Atlas›Domain XIII · Contemplative & religious disciplines›Guide 052
Guide XIII-052

Sadhu tapas

India
A 34 · L 53 · M 1315 interventions in the Trinity explorer
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[source: …] where a claim comes from[uncertain] not confirmed in a primary source[synthesis] the writer's reconstruction

1. Introduction

Version followed: the observance as scholars of contemporary Hindu renunciation describe it (Hausner 2007, Wandering with Sadhus; Bevilacqua 2024 and 2025 on sadhus' tapasya), with the institutional frame of the akharas as India's Ministry of Culture published it for the 2025 Maha Kumbh; the psychotherapist's work alongside it follows the DSM-5 Cultural Formulation Interview (CFI), International OCD Foundation (IOCDF) guidance on scrupulosity, and eating-disorder organisations' guidance on religious fasting.

What it is. Tapas (Sanskrit, usually glossed "heat" or "ardour") is, in Hindu, Jain and wider South Asian traditions, the ascetic discipline undertaken for spiritual power, purification or liberation. In the Vedic texts it names the inner heat produced by austerity, and in creation narratives the creator Prajapati brings the world into being through tapas; the early Upanishads internalise the sacrificial fire as an inner fire cultivated by asceticism. Shiva is, in the tradition's own imagery, the epitome of the ascetic. Practices the tradition lists include fasting, difficult and often painful bodily postures, vigils beside fires or in cold, and breath control; many ascetics keep their practice in cremation grounds. [source: Britannica, "Tapas"] Sadhus are Hindu renouncers (also sannyasis) who have left householder life, family and social ties for a religious life; they form a mobile community with its own internal structure but no fixed location, gathering along pilgrimage circuits tied to festival cycles (Hardwar, Allahabad/Prayagraj, Kathmandu in Hausner's fieldwork) and interacting continually with the householders who support and visit them. [source: Hausner 2007, publisher and Project MUSE descriptions] Contemporary ethnography describes tapasya among celibate ascetic orders as embodied "sacred pain" whose stated purposes are mastering the body, purifying karma and acquiring siddhis (powers, as the tradition holds them); some traditional austerities have declined, but the ascetic body still confers religious authority among both renouncers and lay people. [source: Bevilacqua 2025, abstract]

Who leads or authorises it. Renunciation is entered through initiation by a guru within an order (sampradaya) and, for many sadhus, an akhara. The Ministry of Culture describes 13 akharas, grouped as Shaiva, Vaishnava and Udasin; the Shaiva akharas include the Naga sannyasis (the Juna Akhara is described as the largest), Vaishnava akharas include the Nirmohi, Nirvani and Digambar Ani akharas, and akharas are led by Mahamandaleshwars who oversee spiritual and organisational matters. Women are initiated into sannyas (Juna's women's section has a separate organisation), and a Kinnar (transgender) Akhara took part in 2025. [source: Ministry of Culture/PIB 2025] Teaching notes from a Harvard workshop led by Diana Eck describe Naga initiation as a rite of symbolic death in which the initiate is treated as dead to the world. [source: Harvard Kumbh Mela workshop notes, 2012] The procedure and words of initiation are not given here; they belong to the guru and order.

How change happens, as the tradition holds it. In the tradition's own terms, austerity burns away karma and impurity, disciplines the body and senses, and generates spiritual power and progress towards moksha (liberation). This is a religious account, attributed to the tradition, neither endorsed nor dismissed here. [source: Britannica; Bevilacqua 2025] No austerity is presented here as a treatment for any physical or mental illness; such health claims, where clients make them, have no established clinical evidence base [uncertain: not verified].

Where a psychotherapist meets it. Clients are rarely full-time renunciants. More often they are: householder Hindus who take vows or austerities inspired by ascetic ideals; people (including Western seekers) considering or returning from initiation; families of someone who has renounced; former renunciants returning to lay life; and people for whom austerity has become entangled with scrupulosity, disordered eating or self-punishment. [synthesis] This guide covers the therapist's work alongside the observance, not the observance itself: no fasting lengths, austerity targets, breath practices, durations or initiation content are given.

