Psycho-Spiritual Assessment

Often in life simplicity answers complicated questions. There is a simple Sanskrit phrase that summarizes all of the four Vedas—“Sathyam vada dharmam chara.” It means, “Speak the truth and practice dharma.” There is no English word that translates the word “dharma,” but it means “powerful, super high-integrity, right action.”

I have shared that simple equation with many patients as a way to think about how to handle life's problems. More often than not, people find their solutions within “Sathyam vada dharma chara.” First, ask what the truth and the Truth are for you. Once you know those truths, then dharma, or right action, automatically becomes clear to you.

Using the essence of the Vedas as a foundation, I spent fifteen years developing a four-step process called “Psycho-Spiritual Assessment” (PSA), to help people identify the issues in their lives and then map out a course of action.

Four Questions of PSA

1. What is your Main Concern?

Name it. Your main concern can be a symptom, problem, experience, or goal. A symptom or problem is something you want less of, such as: pain, depressed mood, or insomnia. A goal is something you want more of, such as: money, friends, peace of mind, or work-related or athletic success. When one's main concern is an experience, and is neither a symptom nor a goal, one doesn't need to “get rid of it,” or “acquire more of it.” Examples of experiences are: angels, near-death experience, and past-life memories. When you visit a medical doctor, he is always looking for what's wrong. That is how he is trained. When you tell your psychiatrist or family practice doctor that you saw an angel, he will go into “symptom mode” right away. He can't help it. For the vast majority of doctors, that is all they know. But PSA wasn't created just as an assessment tool for doctors and other healthcare practitioners. It is a tool that you can use on your own, many times a day.

Be as specific as possible in naming your main concern. For example, if you have cancer, your main concern may be pain caused by the cancer. What is your main concern “today?” Realize that your main concern may change from day to day.

This first step may seem elementary, but I cannot tell you how many people come to see me who are not clear about their main concern. I have to ask a number of questions just to find out why they are sitting in my office. So, clarify what your main concern is for today.

2. How do you “feel” about your main concern?

(How does your main concern make you feel?)

3. What does your main concern “mean” to you?

(How does your main concern affect your belief systems or sense of meaning in life?)

4. What is the dharma, the right action, to take regarding your main concern?

As I said at the beginning, sometimes, powerful solutions come with such simplicity that one says, “Well, of course. That seems obvious.” And once people begin using PSA, it does seem obvious, and they wonder why they had not been using it before I taught it to them.

The most difficult step for you may be step 4, “the action or dharma steps.” However, what is most important is step 1, determining and naming your Main Concern. What is it you want to work on? What is your symptom? What is your illness? What is your goal? What is your experience? Before moving from step 1 to step 2, it is helpful to reconsider the wording of your main concern if it is a problem or symptom. For example, your main concern may be “fatigue.” You can state that as a symptom, but you can reframe your main concern as a goal, which would be “more energy.” A positive starting point always works to your advantage. As a goal, you would say, “My goal is to have more energy.” When stated as a symptom, you are saying, “I want to get rid of this fatigue.” This wording creates a battle in your mind, a sense of struggling against something. When you re-state the main concern as a goal, you can martial all of your powers of intention and move toward the goal. This concept applies to all symptoms and problems. If your “problem” is that you are financially struggling, restate the problem as the goal, “I intend to make more money, or to allow more money to flow into my life.” You get the idea. There are a million ways to take that small step from dealing with a problem, to working toward a goal.

Let's run through one PSA, using a “symptom” of pain as the main concern. Here are some possible answers to the four questions:

1. What is your main concern? (Symptom, problem, experience, goal). “Name” it.

“Pain.” Almost everyone wants “less pain,” but see if you can state the main concern as a goal, namely “more comfort.”

2. How do you “feel” about your main concern? “I hate it!”

3. What does your main concern “mean” to you? How does your main concern affect your belief systems or sense of meaning in life? “The pain makes me question if God exists. If he exists, I think he has forgotten about me.”

