Mental Health stigma in Indian Muslim communities
What is stigma ?
Stigma, derived from the Latin "stigmat-" and Greek "stizein" (meaning "to
tattoo"), originally referred to a physical mark . Over time, its meaning
evolved into a figurative "scar," representing the negative and often unfair
beliefs a society holds about certain groups or conditions. Today, stigma is
commonly associated with issues like mental illness or poverty, where
individuals are judged or marginalized. The plural form, stigmata, has
religious connotations too .Stigmas encompass a range of types, such as
social stigma, self stigma, institutional stigma, cultural stigma, mental health
stigma etc. As the title suggests we will explore mental health stigma
examining its causes, associated taboos and perspective within Islamic
teachings.
Narrated Abu Huraira: The Prophet said, "There is no disease that Allah has
created, except that He also has created its treatment.(Volume 7, Book 71,
Number 582 Book: Sahih Bukhari)
Influential causes:
Religious: Mental illness is often associated with shame, frequently
misunderstood as spiritual affliction (exoricism) like possession or black
magic, sometimes perceived as test or punishment from god failing to
address the actual problem. In a study on perceptions of and attitudes
toward mental illness among both medical students and the general public in
Oman, Al-Adawi and colleagues (2002) found that groups believed that
mental illness is caused by spirits and rejected genetics as a significant
factor. In the same study, both groups endorsed common stereotypes about
people with mental illness and affirmed that psychiatric facilities should be
segregated from the community.[1] Participants in a study in the United
Arab Emirates found that participants reported greater willingness to seek
help from families and religious leaders than formal mental health services
(Al-Darmaki, 2003). Many researchers report that disclosure of mental illness
is considered “shameful” (Aloud & Rathur, 2009; Amer, 2006; Erickson & Al-
Timimi, 2001; Youssef & Deane, 2006) which is to be seen in and outside
India
Aside from perceived religious notions, in Indian societies individuals face
religious discrimination despite secular claims and assurance of religious
rights .When women dress modestly, such as wearing the burkha, or men
growing beards in adherence to their beliefs, they are often labeled as
extremist which results in barriers to accessing education, leading to
emotional distress and depression.
Cultural : Cultural restrictions often prevent women from receiving treatment
from male therapists unless accompanied, hindering their access to
psychological therapy and limiting their treatment choices. Researchers
found that many Muslims are hesitant to seek help from the mental health
professionals due to the differences in their beliefs and lack of understating
of the helping professionals about Islamic values in their treatment
modalities. Consequently, Muslims might feel uncomfortable in seeking
psychiatric help to avoid being in conflict with their religious beliefs.[3]
Mental health issues are viewed as a weakness of faith, returning to true
Islam to strengthen faith often seen as a vital approach. Many Muslims prefer
engaging in personal religious practices, such as taking advice from Imam
(religious leader), Quranic recitation, prayer, supplication, and performing
Wudu, to manage mental health difficulties.
Social challenges: “Muslims in Indian Cities” by Laurent Gayer employs an
ethnographic approach to examine the marginalized conditions of Muslims in
11 Indian cities, focusing on areas termed "Muslim ghettos." Christophe
Jaffrelot and Charlotte Thomas highlight the Juhapura neighborhood in
Ahmedabad, illustrating how series of riots forced Muslims into segregated
spaces away from the city center. Gayatri Jai Singh Rathore discusses the
sidelining of Muslims in Ramganj, Jaipur, where Hindus monopolized the
gemstone export and wholesale market, relegating Muslims to minor
manufacturing roles. Economic contractions pushed the Muslim community
to rely on caste and biraderi identities for protection. Gilles Verniers
describes a Shia community in Lucknow, emphasizing that sectarianan and
communal violence has contributed to their ghettoization.
