Home

ISLAMIC MEDICAL EDUCATION RESOURCES 04

9801-PSYCHOLOGICAL AND MENTAL HEALTH

Lecture delivered to 1st year medical students at Kuantan, Pahang on January 17, 1998 by Prof Dr Omar Hasan Kasule, Sr. Deputy Dean for Research and Post-graduate Affairs, Kulliyah of Medicine IIUM

OUTLINE

1.0 DEFINITIONS

            Positive & negative definition

            Inshirah al sadr

            Dhaiq al sadr

            Hayatan dhanqah

            The criterion of balance

            2 types of psychological imbalance

 

2.0 PERSONALITY

            Definition

            Variations

            The nafs and qalb as the essence

            Establishment and modification of personality

            Role in psychological health

 

3.0 ENHANCING THE POSITIVE

            iithaar

            iman

            taqwa

            rahmah

            tamaninat

            tazkiyat

            taubat

 

4.0 DISCOURAGING THE NEGATIVE

            israaf

            hasad

            shuhhu

            shahwat

            dhulm

            ‘ujb

            fitnat

 

5.0 PERSONAL FAILURE

            Miserliness

            Worries

            Sadness

            Debt

            Poverty

            Hastiness


 

1.0 DEFINITIONS

Psychological or mental health can be defined in both positive or negative terms. Positively it can be viewed as a state of being in which an individual is stable and balanced; the balance is 3-dimentional and involves being in harmony with the one-self, the human society around you, and fulfilling the orders and commands of the Creator to attain His pleasure. Negatively it can be looked at as absence of mental or psychological problems. Unlike physical health, mental and psychological health is difficult to define exactly because of inability to define and measure in a concrete way as is done in physical sciences.

 

The Qur’an has used the term inshirah al sadr to refer to a state of psychological well-being as is indicated in the following verses: 6:125, 10:57, 16:106, 20:25, 94:1. The Qur’an has used the term dhaiq al sadr to refer to states of psychological imbalance as shown in the following verses: 6:125, 11:12, 15:97, 26:13, 29:33. Psychological stress (dhaiq nafsi) has also been mentioned in the Qur’an in several verses: 6:125, 9:25, 9:118, 11:12, 11:77, 15:97, 16:12, 18:6, 26:3, 26:13, 27:70, 29:33, 35:8, 65:6). The term hayatan dhanqah has been used to refer to a life that has psychological stress 20:124. Throughout the Qur’an psychological well-being is associated with taqwa whereas psychological or mental imbalance are associated with ma’siyat. The implication is that those who live according to Allah’s guidance will live a balanced life.

 

Psychological imbalances are of two types. The first type, which is the overwhelming majority, is due to physical causes that are either known today or will be known for sure at some time in the future through scientific research. The second type is due to moral causes. The Qur’an has concentrated on the latter. Whereas the first type will respond easily to chemical and other physical methods of treatment, the second type requires spiritual approaches involving strengthening iman, taqwah, and ibadat as well as avoiding ma’siyat. Our discussion today will be confined solely to the second type.

 

2.0 PERSONALITY

Mental and psychological well-being are affected to a large extent by the underlying personality. Personality is the totality of behavior of an individual with a given tendency system interacting with a sequence of situations (tendency means there is consistency). People’s personalities differ (Bukhari 4:461 hadith # 699). Some are good some are. Most people are average; the exceptionally strong are rare (Bukhari 8:3341 hadith #505). There is a modal personality for  a community that is considered the ideal for that community. There is however a universal ideal that is described by the Qur’an and the sunnat of the Prophet (PBUH) (Hayat 3:459-460)

 

The Quran expounds in very clear terms a distinct concept of individual growth and development. A human being is both body and soul, matter and spirit. It is the unique balance between the two contrasts that makes humans what they are, the highest creation. The original condition of the human being is that of fitra which is uprightness. A human being is born in a natural state of purity (fitrat al Islam). The potential to do good or bad exist. It is the early environment that determines how those potentials are enhanced. If the environment is good, the good potentials are promoted. If it is bad the bad ones are.