2. Framework

The sources describe no therapy protocol for this observance; the phases below are an organising frame for the therapist's work, not a published model. [synthesis] No source gives session counts; frequency follows the client's need and whatever the presenting problem's own treatment requires (for example an ERP course for scrupulosity).

  • Phase 1 – Engagement and cultural assessment. Goal: understand what tapas, renunciation or the vow means to this client, their place in the tradition (renouncer, aspirant, householder devotee, family member, former renunciant), and who holds authority for them (guru, akhara, family priest). Tools: CFI core and the Spirituality, Religion and Moral Traditions module. Move on when the client's own account of the practice and the problem is written in their words and you know whom they regard as authoritative. [source: APA CFI; CFI Supplementary Modules]
  • Phase 2 – Safety and health coordination. Goal: identify medical risk from fasting, exposure, prolonged postures or sleep loss; screen for eating disorder, scrupulosity, depression, self-harm, mania or psychosis; route bodily risk to the doctor and medication questions to the prescriber. Move on when risk is assessed, medical review is arranged where indicated, and an agreed safety plan exists if needed. [source: NEDA; National Alliance for Eating Disorders; synthesis]
  • Phase 3 – Focused work. Goal: work on the presenting problem (scrupulosity, moral injury, grief or ambiguous loss in the family, transition out of or into renunciation, the teacher relationship) with the practice respected and accommodations agreed. Move on when the client's goals are met or when the work becomes religious guidance, which belongs with the client's teacher or clergy. [synthesis]
  • Phase 4 – Review and ending. Goal: review accommodations, health coordination and links with the client's religious community; plan for future vow or festival seasons that may bring the problem back. [synthesis]

Criteria throughout: the client leads on religious content; the therapist leads on clinical safety. When those conflict (for example a vow that is medically dangerous), the response is shared decision-making with the client's doctor and, with consent, the client's religious authority, not the therapist ruling on religious obligation. [synthesis]

3. Guiding principles

  • The tradition describes; the therapist does not prescribe. Practical meaning: never set, adjust or recommend austerities, fasts or vows; ask about them. [synthesis]
  • Attribute religious concepts. Karma, siddhis, tapas as spiritual heat and moksha are described as the tradition holds them. Practical meaning: say "in your tradition…" or use the client's words; neither affirm nor debunk. [source: Britannica; Bevilacqua 2025]
  • Renunciation is a recognised religious path, not a symptom. Leaving family and social ties is definitional of the sadhu's life, not evidence of illness. Practical meaning: assess for illness by its own criteria, not by the fact of renunciation. [source: Hausner 2007; synthesis]
  • Know the client's place in the tradition and their authorities. Sadhu life has its own social structures, orders and leaders. Practical meaning: ask who initiated them, which order, and whose counsel they accept. [source: Hausner 2007; Ministry of Culture 2025]
  • Use the client's own words. The CFI asks the clinician to replace bracketed terms with the person's own words and to explore every affiliation named. Practical meaning: record "my vow", "my guru's instruction", "Babaji" as said. [source: CFI Supplementary Modules]
  • Religion can protect and can harm. Eating-disorder guidance states that religion and spirituality can be both protective and a risk factor. Practical meaning: look for both strength and strain in the same practice. [source: NEDA]
  • Separate OCD from faith. IOCDF guidance aims to separate the OCD from genuine religious and moral values so the person can live by those values. Practical meaning: target the doubt and compulsions, not the faith. [source: IOCDF]
  • Health questions go to the doctor; medication questions go to the prescriber. Practical meaning: name the risk, refer, coordinate; give no medical or dietary instructions. [source: National Alliance for Eating Disorders; synthesis]
  • Exemptions belong to the tradition's authorities. Many traditions provide for illness and healing, and spiritual advisers may endorse alternatives. Practical meaning: help the client ask their own authority; do not issue dispensations. [source: NEDA; National Alliance for Eating Disorders]
  • Respect restricted content. Initiation words, mantras and order-specific practice are the guru's to give. Practical meaning: do not ask the client to disclose them; work with their meaning and effects. [synthesis]
  • Stay in role. The therapist is not a guru, confessor or spiritual director. Practical meaning: refer religious questions to the client's teacher or clergy; watch for being placed in a guru role. [source: Vieten et al. 2013; synthesis]
  • Competence and humility. Vieten and colleagues propose 16 basic spiritual and religious competencies spanning attitudes, knowledge and skills. Practical meaning: seek consultation or training where Hindu ascetic traditions are unfamiliar. [source: Vieten et al. 2013, IONS summary]
  • Power and consent. Guru relationships carry authority; the ascetic body confers authority. Practical meaning: check that any austerity is freely chosen, and stay alert to coercion, especially of the young. [source: Bevilacqua 2025; synthesis]