Gayer and Jaffrelot assert that while the marginalization of Indian Muslims is
evident, it varies regionally and unevenly across class and caste. They
identify three key factors: the loss of power during colonial rule and partition,
the exclusion of successful Muslim trading castes from the broader Muslim
community, and deliberate state marginalization. They conclude that
violence is the primary driver of ghettoization, with other factors playing
secondary roles.[4]
Mental Health and Women: Mental health difficulties are considered a global
burden with the World Health Organization estimating that they are
experienced by about one in eight people (Global Health Data Exchange
(GHDx): Institute of Health Metrics .Significant cultural differences with
respect to gender may also put women at risk of diagnosis and treatment of
mental health problems. Muslim women in India face unique mental health
issues related to gender roles, domestic voilence, rape , societal pressures
and are hesitant to speak against it, which results into trauma and
depression.
Islamic lens: It is imperative to understand the difference between spiritual
disease and mental illness, we often confuse the distinction between the two
causing unfavourable consequences. From an Islamic perspective each
requires different approach, unfortunately spritual remedies are used to
address mental illness. Say for instance ,obsessive thoughts are called
wasawis (plural of waswasah), which are whispered into the minds and
hearts of people by Shaytan (Satan) or Exoricism for which we find remedies
in narrations of our beloved Prophet and Quran itself offering guidance and
healing for moral and ethical healing.
Prophet advised reciting Surah falq and Surah naas, if one is affected by evil
and to exoricise (Ruqyah) there is proper way of doing it by the experts only.
Allah says, “Then Shaytan whispered suggestions to them both, in order to
uncover that which was hidden from them of their private parts” (Quran
7:20).
Say: ‘I seek refuge with Allah, the Lord of mankind, the King of mankind, the
God of mankind, from the evil of the whispers of the Devil, who whispers in
the hearts of men’ (Quran 114:1-4).
And the Prophet Muhammad said “Shaytan comes to one of you and says,
‘Who created so-and-so and so-and-so?’ till he says, ‘Who has created your
Lord?’ So, when he inspires such a question, one should seek refuge with
Allah and give up such thoughts” (Al-Bukhari and Muslim).
On the other hand mental illness requires medical intervention through
doctors and medications, seeking professional help becomes essential as
these conditions are better treated by medical care. Psychology branched off
from philosophy in the late 19th century. The term psychology is iderived
from the Greek root word ‘‘psych’’ or soul and ‘‘logos’’ meaning love. So,
psychology originally studied soul as its subject matter. Earlier, in the 14th
century, it referred to a branch of pneumatology, the study of spiritual beings
and in the 16th century, the term anthropologia was coined that branched off
into psychologia, the study of human mind and somatologia, the study of
human body. In the 18th century, the influence of empiricism and rationalism
paved the way for scientific psychology, but it was only in 1879 that the first
psychology laboratory was established in Germany. Muslim social scientists
trained in secular education and under the influence of the scientific frame of
mind also embraced Western psychology. [6]
Muslims wrote extensively about human nature and called it Ilm-al Nafsiat ,
although, the term ‘‘psychology’’ did not exist at that time and such
endeavors were mostly a part of philosophical writings. In the writings of
Muslim scholars, the term Nafs (self or soul) was used to denote individual
personality and the term fitrah for human nature. Nafs encompasses a broad
range of topics including the qalb (heart), the ruh (spirit), the aql (intellect)
and irada (will).The written accounts on the description of self and human
nature given by early Muslim scholars can be found from as early as 800 AD
until year 1100 AD.
Al Kindi (Latin, Alchendius): Hailing from Baghdad is considered as the first
Muslim philosopher. He wrote more than 239 titles including books and short
treatises. Those related to psychology are: On Sleep and Dreams, First
Philosophy, and the Eradication of Sorrow. Kindi explained ‘‘Sorrow’’ as ‘‘a
spiritual (Nafsani) grief caused by loss of loved ones or personal belongings,
or by failure in obtaining what one lusts after.’’
At-Tabari: Persian and a Muslim revert, catalyst for child development, which
he elucidated in his book Firdaus al Hikmah. Firdaus is basically a medical
text that is divided into 7 sections and 30 treatises (360 chapters). Tabari
discusses ancient Indian texts in this book and refers to the contributions of
Sushtra and Chanakya in relation to medicine including psychotherapy
(Hamarnah, 1984). He also highlighted the importance of psychotherapy and
encouraged physicians to be clever and engaging to help improve their
patients' well-being. At-Tabari noted that a skilled doctor can provide
effective treatment through "wise counseling."
