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


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 judge for himself the quality of his
 behavior and his ideals.


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: