The Self-Directed Biological Transformation Initiative and Well-Being

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Objective: To examine the effects of a comprehensive residential mind–body program on well-being.

Design: The Self-Directed Biological Transformation Initiative was a quasi-randomized trial comparing the effects of participation in a 6-day Ayurvedic system of medicine-based comprehensive residential program with a 6-day residential vacation at the same retreat location.

Setting: Retreat setting.

Participants: 69 healthy women (n = 58) and men (n = 11) (mean age – standard deviation, 53.6 – 12 years).

Intervention: The Ayurvedic intervention addressed physical and emotional well-being through group meditation and yoga, massage, diet, adaptogenic herbs, lectures, and journaling.

Outcome measures: A battery of standardized questionnaires.

Results: Participants in the Ayurvedic program showed significant and sustained increases in ratings of spirituality ( p < 0.01) and gratitude ( p < 0.05) compared with the vacation group, which showed no change. The Ayurvedic participants also showed increased ratings for self-compassion ( p < 0.01) as well as less anxiety at the 1-month follow-up ( p < 0.05).

Conclusions: Findings suggest that a short-term intensive program providing holistic instruction and experience in mind–body healing practices can lead to significant and sustained increases in perceived well-being and that relaxation alone is not enough to improve certain aspects of well-being.


Well-being is a multifaceted and dynamic concept that includes spiritual and psychological dimensions and health-related behaviors.1–3 The World Health Organization considers positive well-being to be another term for better mental health.4

Well-being has also been linked to better physical health, including less autonomic arousal and inflammation and better adjustment to living with chronic diseases (e.g., cardiovascular diseases).2,5–8 As Huppert states, well-being is about lives going well.9 The field of positive human functioning, including positive psychology and positive psychiatry,10,11 examines how attributes such as spirituality and gratitude support well-being as compared to the effects of more enduring negative emotions and attributes, which tend to undermine our well-being.12–14

Clinically, this work has helped give birth to fields such as psycho-oncology and behavioral cardiology.15,16 In such clinical populations, positive attributes, such as overall sense of spirituality and hope, are supportive of patients’ ability to cope with the challenges of their illnesses as well as particular challenges of acute treatments themselves.17–19

For example, in patients with heart failure there is a positive correlation between spiritual well-being and better mental and physical health.17,20–22 There are innumerable approaches to enhancing wellbeing in both healthy and clinical populations, including professional self-management, cognitive-behavioral therapy, mindfulness-based stress reduction, and physical activity, to name a few.23–26 As would be expected, efficacy and the maintenance of outcomes across the many approaches to enhancing well-being vary widely. Ayurveda is the traditional system of medicine of India and emphasizes holistic principles primarily focused on personalized health and well-being.

Along with Traditional Chinese Medicine and Traditional Tibetan Medicine, it is receiving increased attention in the medical literature.27,28 Ayurveda offers a ‘‘whole-person’’ approach to wellness that incorporates practices and therapies to support physical, emotional, and spiritual well-being. Integrative medicine, an approach to medicine that combines mainstream allopathic therapies with evidence-based complementary therapies, is a growing movement in the United States and Europe and in many ways seeks to emulate the holistic approaches and values of traditional medical systems such as Ayurveda.29,30

Studies have examined the effectiveness of various individual Ayurvedic treatment modalities for medical conditions, including osteoarthritis and rheumatoid arthritis31,32 and gastrointestinal health.33 Studies have also examined the effects of individual Ayurvedic treatments in isolation, including massage34 and herbs,35,36 on stress, mood, and cognitive performance.

A recent noncontrolled pilot study in a small cohort of patients with coronary heart disease examined the effects of an Ayurvedic intervention program that included diet, herbs, yoga, meditation, and breathing exercises and reported improvements in low-density lipoprotein cholesterol and triglycerides.37 Few if any controlled studies have examined the potential benefits of Ayurvedic approaches to well-being using the more holistic approach advocated by Ayurveda (i.e., not using only isolated modalities found within Ayurveda but rather simultaneous prescription of meditation, yoga, breathing exercises, adaptogenic herbs, oils, massage, diet, and discussion of relevant knowledge related to well-being).

The objective of this study was to examine the psychological effects of a brief multidimensional well-being program based on Ayurvedic principles on psychological well-being as compared with a control condition.

Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA. 2 Department of Psychiatry, University of California, San Diego, La Jolla, CA. 3 Fellow, Samueli Institute, Alexandria, VA. 4 The Chopra Center for Wellbeing, Carlsbad, CA. 5 Duke Institute for Brain Sciences, Duke University, Durham, NC. 6 Genetics and Genomics Sciences, Mount Sinai Hospital, New York, NY. 7 Massachusetts General Hospital, Harvard Medical School, Boston, MA.

© The National Centre for Integrative Medicine (NCIM) is a Community Interest Company (CIC) registered in England (08529099).