Higher Consciousness Through Self-Inquiry Can Improve Cardio Metabolic Outcomes, Mental Health, and Resilience

Heartful Living is our unique cardiac wellness program based on self-inquiry. This meditative system based on Siddha Yoga, positive psychology, and mindfulness, has helped reduce cardiac symptoms, procedures, and medicines all while enhancing confidence and optimism. We share a few illustrative cardiac cases to outline our program. Higher consciousness, through numerous tools and mind-body methods, is at the core of this program. We start with a couple of illustrative cases and explore the basis and scope of self-inquiry in improving health.

Illustrative Cases

Case 1

A 60-year-old white woman presented in spring 2020 with poorly controlled hypertension of 25 years duration. Despite six medications, her BP was over 200/110mmHg on several occasions at home. She was anxious about BP control and leg edema at initial clinic visit when BP was 174/84mmHg, BMI 37.6 and weight 115.3Kg. She engaged with our self-inquiry program and started fasting with mindfulness practice. At six months, although she has not lost any weight yet, her BP is well controlled on only three medications. Her confidence has increased, and she feels more energetic than ever before.

Case 2

A 59-year-old woman developed heart failure with preserved ejection fraction due to morbid obesity, weight 133kg, BMI 47 as well as cirrhosis and functional limitations. She has lost 67 pounds, over 22% of initial weight, over the last two years (Figure 1). She is more confident and enthusiastic now. Echocardiographic diastolic parameters have improved. She is enthusiastic about her future, on fewer medications, and anticipates losing another 67 pounds over the next two years.

Figure 1.

Illustrative case 2 weight graph in kg over last few years from the electronic medical records, where HUGE fasting and intentional weight loss significantly improves heart failure.

What is the Real Scope of Health?

We believe health is the freedom to pursue one’s passions. This requires at every stage of life identifying with activities, pursuits, and causes that are genuinely interesting. Once an individual recognizes this core concept, it becomes easier to accept responsibility for lifestyle choices and health. Connecting with or discovering new interests, especially when older, requires willingness to explore and experiment. Despite supervised weight loss with rigorous research protocols, 50–80% of the weight is regained within two to five years.¹ Self-inquiry appears to succeed through changes at the subconscious level. We have numerous patients naturally sustaining health gains beyond five to ten years. Chronic kidney disease, typically considered irreversibly progressive, tends to improve with this program.² As is often the case, anxiety and hypertension appear to have propagated each other in Case 1. When we address mood and outlook, sustaining lifestyle improvements long term becomes easier. While we routinely see BP reduction with weight loss, this patient appears to have benefited primarily from the mindfulness component of our program. Case 2 highlights the potential to enhance self-confidence and meaningful engagement with life, and thereby improve survival and quality of life in complex heart failure patients.

Self-Inquiry Based Cardiac Wellness Program

Self-inquiry is simply introspecting on the question “who am I?” Siddha, meaning ‘aiming for perfection,’ is the Tamil medical system with a rich 5,000-year tradition. Siddha way of life encourages primary prevention, mental wellbeing, and holistic health through yoga while offering natural and herbal cures for several ailments and chronic diseases.³ Bodhidharma popularized ancient Siddha martial arts and selfinquiry methods in the Orient, now widely practiced as Kung-fu and Zen philosophy.⁴ Since 2015, we have formally offered “Heartful Living,” a self-inquiry based cardiac wellness program, in mid-Missouri for patients, families, healthcare providers, and physicians. This is organized through the whole health initiative at Harry S Truman Veterans Hospital for veterans with cardiac disease as well as the local community at no cost.