4. Intervention inventory

These are the psychotherapist's own interventions alongside the observance. None of them is a religious practice, and none sets or modifies an austerity. [synthesis unless a source is tagged]

4.1 Exploring the meaning of tapas and renunciation in the client's life

  • Purpose / when: At the start, and whenever an austerity, vow or wish to renounce comes into the work. Establishes what the practice means to this person before any clinical judgement. [synthesis]
  • Steps: (1) Ask the client to describe the practice in their own words and record their terms. (2) Ask what it is for, in their understanding (purification, karma, devotion to a deity, discipline, power, liberation; the tradition names these purposes). [source: Britannica; Bevilacqua 2025] (3) Ask how they came to it: a guru's instruction, a family or community custom, a personal vow, inspiration from sadhus met at a mela or temple. (4) Ask what it gives them and what it costs them, bodily, socially, financially. (5) Ask what would happen, in their understanding, if they stopped or broke it. (6) Reflect back the meaning before moving to any risk questions.
  • Example language (illustrative): "Before we talk about anything else, could you tell me what this tapasya is for you, in the words you would use with your guru or your family?" / "What do you hope it will do, and what does it ask of you?"
  • Watch for / working when: Signs it is working: the client corrects or adds to your summary, uses their own terms freely, and does not seem to be defending the practice. Watch for meanings that are mainly punitive ("I deserve this"), driven by fear of punishment, or tied to weight or appearance; these point to 4.7 and 4.8. Watch for your own reactions (admiration, alarm, exoticising) shaping the questions.

4.2 Locating the client in the tradition and identifying their authorities

  • Purpose / when: Early. Sadhu life has its own internal social structures, orders and leaders, and the client's position determines who can speak to obligations and exemptions. [source: Hausner 2007; Ministry of Culture 2025]
  • Steps: (1) Ask whether the client is a householder devotee, considering initiation, initiated (and into which order or akhara, Shaiva, Vaishnava, Udasin or other), or has left renunciation. (2) Ask who initiated or guides them and how they contact that person. (3) Ask who else holds authority for them: family priest, temple, elders, an ashram. (4) Ask whether the guru's guidance covers health and illness, and whether they would want the guru or another authority consulted. (5) Do not ask for initiation names, mantras or restricted instructions.
  • Example language (illustrative): "Who do you turn to when you are unsure what your vow asks of you?" / "You don't need to tell me anything given to you privately at initiation. I'm only interested in how it's going for you."
  • Watch for / working when: Working when you can name the client's authority and the client feels their privacy is respected. Watch for a client who has no authority and is improvising extreme practices alone, which raises risk [synthesis], or for an authority the client fears.

4.3 Cultural Formulation Interview (core)

  • Purpose / when: A structured cultural assessment for intake or when the problem's meaning is unclear. The core CFI has 16 questions in five areas: the person's definition of the problem; perceived causes, context and support; self-coping and past help-seeking; current help-seeking; and the clinician–patient relationship. Clinicians may reproduce it for use with their patients; modifications need APA permission. [source: APA CFI, DSM-5-TR edition]
  • Steps: (1) Read the brief introduction stating there are no right or wrong answers. (2) Work through the five areas in order, using the CFI's own questions and probes (not reproduced here). (3) Note where the client names tapas, a guru, karma or a vow as cause, help or obstacle. (4) In the help-seeking area, ask what the guru, family or community have advised. (5) In the relationship area, ask whether differences in religion or culture between you might get in the way. (6) Use the answers to shape the formulation and plan.
  • Example language (illustrative): "Some people see a problem like this as connected to karma, to their practice, or to something else entirely. How do you understand it?" / "Is there anything about me or this clinic that might make it hard to talk about your spiritual life here?"
  • Watch for / working when: Working when the formulation includes the client's explanatory model alongside the clinical one. Watch for the client giving 'acceptable' answers to a perceived secular clinician; return to the relationship area.