4. What can you do about the main concern? What is the dharmic action?

The action steps for pain are complex. You may want to see a chiropractor, acupuncturist, or orthopedic surgeon. You may benefit from getting massage, or learning to express anger at the person who has become your “pain in the neck.” We can see, by looking at step 3, what the pain means, that this person needs helps with her spiritual connection, with her feelings about God, and her spiritual life in general.

Here's another PSA, which starts with an “experience” of angels as the main concern:

1. What is your main concern? Name it. “I saw an angel.”

2. How do you feel about your main concern?

“It made me feel ecstatic.”

3. What does the angel mean to you? How did the angel affect your belief systems or sense of meaning in life?

“I believe I'm losing my mind. I don't believe in angels. They're not real. Even though it felt real, I'm sure it cannot be real.”

4. What can you do about it? What is the dharma ? What are some action steps you can take?

I might recommend some reading to someone with this question; suggest that they read personal accounts of angelic visitations, as well as more scientific studies. I might quote the Gallup Poll or other survey. A recent survey showed that 60% of Americans believe in angels. That action step, namely hearing new information, might be all that is needed. I would also suggest that this person go back to the religious text of whatever religion he was raised in, and look for accounts of angels. Virtually every major sacred text makes reference to angels. I would reassure her that she is not losing her mind, and I won't be recommending anti-psychotic or other psychiatric medication for her.

If you've just seen your first angel, you will probably be startled, and will be wondering what it is and what it means. If, on the other hand, you've seen so many angels that you've lost count, then seeing one more angel, will not concern you any more than will be going to the mailbox.

All symptoms, problems, experiences, and goals are worthy of our attention. Don't attempt to persuade yourself to dismiss an experience as insignificant. If something has grabbed your attention, that “something” is your main concern, if only temporarily.

The key to working with PSA is to become present and ask yourself what your main concern is today. Work through the four steps and transform the main concern. You may have a main concern that dominates your life, and you will want to deal with that. But over the course of a single day, you may have two or three other main concerns. Deal with them.

PSA is about making your life a conscious experience. Many of us don't even know what we want or what our biggest concern is. We push things aside and tough things out. Most of the time that is not the best strategy. We are all capable of checking in with ourselves throughout the day, noting the main concern, and taking a minute to deal with it. In this way, difficulties and strains won't build up.

Because people may dismiss things that are too simple, let me run through the PSA again:

1. “What” is your main concern? Name it.

2. How do you feel about your main concern?

3. What does your main concern mean to you?

4. What is the dharma , the right course of action to take?

To go back to the Sanskrit phrase this article started with, steps 1, 2, and 3 deal with “Sathyam vada,” or speaking the truth. It also has to do with knowing your truth. Steps 1–3 allow you to do a quick awareness check to find out your personal truth. Step 4 deals with the second half of the Sanskrit phrase, “dharmam chara,” meaning “the practice of powerful right action.”

For some people dharma may raise a question. You may feel that the solution has to do with, “What I WANT to do,” and not necessarily with what is the RIGHT thing to do.” The right thing to do is the thing that will bring no harm to anyone, including yourself. Dharma is action for the higher good. Because we are a society that is more concerned with our rights rather than our duties, dharma may be a challenge. Hollywood celebrities have great access to fame, power, money, connections, and sex. And they may like the status quo. As a general rule, you have to be very competitive and materialistic to rise to the top of the field in movies or music. It may be difficult, once you have all the material things you have, to adopt a different life strategy. You may “want what you want when you want it.” In your case, PSA will bring you short-term relief, but will not lead to long-term positive life changes—if you opt out of dharma for step 4.

For the rest of you, who make up more than 99.9% of the world, PSA with dharma as step 4 will help you zero in on what your issue or main concern is. It will then help you find a solution, and will, over time, spiritualize your life, bringing greater harmony into all relationships, and more inner peace and joy into your heart.

And now, for the really abbreviated version of PSA, now that you understand the process, the four steps are: the name , the feel , the meaning , and the dharma .