This program is unique, incorporating positive psychology, mindfulness methods, and Siddha yoga with evidence-based cardiology. Participants attend eight weekly hour-long sessions with 30 minutes of didactics, 15 minutes of different self-inquiry mindfulness practices, and 15 minutes of open discussion. We tailor the program to individual requirements and set daily goals to practice during the week at home. The key topics of diet, exercise, sleep, stress, time management, optimism, mindfulness, altruism, service, and other ideas for adding meaning to life are covered. Medical management is deferred to patient’s providers. Participants gain a new perspective on consciousness that is simple, intuitive, and self-explorable. Improvements in cardiac symptoms and risk factors naturally ensue from this self-inquiry. As patients gain a deeper mind-body connection, exercise capacity, compliance and self-reported sense of well-being improve significantly (Figure 2). With nearly 90% diabetes and 80% heart disease attributed to lifestyle and our own research demonstrating importance of adolescent outlook and mood, we have now opened this initiative to students and family members of cardiac patients.^{5, 6} Primordial prevention is several-fold cost effective when we enhance physical health and mental wellbeing from childhood.

Figure 2.

Self Inquiry initiated with HUGE, hunger gratitude experience, results in higher consciousness leading to progressive gains in confidence and cardiac risk predictors, which in turn reinforces more self-inquiry, sustaining the long-term improvements in health.

Consciousness

We interpret life events as ‘good’ or ‘bad,’ based on our beliefs and hopes. There is, however, considerable individual variation in deriving meaning and happiness. Consciousness is our perception of ourselves and the world and the basis for experiencing life. Consciousness is awareness by the mind of self and the world, which in turn determines the response to one’s surroundings.^7–9 Based on our perception of the self, we can discern three states of consciousness (Figure 3).

Figure 3.

Mind Consciousness: Our core identification is with our thoughts as our real self and attention is towards our immediate challenges. Heart Consciousness: The individual self is less pronounced due to naturally identifying with close people or higher ideals. This is the path to self-realization through kindness.

1. The predominant state for most people is ‘mind consciousness.’ People identify with their thoughts as their true self, react to life events in an endless loop and this becomes the entire experience of life. Just like thoughts or dreams, life becomes a roller-coaster ride when the mind is the self.

2. A minority of people operate naturally through kindness towards others (family, friends, colleagues) or dedicate themselves to a higher value (ideals, cause, calling). Their thoughts and personal interest take back seat in pursuing ‘the bigger picture.’ This ‘heart-consciousness’ is selfless kindness which offers a natural freedom, higher energy, and ease of movement through the challenges of life. This enables passionate living with deeper empathy.

3. The awakened or enlightened state is very rarely attained. Very few people operate at this expanded state of consciousness. This is truly living free, where the self is boundless, and life simply flows.

The three states are fluid without distinct boundaries. The same person can identify at one instance with his thoughts and trivial stresses while at another time as meaningful integral part serving a bigger purpose. How one operates in each situation is determined by his level of awakening or intensity. Consciousness is not theory or philosophy for the mind to assimilate. Thus, consciousness eludes comprehension even to the most intelligent amongst us. On the other hand, various levels of consciousness can be verified as our personal experience of reality.

Origin of Human Consciousness

Pre-humans did not have ‘self-consciousness’ and related with the natural world more like modern apes.¹⁰ With their limited physical strength, pre-human populations were small, and thrived on eating fruits and nuts as well as scavenging the leftovers of big cats’ prey. With evolution, approximately 200,000 years ago, our thinking and mental capacity attained a critical mass, ¹¹ There was no turning back after gaining this cortical brainpower, which helped us rapidly ascend to the top of the food chain. For the first time in evolution this was brought about by the analytical mind. Our thinking opened new doors -- we discovered strength in groups, invented clever devices and weaponized fire. Bigger, faster and stronger animals could not match our mind’s innovative tools and collective strength. Thus, mankind’s ascent as the master of the natural world coincided with thought-identification or mind consciousness.

Our population expanded, and the hunter-gatherer ancestors found it hard to sustain our growing population. About 10,000 years ago we began farming and settling along riverbeds. Through agriculture, humans were able to produce far more food and our population began to grow exponentially. This surplus of resources enabled specialization of labor and gave birth to the early waves of civilization. Not only did our numbers grow, our collective human knowledge began to compound, rapidly separating us from animals:

1. Animals can only learn intuitively through experience. Instinct helps them relate to their environments and manage natural threats.