4.4 CFI Supplementary Module 5: Spirituality, Religion and Moral Traditions

  • Purpose / when: When religion is central, as it is with any austerity or renunciation. Module 5 has 16 questions in four sections: spiritual, religious and moral identity; the role of these traditions in daily, family and community life; their relationship to the problem, including coping through leaders, texts and practices; and potential stresses or conflicts, including discrimination. A three-question version sits inside the Cultural Identity module. [source: CFI Supplementary Modules]
  • Steps: (1) Explore every affiliation the client names (for example a family Vaishnava tradition and a Shaiva guru). (2) For each, ask about level of involvement and how it affects coping, using the client's own words in place of the module's bracketed terms. (3) Ask how leaders, texts and practices, including the austerity, have helped. (4) Ask about conflicts: with family over renunciation, within the order, or between the practice and health. (5) Consider the Social Network and Psychosocial Stressors modules where family rupture is present.
  • Example language (illustrative): "How has your practice helped you through this so far?" / "Has following this path caused strain with your family or anyone else important to you?"
  • Watch for / working when: Working when the client describes both resources and conflicts. Watch for conflict between family expectations and renunciation, which Hausner's account shows is built into the sadhu's break with family yet ongoing interaction with householders. [source: Hausner 2007]

4.5 Accommodation in scheduling and treatment

  • Purpose / when: Throughout. Sadhus are highly mobile and gather along pilgrimage circuits tied to festival cycles; householder devotees may also travel to melas. [source: Hausner 2007; Harvard workshop notes] Clients may be keeping vows that affect eating, speech, contact, dress or travel. [synthesis]
  • Steps: (1) Ask about festival, pilgrimage and vow calendars at intake and plan breaks or remote sessions around them. (2) Ask whether any vow affects how they can attend (speaking, travel, contact with others, timing). (3) Agree how to reach each other during travel and what happens to safety plans while away. (4) Adapt homework to fit their daily religious routine rather than compete with it. (5) Ask about dress, ash, hair or other markers, and make the setting respectful; do not comment on appearance clinically unless there is a risk. (6) Review accommodations at each phase.
  • Example language (illustrative): "Are there festival times or periods of your vow when it would be hard to meet? Let's plan around them now." / "If you are away at the mela and things get hard, what would you want to happen?"
  • Watch for / working when: Working when attendance is planned rather than lost to absences. Watch for accommodation being used to avoid the work (for example scrupulous clients extending observances), and for loss of support or medical access while travelling.

4.6 Health screening and coordination with the doctor

  • Purpose / when: Whenever an austerity involves fasting, exposure to fire or cold, prolonged or painful postures, sleep loss or breath practices, all of which the tradition lists among tapas forms. [source: Britannica] The therapist names risk and refers; the doctor assesses the body; the prescriber handles medication. [source: National Alliance for Eating Disorders; synthesis]
  • Steps: (1) Ask, qualitatively, what the practice involves for the body; do not suggest limits, durations or targets. (2) Ask about existing conditions (diabetes, heart, kidney or circulatory problems, pregnancy, eating disorder history) and medications. (3) Ask about warning signs: dizziness, fainting, numbness, pain, injury, confusion, weight change, sleep disturbance. (4) With consent, refer to or write to the client's doctor describing the practice in the client's terms. (5) If the client takes medication, advise them to discuss the practice with the prescriber, since fasting can affect timing, absorption and mood. [source: National Alliance for Eating Disorders] (6) Treat any acute warning signs as a medical issue and direct the client to urgent care. (7) Record the plan.
  • Example language (illustrative): "I'm not going to tell you how to keep your vow. I would like your doctor to know what it involves, so they can help you keep well. Would that be all right?" / "Your medicines and your fasting both matter. Your prescriber is the person to ask how they fit together."
  • Watch for / working when: Working when the client accepts medical review without feeling their practice is being judged. Watch for dehydration, electrolyte imbalance and muscle loss with food restriction, and refeeding risk after extended fasting with irregular eating, as eating-disorder guidance names them. [source: National Alliance for Eating Disorders] For cold, heat, prolonged postures and sleep loss, no clinical source specific to these austerities is cited here [uncertain: not verified]; route all such concerns to the doctor.

