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Islamic Values
and Ethics in Prevention and Treatment of Emotional Disorders
by Basheer Ahmed,
U.S.A.
God says about Qur'an
..It (Qur'an) 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 behaviour 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
behavioural 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 behaviour, to conform with prevailing
standards. It helps in motivating the patient to adopt the
alternate ways of behaviour. In our opinion, the Islamic principles
which are based on Qur'an 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 Qur'an IT (Qur'an) IS A GUIDE AND A HEALING
TO THOSE WHO BELIEVE (S.41: v. 44). God says in Qur'an
about psychological and social diseases and cures in several
surahs. In our opinion, Islamic principles which are based
on Qur'an 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 behaviour 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. Freudl 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 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 behaviour .
Our religion, Islam, plays a significant role in satisfying our physical
as well as spiritual needs. Islam teaches us, a code of behaviour,
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 behaviour 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 wellbeing 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
behaviour 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 behaviour 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
sensitised 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 behaviour. 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 behaviour and by rewarding certain
malad- justed 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
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 behavioural 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 behaviour. 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 odious complex resolves. This is the
foundation of Freud's psychoanalytic theory.
Freud's focus on sex as the driving force of human behaviour
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 behaviour: 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 behaviour
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
behaviour 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 introjection 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 interjects the image of God as Qadeer, Raheem
and- Benevolent. The introjection of God's love and authority
influences a Muslim's behaviour incorporating ethical and
moral values of Islam. Once you incorporate the image of God
in inner self 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. Qur'an
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
interjects 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 behaviour, to conform with prevailing
standards and to help in improving the patient to adapt the
alternate ways of behaviour. Muslim psychiatrists and psychotherapists
must have familiarity with Islamic religion and culture and
must incorporate Islamic values, ethics and code of behaviour
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 behaviour 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 REMEMBRANCE OF GOD DO HEARTS
FIND SATISFACTION AND PEACE .
(Qur'an 5.13:27-28)
REFERENCES
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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.
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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,
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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.
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