Personalised Medicine in Sowa Rigpa
There are four primary therapies used to treat imbalance in Sowa Rigpa – diet, behaviour, medicine, and external therapies. While the latter two are considered the responsibility of the physician, diet and behaviour are primarily in the patient’s control. With guidance and support, personalised nutrition and lifestyle activities tailored to the individual are used both to prevent and heal imbalance. Herbal medicine and external therapies, considered more serious remedial measures, are usually reserved for those who are already out of balance.
All therapeutic approaches are determined by the individual needs and orientation of the patient, not just the symptoms of illness. Basic nutrition, for instance, is tailored to their constitutional needs and existing illnesses, but modifications must be made based on season, age, location, and personal preferences. A good practitioner will help you to iron out a diet plan that is personal and sustainable, and not full of unrealistic goals. Also, as the overall health of an individual fluctuates throughout the healing process, dietary recommendations should also shift over time. While this patient-centred approach may seem like a no-brainer, modern nutritional science often lacks this basic dynamism and seeks universal ideals instead.
The truth is, there is no one-size-fits-all approach to nutrition. We should immediately be skeptical of any “dietetic dogma” that proposes a universal diet for everybody. It’s easy to see that each of us has unique physiological needs, and one person’s response to certain dietary choices will most certainly be different from how another person responds. Just because Jerome can eat an entire bar of chocolate without any negative effects doesn’t mean that Allie can necessarily do the same. A raw diet with daily green smoothies might work wonders for your spouse, but that doesn’t mean everyone in the family should start their day with a green drink.
We need to move away from these reductive tendencies in wellness. When discussing diet plans with my patients, I often tell them, “This is cause and effect, not dogma.” Just because your constitutional type should generally avoid caffeine, that doesn’t mean you can never have a cappuccino ever again. This is one of the many reasons that a simple “good food list” is an insufficient tool for improving diet. We need to tap into our ancestral healing wisdom and recalibrate our senses in order to make educated nutritional choices.
By studying the effects of certain foods on our system, we can truly gain a massive amount of freedom. If we learn to listen to our bodies’ needs, we can begin to change our relationship with food and take control of how we feel. If we can identify the moments when we’re feeling more or less vulnerable, and moderate the ill effects of certain foods with healthy preparations or contrasting substances, we can lessen their negative impact on our body.
It’s the same with therapeutic behaviour – there is no one-size-fits-all approach. Healthy behaviour for one person can be quite unhealthy for another. I have a number of friends who swear by hot yoga. They love the feeling of being soaked in sweat in a blisteringly hot yoga studio, and come out of classes feeling totally rejuvenated. The few times I attempted hot yoga, however, I left itchy and lethargic, with a pounding headache. Like diet, much of our basic behavioural orientation is based on our constitutional typology. However, like diet, all activities can be therapeutic in the right doses.
Even meditation practice should really be tailored to the individual. This is one of the reasons that Tibetan tantric Buddhism has so many different meditation techniques. Visualisation, mantra recitation, mindful breathing, physical yoga, analytical meditation, and even dream yoga are all distinct approaches to practice that suit individual types of people. The Buddha is said to have offered 84,000 different teachings for 84,000 different temperaments. For instance, somebody who finds it very easy to calm the mind but tends towards physical stagnation would benefit from physical yoga exercises interspersed with calm abiding meditation, while somebody who is prone to daydreaming may do well with complex visualisation-based practices. Somebody who loves sleeping and has a natural propensity for lucid dreaming would be the perfect candidate for dream yoga, while those who thrive when listening to transcendent music might enjoy the practice of Chöd.
Like Tibetan Buddhism, Sowa Rigpa seeks to work to our advantages, not compromise our happiness with excess rigidity. My teacher, Dr. Nida, often speaks of an individual’s “unique talents,” which are usually obscured from our own view. If somebody loves to eat, then this is an excellent talent because they can better identify the way that their body reacts to certain foods and explore new ways to prepare healing meals. If somebody loves spending time at the spa, this is a talent because they will be joyful recipients of therapeutic massage and external therapies, and may even enjoy learning how to share these techniques with others. If somebody has a tendency to get very angry, then this is actually also a talent! Anger is a potent ingredient for the alchemical process of wrathful deity practice, in which the sensation of anger is essentially reprogrammed as fierce compassion.
More involved healing methods in Sowa Rigpa, namely herbal medicine and external therapies, should also be personalised and environmentally dynamic. Even though I may see a dozen different patients who have received the same biomedical diagnoses, very few of them will receive the same treatments. That’s because each of our bodies experience imbalance somewhat differently, and we each have unique needs for reaching a state of balance. It’s impossible to simply say, “this is the treatment for high blood pressure,” because one’s person’s anxiety-induced hypertension is going to require a very different treatment from another person’s diet-induced hypertension. It is important to look beyond the name of a disorder to better understand the individual experiencing it.
Holistic treatment should also consider the environment in which we live. Here in Europe, there was once a long tradition of “simpling” in medical practice. Per this theory, a trained herbalist would inspect the immediate surroundings of their patient’s home to find a single wild plant to use for treatment. The underlying philosophy is that the Earth organically provides medicine for the beings that inhabit it, and every landscape provides a unique materia medica for its residents. It merely takes knowledge to be able to use these medicines skilfully. While we have a much more diverse pharmacopoeia available to us in the age of globalisation, traditional medicine practitioners in the modern world would do well to explore their local wild pharmacy for sustainable and geographically-linked therapeutic ingredients.
Adapting dietary knowledge for a new climate was one of the most important early responsibilities of medical pioneers in Tibet. Much of the nutritional information used in Sowa Rigpa derives from Ayurvedic theory. But unlike India, the availability of many edible plants is limited in Tibet. Even today, the average Tibetan diet primarily consists of barley, meat, and dairy, with roasted barley flour and butter tea serving as staples in homes across the plateau. Wild and cultivated plants become more common throughout the short summer months, while yak meat and grains are more reliable stables during the winter. To demonstrate its adaptability and mastery of healing knowledge, early Tibetan doctors needed to directly investigate the qualities and effects of local foods, and come to a scientific consensus among their peers regarding their respective effects on the body. The Four Tantras provide the most famous discussion of Tibetan foods and their qualities in Sowa Rigpa, and this is still studied by practitioners across the world today.
As Sowa Rigpa moves into new climates and a new era, adjustments must be made to standard nutritional practices. We need to work with our circumstances, and once again reach across interdisciplinary lines to understand the effects of modern foods. Most Tibetan doctors integrate both Ayurvedic and empirical scientific approaches to modern nutrition, as well as personal and clinical experience, in order to tailor their dietary treatments for new and diverse patients. Like diet and herbal medicine, behaviour should also be tailored to location. While Vitamin D supplementation is a necessity for most of us living in Great Britain, those living in Portugal or Los Angeles would fare much better by simply getting safe and regular sun exposure.
In my experience, telling somebody (or ourselves) to “eat better” is a rather foolish act, especially in the modern western world. While most traditional doctors that I’ve encountered in Asia simply tell their patients to avoid certain foods, and the patients follow suit, this is rarely the case in western clinics. Because we have so many therapeutic modalities open to us, it’s extremely important that we understand why we are engaging with a certain approach. And because many are left with limited resources for natural therapies, it's important that available advice creates space for the unique needs of the individual. Studying lists of good and bad foods may seem straightforward and scientific, but true personalised understanding can only come from exploring the theoretical context and seeking guidance when necessary.