4.7 Eating-disorder awareness where austerity involves food

  • Purpose / when: When fasting or food restriction is part of a vow and the client has or may have disordered eating. Eating-disorder guidance states that restrictive dieting is a known risk factor, that religious fasting can be triggering for those already symptomatic or fasting for weight control, and that beliefs driven by external pressure, an anxious relationship with a deity, seeing the body as needing control or the self as sinful are linked with more disordered eating. [source: NEDA]
  • Steps: (1) Screen for an eating disorder history and current symptoms. (2) Ask what the fast is for: devotion, or also weight and body control. (3) Look for the warning signs that fasting is eating-disorder driven: revived restriction or calorie control; bingeing or purging after; fasting as purging; rigid good/bad food thinking; secrecy, guilt or shame around eating. [source: National Alliance for Eating Disorders] (4) If present, involve the eating-disorder treatment team (therapist, dietitian, physician, prescriber) before any further fast. [source: National Alliance for Eating Disorders] (5) Help the client consult their own religious authority about exemptions or alternative offerings; some advisers suggest non-food sacrifices or deeper non-food practice. [source: NEDA; National Alliance for Eating Disorders] (6) Do not set food rules or quantities.
  • Example language (illustrative): "When you fast, how much of it is about your devotion, and how much is about your body or your weight?" / "Many traditions make room for illness. Would you be willing to ask your guru what your path asks of someone who is unwell?"
  • Watch for / working when: Working when devotion can be expressed without restriction harm and shame lessens. Watch for austerity used as a respectable cover for restriction, and for refusal of exemptions on scrupulous grounds (see 4.8).

4.8 Assessing scrupulosity and adapting ERP

  • Purpose / when: When austerities, vows, purity or recitation are driven by doubt and fear rather than devotion. IOCDF describes scrupulosity as OCD centred on religious or moral fears, with compulsions such as repeated prayer until it feels right, repeated confession, reassurance-seeking from religious leaders or family, purification routines and mental neutralising; it often exceeds what religious law requires and impairs functioning. [source: IOCDF, "What is OCD & Scrupulosity?"] In Hindu practice IOCDF lists checking that puja is done correctly or the right deity honoured, preoccupation with the pronunciation and meaning of slokas, worry about following dharma, perfectionism over festival preparations, fear of negative karma and of failing to reach moksha, and compulsive self-shaming in the belief it may earn good karma. [source: IOCDF, "Religious Scrupulosity in Hinduism"]
  • Steps: (1) Distinguish devotion from compulsion: driven by distress, going beyond what the tradition asks, impairing function. [source: IOCDF] (2) Ask whether austerities are intensified or repeated to undo feared sin or bad karma. (3) If scrupulosity is likely, offer CBT with exposure and response prevention, the primary psychological treatment IOCDF names. (4) With the client, build a hierarchy of faith-related triggers and practise facing them without compulsions (reasoning, prayer used as neutralising, reassurance-seeking, research, analysis, thought suppression); use imaginal exposure for feared outcomes such as negative karma or a flawed puja. [source: IOCDF, Hinduism page] (5) With the client's consent, consult their religious authority (for example to clarify what the tradition actually requires); IOCDF notes treatment may include consulting faith leaders. [source: IOCDF] (6) Exposures must never require the client to break genuine religious commitments; plan them so the target is the OCD, not the faith. [source: IOCDF, synthesis] (7) Expect self-shaming to rise during treatment and name this in advance. [source: IOCDF, Hinduism page] (8) Medication questions go to the prescriber.
  • Example language (illustrative): "We're not going after your faith. We're going after the doubt that keeps telling you it's never enough." / "If you asked your guru whether this extra repetition is required, what do you think they would say? Would you like to ask them together?"
  • Watch for / working when: Working when practice returns to what the tradition asks and distress falls. Watch for the client recruiting the therapist or guru for reassurance, for the austerity escalating as a compulsion, and for exposures being experienced as sacrilege, which means the plan needs revision.

