ISLAMIC
VALUES AND ETHICS IN PREVENTION AND
TREATMENT OF EMOTIONAL DISORDERS
Basheer Ahmed,
U.S.A.
God
says about Quran ..It (Quran) is a guide and a healing to those who
believe." (S.41: V. 44) Religion plays a significant role in satisfying our
physical as well as spiritual needs: Islam teaches us a code of behavior and
gives us a meaning for our existence. Unfortunately, in today's western society
the religious, moral and ethical values have been declining. The families are
falling apart, divorce rate is increasing sharply, substance abuse and excessive
sexual indulgence are common in adolescents and young adults. These factors lead
to conflicts, resentment, loss of self-respect, loneliness, depression, anxiety
and a host of psychological symptoms. Despite progress in the behavioral
sciences, there remains the question of whether current technique of treatment
and prevention of emotional disturbances are effective in making a significant
impact on psychiatric problems.
Psychotherapy is in reality a form of education which directs
the patient to recognize his behavior, to conform with prevailing standards. It
helps in motivating the patient to adopt the alternate ways of behavior. In our
opinion, the Islamic principles which are based on Quran and Hadith are the best
form of prevention and treatment of emotional disturbances. Muslims physicians
and mental health professionals should incorporate the Islamic values and ethics
in techniques of psychotherapy.
God says about Quran
IT (QURAN) IS A GUIDE AND A HEALING TO THOSE WHO BELIEVE (S.41: v.
44).
God says in Quran about psychological and social diseases and
cures in several surahs. In our opinion, Islamic principles which are based on
Quran and Hadith are the best form of prevention and treatment for psychological
and social disturbances.
In
western society many psychiatrists and psychotherapists discourage the use of
any religious concept in treatment of emotionally disordered. Of course,
Freudian theories have a great deal of influence on western thinking. Freud's
focus on sex as the driving force of human behavior and repression of sexual
desires as a cause of neurosis, made a considerable impact on medical and social
scientists. Individuals are encouraged to express freely aggressive and sexual
desires, which further contribute in changing the sexual attitudes and lack of
inhibition in the society at large. Freud and his followers have tried to
explain religion as the ..universal obsessional neurosis." It is
prejudiced, irrational statement and many psychoanalysts contradict Freud's
statement. Erich Fromml defines religion as ..A system of thought and actions by
a group which gives the individual a frame of orientation and an object of
devotion". ArietiJ elaborates further the role of religion in human life.
He states that religion gives people faith for survival of man and to achieve
human ideals. Religion becomes an incentive to greatness of spirit. It offers
new insight which opens up new dimensions of understanding and feeling. Higgins further supporting the importance of religion states that modern psychiatry
has not yet significantly tapped the fund of information about the human
condition ranging from the inspirational writing about the aims of living to
highly systematized doctrine about organization of behavior.
Our religion, Islam, plays a significant role in satisfying
our physical as well as spiritual needs. Islam teaches us, a code of behavior,
conservation of social values and gives us a meaning for our existence. It helps
in toleration and developing adaptive capacities for stressful events of life.
It gives us a sense of self-respect and teaches us about the virtues of family
life and a cohesive society with a sense of brotherhood.
Shall Muslim psychiatrists and psychotherapists incorporate
the Islamic values, ethics and code of behavior in techniques of psychotherapy?
In order to answer this, we should examine the causes of
emotional disorders, effect of current principles of psychotherapies and explore
the importance of incorporating Islamic values and ethics
in psychotherapy. Mental health 5 can be defined as a state of emotional well
being in which a person is able to function comfortable within his society and
in which his personal achievements and characteristics are satisfactory to him.
Emotional disorders are defined as disturbance of behavior and affect which
results in disturbance of a person's function in society. During the last few
decades it is becoming more and more clear that biological, social and
psychological factors influence the human behavior and that the health
disturbing factors operate within the individual, within the group and within
the social system in which he functions. In certain forms of emotional disorders
we see predominent biological factors and in others psychosocial factors. In the
interest of time, I will focus primarily on the psycho-social factors which
contribute to emotional disorders and the use of psychotherapy to bring about
the needed improvement.
Family is an important socio-cultural institution which makes
a considerable impact on personality development and a potential factor in
emotional disorders. Bowlby 6 confirms from his longitudinal studies, that the
permanent loss of a parent during childhood may result in increase vulnerability
to certain forms of psychopathology e.g., depression. The child can be
sensitized by the loss of a loved one, and he breaks down in various ways in
later life when faced with similar situations of loss or rejection. Similarly
permanent loss of father was found in the history of delinquent children.