2. Animals don’t perceive time the way we do. They lack the imagination to project a future reality different from their own past or prior generations.

3. For animals, little logical knowledge or specific memory is accumulated or passed on to subsequent generations.

Human knowledge, however, is far more potent due to the prefrontal cortex.¹¹ Critical thinking, memory, language, and learning keep advancing with each generation, making us unique. The thinking, analytical conscious mind has been talking to us loud and clear for 200,000 years now. We therefore perceive ourselves distinctly from childhood and project our peculiar preferences and dislikes as our personality. With the new information that we have assimilated over many generations, humans have understandably forgotten several aspects of our pre-human selves. Instinct, intuition, and ‘reflexes’ are broadly grouped together as animal behavior to be controlled and outgrown. Religion, culture, and education systematically curb our innate natural self from early childhood and ‘cultivate’ humans to conform to modern society.

Mind Consciousness

We became self-aware and ascended to the apex of the food chain. We owed this to our mind and superior intelligence. We naturally identified with our thoughts and the mind as our real ‘self.’ The mind remained superior to every other force in the natural world and allowed the intelligentsia to rule over the others. Power and praise reinforced the crucial role of the thinking mind in surviving and succeeding as civilization became increasingly complex. Self-esteem and self-awareness are integral to the self-image, which is specific to an individual and his/her lifespan. Our use of the word ‘mind’ typically implies thought-identification that really began in prehistoric times.

The mind has enabled us to learn languages, memorize vast amount of knowledge, and thrive in societies.¹² Education and learning utilize specific aspects of the mind to achieve excellence in specialized arts, skills and crafts. In nature, all deer graze and all tigers hunt, while we humans have been specializing and acquiring particular skills for the last 10,000 years. We have long forgotten our ability to survive in the wild. We now rely on the collective specialized skills, to make the products constituting modern life.

The collective gains for humanity owed to the mind are plenty and indisputable, but the mind is also the source of our individual pain and suffering. Humans feel pressured to perform throughout life. Anxiety and depression are increasing. The world appears insecure and seems constantly on the verge of collapse. The mind is now the source of our insecurities and despair. Artificial goals, increasing expectations and false beliefs contribute to illness and disease. Our stress, fears and biases arise in the mind and impact our quality of life.

Heart Consciousness

‘Selfless kindness’ or heart consciousness is the next level of human evolution. Instead of the conscious mind, we dive deeper down and naturally identify with our ‘heart’ or subconscious self. Its origin dates back to our primitive animal past where we remember to trust our instincts and intuition. It allows us to lead a better life today, less bound to daily stress and deadlines. It gives us a future where we are more awake and living spontaneously in the moment. We are all moving in this direction, naturally but slowly.¹³ Just like water flows downwards, consciousness flows upwards. Life is inherently efficient and moves ahead using the least possible effort. This is the ability to relate with the world through child-like eyes. The mind is needed as the foundation for this new and elevated perception of reality. The mind can be stilled by meditation or self-inquiry. This trust in our natural instincts and belief in our intuition can be nurtured despite the challenges of modern society.

Our mind is a double-edged sword. It helps us clearly see our individual interests and safely navigate our environment. At the same time, it hinders our instinctive surrender to nature and incessantly raises warning alarms. This is the mind refusing to accept reality as it is. It wishes to ascribe higher meaning and special purpose for its existence beyond what nature confers. It refuses to accept its own miniscule place in the larger scheme of things, our frailty and imminent mortality.

Heart consciousness is intensity, energy—excitement arising from kindness. This allows the logical mind to continue thinking and raise its alarms as usual. The mind is still turned on but is now muffled by a much louder identity. There is a deeper level of intensity that the individual has awoken to. Here the subconscious is experienced as the self. We can experience the confidence and clarity of several million years of evolution, and this is part of our natural state. This is inherent to us and does not require effort or memorization. This primitive ‘knowledge’ long pre-dates cortical logic and learning.

