Islamic Values and Ethics in
Prevention and Treatment of Emotional Disorders
Basheer Ahmed
MD
God says about the 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 techniques 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 that directs the patient to recognize
his behavior, to conform to prevailing standards. It helps in motivating
the patient to adopt the alternate ways of behavior. In our opinion, the
Islamic principles that are based on Quran and Hadith are the best form of
prevention and treatment of emotional disturbances. Muslim physicians and
mental health professionals should incorporate the Islamic values and
ethics in techniques of psychotherapy.
God says in the 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
suras. 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 Fromm 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". Arieti
J 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 4 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 predominant 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 a 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 favourable 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 socio-cultural 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 id 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 Oedipus 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 gives a person three alternatives to choose as a desired behavior:
He must follow the instruction of his sexual urges, become 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 feeling 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 play a 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 concept 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 can 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 BEL/EVE 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
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3. ARIETI, S. "The Intrapsychic Self".
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Book, 1974.
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& 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
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8. HORNEY, K.'.Neurosis and human
growth". Published W.W. Norton, New
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Halstead Press, New York, 1978.
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with permission from: http://www.islamicmedicine.org/
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