4.9 Moral injury, broken vows and leaving renunciation

  • Purpose / when: When a client has broken a vow, left an order, been unable to sustain an austerity, or acted against their path. No source specific to sadhus is cited; this is general practice applied. [synthesis]
  • Steps: (1) Let the client describe the vow and the break in their own terms. (2) Separate religious questions (what the tradition says about broken vows, atonement, release) from psychological ones (guilt, shame, identity loss, grief). (3) Refer religious questions to the client's authority, or help them find another within the tradition if their guru is unavailable or the relationship is harmful. (4) Work on shame and self-punishment with standard methods (self-compassion, cognitive work on responsibility). (5) Support practical re-entry to lay life: housing, work, identity, family. (6) Screen for depression and suicide risk using current standard practice.
  • Example language (illustrative): "It sounds like part of you feels you have failed your guru, and part of you knows you could not go on. Can we make room for both?" / "What does your tradition say about someone who returns to family life? Who could you ask?"
  • Watch for / working when: Working when the client can hold their religious identity without total condemnation. Watch for self-punishment through new austerities, isolation, and suicidal thinking.

4.10 Grief, ambiguous loss and community support for families

  • Purpose / when: When the client is a parent, spouse or sibling of someone who has renounced, or is themselves leaving family to renounce. Renunciation is defined by a break with family and social ties, yet sadhus continue to interact with householders. [source: Hausner 2007] Naga initiation is described as a rite of symbolic death, after which the initiate is treated as dead to the world. [source: Harvard workshop notes] Families may therefore grieve someone still living. [synthesis]
  • Steps: (1) Name the loss as real even when the renunciation is honoured. (2) Explore the family's own religious frame: pride, duty, shame, fear for the person's safety or health. (3) Distinguish what contact the order permits from what the family hopes for; the family can ask the order or guru directly. (4) Help the family find community support: temple, satsang, others with renunciant relatives. (5) For the renouncing client, explore how they wish to part and what they owe or can offer family, without urging them to stay or go. (6) Screen family members for depression and complicated grief.
  • Example language (illustrative): "You can be proud of your son's path and still miss him terribly. Both are allowed here." / "In your tradition, what is it right for a family to do when a child takes sannyas?"
  • Watch for / working when: Working when the family can describe a relationship they can live with. Watch for conflict between generations over the decision, and for concern that the person is in danger or under coercion (see 4.12).

4.11 Collaboration with the guru, akhara, priest or Hindu chaplain

  • Purpose / when: When the client wishes, and especially where health, exemptions, scrupulosity or vows are at stake. IOCDF notes that treatment may include consulting the patient's faith leaders, for example to clarify the institution's position on an issue relevant to recovery; eating-disorder guidance suggests clients talk with a trusted spiritual adviser to receive validation for a health-based decision not to fast. [source: IOCDF; National Alliance for Eating Disorders]
  • Steps: (1) Get explicit, specific consent: who, what may be shared, for what purpose. (2) Prepare the question with the client in their words (for example, "what does my vow require of someone who is ill?"). (3) Prefer the client asking with your support; contact the authority directly only if the client wants it. (4) Share only the minimum clinical information. (5) Respect the authority's domain: do not ask them to change doctrine or to act clinically. (6) Where a guru is unavailable (sadhus are often itinerant [source: Hausner 2007]), consider a temple priest, an ashram, or a hospital or university Hindu chaplain, as the client chooses. [synthesis] (7) Record agreements.
  • Example language (illustrative): "Would it help to bring your question to Maharaj-ji yourself, and we can plan together what you'll ask?"
  • Watch for / working when: Working when the client experiences their tradition and their treatment as allies. Watch for collaboration being used for reassurance in OCD, and for an authority who discourages medical care, which shifts the work to risk management and 4.12.