Figure 4 illustrates how the mind values effort, pursues growth, and recognizes achievement. While this holds true in the short term, it also leads to anxiety and stress. The heart accepts the being intuitively and allows life to unfold. There is no feeding the ego and little claim to individual uniqueness or special prowess. With this comes more sustained meaning in life, happiness, and fulfilment without the anxiety for rapid rewards and daily reaffirmations. Bhagavad Gita says, “do your duty, do not worry about the results.” To completely devote years of effort with no expectations of fruition would seem ludicrous to linear thinking—but this is the essence of the teaching. The ease to accept all outcomes comes from a deeper trust, humility, and seeing our limited scope in the bigger scheme of things.

Figure 4.

Operating through Mind Consciousness in well-adapted individuals can result in material success. However, trusting the long-term advantages of attributes of Heart Consciousness in the figure will reduce thought-identification and increase the intensity and meaning in life. This determines our happiness and fulfilment in life.

Living Free

Life is change and growth. Our body is perceived in movement. Our mind is perceived in thought. The heart is perceived in kindness. Intensity is the key. A year’s worth of life experiences accumulated with the mind is attained in a moment of higher consciousness at the heart level. In our modern society, we have become accustomed to carrying our baggage around: the mind. We see life as an endless cycle of hard work, stress, and exhaustion. However, life is not destined to be this way. The burdens of the mind can be eased; the first step in doing so is to realize that there is a better path. Consciousness can be elevated effortlessly by letting go of our thought-identity with its false beliefs. Thoughts cannot be stopped, but they can become less pronounced and not define our being. The mind has a limited role in this elevated reality. With higher consciousness, life gains energy. Every effort contributes to the common good, and we find through helping others, we are adding meaning to our lives.

The inner ‘heart’ can be felt through the acronym: Humility and gratitude, Empathy, our true Aspirations and goals, Reciprocation and gaining Trust all around. When connected with HEART our intensity naturally rises. This ‘thought-free’ intensity has scientifically been described as flow state or zone.¹⁴ Siddha philosophy of tolerance, equality, and empathy have been at the core of individual wellness and societal vitality as described in Tholkappiyam, the oldest Tamil grammar text 5,000 years ago.³ Thiruvalluvar, a Siddha poet and philosopher, directly addresses flow as the highest level of enthusiasm for life itself. Accepting anything less was a disgrace for Tamils 2,000 years ago.¹⁵ Every year during the Tamil harvest festival, Pongal, the rice boils and overflow symbolizing this celebration of life. With gratitude, consciousness spontaneously expands to encompass more of existence. Thus, HEART consciousness is the road to higher consciousness and liberation.

Health in the Future

Self-inquiry has the potential to improve health and mindset. While we use over a dozen tools, Hunger Gratitude Experience (HUGE) is intuitive and universally applicable. Identifying with people or circumstances that we are grateful for is the first step. Next is deeper mind-body connection gained through exploring, accepting, and relating directly with hunger through fasting. Experiencing a deeper gratitude for life automatically ensues when this process is explored and deepens self-awareness. Based on their practice, authors find this tool effective in inspiring a wide spectrum of people. Advanced heart disease, chronic kidney disease, and long-standing type II diabetes improve significantly. Patients find it natural and safe sustaining over 30% weight loss for 10–15 years with HUGE fasting. Similarly, physicians find it is easier to focus, cope with burnout, and experience more empathy towards their patients. Students report lesser anxiety as well as better academic and athletic performance.

Exploring space, taking the first step on the moon, Armstrong said “one small step for man is one giant leap for mankind.” Exploring the inner world, gaining invaluable insight into ourselves, and taking the first step inwards towards self-inquiry may transform our health individually and allow our species to thrive in harmony with nature.

Conclusion

The logical mind seeks growth and dominance over the external world. Thought-identification was natural and essential for our survival. Tapping into the vast potential of our subconscious is possible through tools that promotes selfless kindness or HEART consciousness. Cardiac patients with numerous comorbidities benefit sustainably and profoundly with self-inquiry. This path is both ancient and modern; it will lead to our awakening. Our ability to overcome thought-attachment, expand consciousness and celebrate life may determine our health and destiny.