Posted by: Rhett Hatfield | April 21, 2009

How to Give a Shirodhara Part 5: Preparations for Treatment

How to Give a Shirodhara Part 5: Final Preparations for Treatment

Overview:
For those of you coming into this 7 part series a little later, allow me to provide a little context.  I am owner of the Body Wisdom Massage School here in Des Moines, Iowa and I have also opershirodharaated as a global spa trainer and indigenous researcher in South East Asia for a few months out of each of the past few years.  An up and coming spa treatment which you may not have heard of but is very, very popular in today’s destination spas in both the US and abroad is called Shirodhara.  Shirodhara is the pouring of warm oil on the forehead for an extended period of time.  Although is may seem quite odd to the uninitiated it is one of the most relaxing experiences that can be had along with a massage or other spa treatment.  The purpose of this 7 part series is to report on my documentation of this traditional Ayurvedic treatment during my trips to India and in parts 6 and 7 still to come to describe the traditional approach as well as recommended adaptions of the original for today’s spa community.  Part of my work in documenting this treatment is as the current Chair of the Asia Pacific Spa and Wellness Task Force on Indigenous Therapies dedicated to documenting and preserving traditional therapies in South East Asia.  See Body Wisdom Global

An introduction to Shirodhara is one of three therapies we teach in our Best of Asia Signature Spa Course here at Body Wisdom, the only one of its kind in the nation.  Best of Asia is just one of several Spa courses we offer at Body Wisdom in addition to European Spa, Hot and Cold Stone Massage and Bamboo Massage to name a few.

If you like take a look at Parts 1-4 to get up to speed on where we are at the moment.
Link to How to Give a Shirodhara Part #1: “Intro.”
Link to How to Give a Shirodhara Part #2: “The Droni (table)”
Link to How to Give a Shirodhara Part #3 “Shirodhara Pot and Stand”
Link to How to Give a Shirodhara Part #4 “Preparations of Medicines”

We teach the basics of “How to Give a Shirodhara” in the Body Wisdom Best of Asia Spa Course.

OK, now on to the treatment itself (what follows would probably be most interesting to medical anthropologists such as my good friend Carroll Dunham or the global spa industry or individual practiitoners of Ayurveda.)

The Best Time for the Treatment
In India July-August, October-November and February-March are considered to be the best time for Shirodhara. Ideally in whatever climate you find yourself the climatic conditions should be free of excess of wind (drafts) mist (dampness), cold and rain.  Ideally is should be done on an auspicious day according to the Indian calendar and in the morning hours when it is still cool and prior to any meals.

Attendants
In traditional Shirodhara or any kind of Dhara (pouring of oils) the attendants are considered to be a very important aspect of the process.  For traditional Shirodhara three attendants is considered to be the ideal number. This is in addition to the Ayurvedic physician to completely oversee all aspects of the process.  One attendant to reheat the oil to maintain a consistent temperature throughout (since it cools off over the course of the treatment), one to replenish the oil back up into the Shirodhara pot and one to move the Shirodhara pot and the oil stream carefully back and forth across the forehead.

The attendants need to be very well trained, have experience in working together, remain completely focused and have the greatest well being of the patient in their minds throughout the entire treatment.  I have been a witness to and occasionally a recipient of what I could only characterize as a “Shirodhara disasters” both in and outside of India.  As a practitioner and receiver of this amazing treatment I can truly say that the attitude and focus of the practitioners all things being equal is the main determinant of a successful outcome for the patient.

The Ayurvedic Physician
The Ayurvedic physician in attendance should be well versed with the treatment and the patient’s condition and should oversee all aspects of the preparations and delivery of the Shirodhara to see that no mistakes are made.  This includes the equipment, the prescribing of the medicines for internal use before and after the treatment as well as the preparation of the Shirodhara liquids to be used during the Shirodhara.  From a strictly traditional stand the absence of an Ayurvedic physician to be in attendance throughout the treatment would be considered completely wrong!

Other Preparations
Other preparations include a special pillow covered with a plantain leaf (made soft from heating) upon which the patient’s heads rest and which will allow the oil to run off the head in the direction of the collecting well at the head of the table.  A roll of cloth to tie around the head just above the eyebrows to prevent the oil from getting into the eyes of the patient, a transfer pot to collect the oil and reheat and or transfer back into the Shirodhara pot, two or three small cups made of leaves, oil for the Abhyanga massage prior to the treatment, herbal shampoo, Amalaka water for washing the head, greengram for removing the oil from the body and any medicinee to be taken immediately after the treatment and bath.

