Religion and Spirituality in Psychiatry

Psychotherapy from an Islamic Perspective 309interpretations that, if used appropriately intherapy, can prevent excessive guilt feelingand hopelessness in the troubled client.3.3. Guilt FeelingGuilt, like other negative feelings, is naturaland sometimes helpful. For example, peoplewith antisocial personality disorder have minimalguilt, insufficient to prevent their violenceagainst their victims. Excessive guilt feeling, onthe other hand, is one of the most importantcognitive components of depression. Accordingto Beck’s theory, depressed people have prominentnegative interpretations regarding themselves,their environment, and their future. (20)Guilt is part of negative self-esteem in depressedpatients and may lead to hopelessness, self-destructivebehavior, anxiety, and fear of punishmentin this world and the afterlife. Depressedreligious clients may selectively focus on God’spunishments and thereby enhance their guiltfeelings. Thus, drawing attention toward the followinghopeful scriptures showing God’s mercycan help them.3.3.1. There Is No One Who Does Not Sin“There is no one who does not sin” is a commonpositive concept between Christianity (Kings8:46) and Islam against the negative thoughtin religious depressed patients, which may beexpressed in words something like, “I have sinnedso much, so I am bad.” Shia and Sunni Muslimsboth believe that all people are needful of God’sforgiveness and mercy (Holy Koran 35:15), andall people (except the twelve Imams, the ProphetMuhammad, and his daughter Fatimah in Shiabelief) may sin. So sinning does not mean thatone is totally bad.3.3.2. Mercy and Benefi cence of GodDrawing clients’ attention to many versesfrom the Koran that help them realize the greatmercy and beneficence of God is another wayto decrease guilt feeling. For example, of the114 sections (Suras) of the Koran, 113 startwith “In the name of Allah, the beneficent, themerciful.” Other examples of God’s mercy fromthe Koran are, “O my servants who have actedextravagantly against their own souls! Do notdespair of the mercy of Allah; surely Allah forgivesthe sins altogether; surely He is the Forgiving theMerciful” (Holy Koran 39: 53); and, “Surely Allahdoes not forgive that anything be worshiped withHim, but forgives what is besides that to whomsoeverHe pleases” (Holy Koran 4:48, 116).3.3.3. Number of Good and Bad DeedsAnother way to decrease guilt is to countnumber of good and bad deeds that one has doneduring his or her life. As mentioned above, manyordinary activities are regarded as good in Islam,so the client’s good doings usually greatly outnumberthe sins, leading to decreased guilt.3.3.4. Thoughts Are Not PunishedSometimes guilt is related to blasphemous orshameful thoughts. Usually, the more patients tryto control these thoughts, the more they becomeintrusive and obsessive. According to ProphetMuhammad sayings, people are not punishedbecause of their thoughts, provided that they notput them into action. Sometimes religious obsessionalthoughts are regarded as a sign of strongfaith (10:448–450). (19)3.3.5. Feelings Are Not SinsSome religious clients have guilt related totheir inability to control their negative thoughtsand associated feelings. For example, they mayfeel guilt because they cannot accept their fate ortheir loss of dear ones, and therefore feel sad. (7)Mehraby has used the Prophet MuhammadSunnah successfully with these patients. (7) Shesaid to these patients that the Prophet Muhammadcried publicly on several occasions for the lossof his dear ones, without feeling guilt. He criedover the death of his mother, his son, and hiswife Khadijah. Khadijah was very helpful to theProphet and the Prophet loved her so much thateven several years after her death, he cried everytime he remembered her. Also it is quoted fromhim while burying his little son Ibrahim, “The