SUFISM AND MENTAL HEALTH

From a Muslimah in Bosnia & Herzegovina:

Reciting Al-Fatiha and understanding its full meaning, the believer can achieve wonderful benefits because it improves emotional, mental and spiritual growth... I take it as our basic prayer which is healing our hearts and our bodies, helping us to overcome difficulties, leading to a change of direction of negative effects, enabling us to achieve patience, motivating us to be truly responsible doing good deeds and avoiding sins; to control anger and discontent. It is very supportive and represents a shelter (safe place) for recovery. Al-Fatiha is actually the universal key that is opening the door of a true cognition of the Only One God, s.w.t, and His attributes. Reading Al-Fatiha made me feel His Justice and His Mercy upon all things and all beings..It made me feel secured and safe in Tawakul and completely free from the illusions, from serving the systems, situations and people on this world....

Dr. Amra Delic of Tuzla offers the above submission of her experience of reciting al-Fatiha and the following contribution on "A Holistic approach to mental well being."

A HOLISTIC APPROACH TO MENTAL WELL BEING

According to the World Health Organization there is no one "official" definition of mental health. Cultural differences, subjective assessments, and competing professional theories all affect
how mental health is defined. "From perspectives of the discipline of positive psychology mental health may include an individual's ability to enjoy life, procure a balance between life activities, and efforts to achieve psychological resilience. Mental health can be seen as a continuum
whereas an individual's mental health may have many different possible values.
Mental wellness is generally viewed as a positive attribute, such that a person can reach enhanced levels of mental health, even if they do not have any diagnosable mental health condition. This definition of mental health highlights emotional well being, the capacity to live a full and creative life and the flexibility to deal with life's inevitable challenges.

A holistic model of mental health generally includes concepts based upon anthropological, educational, psychological, religious and sociological perspectives as well as theoretical perspectives from personality, social, clinical, health and developmental psychology.

An example of a wellness model includes one developed by Myers, Sweeny and
Witmer. It includes five life tasks - essence or spirituality, work and
leisure, friendship, love and self-direction-and twelve sub tasks-sense of
worth, sense of control, realistic beliefs, emotional awareness and coping,
problem solving and creativity, sense of humor, nutrition, exercise, self
care, stress management, gender identity, and cultural identity-are
identified as characteristics of healthy functioning and a major component
of wellness. The components provide a means of responding to the
circumstances of life in a manner that promotes healthy functioning.

Cultural and religious considerations

Mental health can be socially constructed and socially defined; that is different professions, communities, societies and cultures have very different ways of conceptualizing its nature and causes, determining what is mentally healthy, and deciding what interventions are
appropriate. Therefore different professionals will have different cultural and religious
backgrounds and experience which may impact the methodology applied during treatment.

Many mental health professionals are beginning to or already understand the importance of competency in religious diversity and spirituality. The American Psychological Association
explicitly states that religion must be respected. Education in spiritual and religious matters is also required by the American Psychiatric Association (as far as I know it is now included in
Training Programs in Psychiatry in the States with a tendency to include it in European Training Programs too).


OUR EXPERIENCE

It is stated in DSM IV and confirmed by clinical studies that extreme trauma exerts an impact on important aspects of functioning of the survivors. Wilson and Moran (1997) have also emphasized that highly traumatic experiences can have a devastating impact on human psyche and personality, which results in collapse of inner coping mechanisms and severe complaints
that put normal life in disorder (Pajevic, 1999), including religious belief and spirituality that are integral parts of human existence. Facing with reality of today (with entire tragedy and insecurity of human existence onto Earth), mental health professionals have to understand the influence of psycho-social trauma and PTSD on spirituality and personality (Hasanovic,
1999). During and after the aggression against Bosnia and Herzegovina (1992-1995), mental health professionals are facing with a number of various mental health disorders, the consequences of severe traumatic experiences.

In our clinical work with survivors we meet people that "have lost" their faith, complaining on the "God's injustice" and "so cruel punishment they have gone through although being innocent". In the souls of highly traumatized we found out that they feel disconnected, spiritually abandoned by God and His system of protection, which has been supportive until then. Majority of our clients belong to Muslim cultural circle. They actually belong to Islamic spiritual background regardless their active or passive participation in daily religious 'rituals' (salat). During various methods of clinical treatment most of them expresses the needs to talk about spiritual perspectives of the meaning; death and significance of martyrdom
sacrificing their closest that have been killed. Within the frame of individual and group sessions, a need for Islamic explanation of life on this world (dunja) and hereafter appeared. They expressed the wish to establish a daily rhythm of prayers during their stay at the department.