Medicated Oil for the Head
Medicated oil for the head should be prepared according to the doshas of the patient but generally Bhringamalakadi, Manjishtadi, Asanavilwadi, Triphaladi, Chandanadi and others are used for this purpose.

Medicated Oil for the Body
Traditionally a complete oil massage is given to the patient prior to the Shirodhara itself.  This is done in 7 traditional positions right on the same Droni (table) and medicated oils (tailam) such as Ksheerabala (most often) and Pinda and Dhanwantaram tailams are also used for this purpose.

The Amalaka Water
The Amalaka water is used at the very end of the treatment to pour over the head of the patient. This water is made from ten grams of Amalaka (Embelic myrobalan) seedless which is put in 1800ml of water, boiled and reduced to half.  If there is an excess of Pitta, Vetiver can be added, for Vata type conditions leaves of Bala (Sida cordifolia) and for Kapha conditions Haritaki are also added to the water as per the instructions of the physician.  This water should be prepared the day before and made ready for the treatment.

Warm Water
Warm water should be prepared on the day of the treatment to used to pour over the whole body.  This should be prepared with herbs to reduce Vata by boiling with the leaves of the castor plant or of the Jack tree.  It should not be too hot especially in the case of a Pitta constitution.

Power for Rubbing on the Head:
It is traditional before starting the Shirodhara to rub Rasnadi powder mixed with a little oil on crown of the head.  This the powder most commonly used but other powers such as Kachoradi and Manijishtadi are also recommended.

The Medicine to be Taken Prior to Treatment
In general before any Dhara the common practice was to take Gandharvahastadi kashayam both a laxative and a digestive.  In the case of Pitta is was recommended to rather take a decoction of grapes and haritaki to promote proper evacuation of the bowels.  There are several other medicines that can be given based on the physician’s observation of the Dosha and the tissues involved.  Prior to receiving Shirodhara in India I was never asked to take any medicines beforehand but rather only to come to the early morning treatment with an empty stomach.  Certainly eating before hand would be strictly contraindicated.

Room and Equipment Preparations
It is very important that the room is free from drafts and cold of any kind as this would aggravate the treatment.  The Droni (table) needs to wiped clean and the pillow put in place.  The Shirodhara vessel should be suspended directly over what will be the forehead of the patient and minor adjustments can be made when the patient (client) is resting in place.  The height adjustment should be estimated to so that the wick coming out from the bottom of the Shirodhara pot is approximately two finger widths over the head of the patient.  Make sure that necessary towels cloth for tying around the head are at hand and available.

With all this ground work layed it gets a lot more interesting in the upcoming Part 6 where I will cover the actual traditional treatment and in Part 7 will demonstrate and suggest adaptions that can be made to the traditional to accommodate today’s busy spa world.

Please let me know what you are thinking by commenting on this post

rhett


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Rhett Hatfield, Owner/Director of Education Body Wisdom School
“750-1600 Massage Therapist Certification Programs, 5 Different Career Tracks.” Create your “custom massage certification program” of anywhere from 750-1600 hours of World Class Massage and Bodywork Education.  CEU Programs available

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Responses

  1. […] View original here:  How to Give a Shirodhara Part 5: Preparations for Treatment […]

  2. […] and Stand” Link to How to Give a Shirodhara Part #4 “Preparations of Medicines” Link to How to Give a Shirodhara Part #5 “Final Preparations for […]

  3. Hi Rhett,
    I have read through all the links on how to give a shirodhara. I just had to thank you for writing with clarity and integrity. I really appreciate this. These readings have been very informative. I finished an ayurvedic practitioner program this passed summer and I am now certified. I can practice ayurvedic therapies but I feel the need to dive deeper before I would consider doing them. I have been moving forward with food and lifestlye recommendations for ayurvedic consultations and this suits me fine. I do feel informed enough to choose the appropriate medicated oils for any dosha with imbalance, for shirodhara tx. but want to further my education on technique. For now, I would like to practice with family and fellow ayurvedic practitioners. I know that the traditional way of practice is more time consuming but this is what interests me the most. I am not interestd in shortcuts. l wondered if there was any DVD or other learning material you might recommend.

    Thank you,
    alison

    P.S. I will take a look at your site to see if you have anything on line to purchase.


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