4.12 The teacher relationship, power and coercive control

  • Purpose / when: When a client is in a close relationship with a guru or order, is considering initiation, or describes pressure. Ascetic authority is real in the tradition: the tapasic body confers authority in religious and lay communities. [source: Bevilacqua 2025] Workshop notes record accusations that some orders recruit young men to swell numbers. [source: Harvard workshop notes] No independent investigation of a named teacher is cited here.
  • Steps: (1) Ask how decisions about austerities are made and whether the client could decline one without punishment. (2) Ask about access to money, documents, family, medical care, and freedom to leave. (3) Ask about any sexual contact or demands, financial exploitation, violence, or threats, including spiritual threats. (4) Distinguish a demanding discipline freely chosen from control enforced by fear, isolation or abuse. [synthesis] (5) If abuse is disclosed, follow safeguarding and reporting duties for your jurisdiction. (6) Support safe exit planning if the client wishes to leave, and later work on religious trauma, without attacking the tradition itself.
  • Example language (illustrative): "If you decided this practice was not right for you, what would happen?" / "Has anyone in the order asked you for things that made you uncomfortable?"
  • Watch for / working when: Working when the client can speak freely about their teacher and choices. Watch for escalating austerity at another's insistence, cut-off from medical care, and the client transferring the guru role to the therapist.

4.13 Unusual spiritual experiences, solitary practice and mental-state assessment

  • Purpose / when: Austerities may be practised in seclusion, with meditation, fasting and sleep loss, and the tradition associates them with siddhis and powers. [source: Britannica; Bevilacqua 2025] Clients may report visions, heat, energy, voices or powers. Published research on challenging meditation experiences (Lindahl et al. 2017, PLOS ONE; Farias et al. 2020, Acta Psychiatrica Scandinavica) and Treleaven's trauma-sensitive mindfulness are relevant reference points [uncertain: not verified].
  • Steps: (1) Ask about experiences with curiosity and in the client's frame. (2) Assess sleep, food intake, physical state and any substance use, since physiological strain can drive mental-state change. [synthesis] (3) Screen for psychosis, mania, severe depression and dissociation by their own criteria, including impaired functioning, risk and loss of insight. (4) Where experiences are culturally congruent, non-impairing and valued, consider a religious or spiritual problem formulation (DSM-5-TR has a code for a religious or spiritual problem, Z65.8) rather than a disorder. (5) If the client wishes, involve the teacher about reducing the intensity of practice; route physical strain to the doctor; use grounding and routine. (6) Refer urgently for psychiatric assessment when risk or psychosis is present.
  • Example language (illustrative): "Some people in long practice have experiences that feel holy, frightening or both. What has it been like for you?" / "Has your sleep or eating changed alongside these experiences?"
  • Watch for / working when: Working when the client feels heard and risk is clearly assessed. Watch for both errors: pathologising a valued religious experience, and missing illness because it is framed spiritually.

4.14 Safeguarding children and young people

  • Purpose / when: When a minor is involved in initiation, harsh austerity, fasting or residence in an ashram or order, or a young client describes pressure to renounce. No safeguarding body's guidance specific to sadhu austerities is cited here [uncertain: not verified]; general child-protection duties apply. [synthesis]
  • Steps: (1) Assess the young person's assent and the parents' consent separately. (2) Ask about food, sleep, schooling, medical care, discipline and contact with family. (3) Treat harsh austerities imposed on a child, denial of medical care, or physical punishment as safeguarding concerns and follow your jurisdiction's reporting procedures. (4) Work with parents and, if they wish, their religious authority on age-appropriate forms of practice. (5) Never name the child in correspondence beyond what procedures require.
  • Example language (illustrative): "Your family's faith matters, and so does your health. Can you tell me how the fasting days go for you?"
  • Watch for / working when: Working when the young person speaks freely and their health and schooling are protected. Watch for fear of the order or of family shame preventing disclosure.

4.15 Holding the therapist's role: boundaries, self-disclosure and competence

  • Purpose / when: Throughout. The therapist is not a guru, confessor or spiritual director. Vieten and colleagues propose 16 basic competencies across attitudes, knowledge and skills for working with clients' spiritual and religious beliefs and practices. [source: Vieten et al. 2013, IONS summary] Professional ethics codes on competence, multiple relationships and respect for religion apply [synthesis: the APA Ethics Code was not consulted for this guide].
  • Steps: (1) Notice your own beliefs about asceticism (admiration, suspicion, romanticism) and seek supervision when they pull. (2) Disclose your own religious position only when it serves the client, briefly, and return to their frame. (3) Avoid dual relationships: do not attend the client's ashram as a devotee, accept a role in their religious life, or give religious rulings. (4) Learn the basics of the client's order from scholarly sources and the client, without asking the client to educate you at length. (5) Refer to or collaborate with clergy, a chaplain or the guru for religious questions; refer to a clinician with relevant cultural competence when yours is insufficient.
  • Example language (illustrative): "That's a question about your dharma, and your guru is the right person for it. What I can help with is how you're coping while you think it through."
  • Watch for / working when: Working when the client sees you as a clinician who respects their path. Watch for the client treating you as a spiritual authority, or for you advising on practice.

