TRESS RELATED DISORDERS AND HOW THE NEW BEHAVIORAL MEDICINE CONCEPTS REFLECT TEACHINGS OF ISLAM WITH EMPHASIS ON COGNITIVE DISCIPLINE AND SELF REGULATORY ACTIVITIES INCLUDING DAILY PRAYERS
U. Khan and Michael S. Gaylor,
Among the great religions of the world, Islam enjoys the distinction of being significant name, the name that points to its very essence. The root meaning of Islam is to enter into peace and the believer is one who makes his peace with God and man.
NAY, WHOEVER SUBMITS HIMSELF ENTIRELY TO GOD AND HE IS A DOER OF GOOD TO OTHERS. HE HAS HIS REWARD FROM HIS LORD AND THERE IS NO FEAR FRO SUCH NOR SHALL THEY GRIEVE. (Qur'an S2:V112).
At the time when daily stress is being found to play a role in many disease processess and emphasis now being placed in Western medicine in not considering the patient as merely an organ system or cellular physiology problem but as a person, this "psychosomatic" or holistic model points to the importance that the patient's indiviudal cognitive processes, his role in the family unit and his role in the social milieu all play important factors in ultimately determining his response to an illness process 1.
This increased awareness of the psychophysiological role that stress plays in all illness processess come at a time when the practical aspect of psychoanalysis seem few and at a time when the potential addicting effects of tranquilizing drugs are becoming problematic. Further with the dissolution of the nuclear family as a support is an increasing tendency in Western medicine to rely on other factors to help their patient cope with stress.
The trend in the medical field to what is called behavioral medicine or stress medicine, this field emphasizes self regulatory techniques and emphasizes what the patient through daily dixipline can do himself to further his own adaptation to the stress of illness.
Among the five fundamental duties recognized by th ereligion of Islam, prayer undoubtedly occupies the most important position and is given great prominence in the Holy Quran.
The place of prayer in the self development of man is given such a prominence in Islam that in the call to prayer (azan) the words "come to Falah" thus showing that self development is attained through prayer and the Quran says
SUCCESSFUL INDEED ARE THE BELIEVERS WHO HUMBLE IN THEIR PRAYERS (Qur'an, S23:V1-2).
Again, The word used for being successful is 'Alfalah' carrying the significance of full self development. Through daily 'discipline of prayer and self development, one can further his own adaptation to stress of illness. These programs stand to have three common elements. The first is an attempt to decrease psycho-physiological arousal with what has been called "relaxation response". This tropho trophic is a prayer-like activity which seems to have as common elements a mental device, a passive attitude, decreased pointed out in an article called The Relaxation Response 2 and the Islamic mode of worship is calculated to concentrate attention on one object, the realization of divine presence and the ablution preceding the prayer, the reverential attitude in standing, th ebowing down, the kneeling with the forehead placed on the ground and the reverent sitting posture. All help the mind to realize the divine presence as a fect and the worshipper, as it were, finds his heart's joy in doing honor to the great Master, not only with his recitation but with his whole body, adopting a reverent attitude. There is not the least doubt that the spirit of humility in man finds particular expression in the reverntial posture that must be adopted in prayer. The whole prayer is a most solemn and serious affair during which the worshipper does not turn his attention to anything else, nor does he indulge in any movement which should distract his attention or disturb his prayerful attitude. The prayer is thus an undisturbed meditation on the Divine and it is for this reason that prayer is accompanied by a recitation from the Holy Quran speaking of divine love, mercy, power and knowledge. It cannot be dienied that a particular posture of the body during prayer will generate in man a feeling of pride and hughtiness while another is suggestive of true humility and it is only the latter frame of mind tha can bring man closer to God. If, therefore, humility is the esence of prayer, the practical posture of standing, sitting, bowing down and prostration are also essential for creating that spirit in man and any change would be a change for the worse, a change that might well bring about failure toachieve the very end for which prayer is intended.
The second element common in these programs for dealing with stres centres around positive cognitive self statements faith-like in their application, for instance, denial of possibility of dying in the coronary care unit has been associated by many researchers with an increasing apparent survival rate 3. Much attention is being paid in these medical situations to fostering positive thoughts, faith in ultimate recovery, the impact on one's life etc., in a way that not onlyproduces a physiological relaxation but also helps a patient to cope effectively then through denial with the realities associated with his care. In relation to this Islam does teach man to pray but prayer instead of making him idle is intended to give him strenghth to carry on a harder sturggle in the face of disappointment and failure by turning to God who is the source of all strength. The Holy Quran teaches man to wrk hard for success in life and it says
THEREFORE MAN CAN HAVE NOTHING BUT WHAT HE STIRVES FOR (Qur'an S53:V39)
Thirdly, other attention is given to more overt interactional behaviors and th epart they play in many chronic illness process 4. In behaviorual medicine's approach to chronic pain treatment depends not only on modifying the pain alone. Talke and thought about in a way that provides for rewarding day to day family and social responsibilities, it has also been shown that the communication and the support of the spouse at such times is one of the key dterminants of a sucessful recovery for the treatment of a painful condition 5. Similar to an Islamic ideal dealing with stress factors in illness and environment with not only relaxation and positive cognitive framework but also one that provides social support incentive for useful, purposeful activity and one that fosters marital and family harmony and support seems to play a potentially significant role in the outcome of many illness processes.
GEORGE ENGEL Am J. psych 137, 8 May, 1980 -Biopsychosocial Model