Longitudinal observations have further confirmed that children reared in an
atmosphere of love, care, consistency and firm limitations develop healthy
personalities with trust and self confidence. Those reared in a hostile
environment with rejection and humiliation may develop apathy, anxiety or
aggressive behavior. Similarly, culture has also been described 7 as a causative
factor for a host of mental disorders. Culture may produce and maintain a mental
disorder by creating basic vulnerable personality , establish pathogenic
child-rearing practices, fostering sanctions against selected behavior and by
rewarding certain maladjusted deviants. Further emphasizing the role of family
and culture on human development, Karen Horney 8 pointed out: Man is no longer
an instinct ridden creature but being capable of choice and responsibility.
Hostility is no longer innate but reactive, egocentric and antisocial cravings
like greed or the lust of power were not inevitable phases of man's development
but the expressions of a neurotic process. By growing up under favorable
conditions man would develop his inherent constructive forces and like any other
living organism would want to realize his potentialities.
Unfortunately, today's western society, the religious, moral
and ethical values have been declining. The society is plagued with moral decay.
Families are disintegrated, divorce rate and number of unwed mothers have
increased sharply. Drug abuse and excessive sexual indulgence are predominant in
adolescents and young adults. These events lead to conflict, loneliness, guilt,
loss of self-esteem which result in manifestation of a variety of pathological
disorders. Many young persons are confused about self-identity, lose meaning in
life and often turns toward pseudo religious cults, drugs or suicide. Recent
research studies 9 confirms that both sociocultural and personality aspects are
responsible for high incidences of drug use in youth. In order to protect an
Islamic society and culture from the abovementioned influences, the moral,
social and inspirational forces of the Islamic religion are to be enforced.
Despite progress in the behavioral sciences there remains the
question of whether current techniques of psychotherapy and preventive measures
for emotional disturbances are effective in bringing about necessary changes in
individual, family and society. Obviously the answer is no. In my opinion, one
of the reasons for ineffectiveness is the predominant influence of Freudian
theories on western medical and social scientists. Freud gives us a clear
understanding of psychosexual development and unconscious motivation of
behavior. He described unconscious inner self as if and conscious self as ego.
Ego is regarded as active portion of personality adapting to forces of
id, external reality and superego. Freud further postulated that the sexual
urges of the child remain active from childhood and express in activities such
as sucking and swallowing. He further explains that child's love for his parents
is due to his sexual urges. The child develops a sexual attitude toward parents
of the opposite sex and a simultaneous rivalry toward the other. Freud calls
this is "oedipus complex". As a child grows the odipus complex
resolves. This is the foundation of Freud's psychoanalytic theory.
Freud's focus on sex as the driving force of human behavior
and sexual repression as a cause of neurosis is used as a basis of psychodynamic
therapy. According to Freud, our higher activities like art, science and
religion have no intrinsic worth. These activities are attempts of man to
compensate for his unsatisfied sexual desires. Criticizing Freud's over-emphasis
on sex, Rafilo outlined that Freud give a person three alternatives to choose as
a desired behavior: He must follow the instruction of his sexual urges, becomes
wicked and face the disgrace of society; repress his sexual desires to please
society and expose himself to the danger of suffering from neurosis or renounce
his instinctual desires and try to deviate himself by substitutes as art,
religion and morality. Obviously, Freud portrays a miserable picture of human
beings. The apparently distorted and disappointing view of Freud about the lot
of man is necessitated by his hypothesis that the nature of our unconscious
desire is sexual.
Freud's theory of sex as the driving force of human behavior
and his theory of the universality of oedipus complex have been widely
criticized. Even Freud's own followers, Adler and Jung, found it difficult to
agree with Freud. Adler maintained that the unconscious urge is the impulse to
power while Jung emphasized on collective unconscious. Karen Horney and Erich
Fromm, the renowned psychoanalysts, also rejected Freud's ideas about sexuality
as the basic force of life. Horney 11 stated that Freud's focus on sex as the
driving force of human behavior was one-sided and led to other distortions. She
emphasized on influence of family in development of personality and pointed out
that oedipus complex occurs only in distorted parent-child relationship.
As an alternative to Freud's theory, Rafilo explains that the
child loves his parents and feels an admiration for his parents and ascribes a
perfection to them. Thus, superego which develops as an interaction between
parent and child demands an ever-increasing perfection. Therefore, one can say
that the individual is under powerful influence of a desire for the perfect and
admirable throughout his life. In childhood his desire finds an outlet in the
persons of the parents and teachers. As his knowledge increases he finds other
and better objects and ideas worthy of love and devotion and he is naturally
attracted to them, being compelled by the urge of his nature. It appears that
the repression of the sexual urge is the cause of neurotic symptomatology but it
can also be explained that the symptom may be due to obstruction of the urge of
consciousness for perfection and conflict created by sexual urges. The
fundamental cause of emotional trouble is the choice of the love of a wrong
ideal. Therefore, the cause of cure may not lie so much in the discovery of
conflict as in the changing or the raising of the ideal. Therefore, the focus of
therapy should be toward achieving the ideal.
