Bhagavad Gita and Psychotherapy: Applications and Handling Concerns

Dear Sir, We thank the authors for their valuable inputs1 for the narrative review.2 We aim to address their concerns comprehensively. Regarding the first concern of doctors escaping responsibility,1 we emphasize the selective use of the 4"D" concept within the context of a moral paradox only and not as an escape from accountability.2 That is, therefore, used when, if while performing his duties the person starts sacrificing his own personal well-being. Like other psychotherapeutic principles designed for specific circumstances, such as distress tolerance skills for managing distress rather than correcting cognitive distortions, Doership addresses the unique situation of a moral paradox. In the author's statement, the concept of "karma" should be followed, in which doctor, while treating their patients, should dutifully perform their tasks. In the current scenario, a doctor's duty involves adhering to ethical codes, legal standards, and professional obligations to ensure patient well-being and safety, and in challenging situations, seeking guidance from mentors is crucial to determine an appropriate course of action. Despite conscientious performance of duties or "karma," unforeseen events may occur, such as a patient succumbing to incurable end-stage cancer. In such cases, doctors should recognize that the ultimate outcome is beyond their control and falls under the realm of the divine, embodying the concept of "Dharma ' – ' Your right is to perform your prescribed duties. Never consider yourself to be the cause of the results of your activities, nor be attached to inaction."2 In the second concern, the author quotes the limitations from Dabas and Singh's3 article on Positive Psychology and Gita. In this, the authors stated that positive psychology would be more effective with multiple sessions. Furthermore, any psychotherapy does not end with just a one-time interaction, which is usually inadequate for changes to occur, especially for complex emotional issues, and even with intense training on the part of the counselor and receptivity on the part of the client, it takes several sessions of counseling to generate changes. Thus, to determine the effectiveness of either Bhagwat Gita or positive psychology over multiple sessions, good-quality longitudinal studies should be conducted.3 Regarding the authors' concern about the validity of religious texts in scientific literature, as discussed in the meta-analysis4, predominantly Western scientific theories and writings have been widely promoted, even in culturally diverse countries.4 To address this, it is essential to explore religious resources, such as the Gita, to integrate indigenous and cultural knowledge into a discipline that has historically overlooked these perspectives. Thus, by generating interest in this field, we can promote the development of empirically tested therapeutic modules and intervention studies. This, as indicated by the meta-analysis, not only facilitates the greater acceptance of the Bhagavad Gita in psychology but also contributes to its practical application.2,4,5 The fourth concern addresses personalization through a natural course of action in Gita.1 Here, Gita does not talk about this as a sole principle; rather, it uses it in conjunction with the concept of "Dharma," where one should first do his duty diligently and the rest is left to a higher power. Regarding the concern on the justification of an eye for an eye, yes, we accept the author's concern that it is not always justified unconditionally, as in the Mahabharata this course of battle was taken as a last resort after many attempts to resolve the conflict via use of diplomatic negotiations, peace talks, and proposals for compromise. To answer the fifth concern, Lord Krishna justified this path of Arjuna killing unarmed Karna by pointing out that Karna had violated the rules of war by targeting Abhimanyu, in an unfair manner during the battle. Krishna argued that Karna's actions had already breached the principles of righteousness and dharma, and therefore, it was justifiable for Arjuna to retaliate, even if Karna was unarmed at that particular moment. Similarly, we can see in "Ramayana" that Lord Rama killed Vali, giving a similar rationale. To answer the final concern, yes, we humbly accept that the orientation of students must also be considered. Furthermore, it is neither necessary nor mandatory to use Gita-based psychotherapy in every aspect of day-to-day life or every client and by every clinician, and it should be tailored based on the client's and clinician's suitability and needs. Regarding the concern of risk of bias and conflict of interest, the review2 summarizes the literature related to Gita's application, practical aspects, and gaps in existing evidence. The primary focus is enhancing clinicians understanding and promoting the development of indigenous therapeutic models by taking the cultural background of the client into account. Data availability statement Nil. Author's Contribution The first draft was written by Dr. Vasu Mishra, which was further modified by Dr. Surendra Singh Rajpurohit. The response to the letter was written under the guidance of Dr. Naresh Nebhinani, who further updated and modified the same, and all the authors have finalized the manuscript. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.