5. Handling problems

The sources cited do not address therapy problems specific to this observance; except where a source is tagged, the guidance below is [synthesis].

  • Client refuses medical review ("my body belongs to my practice"). Return to meaning (4.1): ask what their tradition says about caring for the body that does the practice, and whom they would trust to answer that. Offer a doctor with cultural familiarity. Many traditions provide for illness, and spiritual advisers may endorse alternatives. [source: NEDA; National Alliance for Eating Disorders] Document risk; if danger is imminent, act on it as for any medical emergency.
  • The client wants the therapist to approve, adjust or forbid an austerity. Decline the religious role (4.15) and offer what you can: risk information from the doctor, a question prepared for the guru, and work on whatever makes the decision hard.
  • Stuck: the austerity keeps escalating. Assess for scrupulosity (4.8), eating disorder (4.7), depression with self-punishment, or coercion (4.12). Escalation driven by fear of karma or of never being pure enough points to ERP with religious consultation. [source: IOCDF]
  • Exposure feels like sacrilege. Revise the hierarchy so exposures target doubt and compulsion, not genuine commitments, and check what the tradition actually asks with the client's authority. [source: IOCDF; synthesis] Expect increased self-shaming during treatment. [source: IOCDF, Hinduism page]
  • Non-adherence linked to travel and festivals. Plan around pilgrimage and festival calendars at intake (4.5); agree remote contact; keep safety plans portable. [source: Hausner 2007 for mobility; synthesis]
  • Rupture: the client feels you disrespected their path. Name it, apologise specifically, ask what felt dismissive, and use the CFI's clinician–patient relationship questions. [source: APA CFI] Check your own reactions in supervision.
  • Rupture: the family wants you to talk the client out of renouncing. Clarify your role with consent boundaries; you serve the client's wellbeing, not a family or religious outcome. Offer the family separate support (4.10).
  • Overwhelm or unusual states after intensive practice. Prioritise physical safety and sleep, use grounding, involve the doctor, and, if the client wishes, the teacher about lightening practice; assess urgently for psychosis, mania or suicide risk (4.13).
  • Suspected eating disorder framed as devotion. Use the warning signs in 4.7, involve a specialist team before any further fast, and help the client seek their authority's view on exemption. [source: National Alliance for Eating Disorders]
  • Disclosure of abuse by a teacher or within an order. Believe and document; follow safeguarding and reporting law; support safety and choice about leaving; avoid blaming the tradition as a whole (4.12).
  • Former renunciant with shame and identity loss. Work with 4.9; help them find a voice within the tradition who can speak to return to lay life, if they want one; build practical supports.
  • The therapist lacks knowledge of the order or practice. Use the client as guide to their own meaning, scholarly sources for background, and consultation; refer if competence is insufficient. [source: Vieten et al. 2013; synthesis]
  • A minor is involved. Follow 4.14 and local child-protection procedures; do not let respect for religion delay action on harm.

Sources

Books and articles cited:

  • Hausner, S. L. (2007). Wandering with Sadhus: Ascetics in the Hindu Himalayas. Indiana University Press (Contemporary Indian Studies).
  • Bevilacqua, D. (2024). From Tapas to Modern Yoga: Sādhus' Understanding of Embodied Practices. Equinox.
  • Bevilacqua, D. (2025). Embodying sacred pain: Practice of austerities among Hindu ascetics. South Asia: Journal of South Asian Studies, 48(4), 804–823. doi:10.1080/00856401.2025.2524248.
  • Vieten, C., Scammell, S., Pilato, R., Ammondson, I., Pargament, K. I., & Lukoff, D. (2013). Spiritual and religious competencies for psychologists. Psychology of Religion and Spirituality, 5(3), 129–144 (summary only).
  • Lindahl et al. (2017), Farias et al. (2020) and Treleaven (2018) are named as reference points [uncertain: not verified].
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