Dennis Gersten, M.D. practices nutritional medicine and psychiatry out of his Encinitas office and can be reached at 760-633-3063. Please feel free to sign up for Dr. G's Health Digest newsletter at and access 1,000 on-line pages about holistic health, amino acids and nutritional therapy.


Dear Louise

Dear Louise,

Over the past few years, I seem to have become more self-conscious and anxious. I find that when I'm in quiet places where there are lots of other people, I become very aware of the silence, become anxious, and my stomach starts to rumble. I know this sounds crazy, but it really embarrasses me and makes me feel self-aware. I'm currently taking some classes, and find that sometimes I don't listen to the lecturer because I'm trying so hard to concentrate on my stomach being quiet. I don't know where this has come from, but it's really frustrating, and I'd really like it to stop. When my mind is focused on something else, it doesn't seem to happen.

Similarly, in the summer when it's very hot, I start to feel self-conscious that I'll sweat (because girls don't generally sweat much), but being anxious seems to make me sweat more, so it's like a vicious cycle. How do I overcome this anxiety and just live my life normally again?

K.S., Dublin, Ireland

Dear K.S.,

Learn to breathe deeply and fully. Your breath is your connection to relaxation and inner peace. Practice doing this several times a day. Take a deep breath, and as you exhale, say to yourself, “I relax and let go.” Do this four or five times and watch how your body and mind relaxes.

You've been stressing yourself out so much so that every little thought becomes a mountain of problems. Please stop that. Do the above exercise several times a day and you'll find that you're much more at ease with living. Then, when a stressful situation arises, you'll already have tools to work with. Just breathing and relaxing will solve it all. It's also a perfect way to allow yourself to sleep easily.

Dear Louise,

I recently realized that I have conflicting values that are causing me confusion. Part of me feels that I have to work really hard to get anywhere in the world, but the other part believes that fun, love, and my relationships with family and friends are most important. I'm about to go into my fourth year at a university, but I've have been feeling as if it's going to be such a grind, stress, and work, work, work; and it's also not really my passion. But I feel that I should get this degree, as it gives me more options.

One part of me is saying that I need to go out and follow my real dream right now (as a singer/songwriter) because time is of the essence; the other part is saying, “You're only 20, you have plenty of time.” I feel like I'm dragging my heels, half of me trying to be sensible, the other pulling me to follow a dream. I'm afraid that I'm just going to end up in a dead end job to stay afloat. I feel like my values are in a muddle, and I don't know where to commit myself, or what's real. Maybe it's the idea that I have to specialize to master anything that's causing me confusion. It is pretty funny, isn't it? I think my greatest fear is that I'll wake up ten years later and still not have sailed to great heights, and I'll feel as if I've missed the boat. Do you have any advice?

M.A., Santa Fe, New Mexico

Dear M.A.,

My advice to you is almost the same as I gave to the person in the previous letter. Relax and breathe. Do it often. Stop being so tense. Don't take life so seriously. Life is supposed to be fun. Don't try to sort out your entire life in this one moment. You'll change and grow as long as you're alive.

Having a balanced life is enjoying it all—the fun, games, study and the work. This is what makes life so interesting. Feel love for everything—for all the people in your world, for your passions, for the everyday things in your life—and most of all, for yourself. You have no idea of all the wonderful adventures that lie before you.

Affirm: I trust my inner wisdom to guide me and protect me at all times. All is well.

Dear Louise,

What if you want something in your life and you think about it every day. You only put positive energy in that thought, but you want it so bad. Is it possible that instead of attracting that goal, you will only make worse?

E.C., the Netherlands

Dear E.C.,

You're worrying too much and therefore pushing your goal away. Anticipate it with joy and then release it to the Universe to take care of. If you truly believe that the Universe and all of Life is on your side, then you can stop thinking about it (or release it), and you will be provided for. Know that the Universe is in the process of taking care of your dream. It will arrive. Think of how you can have fun in the meantime. Remember this is only one of many, many goals you'll have in your lifetime. The Universe can provide them all if you will allow it.

Affirm: All is well. Everything comes to me in the right time and place. Life loves me, and I love Life!

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