 

The essence of a person is the nafs and not the physical body. Thus personality or behavior are referred to the nafs. The Qur’an has described several states of nafs, maraatib al nafs (12:53, 89:27-28, 75:2, 89:27): nafs ammarah (tendency to evil, 12:53), nafs lawamah (conscience and concern with moral rectitude, 75:2), nafs mulhamah (inspired to piety and taqwa), nafs qanu’ah (satisfied with what it has), nafs mutma’inna (calm, 89:27), nafs Radhiyah (appreciative, 89:27-28), nafs mardhiyyat (appreciated, 89:27-28),and nafs kamilah (perfect). The nafs can be purified by acts of ibadat, avoiding the forbidden, generally being conscious of the creator, and constant meditation about the creation. An individual may not succeed alone. Living in a righteous community surrounded by others is necessary to motivate and encourage purification.

 

The factors that determine the development of personality are: biological inheritance, the physical environment, the culture, socialization, group experience, and unique individual experiences. With the exception of biological inheritance, all these factors can be manipulated for good or for bad.

 

Personality is set quite early in life. It can change during life but these changes are minor. A person has the capacity to overcome many disabilities in the basic personality. Thus behavior does not always reflect the underlying personality. It is this capacity for self improvement, taking charge, and striving for the best that makes humans morally responsible.

 

It is a matter of disagreement whether personality once set is permanent or is changeable. The moderate view is that personality is fairly constant and only minor modifications can be made to it in later life. This emphasizes the importance of education and training early in life when the personality is still malleable and can be modified in the desired way.

 

Thus early childhood upbringing is the main determinant of psychological health. Societies that neglect this stage pay a heavy price in terms of psychological imbalances later on.

 

3.0 ENHANCING THE POSITIVE

Communities and individuals who strive to enhance the positive attributes of the nafs and qalb enjoy good mental and psychological health: The Qur’an has described positive attributes of the nafs: giving preference to others (ithaar al nafs, p 1250 59:9), belief (iman al nafs, p 1250 6:158, 10:100),, fear of Allah ( taqwa al nafs, p 1253 91:7-8), The positive attributes of the qalb are: health (salamat al qalb, p 960 26:89 … 83:41), purity (taharat al qalb, p 961 5:41, 33:53),  mercy (rahmat al qalb, p. 959 3:159, 57:27),, balance and equilibrium (tama’ininat al qalb, p 957 2:260 …48:18), softness (liin al qalb, p 958 3:159, 39:23), openness (inshiraah al qalb, p 957 6:125 … 94:1).  The nafs can undertake actions to improve or strengthen itself: selling itself,to Allah to get His pleasure (bai’u al nafs li llah, p 1252-3 2:207… 9:111),  purification (tazkiyat al nafs, p 233-4 2:151 … 92:18),  change to improve (taghyiir ma bi al nafs, p 1253 8:53, 13:11),, repentance (tawbat al nafs, p 1252 2:54 .. 4:64),

 

4.0 DISCOURAGING THE NEGATIVE

Good mental and psychological health can be achieved by discouraging the negative attributes of the nafs and the qalb. The negative attributes of the nafs described by the Qur’an are: extravagance (israaf al nafs, 39:53),, jealousy (hasad al nafs, p 1254 2:109), covetousness (shuhhu al nafs, p 1255 4:128, 59:5, 64:16),  passionate bodily desires (shahwat al nafs, p1255 21:102…43:71), transgression (dhulm al nafs, p 1256 2:54 … 65:1),  pride (ujb al nafs, p 1256 4:49),  temptation (fitnat al nafs, p 1257 57:14),  corruption (fujuur al nafs, p 1257 91:7-8). The nafs can be deceived (khidau al nafs p 1254 2:9) and can be a victim of treachery (khiyanat al nafs p 1255 2:187, 4:107). The negative attributes of the qalb are: thinking of the bad (dhann al qalb bi al asayi, p 960 48:12), hardness (qaswat al qalb),confusion (waswasat al qalb, p 975 2:74 … 57:16, p 958 44:5). The qalb can be afflicted by diseases. It has been described as the seat of diseases of a moral nature (amradh al qalb p 958 5:52 … 74:31): lahw (p 958 7:43 … 59:10), ghaflah (p 958 18:29), ghill ( p 958 21:3) , ghaidh (p 958 3:118-119), ma’siyat, kibr (p 958 40:35 … 40:56), nifaq,(p 958 2:8-10 … 3:167). The qalb can be influenced or changed. This can be from human action or sometimes divine intervention from Allah (SWT).

