October 09, 2017

Islam: Spirituality and Mental Health

The World Health Organization defines health as "a state of complete physical, mental, and social well-being…" [1]. At present, this definition does not include spirituality, though attempts have been made for its inclusion [2]. Studies that show positive effects of mindfulness meditation [3] provide the possibility of it being used as a therapeutic intervention (see also article on page 5). When it comes to mental health, the spiritual philosophy in Islam is often overlooked or not thoroughly delved-into. Islam is mostly taken as a religious dogma comprising of political, religious and legal doctrines without considering its spiritual and moral dimensions [4].

Do We Need Spirituality?
Ibn-e-Hazm (994-1064 AD), a famous Muslim polymath, remarked "I searched for a common goal amongst humankind, to which all would agree to strive for excellence. I have not found anything other than the vanquishing of anxiety" [5].  The decline in mental health has been dramatic in the past few decades, with rates of depression increasing from 1988-2007 in the US [6]. Furthermore, the incidence of suicide has increased almost 40% in the middle-aged population [6]. The results of a cross-cultural study indicated that while wealthy countries may score higher on a happiness scale, they scored lower than poor ones on perceived meaning in life [7].

Islamic prayers as form of spiritual purification

One of the core features of spirituality lies in man’s ability to extract meaning from the world. According to Ibn-e-Hazm, the ephemeral nature of the world drives a person into an existential crisis and the only way to achieve happiness is to return towards God Almighty [4]. In Islamic tradition, spirituality may involve pondering over the ayaat (signs) of the Almighty and getting inspired from them to lead a life of servitude. Signs such as the presence of trees may remind one of the temporary nature of life. The intricate features and behavior of birds and animals may inspire one to marvel over the accuracy, beauty, and wisdom of the creator. However, not all may interpret these signs in a spiritual context.

Imaging Spiritual Prayer
A preliminary study in 2015 attempted to uncover the neurophysiological effects of salah (prayer) [11]. Muslims performing salah and dhikr (remembrance) showed less frontal lobe activity (crucial in executive functioning). The study also compared subjects performing prayer with and without spiritual concentration (khushu). Those performing prayer in a ritualistic manner without a lot of spiritual focus did not display any changes in brain activity, while those performing prayer with more spiritual fervor showed less activity in the frontal lobe and more in the basal ganglia (involved in the reward system) and anterior cingulate gyrus (involved in mood) [11].

"Sabr" and Its Role in Depression
Positive psychology includes studies that correlate self-regulation and gratitude with a lower incidence of mental illness. Dr. Timothy Strauman has suggested clinical depression to be a consequence of self-dysregulation [8]. In Islamic tradition, this practice of self-regulation is called sabr and Ibn al-Qayyim (1292-1350 AD) describes it as restraining and building character [4]. He also argued that the past cannot be changed with sadness, but by contentment, gratitude, patience, and a firm belief that everything that happens occurs due to the will of God [9].
In Islam, there are numerous supplications to ward off anxiety and depression. One factor that might explain the reduction in anxiety and depression experienced by depressed people performing supplications could be due to supplication working as a spiritual therapy. This practice may produce neurochemical alterations that may decrease the need for pharmacological intervention (which does not undermine the efficacy of the latter) [10].

Source

The interesting aspect about supplication or du’aa is that it can be used as a powerful form of psychotherapy. The crux of many supplications is not a request, but rather admitting one’s helplessness and asking for the Almighty’s mercy. Surrendering oneself may offer liberty from the world and its tribulations because the individual leaves the matter in the hands of someone far more powerful than him or her [4].
Many supplications call on to the Almighty by using names and qualities that evoke feelings of awe. According to Jonathan Haidt, the reality of awe involves a two-step cognitive process: vastness (anything experienced by the mind that is larger than one’s self) and accommodation (upon experiencing vastness, the mind adjusts to assimilate new information) [12]. So, experiencing awe by calling on the Almighty provides contentment in times of adversity. Islam envisages trials and tribulations as opportunities for submitting to the Almighty and building character.
In Islam, spirituality is intertwined in different everyday rituals and serves to elevate not only the physical, but also the psychological well-being of an individual [13].

[1] http://bit.ly/2f3Sbe1
[2] Chuengsatiansup, Envir Impact Assessment Rev, 2003
[3] Chiesa and  Serretti,  Psycho Med, 2010
[4] http://bit.ly/2f4epfR
[5] Ibn Ḥazm. Akhlāq wa as-Sīr, p. 76.
[6] Smith, The power of meaning, p. 22.
[7] Oishi and Diener, Psycho Sci, 2013
[8] Strauman, Self and Identity, 2002
[9] Ibn al-Qayyim, Zād al-M’aād, vol 2. p. 325.
[10] Porto et al., J Neuropsychiatry & Clinical Neurosci, 2009
[11] Newberg et al., J Physiology, 2015
[12] Haidt and Keltner, Cognition & Emotion, 2003
[13] http://bit.ly/2hjgViR


By Zara Khan, MSc Student MedNeuro

This article originally appeared September 2017 in CNS Volume 10, Issue 3, Spirituality in Science

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