The Muslim psychiatrist and psychotherapist must have a clear
understanding about the development of a healthy personality and ego ideal.
Mother satisfies the need of the child since birth which gives him a sense of
possession and omnipotence. Gradually the child realizes that he has to share
mother's love and attention with siblings and father and he also learns that
mother expects him to restrain his urge for immediate gratification. From this
prohibition and discipline the conscious and superego develops. Discipline
creates conflict but the child overcomes the conflict by introjecting mother and
her authority and maintains the affectionate relationship. In a healthy
mother-child relationship the child must believe "I am so strong in my
mother's love that I can yield to her without fee long defeated" 12 The
same mechanism involved when a Muslim introjects the image of God as Qadeer,
Raheem and- Benevolent. The introjection of God's love and authority influences
a Muslim's behavior incorporating ethical and moral values of Islam. Once you
incorporate the image of God in innerself there is no conflict with external
reality and superego. A child's religious orientation is influenced by the kind
of family relationship that exists at home. Quran emphasizes again and again,
about healthy parent-child relationship and parents' responsibility toward
upbringing. In a home where parents playa role of strong loving and protective
figures, with proper attention toward developing a sense of self-worth and
dignity, the child develops trust, self-confidence and introjects the love and
authority of parents and God. In a home where parental figures are unloving,
show no respect toward each other, rejecting and punitive towards their
children, then the conept of God is distorted.
Psychotherapy is in reality a form of education which directs
the patient to recognize his behavior, to conform with prevailing standards and
to help in improving the patient to adapt the alternate ways of behavior. Muslim
psychiatrists and psychotherapists must have familiarity with Islamic religion
and culture and must incorporate Islamic values, ethics and code of behavior in
techniques of psychotherapy. Many patients suffering from emotional disorders
have lost the ability to lead responsible lives. For them therapeutic guidance
in an environment of care, respect, dignity and understanding is necessary. The
goal of therapy need not be happiness but acceptance of reality and
strengthening the coping mechanisms. A trustful relationship with therapist, a
clarification of problem and conflict, influences the positive outcome. Moral
and ethical issues should not be avoided and problems should be clarified so
that patient c.an judge for himself the quality of his behavior and his ideals.
BUT HE GUIDETH TO
HIMSELF THOSE WHO TURN TO HIM IN PATIENCE, THOSE WHO BELIEVE AND WHOSE HEARTS
FIND PEACE AND SATISFACTION IN THE REMEMBRANCE OF GOD: FOR WITHOUT DOUBT IN THE
REMEM- BERANCE OF GOD DO HEARTS FIND SATISFACTION AND PEACE .
(Quran 5.13: V.27-28)
REFERENCES
1. FREUD, S.'.The
future of an Illusion". Livenright, New York, 1949.
2. FROMME, E. '.Psychoanalysis and religion". Yale University Press,
New Haven, Conn, 1950.
3. ARIETI, S. "The intrapsychic self". Basic Books, New York, 1967.
4. HIGGINS J.W. .'Psychiatry & Religion". In American Handbook of
Psychiatry Ed. S. Arieti. Basic Book, 1974.
5. Comprehensive textbook of Psychiatry/111. Ed. by H. ,. Kaplan, A.M.
Freedman & B.J. Sadock. Williams & Wilkins
Press, Baltimore, Md. 1980, page 3339.
6. BOWLBY, J."Maternal care and mental health". Monograph World
Health Organization. Geneva 1952
7. ARMANDO FAVAZZA & MARY ORMAN '.Anthropology and Psychiatry"
in Comprehensive Textbook of Psychiatry. Ed. A.
Kaplan, A. Freedman and B. Sadock. Published by Williams&
Wilkins, Baltimore, Md. 1980, page 488.
8. HORNEY, K.'.Neurosis and human growth". Published W.W. Norton,
New York, 1950.
9. KANDEL, D.B. Editor .'Longitudinal research on drug abuse".
Halstead Press, New York, 1978.
10. RAFIUDDIN, M. "Ideology of the future". Published by Sh. M.
Ashraf, Lahore, 1970.
11. HORNEY, K. "New ways in psychoanalysis". W. W. Norton, New
York, 1939.
Article
printed with permission from Dr. A.R. El-Gendy, Secretary General Assistant,
Islamic Organization for Medical Sciences (IOMS)
Please Check out IOMS's website which contains a wealth of information on
health/medical issues for Muslims at:
http://www.islamset.com
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