Religion and Spirituality in Psychiatry

20 Psychiatric Treatments Involving Religion: Psychotherapyfrom an Islamic PerspectiveSASAN VASEGHSUMMARYReligious thoughts and behaviors can play animportant role in the relief or exacerbation ofpsychopathologic symptoms in Muslim patients;therefore, every successful psychotherapist needsto be familiar with Muslim culture in his or hercountry. Furthermore, some clinical trials showthat adding religious psychotherapy to the usualsecular therapy can accelerate clinical improvementin religious Muslim patients. In this chapter,I will (a) provide a short description of thebasic tenets of Islam, (b) describe importantpoints in initial assessment of Muslim clients,addressing transference and countertransferenceissues, and (c) discuss several Islamic conceptsuseful in treatment of depression, anxiety,and interpersonal problems in Muslim clients.Clinical examples are also provided to show howthese concepts can be used in psychotherapeuticsettings.Defining psychotherapy is difficult(pp. 6–7). (1) Although there are many kinds ofpsychotherapy (2) and many differences betweenthem, it seems that all of them have at least onecommon goal: decreasing clients’ overall suffering.Each client coming to a psychotherapeuticsession has some problems, that is, some issuesthat cause (usually serious) negative feelingssuch as depression, anxiety, or anger. The morea psychotherapist succeeds in helping the patientovercome these negative feelings and preventtheir recurrence, the more successful is his or herpsychotherapy.There are about 1.2 billion Muslims in theworld and Islam is the second largest religionin Europe and anticipated soon to be the secondlargest religion in the United States. (3)Whether psychotherapists are Muslim or not,if they are to help their clients, they need to befamiliar with Muslim clients. If not, they maytry to apply unmodified Western theories of psychologyand psychotherapy and apply their ownstereotypes of Muslims to Muslim clients, whichcan cause therapeutic failure and frustration (p.ix). (4) Moreover, unfamiliarity with Muslimculture can cause serious diagnostic errors. Forexample, some Muslim patients may fear invisiblecreatures called Jinns, and this fear couldbe falsely diagnosed as psychosis by inexperiencedclinicians. (5) Also, the collectivist natureof Muslim culture may be interpreted as “dependentpersonality disorder” (p. 73) (4) and Muslimwomen’s hair coverings as a sign of their oppression.(6) Attempts to free Muslim clients fromthis perceived dependency or oppression maycause them to feel misunderstood and may causethem to drop out of therapy.Muslims come to psychotherapy for variousproblems, including anxiety and depressive disordersor family and cultural problems. In addition,after the September 11 terrorist attacks,many Muslims in Western countries sufferedincreased social pressures such as physical orverbal attacks and discrimination (7) and experiencedadjustment problems.There is no single, best type of psychotherapyfor all Muslim patients, and many of themneed an eclectic approach. Although theoreticallyall kinds of psychotherapy can be used withMuslims, cognitive and behavioral interventions301