 

5.0 PERSONAL FAILURE

Many situations or psychological imbalance are actually cases of personal failure (‘ajz) that the prophet warned about.

 

Personal failure can manifest in many ways. Persons may become addicted to bad habits and sins. They become socially incompetent or lazy about their basic responsibilities in the family and society. This failure is a cause of sadness and distress to the individual concerned, the family, and the whole society.

 

Causes of personal failure: Forgetting Allah and neglecting His commands is the start of failure. There are some cases of failure that can not be attributed to any fault of the person but to unfortunate circumstances. Allah usually helps such people when they turn to Him and ask for help.

 

"Anas reported that Allah's Messenger ( may peace be upon him) used to make this supplication:"O Allah, I Seek refuge in you from miserliness, from sloth and from decrepitude." Muslim 3: 1421, Chapter 1129, Hadith # 6539

 

"O Allah! I seek refuge with You from distress and sorrow, from helplessness and laziness, from miserliness and cowardice, from being heavily in debt and from being overcome by men" Bukhari 4:92, hadith # 143

 

Umar b. al-Khattab said: The Prophet (may peace be upon him ) used to seek refuge in Allah from five things; cowardliness, niggardliness, the evils of old age, evil thoughts, and punishment in the grave. Hadith 1534

           

Anas b. Malik said: The Apostle of Allah ( may peace be upon him ) used to say: " O Allah, I seek refuge in you from incapacity, slackness, cowardliness, niggardliness, decrepitude; and I seek refuge in you from the punishment in the grave; and I seek refuge in you from the trial of life and death." Hadith 1535

 

Anas b. Malik said: I used to serve the Prophet ( may peace be upon him ) and often hear him say: " O Allah, I seek refuge in you from care, grief, burden of debt and being overpowered by men." The narrator then narrated some more things which the narrator al-Taimi ( in the previous tradition ) reported. Hadith 1536

 

Abu Hurairah said that the Prophet ( may peace be upon him ) used to say: "  O Allah, I seek refuge in you from poverty" lack and abasement, and I seek refuge in you lest I cause or suffer wrong." Hadith 1539

 

Abu Hurairah said: The Apostle of Allah ( may peace be upon him ) used to say: " O Allah, I seek refuge in you from four things: Knowledge which does not profit, a heart which is not submissive, a soul which has an insatiable appetite, and a supplication which is not heard." Hadith 1543

 

Anas b. Malik said: The Prophet ( may peace be upon him ) used to say " O Allah, I seek refuge in you from a prayer which does not profit," He also mentioned another supplication. Hadith 1544

 

 

Shutair b. Shaki ( b. Humaid ) said: I said: Apostle of Allah, teach me a supplication. He said: Say : " O Allah, I seek refuge in you from the evil of what I hear, from the evil of what I see, from the evil of what I speak, from the evil of what I think, and from the evil of my semen" ( i.e. sexual passion ). Hadith 1546

 

Anas said: The Prophet ( may peace be upon him ) used to say: " O Allah, I seek refuge in you from leprosy, madness, elephantiasis, and evil diseases." Hadith 1549

 

 

"Narrated Anas bin Malik: The Prophet ( may peace be upon him ) said to Abu Talha " Choose one of your boys to serve me." So Abu Talha took me ( to serve the Prophet ( may peace be upon him ) by giving me a ride behind him ( on his camel ). So I used to serve Allah's Apostle ( may peace be upon him ) whenever he stayed somewhere I used to hear him saying, " O Allah! I seek refuge with you ( Allah ) from worries and grief, from incapacity and laziness from miserliness and cowardice, from being heavily in debt and from being overpowered by other men." Bukhari 8:250, hadith # 374

Professor Omar Hasan Kasule January 1998