<Ethics> <Islamic Values
and Ethics in Prevention and Treatment of Emotional Disorders>
VALUES AND ETHICS IN PREVENTION AND TREATMENT OF
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.
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 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 con- cept 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. 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 behavior .
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 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 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
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 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 predominent in
ado- lescents 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 pseudoreligious 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 techni- ques 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 predominent 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 innerself 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 renouned 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
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.
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)
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Health Organization. Geneva 1952
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Press, New York, 1978.
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M. Ashraf, Lahore, 1970.
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