Abu Zaid al-Balkhi: He is probably the first cognitive and medical
psychologist who was able to clearly differentiate between neuroses and
psychoses, to classify neurotic disorders, he underscored significance of
rational and spiritual cognitive therapies can be used to treat each one of his
classified disorders. He classified neuroses into four emotional disorders: fear
and anxiety, anger and aggression, sadness and depression, and obsessions.
He also compared physical with psychological disorders and showed their
interaction in causing psychosomatic disorders. He proposed that much like
healthy individual keeps First Aid and medications on hand for unexpected
emergencies, he should also maintain healthy and positive thoughts in his
mind for emotional flare-up. Al-Balkhi categorized depression into three
kinds: normal depression, endogenous depression which arises from internal
factors and reactive depression which is triggered by external circumstances.
Al-Razi : Famous by the name of Rhazes in the west, promoted
psychotherapy, just like his educator, al-Tabari. He pointed out that hopeful
comments from doctors encouraged patients, made them feel better, and
promoted speedier recovery. Al-Razi believed that sudden
emotionaleruptions has a quick curative effect on psychological,
psychosomatic and organic disorders. He was a master of prognosis and
psychosomatic medicine and anatomy.
Al Farabi: Often referred as Alpharabius, Avenasser, or Abynazar . He wrote
his treatise on Social Psychology, most renowned of which is his Model City.
Al Farabi stated that an isolated individual could not achieve all the
perfections by himself, without the aid of other individuals. It is inherent for
individuals to seek companionship with others in their work .Therefore, to
reach their fullest potential, one must engage and interact with others.
Al-Majusi: In Europe, as ‘‘Haly Abbas’’ was Persian, writes about the entire
health field including mental diseases and the brain. Majusi described the
anatomy, physiology and diseases of the brain including sleeping sickness,
loss of memory, hypochondria, coma, hot and cold meningitis, vertigo
epilepsy, love sickness, and hemiplegia.
Ibn Sina :Persian polymath also renowned by name of Avicenna in the
western world, wrote about mind, its existence, the mind–body relationship,
sensation, perception, etc. Ibn Sina also gave psychological explanations of
certain somatic illnesses. In his well known book Ash Shifa (Healing) he
spoke about the influence of the mind on the body which can be seen in
voluntary movements, i.e., whenever the mind wishes to move the body, the
body obeys.[7]
Last, but not the least ,we must remain cognizant regardless of our struggle
whether mental or spiritual, Allah(SWT) assures us by His clemency and
encourages us not to despair .Without least shadow of doubt His words bring
comfort, ultimate cure comes from Him only and so is mentioned in the
Quran:
“Surely in the remembrance of Allah do hearts find comfort”[13:28]
“And whosoever puts his trust in Allah, then He will suffice him…” [Quran,
65:3].
“So, verily, with every difficulty, there is relief [Quran, 94: 5]
“And for those who fear Allah, He always prepares a way out, and He
provides for him from sources he never could imagine. And if anyone puts his
trust in Allah, sufficient is Allah for him. For Allah will surely accomplish His
purpose: verily, for all things has Allah appointed a due proportion.”[Quran,
65: 2-3]
“We shall certainly test you by afflicting you with fear, hunger, loss of
properties and lives and fruits. Give glad tidings, then, to those who remain
patient”[Quran 2: 155]
Conclusion: Let us commit to identify and clarify true knowledge in general
and develop a deeper insight into nature ,distinction between mental health
and spiritual disease, and purpose of knowledge. By doing so, we can
become more aware of appropriate avenues of healing. We ought to redefine
psychology through Islamic perspective to integrate religious beliefs while
taking serious issues into considerations as well. The holistic approach will
surely empower us to seek effective solutions that honour both our faith and
well being.
