Dealing with Mental Illness Islamically:
Demythologization of inherited forms of religious thought
by Farhan Shah
background reading:
Let me start with a personal, first-hand experience related to spirit/demonic possession and its harmful effects on individuals dealing with mental health issues.
I remember visiting a family in my fathers’ village in Pakistan some years ego. There was a rumor about a young girl who was “possessed” by demons/spirits. Upon hearing about her condition, I decided to pay a visit. What I encountered was a little girl (10-12 years old), who struggled with, in modern terms, panic disorder. She was subjugated to harsh treatment, mentally speaking, i.e. isolation, stigma, malnutrition, and fear of transferring her “possession” to other family members. I took the girl into my lap, stroked her gently, and kissed her forehead. It was intentional. It was a signal to those watching, that there is nothing inhuman, malevolent or demonic about the little, beautiful girl. She was just a human being like us, with hopes, fears, vulnerability, uncertainties, perhaps traumatic experiences, with needs of healthy relational attachment.
Sadly, this beautiful and godly girl is one example among many thousand in my parents` home country who are victims of such supernatural explanatory narratives and frameworks.
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I do not want to belittle individuals for whom supernatural explanations to mental illness are meaningful, perhaps as a coping strategy to create a sense of coherence. Indeed, I learn from my colleagues in the worldwide process community that we live in a multi-dimensional universe in which there may well be non-three-dimensional planes of existence, some occupied by forms of actuality that have agency of their own. Nature is much more complex and multi-textured than simple minded reductionism allows; I am not opposed to the idea of spirits; Along with John Cobb, David Ray Griffin, and Jay McDaniel I am open to phenomena that others too easily dismiss: feeling the feelings of others, remembering events in the lives of people that lived long ago, out of body experiences, for example. A simple minded "demythologization" that brings with it a disenchanted understanding of the universe is not something I endorse. The very idea of "demythologization," pioneered by the New Testament scholar Rudolf Bultmann more than a century ago, can seem outdated in light of a more organic understanding.
However, I do want to advocate what I will call Islamic demothologization. This is demythologization which carries with it the idea, true to Islam, that what is most important in human life is not an appeal to any given vision of the universe, much less attention to spirits should they exist, but rather the well-being of human life itself. Such demythologization recognizes that, when appeal to spirits inhibits or harms human life, the appeal itself must be demythologized: that is, recognized as unhealthy and invalid, given the needs of human life. And here, it seems to me, the appeal to spirits in Pakistan deserves to be critiqued for the well-being of life. The appeal to spirits should be replaced by an unapologetic reliance on evidence-based scientific models and by bio-medical and psychoglical interventions.
Human existence is fragile. Intra-Islamically, what is needed is initiatives to Islamically demythologize inherited forms of religious thoughts and world-views by translating them into the best modern, scientific terms that are available. This is especially true when people suffer from dual personalities, schizophrenia, panic disorders, epilepsy, or neurotic anxiety, which are pathological products of normal anxiety. Existential-humanistic psycho-philosophical accounts, and/or explanations in terms of medications, is more convincing and helpful for therapy.
On this point, enlightened religious scholars should be interpreting their religion in responsible ways, encourage in depth psychological studies and medical interventions in order to avoid demonization of people dealing with various psychosis and mental health issues. Put differently, we need do create new “myths”, i.e. narratives that make sense out of our existence, both personal and collective. An example is how people live and structure their lives based on narratives from the Qur`an or, for that matter, the prophetic praxis (Sunnah). Muslims need new guiding narratives, nourished by their own faith, that encourage a holistic medical health that incorporates psychological, cultural, biological, existential, and spiritual factors.
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There is another danger looming. By taking possessions by malevolent spirits as a real explanation, we can thereby use it as an excuse to avoid taking responsibility for our lives. We are familiar with the line, “The devil/evil spirits made me do it”. The understanding that demons have the potential to control humans works against the acceptance of personal responsibility, and also for possibilities of enhancing healing factors and recovery in psychotherapy, which is empirically and clinically well-documented. Furthermore, as we learn from existentialist thinkers, all human life is human. This tautological maxim implies that the more we tend to attribute nonhuman explanations to human behaviour and conditions, the more likely we are to view psychic illness as characteristically human.
There is yet another point to be conscious of when dealing with clients in a clinical setting, that of overly structured and rigid forms of diagnosis. The issue is not of the fact of diagnosis, i.e. that it exist, but rather how clinicians use it. The DSM diagnosis usage in therapeutic context is based on a bio-medical model, viewing the individual as neuro-chemical selves. Again, the issue is not with incorporating biological causes to mental illness and issues, but clinicians should be conscious in writing off any mental illness as merely being biological in need of bio-medical intervention. Moreover, just as supernatural causes to mental illness can promote an avoidance of freedom and responsibility, and a sense of hopelessness, a superficial usage of diagnosis can be harmful and hamper healing possibilities by an avoidance of responsibility and creating a label causing shame and stigma in those seeking psychotherapy. By viewing clients merely as a diagnosis, we thereby reduce their full humanity and thus fail to recognise and explore the clients’ existential dimension and his/her unique experience as being in the world. As Rollo May points out, whenever clinicians perceive individuals just as an particular diagnostic disorder, a composite of drives and deterministic forces, biochemical imbalance, or genetic predisposition, they have thereby “defined for study everything expect the one to whom these experiences happen, everything expect the existing person himself.” When dealing with patients with mental health issues, therapeutic strategies that only target specific symptoms should be extended with modalities that focus on and are inclusive of helping clients addressing issues such as identity, agency, responsibility, self-awareness, meaning making, and alternative religious narratives and world-views. That is, therapeutic modalities that put emphasis on the existential, and spiritual aspects of life, should be incorporated in working with clients with mental health issues.
In conclusion, Pakistanis and many others may need to come "down to earth" when it comes to dealing with mental illness, not by rejecting out of hand appeal to spirits, but by regognizing that such appeals, in many context, can be quite harmful given the actual needs of a human being in his or her situation. At the same time they need to avoid reducing human beings to diagnostic categories, as if they (human beings) are reducible to the chemistry in their bodies and brains or to whatever categories of thought are operative in therapy. Humans are agents of their own lives, even as they - we - are sometimes subjects of debilitating diseases both psychological and physical. A truly Islamic or prophetic demythologization begins and ends with this sttrong recognition and appreciation of the dignity of the human.