapy actually may weaken the mucous membrane and dry the colon, further disrupting the eliminative function of Vata. When Basti Karma is used in conjunction with Purvakarma therapies, it does more than just cleanse the colon. It helps nourish all tissues and remove toxins from the whole body. In other words, Basti removes the Ama from the whole body that has been brought to the colon by Purvakarma.

Paschatkarma: post-Panchakarma procedures to restore the mind and body

The set of procedures that follow the main therapies of Panchakarma, called Paschatkarma, are aimed at assisting the body in the re-establishment of healthy metabolic system and immunity. If these post-Panchakarma procedures are neglected, the digestion may not normalize and the production of Ama will continue. The mind-body is in a sensitive, somewhat vulnerable state after detoxification. A slow and gradual return to regular activities is recommended along with personalized diet, herbal formulations and lifestyle recommendations.

Rasayanas, or herbal preparations with specific rejuvenating effects on body and mind may be recommended during this phase. Rasayanas increase vitality and energy, nourish and rejuvenate the entire organism, and thus are an important part of the Paschatkarma procedures.