Therefore, we provided two rooms; one for our Muslim clients (masjid) and one for non-Muslims, mainly Christians (a prayer room). The clients found it of great importance and helpful. Knowing historical roots of mental health care that in our social reality absorb the spiritual forces from Islamic background, we interfaced arguments between spiritual dimension of personality from Muslim perspectives on one side, and psycho-social trauma
and PTSD and efforts put for its healing using Islamic principles on the other side. Compared to other religions, Islam is not religion only but a comprehensive, holistic system that addresses all aspects of our life (both individual and community level). Unfortunately, being weak, we have tended to reduce this most special way of life (universal model) to the lowest common denominator of a set of legalistic rituals. This Deen, that our Lord and Creator has entrusted to us is greater than we are and our limited knowledge and understanding of it is indicative of the dilemma we as Muslims are facing today.

In the Quran, Allah s.w.t., draws our attention to all aspects of our life, as physical beings with an intellect as well as emotions and most importantly as spiritual persons. We are reminded,

"It is He Who brought you forth from the wombs of your mothers, when you knew
nothing, and He gave you hearing and sight and intelligence and affections that you may give thanks" (Quran 16:78). It is logical, therefore, that when we reject His way, "Allah hath set a seal on their heart and on their hearing and in their eyes is a veil" (Quran 2:7).

El-Azayem (1995) stated that a firm bonding to Islamic principles enables humans to overcome depression, to strengthen the will and support feeling of hope and optimism.
Islam, with all of its disciplines (including shariat/fikh, tafsir, hadith, Sufism etc.) is offering such a life concept that enables individual living in harmony and spirit of Islamic principles
to affirm himself/herself as healthy, creative, self-aware and stable personality. The prayer (including dikhr) neutralizes emotional conflicts, which is greatly illustrated by the
life model of Prophet Muhammad, s.a.w.s., who, according to the ayats and
hadiths, in the state of sorrow and suffering, arousal or anxiety, took refugee in the prayer.

"And if you fear, perform prayer." (Al-Baqarah, 239).

Beside the prayer, our clients participate in spiritual group setting with religious/spiritual psychotherapy oriented staff (trained in neuropsychology and neurophysiology of spiritual experience as well as in Islam). We also co-operate with (Islamic) theologians, some of which
completed Group Analysis Education with us, Seminar on Psychoactive Substance Abuse as well as the School of Psycho-social Trauma (at the Missouri University, Columbia, Missouri). Our clinical experience with traumatized confirmed the scientific evidence that after the prayer and spiritual therapy, the clients feel less anxious, less depressive, and they report on improving communication skills, and decrease in symptoms of avoidance and hyper-arousal. Following religious and spiritual needs of our patients and developing holistic (multidisciplinary) approach in our work, we found out that dealing with spiritual issues in the process of healing is
beneficial and supportive.

He created us as physical, mental and spiritual beings. Our responsibility is to understand ourselves first, because it is only when we do this, that we can help our community. If there
is the absence of Islam, Iman or Taqwa, then the "security and safety" of the individual is missing. The rebellion against Allah is a state of neglect of the spirit which leads to a corrupted
heart. Understanding the physiology of the brain-heart connection we will understand how it affects our health, both physical and spiritual and how to achieve a peacefulness of the heart
which is the greatest treasure.

Tracing back to the history, it can be seen that very many people embraced Islam via Sufism (spiritual aspect of Islam). I would say that the basics are of importance. Namely, the body
requires regulations that are needed in our lives in order to function normally. Sharia, tariqat, hakiqat and marifat in Sufism can be compared to the egg where we can see the shell,
membrane, white and yolk..Each part has its own function. The function of the Law is to put all the things on this Earth in order.. From my point of view, the basic is to do no harm to the
others, while performing duties towards God in a proper way (as it is 'prescribed') is a matter of maturation and decisions. Yet, it is a private matter, which does not necessarily harm or benefit others.

Islam came to Bosnia via Turkish sufis not in the way the missionaries are doing. It simply came as a model of life demonstrated by sufis. Starting point in Sufism is that all people are same (the way I perceive Islam), His creatures, with predispositions to be better than me or you..In this way, the door is opened to all as Mowlana Jelaluddin Rumi says: "Come, come, and
come over again, whoever you are, wherever you are." When the heart is opened the gifts are coming.. It is said that most important is to have a good intention (nijjat) so the one does not have to care how God will treat him/her. Allah, s.w.t., the Creator of people, loves people and wont reject sincere intention of people.

We are all seekers and we all lean upon His Mercy through the stages of our spiritual development. Zikr (type of meditation technique) is performed for it cleans and calms our hearts and support our further growth and integration..The Holy Qur'an says: Be with
those who are calling (remember) Your Lord..

The Prophet Muhammad,
s.a.w.s., said: "Oh Allah, I seek refuge in You from perversity and anxiety
and I seek refuge in You from aspiring after that which is beyond aspiration."


In peace..

Dr. Amra Delic
Department for Psychiatry
University Clinical Center Tuzla
President of the Association of Trainees and Young Psychiatrists
Bosnia and Herzegovina